Follicular Unit Grafts and Multi-Follicular Unit Grafts
Modern techniques of surgical hair transplantation can restore lost hair and replace or re-shape your hairline with your own natural, growing hair, which needs no more care than the ordinary washing, styling, and trimming you have always done. Transplantation can be done today so well that often a barber or stylist cannot even tell that grafts have been placed.
Hair transplantation involves removing permanent hair-bearing skin from the back and/or sides of the scalp (donor area). Then, using magnification, the tissue is dissected into follicular unit grafts (containing 1-4 hairs) and multi-follicular unit grafts (containing 3-6 hairs each). These small grafts are then meticulously planted into the bald or thinning area of the scalp (recipient area) so as not to injure any follicles already existing in the area and at the same exact angle as the other hairs present. The creation of very small follicular unit grafts has enabled the hair surgeon to create very natural, feathered hairlines, which do not have the abrupt, "pluggy look" that was commonly seen in hair transplants of years past. Some surgeons prefer to transplant exclusively with follicular unit grafts, while others feel that placing the multifollicular unit grafts into the central areas of the scalp allows them to better create central density. Depending on the degree of balding in the frontal, mid-scalp, and vertex (crown) areas, usually 2-3 procedures are performed. Hair transplant surgery today is remarkably well tolerated. Within 24 hours small crusts will form on each graft that are then shed in approximately 4-14 days. The grafted hairs will often start to grow by 10-16 weeks after the procedure and will continue to grow for most, if not all, of one's life. (As men and women age, in many there is a slight loss of hair density all over the head, which would naturally also affect the transplanted hairs).
Who can benefit from hair restoration surgery?
Anyone who has experienced permanent hair loss may be a candidate for hair restoration surgery, including
- Men with male pattern baldness
- Women with female pattern hair loss
- Men or women who want to restore or change the shape of their hairline
- People with areas of scarring from injuries or "scarring" skin diseases, and also patients who experienced some hair loss after surgery, such as face lift procedures
- People who want to thicken or restore eyebrows, eyelashes, and beards
- Men and women who want hair in an area where they have little or no hair
What happens during a hair transplant surgery?
Hair transplantation surgery is considered to be "minor out-patient surgery." Hair transplant procedures can take from 2-4 hours and performed using local anesthesia on an out-patient basis. There is typically little discomfort during the surgical procedure. The donor areas, where the grafts have been harvested, are closed with sutures, these are usually removed in 7-14 days. The recipient sites, where the grafts are placed on top, are essentially small, superficial slits in the skin of the scalp. At the end of the procedure, a very light dressing is applied. At the conclusion of the procedure the surgeon usually checks the final placement of the grafts, and an assistant then explains the postoperative instructions, which are supplied in written form as well.
Hair in the donor area is clipped to a 2mm length. If the hair in the donor area is left 1.5 - 2" long, the hair above the donor site can be combed over and completely camouflages these areas immediately after the procedure.
The donor area and the recipient area are anesthetised by injecting a local anesthetic with a very small gauge needle that is about the size of an acupunture needle. Anesthetising the area is the only uncomfortable part of the session.
After the local anesthetic has taken effect, a scalpel is used to cut narrow strips from the donor areas and the wound is closed with sutures. (A similar method can also be used to remove scars in the donor area). This tissue it then divided in to a number of graft sizes.
Complications
Are very rare, but as with every surgery there are associated complications. Those associated with hair transplantation are -
- Infection
- Itching
- Swelling
- Poor growth
- Poor scarring (wide scarring)
- Paraesthesia
- Cyst, papules, pastules
- Epidermoid cyst and ingrown hairs
Up to date techniques
Many hair transplant clinics, including the large commercial centres, find it more profitable to do the standard mini/micro procedure, because one doctor can do two or three patients a day using this older and less demanding hair transplant technique. This produces more revenue for the clinic but less than ideal results for the patient. We specialise the very latest surgical procedures giving much better results.
What happens after hair transplant surgery?
Hair transplantation is a very safe, relatively minor surgical procedure. There is usually little or no discomfort in the grafted area. Most patients feel some "tightness" in the donor area for 1-2 days and are prescribed a mild analgesic to help cope with this. Patients may be asked to use moist compresses or sprays and to sleep in a semi-upright position for 2-3 days following the procedure to minimize swelling and bruising. Small crusts may form on each graft, and these can usually be camouflaged by any existing hair that can be combed over the recipient area. Numbness that may occur in the donor or recipient area usually disappears within 2-8 months following surgery.
Complications are rare. Minor inflammation can occasionally occur around a newly transplanted hair follicle, similar to an infected ingrown hair or pimple, and usually responds to simple warm compresses. The scar that occurs in the donor scalp as a result of the removal of donor skin is usually quite narrow and can be easily hidden by the surrounding hair. The graft sites in the recipient frontal area heal with almost no visible scarring and are covered by the transplanted hair. A minority of patients may experience mild swelling in the forehead area for a few days following surgery. It typically appears around the 3rd post-op day and goes away after 3-4 days.
When should I start treatment?
We recommend beginning Medical Treatment of significant hair loss as soon as the problem has been identified. Patients may have hair restoration surgery at any age after the early 20s, the decision for any given patient may be different, depending on a number of factors. The vast majority of patients have their first procedure while they are not yet completely bald. medical treatments such as finasteride and minoxidil are usually recommended for men with hair loss to help preserve or partially reverse thinning hair in the crown. Hair transplants can be used to fill in the front hairline and thicken the front half of the scalp, and medical treatments can be used to maintain hair behind the transplants and to possibly enhance the long-term results of hair restoration surgery. We will work with you to design an individualized plan to fulfill your specific needs.
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