Hair Transplants Using FUT (Follicular Unit Transfer)
At the New York Hair Transplantation Center we perform many types of hair restoration procedures including FUT Hair Transplants. Follicular Unit Hair Transplantation (FUT) implants hair into the balding area as individual follicular units (naturally occurring groups of 1-4 hairs). Because of this the hairline looks totally natural and be undetectable as a hair transplant. This is the state-of-the-art in hair restoration surgery.
Many are afraid of the procedure because of the unnatural look many have from old techniques that we do not employ at our facility. The out-dated “plug” techniques tranplant the hair into the scalp like “corn rows” or “dolls hair”. These older techniques were more traumatic, and patients would leave the office with their head wrapped in bandages and enduring significant bleeding and pain. With our modern follicular unit hair transplants, patients leave the office with only a hat and headband. In fact they are able to shower and shampoo their hair the day after the hair restoration surgery.
Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) are different in the way the hair is harvested (removed) from the donor area in the back of the scalp. During FUT, the hair is removed in a single, thin strip and then microscopes are used to dissect it into individual follicular. In FUE, the follicular units are removed directly from the back and sides of the scalp using a the NEOGRAFT Device.
All of our hair restoration procedures are performed under local anesthesia. Many patients will have thousands of hair follicles transplanted in one day. In our facility, patients can watch TV or a movie on flat screen television, surf the internet on IPADs, listen to their music with our IPHONE and IPOD docking stations, OR take a nap. During the procedure refreshments are provided, and for longer sessions breaks for lunch are planned.
The FUT Procedure
When you arrive for your hair transplant, the staff begins by going over the activities for the day. The paperwork and surgical consent forms are reviewed. Dr Jacono reviews the goals that have been established and answers any questions. With a mirror the Dr Jacono will review the hairline you discussed during your consultation, and draw the hairline for your review. He also will add other markings to further delineate the extent of the procedure. You will have a chance to examine and discuss them before proceeding. He then takes high definition (HD) photographs that will become part of your permanent medical record.
Sedatives are given to relax you before the start of the hair restoration procedure, but some patients elect to be fully alert. The graft dissection will be performed in the same room as your hair surgery. We believe this is helpful, because we can explain what we are doing, discuss the density and amount of hair grafts we have to work with, and answer any questions that you may have.
The permanent hair transplant procedure take time due to the meticulous nature of the procedure; it will depend upon how may follicular unit grafts are transplanted. Small sessions of less than 1000 grafts can be finished by mid day while larger sessions, of 2,000 to 2,500 take a full day.
The donor tissue is removed from the scalp in a single thin strip to minimize scarring, The location of the donor area is carefully chosen to be a region of the scalp with maximum hair density that is genetically stable and will not fall out over your lifetime. The hair in the area to be removed is clipped 1 mm short. By doing this the uncut hair can completely cover the donor area, and you can get back to work and your normal life immediately. In Follicular Unit Transplantation, the donor area is closed with absorbable sutures (that don’t need to be removed). Dr Jacono does not use staples because he believes it does not heal as well.
The donor tissue is immediately placed into a holding solution consisting of chilled Ringer’s lactate solution which closely mimics the body’s own fluids. This maximizes the survival of the grafts while they are being held outside the body.
The Donor Area Incision Healing
Thin strip harvesting produces a linear scar. The appearance of the donor strip scar can be a significant concern for patients who wish to wear their hair very short. The vast majority of patients who undergo strip harvesting have a thin minimal scar that is easily concealed by the hair above the incision even immediately after the procedure to harvest the hair. In many instances the scar may not be evident at all except on careful inspection. If you do not want any scar this can be avoided with an FUE Hair Transplant or Follicular Unit Extraction. Judicious planning on the part of the surgeon can largely diminish the problems associated with strip scars. By limiting the width of the strip to be taken and avoiding tension on the wound, the surgeon can minimize the donor scar. To avoid multiple scars many physicians who use strip harvesting employ a single scar technique even if multiple procedures are performed. By utilizing careful dissection along the incision line, damage to hair follicles can be diminished.
In Follicular Unit Transplantation, the individual follicular units (each containing from 1 to 4 hairs) are meticulously dissected from the donor strip in their naturally occurring groups under strict stereo-microscopic control. The follicular unit grafts are then sorted into groups containing either 1-, 2-, 3- or 4-hairs and stored.
Creating the Recipient Sites
Recipient sites are made using a fine instrument the size of 19- gauge hypodermic needle. The recipient sites must be made to parallel the direction the hair grows out of your scalp. This determines much of the aesthetic look of the transplant. Recipient site creation is a critical aspect of hair restoration surgery that requires considerable experience. These sites are created around your existing hair so that it does not need to be cut. This is particularly helpful so that you can use your hair to camouflage the transplanted area during the immediate post-op period.
One-hair follicular units are used in the frontal hair line to give a soft, natural appearance and 3- and 4-hair grafts are used in the central forelock area to achieve maximum fullness. Placing is the most time-consuming part of the hair loss surgery. Graft placement is an exacting process.