Follicular Hair Transplants

By: Michelle Hudson

The process involving follicular hair transplants is considered to be the most effective among hair restoration methods. In follicular hair transplant, the surgeon transplants hair from the permanent zone in the back of the scalp onto the affected areas.

The donor tissue is removed in one piece. This is to ensure that the follicular units being relocated from the back of the scalp are not damaged. An integral part of hair follicle transplant is single-strip harvesting as it preserves the follicular units. It also ensures that no damage is caused to the individual hair follicles.

Follicular hair transplant technique follows a well laid out pattern. Follicular hair transplants allow the surgeon to use small recipient site. During the surgery the follicular units that are removed from the donor tissue are minutely studied by a microscope. This stereomicroscopic dissection raises the yield of the absolute number of follicular units, and that of the total amount of hair as well.

Follicular hair transplant procedure

During follicular hair transplant the surgeon scans – under a microscope - the follicular units to be removed from the donor tissue. This stereomicroscopic dissection helps in protecting the follicular units. It also ensures a rich yield of both the follicular units and the total amount of hair that is restored.

Donor strip - In follicular hair transplants the donor strip is the hair strip that is taken from one part of the body and transplanted to the bald region of the scalp. In this technique the donor tissue is removed in one piece. This ensures that the follicular units being removed from the back of the scalp do not suffer from any damage.

Donor strip extraction - The donor strip is first taken out from the permanent zone in the back of the scalp. Then it is transplanted onto the areas of the scalp where there is no growth of hair.

The single-strip harvesting in follicular hair transplants ensures preservation of the follicular units and protection of individual hair follicles from possible damage.

Follicular units - Follicular units are a bundle of hair growing together. A follicular unit is usually formed of one to four terminal hairs. Every follicular unit is surrounded by one to two fine vellus hair, oil glands, a small muscle and a fine band of collagen. The follicular unit is the skinâ's hair-bearing structure ensuring maximum growth. It looks like a well-formed structure under the microscope.

In genetic balding the transplanted hair is of smaller diameter and length than the hair replaced. It is highly advantageous to use individual follicular units. It facilitates the use of very small units. At the same time the amount of transplanted units is proportionately much large. Therefore a surgeon can place up to four hair strands in a tiny recipient site. It has tremendous implications for cosmetic surgery in general.

This gives follicular hair transplant a considerable edge over micrografting. Transplantation of individual follicular units also gives a natural look to the transplanted hair.


Follicular transplant removal

In hair follicle transplant, individual follicular units are directly removed from the donor area. It means that this method is independent of linear incision. The surgeon uses a 1mm punch to make a small circular incision in the skin around the upper part of the follicular unit. It is then directly extracted from the scalp.

Very often follicular unit extraction (FUE) and follicular unit transplantation (FUT) are treated as two different things. It's wrong. FUE is basically a type of FUT in which the follicular units are extracted directly from the scalp, instead of microscopically dissected from a strip that has already been removed. In follicular hair transplant the individual follicular units can be obtained either through single-strip harvesting and stereomicroscopic dissection or through FUE.

Follicular transplant preservation

In follicular hair transplants it is crucial to keep the individual follicular unit as it is. Neither the unit should be broken up into smaller units nor combined with larger ones.

This is a ground-breaking development in the history of cosmetic surgery. Often hair transplant surgeons combine several follicular units or split them up.


Follicular hair transplant and mini and micro grafting

There is similarity between follicular hair transplant techniques and those followed in minigrafting and micrografting. However, follicular hair transplantation is different from mini and micro grafting. Both of the latter procedures use a multi-bladed knife to split the follicular units. This results in unacceptable levels of transaction of hair follicles.

In follicular unit transplantation it is the nature that determines the graft sizes. In mini-micrografting the graft sizes are arbitrarily determined. The donor tissue is sliced to the size the surgeon considers fit.

There is another difference between follicular hair transplant and mini-micrografting. In the latter neither the hair follicles are kept intact nor the follicular units are preserved. In mini-micrografting, speed and economy of the procedure are more important. The process entails using a multi-bladed knife to quickly generate thin strips of tissue.

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