Follicular Unit Transplantation

State of the art Follicular Unit Transplantation is now the “gold standard” by which all hair transplant techniques are measured. It is the newest technique of permanent surgical hair restoration in which hair is transplanted from the permanent zone in the back of the scalp into areas affected by genetic balding, using only one’s own naturally occurring, individual follicular units. This procedure is unique in that is provides what we all want – hair that looks natural throughout, no matter which way the wind blows!

What Are Follicular Units?

Hair naturally grows in clusters of one, two, three, and some times four hairs. These naturally occurring groups of hair are called Follicular Units. The follicular unit is very small and can only be identified under magnification. Notice that they are scattered about in an irregular pattern. This is how hair grows … in follicular units and in an irregular pattern.

So given how hair naturally grows, an excellent hair transplant replicates nature by relocating these naturally occurring follicular units from the donor area to the recipient site (balding area) – one at a time.

Follicular unit transplantation
Follicular Units

F.E.U. Hair Transplants
Follicular Units – Magnified

Follicular Unit Extraction

F.U.E. otherwise known as Follicular Unit Extraction is a new method of removing donor hair follicles. Most of our cases are performed with the traditional “strip method” which involves removing a small strip of hair from the donor region (the sides and the back) and suturing it closed. This allows us to remove a large number of donor hair follicles at one time. With FUE we use specialized instruments .7mm- 1.2mm in size and remove each follicle individually. The main advantage of this method is that there are no sutures placed, so the patient does not need to return for suture removal 10 days after the procedure.

The disadvantages are that a larger area of the scalp needs to be shaved in order to remove the follicles and this method is much more time consuming and therefore costly. For someone who only needs a relatively small number of grafts, this can be an option. Dr. Dauer is very well versed in performing F.U.E., and if this is something you are interested in, he can explain this procedure in more depth on the day of your consultation.

How is Follicular Unit Transplantation Performed?

The real key to performing this procedure successfully is to transfer each follicular unit intact from the donor area to its destination. In order to remove Follicular Units from the back of the scalp without damaging them, the donor tissue must be removed in one piece. This technique is called “Single Strip Harvesting.”

hair transplant photos

The individual Follicular Units are then separated from the donor strip and trimmed under a microscope to create the ultimate micro graft. These micro grafts are then placed in very close proximity and in an irregular pattern that mimics how they naturally grow in the scalp. The end result is a hair transplant that looks natural because it applied the way hair actually grows.

Complete stereo-microscopic dissection has been shown to produce an increased yield of both the absolute number of follicular units, as well as the total amount of hair, in upward of 25% when compared to other techniques.

Also, the ability to do this successfully, and in a session of 1500 or more grafts (“a mega session”), has only come about in the past few years. The very small insertion sites permit many follicular unit grafts to be safely transplanted in a single procedure allowing the entire hair restoration process to be completed as quickly as possible. At this time only a small group of experienced hair transplant physicians perform this procedure with excellent results.

When performed by a skilled surgical team, Follicular Unit Transplantation can provide a totally natural looking result in as few as one or two sessions.

Why Aren’t All Transplant Physicians Using Follicular Units?

Basically the reason is that it takes time to change and adapt to these cutting edge advancements in technique. Follicular unit grafts require more time, skill, and expense to create compared to the mini/micro grafts.

Many hair transplant clinics, including the large commercial operations, find it more profitable to do the standard mini/micro graft 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.

Follicular Unit Grafts

It is possible to achieve the appearance of naturalness and density on a consistent basis with natural follicular unit transplantation. This method requires greater numbers of grafts and technical skill in order to achieve the desired result. But once the technical skill to perform this technique is achieved the look is invariably natural. As stated earlier, Follicular Unit Transplantation is the “gold standard” by which all hair transplant techniques are measured.