How does hair transplantation and hair restoration surgery really work? While the general public may be vaguely aware of these procedures – perhaps through advertisements on TV and radio – very few have a handle on how the surgery actually works.
The world of HT (hair transplants) begins with the concept of “donor dominance.” Donor hair grows on the back and sides of the scalp and is resistant to the causes of hair loss. Even extremely bald men hold onto the hair on this part of the head. Donor dominance dictates that some hair is genetically blessed to grow throughout one’s life span regardless of the area on the scalp that it is surgically relocated too. This phenomenon enables the process of hair transplantation. Men with patterned baldness can have donor hair surgically redistributed into areas of baldness without the fear that this new hair will succumb to the hair loss process.
Natural hair can be relocated in hair transplantation but this does not necessarily mean that hair transplant results will look natural. In the early days of hair restoration surgery, physicians used 4 and 5 mm biopsy punches to remove “plugs” of hair bearing tissue from the donor site. The plugs were then implanted into the balding areas. As you can image this left tremendous scarring over the scalp. Moreover, the densely haired grafts, when placed into thinning or bald tissue, stood out as tufty-looking “dolls hair”.
HT surgery slowly evolved into the strip excision method whereby an ellipse of tissue is removed via scalpel from the donor zone. The incision is closed with sutures or staples reducing the surface area of scar tissue. Unlike the open plug graft harvests where the donor is littered with circular punch scars, the strip method leaves a single linear scar on the back of the head. When expertly handled, the incision can sometimes heal as a fine line.
In the infancy of the procedure, strips were cut into large grafts but over time physicians began to recognize the aesthetic benefits of using smaller grafts. This movement led practitioners to what is known as follicular unit grafting or Follicular Unit Transplantation (FUT). In this process, naturally occurring follicular units of 1, 2, 3, or 4 hairs are carefully dissected out of strips with the use of microscopes. The process honors the way hair naturally grows on the scalp and has the potential to produce an undetectable result even under close examination.
Recent developments in the field have lead to harvesting techniques whereby strip excision and strip scarring can sometimes be avoided. The generic term for this surgery is Follicular Unit Extraction or FUE. During Follicular Unit Extraction, follicular units are identified prior to removal and are harvested from the donor site one by one with a tiny surgical utensil. As with FUT, the units are placed into small incision over the area of loss or thinning. While FUE does not create the linear donor scarring associated with strip excision, both approaches can be used to exclusively manufacture follicular unit grafts.
Regardless of harvesting technique - FUT (strip) or FUE - the follicular unit graft is essential in creating an authentic appearance in hair restoration surgery.
(text taken from
www.hairlossconnection.com)
