Follicular Unit Transplantation (FUT) - A guide to Hair Transplant Surgery

This is a procedure in which small clusters of hairs or ‘follicular units’ are removed from the donor area of hair (the fringe of hair around your head) in a strip, and inserted into the recipient area (the bald area of your head). These are naturally occurring units which if transplanted well, will replicate this natural growth in the recipient area of the scalp.

In other words, there will not be any unsightly clumps or corn rows of hairs as seen in older techniques. These grafts are very small and can be inserted into tiny recipient areas on the scalp.

This is a minimally invasive procedure with a brief recovery period and few complications. However, it takes a great deal of experience and skill on the part of the surgeon which is acquired, only after years of practice.

The difference between this and follicular unit extraction (FUE) is that FUT involves removing a strip of follicular units via microscopic dissection; whereas FUE involves removing the actual follicular units directly from the donor site.

What is a follicular unit?

Our hair grows in tiny groups, anywhere between 1 and 4 hairs in a group. These groups consist of the hair itself and the follicle: a sac-like structure beneath the scalp which produces and nourishes new hair growth. There are groups or units which consist of just a single hair but most of these contain two to three hairs. A person with thicker hair will have follicular units with four hairs. These are small independent units which can be damaged during surgery which may result in poor hair growth. So it is important that they are removed carefully.

This means a long and intensive procedure but the effects are generally worth it!

Before follicular hair transplants, surgeons often used a method in which large grafts of hairs were removed, usually in groups of 3 to 8 hairs. One problem with this method is that the follicular units could be damaged or broken up which would then affect hair growth.

But this isn’t a problem with follicular hair transplantation which enables implanted units to remain the same as when they were in the donor area.

The FUT procedure

This involves placing the follicular units in the following manner:

    • Places single hair units at the front of your hairline
    • Places 2 hair units behind the hairline
    • Places 3 hair units behind the 2 hair units
    • Then places 4 hair units behind the 3 hair units

This will produce a natural looking appearance and the right amount of hair density without the risk of ‘plugginess’. Plugginess occurs when groups of hair are arranged in corn rows or tufts which often look like the hair seen on a child’s doll.

You will have an initial consultation with the surgeon to discuss all aspects of the procedure. This includes a frank and honest discussion about what you can expect and whether this is likely to meet your expectations. If you are satisfied with this meeting then it’s a case of arranging a date for your surgery. Your surgeon will give you a set of ‘pre-operative’ instructions to follow which include stopping smoking (if you are a smoker), stopping any medications such as aspirin and anti-inflammatory drugs and massaging your scalp.

For more information on this visit our preparing for your hair transplant surgery section.

The surgery itself is performed under a local anaesthetic. The hair in the area where the units will be removed will be trimmed to enable easier access.

The surgeon will then inject a local anaesthetic into the donor area of your scalp which will numb the area. He/she will then remove or extract these hairs one by one. This is done in a particular pattern known as a ‘spread arrangement’ so that it is difficult to tell which hairs have been removed.

Your surgeon will use a microscope whilst doing so to prevent the risk of damage to the hair follicles. These units are removed in strips for micro-dissection (under a microscope) before implantation. The strip is removed from the centre of the donor area which enables him/her to obtain a large amount for transplanting.

He or she will then inject an anaesthetic into the recipient area (bald area of your scalp) and will use a specially designed ‘micro-needle’to insert the follicular units into the scalp. These hairs will then grow as per usual.

A maximum of 4,000 hairs can be transplanted in a single session.

The surgeon will use staples or stitches to close the incision made in the donor area.

You may require several sessions to achieve the look you want which will depend upon the type of hair loss and the amount of coverage you require.

On the other hand you may be lucky and get the result you want just in the one session.

Once the anaesthetic wears off you may experience some soreness, swelling and discomfort. Take painkillers if necessary.

You will have been given a set of ‘post-operative’ instructions which include advice on looking after the treated area, washing your hair and new hair growth.

For more information about this, visit our after your hair transplant section.

What are the risks/side effects of the FUT procedure?

Every surgical procedure has a small amount of risk and hair transplantation is no exception.

This surgery is highly successful and safe but problems can arise as it is hard to predict how it will work for every patient.

After all, we are all individuals and react to things in different ways.

Generally, most people take to the grafts very well but things can occur, however experienced the surgeon and it is as well to be aware of these.

It is usually minor things which go wrong and these can be dealt with without any impact upon the final result. So you can still get that head of hair you have always wanted.

But it is better to know these things upfront so you are aware of what can go wrong.

Possible complications/risks include:

    • Poor/slow hair growth: may be as a result of damage to the follicles.
    • Infection: this is extremely rare as antibiotics are prescribed before and after surgery.
    • Noticeable scarring: the surgeon will try and place the incision in an appropriate part of the donor area so that it difficult to see.
    • Poor wound healing: genetics can play a part in this and some people do heal more quickly than others.
    • Changes in the pigmentation of the skin: there is a risk of hyperpigmentation (darkening) to the skin although this is very rare.

If you notice any problems after your surgery then consult your surgeon.

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