The FUT hair transplant procedure involves surgically removing a thin strip of hair from the back of the head at the base of the neck, dividing the grafts, and relocating the hair follicles to the top and front of the head. The doctor performs this removal process. The hair at the back of the head is resistant to the chemical dihydrotestosterone (DHT). Because of this it is resistant to falling out of the scalp. This is why we often see men with only a wreath of hair at the back and sides of the head.
After the application of a local anesthetic, the doctor will proceed with hair transplant surgery. This starts with the removal of a small strip of hair at the back of the head from the “donor” area. The incision will be secured with sutures. The wound will quickly heal, and while it will leave a minor scar, this will be hidden by the hair at the back of the head which falls down over the scar area.
The doctor will then instruct his surgical team precisely how to divide the grafts. The strip is then dissected into very small follicular units or hair group grafts. These grafts may contain 1, 2, 3, 4 or more hairs. Each of these units is essentially an organ. They have a blood supply, are chemically regulated like other organs of the body and when transplanted will quickly return to homeostasis.
The doctor will then create small slits in the area in which the grafts will be transplanted. This involves both artistry and technical skill. The slits (or receptor sites) are created in such a way as to re-create the natural hair growth pattern. The specific depth, angle, direction, size and width are crucial to proper placement and growth of the transplanted hair. This is by far the most critical and time-consuming phase of the procedure.
Following this the doctor will supervise the placement and relocation of the grafts to the receptor area. It is important to note that the grafts can only be placed into the receptor site one way, similar to a square peg being fit into a square hole.
The relocation process is minimally invasive and is a minor surgical procedure, not much different from having a filling placed by the dentist. While there may be some discomfort during and after hair transplant surgery, there is rarely serious pain involved. Patients are awake and alert during the entire procedure and they can have a friend or spouse present.
The time it takes to complete a hair transplant procedure varies according to the number of hair grafts implanted. Shower and wash and dry your hair thoroughly prior to the surgery. It is also important that patients remember NOT TO CONSUME ANY ALCOHOL or take ANY ASPIRIN for a period of 24 hours prior to the surgery. This may cause excessive bleeding during the procedure.
When will my hair start growing…
AND what will it look like?
Some people are concerned about how they will look after the procedure. Since hair restoration is a minor form of surgery, directly following the procedure it may be possible to return to normal activities fairly quickly, but we do recommend resting during the day of the procedure.
During the days following the procedure, the patient can return to work and recreational activities. We recommend refraining from strenuous activities such as weight lifting, racquet ball or tennis for a week or two to avoid accidentally damaging the grafts. The hair can and should be washed gently with the fingers and a very mild shampoo.
After a few days, the redness will subside at the top of the head and the grafts will blend in with the existing hair.
During the first 1 to 3 weeks, new hairs will appear to be growing quickly. This in actuality represents the beginning of a phase known as “shedding,” the time when the hair follicles actually go dormant.
Following transplant surgery, the hair follicles go into shock, or a dormant phase. This is normal, expected and predictable. This phase typically lasts 3 to 6 months so you will not begin to see new hair growth until the follicle moves out of this phase and onto the next growth phase. Many patients get anxious waiting to see if the transplant was successful. However, if you know that this “shedding” is typical and normal it sometimes eases anxiety.
Typically, hair growth starts within 2 to 4 months. Hair growth occurs in cycles, with each cycle starting a few days or weeks from the previous cycle. Initial hair growth produces a smaller than usual shaft. This changes as the hair reaches about 1/2 inch in length. Most men actually prefer this slower hair growth process because it makes any change subtle and less obvious.
By 6 months, most people can see the effect of the process, and by 12 months, the growth and bulk will have reached 90% of its total growth. Hair can, and sometimes does, continue to mature for as long as another 24 months following surgery. For this reason, we advise patients to not evaluate the results until a full year has passed.
Surgical healing is also fairly fast. Within 1 to 2 weeks the specific sites that received donor “hairs” have healed. However, it might take many months for the hair to regain full strength.
About half of our patients see results on the crown area within the first 1 to 2 weeks. And even when they do, the hair is just barely visible.
If you have previously had a Follicular Unit Transplantation, your previous obvious scars can make you skeptical about what to expect with our procedure. If this is the case, we strongly urge you to speak with a patient of ours who is one or two weeks post surgery and ask them about their experiences. Most patients are all too glad to share their experiences and help you decide if this procedure is right for you.