Fortunately for balding men, one’s hair can be divided into permanent hair-bearing regions (the donor area) and also a regions in which hair loss can prone to take place (the recipient area). Simply put, hair transplants involve transferring people ‘hardy’ hair follicles from the donor area across to the hair loss region. After the transplant has been carried out, the transferred hair will then grow for a long as it would have in the donor region.
The Figure below shows a standard location for a donor area:
More about the onset of hair loss:
Hair loss areas are commonly divided into the following zones:
- Frontal area
- Mid-scalp area
- Crown area
Normally one procedure will normally treat just one area; multiple treatments are required for a full solution.
Follicular Units and Hair Transplants
15% Follicular units contain 4 or 5 hairs
15% Follicular units contain 1 hair
The rest of Follicular units contain 2 or 3 hairs
Most modern hairs transplant procedures us FUs as the building blocks of the process.
Groups of FUs are typically extracted by “sectioning”. This involves taking an 8 – 10mm strip of skin from the donor are. By the end the procedure, the donor are is closed, leaving thin scar which normally heals within 7 – 10 days.
Transferring the Follicular Units
Using the 8 – 10mm strip of skin removed from the donor area, individual Follicular Unit are extracted using a dissecting stereomicroscope. The recipient area is prepared by making small incisions into the scalp using small bore needles or blades. In order to replicate the hair that wold have been originally present in the recipient area, the incisions are made at angles which orientates the FUs appropriately.
DO NOT PANIC – it is normal for all of the hair on the transferred hair follicles to fall out within 2 – 3 weeks after the procedure. After a further 2-3 months the patient will experience regrowth on the transferred FUs in the recipient area.
A relatively new procedure – Follicular Unit Extraction (FUE)
This technique skips the removal of whole strips of skin by removing individual FUs from the donor area and transferring them to the recipient area. A small round punch is used to excise individual FUs, similar to the process of using a cookie cutter! However this process has advantages as well as considerable disadvantages relative to excising strips from the donor area:
- No linear scar
- Good for tight scalps
- Good for people who have the tendency to scar easily
- Good for body to scalp transplants
- Less time-efficient
- More expensive
- Can result in the lower survival rate of FUs
The final result of a hair transplant is dependent on the nature of the grafts that are transferred. The best results occur when the FUs are placed as close as possible together. For example, a follicular implant (shown in the Figure B above) covers 2/3s of the area in comparison to using a micrograph containing 2 FUs: 1 X 1-hair follicular unit and 1 X 2-hair follicular unit.
Ensuring that the recipient sites for the individual grafts are as close together as possible has the following advantages:
- More recipient sites can added per unit area in on session while ensuring –
- No scalp damage
- No adverse effect on blood supply
Ensuring that the FUs are used containing multiple hairs have the following advantages:
- Increased look of fullness of hair
- Natural looking hair, without looking ‘pluggy’. However, grafts must still be skilfully inserted in the correct direction
It is also worth noting that if the individual graphs that are inserted into each recipient site are larger than the FUs this will compromise the naturalness of the of final crop of hair.