Surgical Treatments

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All you need to know about any surgical hair transplant procedure

For men and women suffering from hair loss, hair transplantation can be a life-changing procedure. Hair transplant surgery restores naturally growing hair to areas that had been thinning or bald. In addition to scalp hair restoration, hair transplants can be used to restore eyelashes, eyebrows, facial hair, and hair loss due to trauma on the scalp and on the body, as well.

Many people worry about the cost of a hair transplant. Hair transplant surgical fees can vary depending on the type of service and area of coverage chosen, the area in the world one lives, as well as the causes of the patient’s hair loss. Hair transplant reviews differ, but most patients are happy with the results. The effect of the procedure is not only aesthetic but also emotional, granting many patients increased confidence and self-assurance.

Follicular Unit Transplantation (FUT) involves moving the small naturally occurring hair bundles (aka follicular units) usually from the scalp’s permanent donor area to the area of hair loss. This procedure can be performed to treat a variety of hair loss conditions in appropriately selected and diagnosed men and women. Follicular Unit Excision (FUE), is one of two donor harvesting methods used to harvest the small follicular units.

With the FUE technique, follicular units are individually extracted from the patient’s donor area using a small round micro punch. It has gained popularity in recent years and is often described as a “minimally invasive” procedure because it does not involve stitches, and the tiny round excisions are left open to heal without sutures. However, it must be noted that when thousands of small cuts are made in the skin, it is an invasive procedure and does constitute surgery. The actual transplantation occurs the same for both donor harvesting techniques, as the grafts are inserted using various tools and needles or micro blades into recipient sites (small incisions) in the areas where the patient has experienced hair loss.

The other method of donor harvesting involves taking a full thickness ellipse of skin and hair and is referred to as a linear excision, or linear ellipse strip harvesting, and the small grafts are individually dissected using a microscope. The wound is closed usually with stitches, and this leaves a linear scar, confined to one area rather than diffusely distributed like the FUE. This technique has been successfully used by hair transplant surgeons for decades.

While the FUE harvesting technique has gained popularity in recent years because it does not produce a linear scar, patients must be knowledgeable about potential risks too. Despite false advertising claims of ‘a no scar technique’, FUE almost always leaves small round scars which, when performed correctly, can be hidden with short hairstyles. When performed improperly, FUE can result in diffuse donor thinning and leave visible scarring.

Recently there has been an explosion of marketing terms such as Ice FUE, Sapphire FUE, Gold FUE, hybrid FUE, micro FUE, nano FUE, modified FUE, FUE2, 3rd and 4th generation FUE, and needle free FUE. These terms are not recognised by the ISHRS.

Implantation Methods

Regardless of the donor hair harvesting method used, there are two techniques for implanting the follicular unit grafts – forceps and implanters. With forceps, the individual graft is held gently and inserted into a pre-made incision taking care not to damage the bulb. The implantation can be done after all the incisions required have been made or after each incision has been made – known as the ‘stick and place’ method. Patients should take note of the ISHRS Position Statement on Qualifications for Scalp Surgery with regards to who should make incisions in the skin.

Implanters are tools where the grafts are loaded into a channel and then a plunger is deployed to insert the graft into the skin. Implanters can be dull or sharp. Dull implanters are used to insert the grafts into pre-made incisions. Sharp implanters are used to make an incision in the skin and immediately implant the graft. Since the use of sharp implanters involves making a skin incision, the same Qualifications for Scalp Surgery guidance applies with regards to who should use sharp implanters. 

The advantage of implanters is that the bulb is not handled directly and therefore is potentially subject to less trauma than when handled with forceps. The term direct hair implantation (DHI) is used by some practitioners to refer to the immediate implantation of a follicular unit following its extraction. The term direct hair implantation is also used by some practitioners to refer to the sharp implantation technique. In either case DHI is not a hair transplant method and should not be marketed as such.

The ISHRS urges consumers to do their research before choosing a hair restoration surgeon—and be sure your doctor is actually going to be performing your surgery, and not delegating it to an unlicensed technician.

Before You Choose a Surgeon

Before you make a final commitment for hair restoration surgery, it’s a good idea to ask your hair restoration surgeon a lot of questions so you can have confidence in your decision.

Consumer Alert / False Advertising

After months of researching hair restoration surgery, you’ve finally decided it is time to talk to a physician. But your research shouldn’t stop there…

Noticeable Hair Transplants are Never in Fashion, So Why are They Making a Comeback?

In the old days (think 1980s), there was no mistaking who had a hair transplant. The telltale corn row, doll hair, pluggy-looking hair transplants of yesteryear were — believe it or not — once considered state-of-the-art. But that was well before the evolution of hair transplantation. Over the last 20 years, hair restoration techniques have evolved considerably. These techniques have become so refined and results so natural-looking that most people cannot tell if someone has even had a hair transplant.

Medical Tourism: The Good, the Bad, and the Ugly

As the old adage goes “if it sounds too good to be true, it probably is”, consumers need to exercise extreme caution when considering a hair restoration procedure across borders and do their homework well before their tickets are booked and bags are packed. Many specialists in the field of hair restoration have been seeing complications from these “cheap clinics” that no patient bargained for.

Comparison Between Strip Harvesting & FUE – Part 1

Years ago, experts started advocating a new way of performing hair transplant surgeries. Instead of the traditional strip harvesting– meaning that doctors would take strips of hair-bearing tissue from part of the head and place them elsewhere, the experts started advocating FUE hair transplants.

Comparison Between Strip Harvesting & FUE – Part 2

We continue our comparison of the hair restoration surgical procedures of Strip Harvesting versus FUE hair transplants.

Comparison Between Strip Harvesting & FUE – Part 3

We conclude our three part series, “Strip Harvesting versus FUE” in discussing a number of remaining issues between the two procedures.

FUE Instruments and Their Use

Improvements in instrument technology and technique have now made Follicular Unit Excision (FUE) a procedure competitive with strip harvesting for obtaining donor hair for transplantation.

Follicular Unit Excision: It has grown in popularity, but transection remains a concern

Follicular unit excision is one of the techniques for obtaining donor hair for hair transplantation.

Hair Loss & Innovations – Cutting Edge Research Part 2

New findings from research help explain why hair loss happens (ie. specific gene/hormone carried by individual).

Excision Of Bald Scalp Utilizing Tissue Expansion Or Extension

Although hair transplantation alone is by far the most common method of hair restoration utilized in modern times, excision of bald scalp after either tissue expansion or scalp extension can play a very useful and important role in hair restoration as well.

Scalp Flap Surgery for Hair Restoration

Skin flap surgery is a method of moving a “flap” of skin from one area of the body to another. Scalp flap surgery has an important but limited role in hair restoration.

FUE: What is it?

FUE or Follicular Unit Excision is a method of harvesting hair follicles from the donor area (the back and side of scalp where hairs won’t fall out during the patient’s lifetime).

Hair Restoration Surgery Risk Factors

The hair restoration surgeon will determine risk factors based on the information given by the patient prior to any surgical procedure.

Scalp Reduction Surgery for Hair Restoration

Alopecia reduction-also called scalp reductio-is a surgical hair restoration procedure that (1) surgically removes bald scalp, and (2) stretches hair-bearing scalp upward to replace bald scalp that has been removed.

After Hair Restoration Surgery

Postoperative discomfort is experienced at different intensity and duration by individual patients. Most patients report no more than mild discomfort after surgical hair restoration.

Hair Restoration Surgery Begins with Why You Want Hair Restoration Surgery and What You Expect It to Do for You

Hair restoration surgery restores hair to areas of hair loss. It’s a successful procedure but one that cannot be undone after it has been accomplished. It can be revised over time with additional surgery, but it cannot be undone.

Follicular Unit Excision (FUE): Manual and Powered-Device-Assisted

Improvements in instrument technology and technique have made follicular unit excision (FUE) a procedure competitive with strip harvesting for obtaining donor hair for hair transplantation.

Hair Restoration in the Scarred Scalp

The method of hair restoration is usually hair transplantation to scarred areas of the scalp.

Followup Hair Restoration Procedures

There are several steps following a hair restoration: determining if subsequent sessions, progressive hair loss due to Androgenetic Alopecia, hair transplants done years ago and hairline revisions as patient ages.