Hair Transplant Basics
The number of follicles per square centimeter of scalp is called the hair density. The flexibility of the scalp or looseness of the skin is called Scalp laxity. For the “Strip technique” the more scalp laxity and density make it easier to harvest donor follicles. Conversely, the tighter the scalp and the lower the density the more difficult it is to harvest donor hair and to close the donor area after surgery. For NeoGraft the laxity and density are not major issues.
No two patients are the same and each patient needs a custom designed hair transplant procedure that suits their face, hair loss pattern, age, hair type, and skin tone.
Follicular Unit Extraction
Follicular Unit extraction (FUE) is a hair transplant technique in which a small round punch is used to extract follicular units from a patient’s donor areas one at a time. These 1, 2, 3 and 4 hair groupings (called follicular unit grafts) are then transplanted into a patient’s balding areas. While in principle follicular unit hair transplantation is very simple, its implementation requires meticulous micro-surgical skills, attention to detail, and artistry.
Follicular Unit Transplant
Follicular Unit Transplant (FUT) is a method by which follicular units are transplanted into a donor area. Patients often confuse FUE and FUT. FUE is actually a sub-type of FUT. The difference is in how the grafts are obtained. The traditional strip technique removes a strip from the back of the head and then the follicles are cut into smaller units. The newer FUE extracts the follicles unit by unit without any cutting of a strip of tissue.
Hair grows in many different directions on the scalp. It is imperative to try to maintain a natural look. Coarse, curly and wavy hair has naturally greater bulk so it covers more surface area and can be transplanted with fewer grafts. Fine straight hair has less bulk so more grafts will be required to create a fuller appearance.
Patients with advanced patterns of hair loss usually desire more dramatic results with fewer hair transplant procedures with the maximum number of hair grafts transplanted. These procedures usually require 3000 or more grafts and are called megasessions.
Hair Transplant History
The world’s first hair transplant surgery was performed in Japan in 1939 by a Japanese dermatologist, Dr. S. Okuda. Dr. Okuda extracted small sections of hair-bearing skin and then transplanted them into small holes in the area of hair loss. Once the grafts healed, many began to produce hair in areas that were previously bald. Although hair transplants were ground breaking technology, the results were poor. The large grafts looked fake and unnatural.
The first hair transplant in the United States was performed in 1952 by New York dermatologist, Dr. Norman Orentreich, using a technique similar to Dr. S. Okuda from Japan. This was for a patient with male pattern baldness, but the results did not look very natural and Dr. Orentreich was heavily criticized for the comical appearance of his procedure.
1960's & 70's
Throughout the 1960s and 1970’s, many patients sought out hair transplants for their balding head, but again there was strong negative stigma attached to the procedure because of the poor results and sometimes obvious and even comical appearance of the “plugs” which were about 10-20 hairs punched out of the back of the scalp and thus unnatural in size.
In 1984, mini-grafting was introduced. Instead of grafts of 10-20 hairs being used the technique used smaller grafts cut from strips of donor tissue. Mini-grafts were used to create density and fullness, while micro-grafts (1-2 hairs) were implemented to maintain a feathered hairline. Mini- and micro-grafting became the industry standard and replaced the doll-like look of the old plugs technique. This is the traditional “strip technique.”
Follicular hair transplantation consists of groupings of only 1-3 follicles and results in attractive, natural-looking, full hair. But with the transplantation of thousands of these groupings over long arduous sessions follicles tended to dry up and be useless. The new NeoGraft now lets doctors transplant thousands of hairs in one short session with maximum survival of grafts.