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Follicular Unit Transplantation (FUT)
Our office offers the two most common proven surgical techniques in hair restoration surgery, Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). FUT is commonly referred to as the Strip procedure. It is the more familiar surgical hair restoration technique using naturally occurring groups of 1 to 4 hairs, called follicular units. FUT is an advanced hair transplantation procedures that produces a naturally appearing hairline and appearance.
With the FUT procedure, a strip of scalp is surgical excised and the individual hair follicles are created into naturally occurring hair grafts by our surgeon and skilled technicians. The strip removed is taken from the “safe” or permanent zone of the scalp where the hair follicles are resistant to hair follicle miniaturization or balding. The entire procedure is done under local anesthetic with light sedation if requested by our patients. Most patients are able to watch television or relax with headphones listening to music with their MP3 player of IPod.
Since the follicular unit is a distinct anatomic and physiologic entity, preserving it intact during the graft dissection is felt to maximize growth. In FUT, after hair is removed from the back of the scalp in a single strip, stereo-microscopic dissection allows the individual follicular units to be removed from this strip without being damaged.
Follicular Unit Transplantation enables the hair transplant to look natural both at the individual follicular unit level, and in regards to the overall graft distribution. Since scalp hair normally grows in follicular units of 1 to 4 hairs, the exclusive use of these naturally occurring units with FUT ensures that each graft will be identical to the surrounding follicular units. Thus, when the transplanted follicular units grow hair after a transplant, the overall results of the transplant will appear natural.
There are many holding solutions that can be used to allow the hair follicle to survive after transplantation. We routinely use HypoThermosol for all our surgical cases because it helps strengthens the survivability of the hair follicle. HypoThermosol is a preservation media that enables improved and extended preservation of cells, tissues, and organs. Its use and efficacy is well established in the surgical and medicine disciplines. It is used in other surgery for organ preservation such as heart, lung, and liver transplants. This solution reduces molecular stress and provides nourishment, electrolyte balance, pH buffering, decrease free radical scavenging, and increase energy substrates. During the harvesting and graft creation process our follicles are also cooled to 4 degrees Celsius to decrease the metabolic activity of the hair grafts to ensure their viability while outside the scalp before they are placed in the recipient sites of the scalp.
GRAFT CREATION AND PLACEMENT
Follicular units are relatively compact structures, and are surrounded by substantial amounts of fatty tissue containing critical Stem or regenerating cells for subsequent hair regrowth. The hair graft is trimmed and excess tissue is removed without injuring the hair follicles ability to regenerate using stereo-microscopic dissection. The trimmed follicular unit grafts are then placed into tiny incisions in the patient's scalp. In contrast to older and outdated surgical techniques, larger wounds produced by mini-micrografting and plug transplants caused cosmetic problems that included dimpling and pigment changes in the skin, depression or elevation of the grafts; and a thinned, shiny look to the scalp. These problems can be avoided using very small natural follicular grafts and very small recipient wounds.