FUT Surgery and Skin or Scalp Laxity

FUT, Follicular Unit Transplant, also known as FUT surgery is a surgical hair restoration method of removing hair follicles in their intact groupings or follicular units (FU´s) from an area around the sides and back of the scalp, known as the donor area

The procedure relies on removing a thin hair bearing strip that contains the FU´s, and from there they can be divided into the individual groupings dependent on the size, from a single hair unit up to normally a 4 hair follicular unit

Post Op Healed Donor Region via FUT

Post Op Healed Donor Region via FUT

The length of the strip is determined by a few factors, the number of grafts or FU´s required the density of hair naturally in the donor area and importantly the skin or scalp laxity. Laxity is basically how tight or loose the skin is; how much can you pinch or how much the skin can move when massaged

Especially with advanced hair loss the demand for hair will be high to be able to treat the surface area; ideally being able to treat as larger surface area as possible to achieve a balanced coverage in one pass

The strip removed can run from one side of the head, around the back and to the other side, running along the occipital bone, the protruding bone you can feel on the back of the head; the hair density can be calculated and then the dimensions of the strip calculated

A balanced size strip is required to help with a tighter, neater closure, length against width; therefore the scalp laxity is important. With a tighter scalp laxity it may be required the strip length is longer to compensate for the tight laxity; whereas good laxity can allow for a wider strip, still allowing for the length and achieving a higher graft count as required

On a good candidate it can be possible to achieve 6000 plus grafts from a single strip and performed in a single day procedure; dependent on the design and hair loss stage can give total coverage with a natural looking density. The average hair transplant patient can achieve around 4000 grafts in a single procedure which can still repair advanced hair loss stages in one procedure

The closure of the strip, bring the two sides together to achieve a neat closure line and healing also relies on the laxity; there is a fine balance and cosmetic surgical skills have allowed for larger strips to be harvested and still achieve a neat closure and good long term healing

An irony can be that tighter laxity can allow for a neater closure of the line, whereas “flabby” or loose laxity can create stretch back; the technical ability and understanding by the doctor is important

The strip area can be stapled or sutured, such depending on the technique preferred by the doctor; either way these will need to be removed around ten days post-operation, with instructions from the clinic. Tight or loose scalp laxity some due care needs to be applied by the patient during the healing; some tension will be felt in the first few days and it is recommended that no heavy lifting on physical activity is taken that can put a strain on the area; the time frame can differ per person, week to months so always take the advice from your clinic

Healing is important as after the first procedure the laxity will change, so future procedure size will largely be determined by the change in skin laxity, being able to remove the first strip scar by englobing with the second to leave only a single line


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