Hair Transplant Technique: FUT, FUE or Both?

When deciding on the technique to best use; remember:

The harvesting method is not a matter of taste but a matter of necessity. Every patient has different characteristics and these should be taken into account when deciding on the best technique that should be employed

To gain the best long term result it must be thought about from the first session, then the optimum and maximum utilisation can be made of the donor area as it is untouched and has the greatest potential. Prior to surgery the donor and recipient area will have their best properties; the donor having the best density, laxity, no scarring and the recipient has also never been touched or impaired

Achieving high numbers is not only about the characteristics of the patient. The Doctor´s & Medical Team must be able to work together efficiently and with high skill to ensure graft survival and patient care is the priority

The hair loss pattern will determine the number of grafts required to cover the surface area. Each technique has pros and cons and before deciding on the technique to first use it is important to access the long term donor management.

If hair loss has progressed to an advanced state the need for grafts is high to cover the surface area. The larger the surface area the harder it is to treat the entire area in one procedure with either technique

The options is to treat the area over multiple procedures, starting with the hair line and working back over the frontal third and mid-section and later to treat the crown; this will require maybe 2-5 procedures dependent on technique and the quality of the donor resources

There are 2 recognised hair transplant techniques in use today, the FUT and FUE techniques. They differ mainly in the donor management and the manner the follicular units are removed from the scalp

Utilising the benefits of both FUT and FUE and combine the techniques to maximise the graft numbers in a single procedure; allowing for the potential to reach total coverage and possibly a “home run” result

By combining the two there is the potential to reach in excess of 8000 grafts on a good candidate; on an average candidate that would maybe only achieve 4000 grafts increase the number to 6000

Combining the techniques can also be of great benefit to repair hair transplant candidates; when the donor area has been impaired by improper previous surgery. Being able to remove a strip and widen the extraction zone at the same time can provide the maximum graft numbers to correct the pattern of hair growth over the recipient area


One Pass Hair Transplants

For individuals with a high Norwood pattern, Nw4 and above a normal goal is to cover as much of the balding surface area as possible and ideally in a single session to achieve a result in one pass

The terms Mega and Giga sessions have been used to denote the large movement of grafts in a single session; much is dependent on the quality of the donor zone characteristics on how many grafts can be removed safely and maintain the quality of the donor area as best as possible

Individuals suffering from advanced Male Pattern Baldness (MPB) will require anything from 4000 to maybe as much as 8000 plus grafts or follicular units to achieve total restoration; some candidates will not be able to achieve these numbers due to deficiencies in the donor hair safe zone, other may require multiple sessions

Technical ability and planning is required to ensure the grafts can be harvested, divided into the natural follicular units, the recipient sites made and the placement of the grafts administered efficiently. This requires a skilled team that work together and understand each other’s role within the process

A hair consultation can measure the quality of the donor safe zone and the recipient area to be covered, from this the plan can be made; when researching always request to see a number of results the clinic has achieved with high graft numbers to ensure they have a consistency and proven track record in achieving restoration on advanced hair loss candidates

A master plan must be made between patient and doctor to ensure this can be achieved and if there are any compromises they are calculated and agreed upon; for example the overall density that can be placed from hair line to crown

The patient must also be prepared when undergoing a large hair transplant procedure; the day will be relatively long and the individual will need the virtue of patience to allow the medical team to perform the operation with efficiency but care

Prior to any surgery the donor and recipient area will have their best properties; the donor having the best density, laxity, no scarring and the recipient has also never been touched or impaired.

Large hair transplants when performed to the highest standard allows the individual to achieve the maximum aesthetic result in the shortest time frame, less down-time away from work and excuses to friends, family and colleagues, as well as it being financially more agreeable to the wallet.

What Influences The Decision For Surgical Hair Restoration


What Influences The Decision For Surgical Hair Restoration

Hair loss can be an emotive issue for many, men and woman, the desire to look and feel young, not ageing maybe beyond our years and attractive, to feel good about one´s self

As hair loss affects individuals in different ways there is no right or wrong answer to whether hair restoration is essential, to one it may not have any influence on their life, but to another it can be traumatic and impact greatly how they socialise

Hair transplantation can be an excellent method or hair restoration, but it is not a miracle cure and does have limitations; the largest being the donor resources are finite, if hair loss progresses it can be harder to reach total restoration unless your hair characteristics are good and a correct plan is made to deal with progressive hair loss

The timing of a hair transplant will also play an important role, age, current hair loss pattern, potential for future loss have to be considered on an individual basis. A good start is to research a number of doctors and clinics, how they approach hair restoration

Peer pressure is something that surrounds us every day, from sales marketing to what friends, family and business colleagues say and do and how it is perceived we should or should not live our lives

No one should influence you when deciding to undergo surgical hair restoration, or for that matter certainly any elective cosmetic surgical procedure; the decision should be yours alone.

If you wish to tackle hair loss the decision should be yours with the first steps to take in researching the various options available, medications, non-surgical and hair transplant restoration

Collate the information from as many sources as possible; it is very possible that much will contradict each other; if so ensure you qualify your research as to why answers to your questions differ

As hair loss can be emotive it can be hard to be logical and easy to make a decision emotionally without thinking the consequences through; especially in the early stages of hair loss and especially when younger

It must be remembered that making an emotional decision usually leads to wishing for everything to be returned to before; and a hair transplant may be able to deliver this in the short term but as hair loss progresses this becomes impossible, especially if the progression advanced to a high Norwood pattern

From the first procedure a long term plan should be taken, especially if the hair loss pattern is minor with the potential for it to advance; using a relatively high % of the donor in a small area will hamper future restoration and achieving a balanced natural coverage


Realistic Results From A Hair Transplant

Prior to undergoing surgical hair restoration it is important to understand a hair transplant is not a miracle cure; as positive it can be on the right candidate it does have limitations that cannot be overcome

As tempting as it maybe to jump into hair restoration it is always better to take a step back and rethink your goals long term. A hair transplant is not something that can be reversed if you do not like the result

Understanding the limitations and accepting them it is then possible to set your goals accordingly; this will go a long way to ensuring your long term happiness and well-being, and not being another “repair case” statistic.

The goals of the individual have been met but what happens as hair loss progresses over the years and the balance of hair to bald area becomes disproportionate and unnatural with a hair line fixed in a low position

Of course it is possible to have multiple hair transplant procedures but the donor hair is a finite resource and needs to be managed well to ensure the maximum number of follicular units can be safely removed as hair loss advances

As the donor hair is key to the long term result, especially as hair loss is progressive over our lifetime, it is essential to have a clear plan in the worst case scenario what the donor resources can give

Have the donor hair density measured, calculated the approximate average hair to FU count, good, bad or fair hair characteristics, skin healing and laxity, donor safe zone size, the best techniques to use now and in the future

How realistic your goals are in relation to your hair characteristics and potential for advanced hair loss. A man in his early/mid 20´s with minor hair line recession wanting to rebuild the hair line to its original position; can this be achieved? Yes of course, with a relatively minor number of grafts the hair line can be rebuilt, 1000-1500 FU´s needed.

A common response is “I will shave if I do not like the result or cannot have more procedures”; shaving is rarely an option as there will always be some signs a surgical procedure has been performed. This is not a good plan to enter into surgical restoration with.

Create a plan based on these qualities and then review your goals to ascertain whether at your stage of hair loss now your goals can be sustained over the longer term as the hair loss advances. Be aware that to rely solely on family “hair history”, especially at a younger age is ill-advised as hair loss does not always follow the genetic pattern of our paternal, maternal or siblings; it is a guide only.

In the early stages of hair loss important factors such as potential for future loss, recipient surface area, the size of the donor safe zone are impossibly to determine accurately. In more stages of hair loss compromises may be required on hair line placement.

It is important to be realistic and objective, if your goals cannot be met and the reasons are explained logically it is sensible to come to terms with this and either not undergo a hair transplant or revaluate your goals to fit with what is possible with the hair resources available.


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4894 FUT Hair Transplant Result

FU’s               Hairs
1.       575                     575
2.     3412                  6824
3.       655                  1965
4.       252                  1008

Total  4894              10,372    2,12/FU

Before Any Hair Transplant Surgery

4894 Graft Placement Before and Grown Out Result. 4894 FUT. Hattingen Hair, Switzerland 1 Before and Grown Out Result. 4894 FUT. Hattingen Hair, Switzerland 2Before and Grown Out Result. 4894 FUT. Hattingen Hair Transplantation, SwitzerlandBefore and Grown Out Result. 4894 FUT. Hattingen Hair Transplantation, Switzerland 5 Before and Grown Out Result. 4894 FUT. Hattingen Hair Transplantation, Switzerland 4  Hair Line Reconstruction. Hattingen Hair Transplantation, Switzerland

Ways To Achieve Coverage And Fullness From A Hair Transplant

As we cannot replace like for like hair lost with a hair transplant it is vital to gain the most coverage from each hair as possible, especially as the donor resources are finite. The art of a hair transplant is being able to distribute the hair available so even high levels of hair loss can be treated

As well as coverage achieve a natural looking density. There are a few “tricks of the trade” to achieve maximum coverage and density with a limited number of follicular units available

Since each follicular unit group varies in size, from one to four hairs we use different blades to create custom reception slits of varying width and depth to the follicular units. The width of the blade is very small, about 0.6-1 mm

This can be easily demonstrated by holding out a blade of grass and watching the curvature of the blade, up or down

This can be easily demonstrated by holding out a blade of grass and watching the curvature of the blade, up or down

Our use of custom-made instruments also promotes speedier healing in the recipient area; the use by some of standard tools have to be large enough to facilitate the larger FU´s so do not take into consideration the variant in sizes or depth of the slit that needs to be made.

Custom blades allow for greater precision of placement, allowing for larger sessions to be performed and higher densities placed, whereas standard tools restrict the density that can be placed due to circulatory disorders when trying to place too high a density

Watching the natural curvature ensures maximum coverage from each hair, allowing the hair to blend with the native hair more effectively; even with a shorter cut the curvature does not oppose the surrounding hair

Even a straight hair has a curvature, the lay of the hair when it is held up or when in the scalp will always fall in a certain direction when it exits the scalp, normally facing downwards. The hair curvature is different from the angle or orientation of the hair or when the slit is made; the curvature is seen when the hair is placed in the recipient area

Controlling the curvature has three major benefits:

1. it will blend with the surrounding hair and not give the appearance of misdirected hairs

2. It will allow each hair to give greater coverage allowing for fewer grafts to be used over an area of the recipient zone

3. Ensure more fullness or density can be achieved as the hairs are laying in a uniform pattern

Controlling these aspects will help in achieving the maximum coverage and density possible with the minimum number of grafts; this is good donor management as it reduces the amount that has to be extracted and preserves the donor in the best possible condition; also allowing for future sessions if hair loss continues


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Hair Meds Or Hair Transplant?

Dependent on whether you use medications will have an influence on how the doctor plans your hair restoration, along with your age and hair loss pattern now and potential in the future

Before deciding on what approach for either hair retention or hair restoration it is vital to always research well and choose the best option for you at that time but with your long term well-being in mind.

The decision should not just be based on what you would like most as a result but what result is sustainable over time. Much will depend on the age of the individual and the hair loss pattern they have

Timing is very important when considering a hair transplant, treating minor hair loss at a young age can lead to problems in the future if the hair loss progresses aggressively and you cannot sustain a balance natural restoration

A Mature Hair Line Or The Start Of Male Pattern Baldness

A Mature Hair Line Or The Start Of Male Pattern Baldness

It is important to understand that surgical hair replacement without medical therapy may not provide a suitable result, dependent on your hair loss stage and future loss. Planning is important before deciding on a hair transplant, whether you intend to use hair loss medications or not, and having an open and honest dialogue with your doctor.

There are three FDA approved medicated treatments and therapies for treatment of hair loss, although FDA approved it must be understood there is no miracle cure and results can vary from person to person, and always consult a specialist before using

Combining medications and surgical hair restoration is an option; this can have the benefit of potentially reducing the size of the operation required and sustaining much of your natural hair growth

When consulting a hair loss or hair transplant doctor be clear whether the intention is to use a treatment programme long term after a hair transplant has been performed as this will have a bearing on the approach and master plan the doctor makes in your restoration

Dependent on the individual´s hair loss pattern some clinics may advise to wait before undergoing a hair transplant, either use medications or simply allow the hair loss pattern to mature a little more

This allows for the potential hair loss pattern to be easier identified and making long term planning easier; also allowing for the individual and doctor to agree on the goals and set out a plan, hair line design and coverage

Surgical hair restoration for the correct candidate can help restore hair permanently to areas that have suffered from hair loss; but it is not a miracle cure and will not prevent future hair loss of the native hair

Hair Transplant Education   Hair Transplant Patient Results

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