Modern hair transplantation is a true microscopic skilled and artistic procedure which requires only the best surgeon to achieve the natural results seen today. It involves taking hair follicles from the very back and sides of the head and strategically placing them into the thinning or balding areas of the scalp. In today’s modern age of hair restoration you should only consider the current gold standard of taking individual follicular units and placing them in a fashion which creates the fullest density and the most pleasing natural result.
Frequently Asked Questions
What is Hair Transplantation
What results can I expect?
Results from hair restoration truly depends on several factors which many people don’t fully appreciate. It depends largely on the supply of hair follicles in the donor area at the back of the head; the natural density of available hair will determine how many individual hairs can be place in the balding areas. The more density you have the thicker and fuller the result. The hair transplant should be done ethically, meaning the surgeon must seek age-appropriate results with the prudence to have enough supply of donor area for possible future loss.
What is FUE?
FUE is an abbreviated term for Follicular Unit Extraction. It is a hair transplant technique whereby the surgeon takes individual follicular grafts using specialized tools such as the Feller manual or motorized extraction device — designed and created by Dr Feller himself. FUE has advantages and limitations which determines whether the treatment is appropriate for the individual.
What is mFUE?
mFUE is an abbreviated term for modified FUE. The procedure seeks to do one simple thing: offer patients the reliable “gold standard” results of FUT without the linear donor scar. During an mFUE procedure, small groupings of follicular grafts are isolated and superficially cut around with a larger FUE punch tool. The grouping of grafts is gently lifted and scissors or a small blade is used to carefully cut around the follicles – thus freeing the grouping of grafts. The grouping is then cut into perfect individual follicular units using the same microscopic dissection technique utilized in FUT. The holes created with the punch tool are then closed with a single stitch or staple, thus creating small “dash” scars in the donor region. Many quality follicular units can be removed in one grouping, so patients are left with a small number of “dash” scars (millimeters long) compared to hundreds or thousands of circle scars from FUE. And in return, they avoid the lower yields and less consistent results associated with traditional FUE.
What is FUT?
FUT is an abbreviated term for Follicular Unit Transplantation. The procedure consists of taking hair from the donor area at the back of the scalp, but the difference compared to FUE is that the donor area is taken in the form of a “strip.” This literally means cutting a long and thin section of the actual scalp after extensive anesthesia (during which the patient will not feel anything). Once extracted, the donor strip is cut into many individual follicular units using microscopic dissection techniques. As these follicular unit grafts are being prepared, the doctor makes tiny holes in the scalp, called recipient sites, where the grafts are placed. It is important to note that whilst this procedure seems much more dramatic or invasive compared to the FUE technique, it produce higher yields, more consistent results, and creates less damage in the donor. Thus, it is considered the “gold standard” in the hair transplant industry.
How long does the procedure take?
This is dependent on the procedure and the amount of grafts placed. Strip procedures of 5000 grafts plus can now be completed in one day; FUE procedures take much more time, as it is very labor intensive and each follicular unit must be extracted skillfully to minimize damage. Typically FUE procedures over 1,500 grafts will require more than one day to complete to a high level. mFUE procedures can be completed in one day.
How much does it cost?
This is dependent on the number of grafts required and the type of procedure. Full costs can be seen here
How long does the new hair take to grow?
Transplanted hair takes up to 18 months to mature to its final and permanent integrity. Each person is unique; some people see huge growth at around 6 months, some people take 12 months. The growth rates come down to individual physiology. Newly transplanted grafts will actually fall out after 2 weeks; this is normal. The actual follicular unit is intact, making nerve and blood supply connections and eventually these start sprouting and maturing from 2-3 months and continue to grow to about 18 months – when you can expect the ultimate final result. It is important to understand the expectations of growth and to not feel any anxiety during this time.
What about scarring?
FUE, FUT, and mFUE will all leave some form of scarring. FUE will be in the form of small, circular punch holes which are difficult to detect due to the uniform spread of donor sites. With FUT there will be a linear scar; however at Feller and Bloxham Medical we use the trichophytic closure technique. This method creates a bevel which basically allows a neat overlap of the two donor scars when they are joined to reform the scalp. The beveled edge allows a much neater scar line and also allows hair follicles to grow through the scar, thus softening any potential scaring even further. mFUE, on the other hand, leaves small “dashes” spread throughout the donor. Once again scarring is down to the individuals own physiology. Some people will naturally scar more than others. Feller and Bloxham Medical will create the smallest and least noticeable scar possible.
What would a typical day like for surgery?
On the day of the surgery you will arrive at the clinic at 7:45AM. You will then discuss with Dr Feller and Dr Bloxham the expectations and final design of where the transplanted hair will be placed. Pictures will be taken and the final expectations agreed upon by both you and the doctors. You are then taken into a room where your donor region will be anesthetized along the area where the donor supply will be taken from. Once the area has been numbed, your scalp will be tested to make sure you are free from pain.
The donor area will then be removed whilst you watch TV, use your smart phone, or read. The experience is very calm and pain free. After the donor supply has been harvested, the transplant team take the follicles and then begin trimming them and organizing them into 1,2,3 and 4 hair grafts for strategic placement into the recipient sites. Whilst the technicians are looking after the grafts, Dr Feller and Dr Bloxham will then create the recipient holes for the grafts to be placed into. Once the grafts are ready they are then strategically placed into the scalp where the holes have been made. The key to a natural and artistic result is the placement of different hair grafts into the scalp.
You will have some lunch (which you will order in the morning before the surgery begins). Once the final graft is placed the scalp, the donor area and recipient sites are thoroughly washed and cleaned several times. A bandage is then placed around the donor area and pain medication is prescribed for a number of days. Your surgery is then complete and you are free to go home.
What about after the surgery?
After the surgery you are given post-operative instructions, but in answering the common questions here:
You will need to try to sleep as upright as possible (usually at 45 degrees) for the first 3 nights. The new grafts will be locked in after 3 days and you should not feel too anxious touching them. Downtime can be up to 2 weeks, but it is an individual thing.
Your recipient sites will possibly scab up over a few days, but this is normal. They will eventually flake off, and any redness and soreness will subside over the next two weeks as well. It is now out of your hands and there is nothing you can do but allow nature to start working its magic.
It is advisable to use any holidays and or time off if you are concerned about your appearance during this time. After 10-14 days your staples/sutures are ready to come out (if you had a strip or mFUE procedure). If you are local to the clinic you can come in and have these removed for you. If you have access to a health care professional in your home town, the clinic can give you a staple remover to remove he staples.
The following was written by our U.K. representative, Spencer “Spex” Stevenson:
It’s important to remember that all patients are different and no two will “mature” in exactly the same way. But on average, hair transplants mature as follows:
3 months – beginning of new growth (10% maturation max)
4 months 20% maturation
5 months 30% maturation
6 months 40% maturation
7 months 50% maturation
8 months 60% maturation
9 months 70% maturation
10 months 80% maturation
11 months 90% maturation
12 months 100% maturation
With additional maturing up to 18 months. Please note that percent refers to the amount of growth compared to the final, matured result.
Many doctors have commented on time scales for growth. Even if their assessments differ from the chart above, all agree that you need to wait at least 12 months before assessing your hair transplant results.