Modern hair transplantation is a procedure that utilizes microscopic dissection and implantation to relocate hair follicles from the back and sides of the head to the thinning or balding areas of the scalp. Modern hair restoration techniques implant individual follicular units in a fashion that creates the fullest density possible and the most pleasing natural result possible.
Hair Restoration & Hair Transplants FAQ
Below are some of the frequently asked questions that Drs. Feller and Bloxham receive from patients. For further questions or inquiries, please contact our NY office directly at (516) 487-3797.
What is hair transplantation?
What results can I expect?
The results of your hair transplant procedure can depend on a variety of factors which include the supply of hair follicles in your donor area, your remaining hair, your individual skin characteristics, and the type of hair transplant procedure that is available to you. Your surgeon must seek age-appropriate results that account for possible hair loss in the future.
What is FUE?
FUE is an abbreviated term for Follicular Unit Extraction (although in 2018, leaders in the hair transplant industry have changed this definition to mean Follicular Unit Excision- a change which Drs. Feller and Bloxham support). It is a hair transplant technique in which the surgeon takes individual follicular grafts from the scalp one-by-one using specialized tools rather than all at once in a strip (FUT). While FUE is an excellent procedure for some patients, it is not recommended to all patients as the growth rates and overall results tend to be lower when compared to the strip procedure (FUT).
What is mFUE?
mFUE is an abbreviated term for modified FUE. It is the middle ground between FUT and FUE. Rather than a long donor strip being taken as in FUT, smaller strips are taken leaving large untouched areas of scalp between them. This eliminates a long donor scar, but also avoids most of the lower yields commonly expected with FUE procedures.
During an mFUE procedure, small groupings of follicular grafts are identified, isolated, and removed painlessly. The grouping is then cut into individual follicular units using the same microscopic dissection technique utilized in FUT and FUE. The holes created are then closed with a few stitches or staples, thus creating small “dash” scars in the donor region that are easily concealed by surrounding hair.
Many quality follicular units can be removed in one grouping, so patients are left with a small number of “dash” scars (only millimeters long) compared to hundreds or thousands of circle scars from FUE. More importantly, mFUE grafts do not undergo the trauma FUE grafts do and therefore tend to grow FAR better than standard FUE grafts.
What is FUT?
FUT is an abbreviated term for Follicular Unit Transplantation. It is also properly termed “strip procedure.” After the skin in the back of the head is numbed, a long but thin strip of hair-bearing skin is removed. This strip is then divided up among our in-house technicians and are dissected into follicular units which is just a fancy way of saying small hair root groupings. The remaining open skin in the back of the head is instantly stitched closed and heals within 8 days.
The hair around the strip area is left long so it will conceal the stitched area almost immediately. 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 slits in the scalp, called “recipient sites,” into which the grafts are placed.
It is important to note that whilst this procedure may SEEM much more invasive compared to the FUE technique, it produces higher yields, more consistent results, and creates less damage in the donor. As such, the overwhelming majority of hair transplant experts consider FUT to be the industry gold standard. It is usually best to begin the hair transplant process with one or two strip (FUT) procedures and then using FUE when the strip procedure is no longer an option. This has become the industry’s standard protocol.
How long does the hair transplant procedure take?
The length of your hair restoration procedure is dependent on the technique used and the amount of grafts placed. Strip procedures of 4,000 grafts or more can now be completed in one day. However, FUE procedures are very labor intensive and require more time to extract individual follicular units with minimal damage. Typically, FUE procedures over 1,500 grafts will require more than one day to complete. mFUE procedures can be completed in one day. In most mFUE cases, the excision process usually only takes about 30 minutes which makes it lightning fast compared to any FUE procedure and makes it the favorite for most patients when deciding between FUE and mFUE cases.
How much does hair transplantation cost?
Hair transplant costs can depend on the number of grafts required or the type of procedure. Please consider our costs for a more comprehensive explanation of Feller & Bloxham Hair Transplantation fees and cost structure.
How long does the new hair take to grow?
Transplanted hair will usually begin to grow by 4 months, usually in the form of stubble or very short hair. By 8 months, the growth should be blatantly obvious to the casual observer as a pleasing and significant cosmetic difference. By 18 months, the new hair is usually fully matured to the point no more growth or thickening is expected. Every head is unique: some people see huge growth at around 6 months, for some people it may take 20 months. The growth rates depend on each individual’s physiology. Some patients may not even grow a significant amount of hair due to their personal physiology. It’s rare, but it does happen and is a risk every patient takes.
It is normal for newly-transplanted grafts to fall out after 2 weeks. The actual follicular unit is still intact, and as new individual nerves begin to regrow by month 4, new hair will begin to sprout and mature.
What about scarring?
FUT, FUE, and mFUE procedures all leave some form of scarring. Anybody who claims that FUE in particular does not leave scars is being misleading. Anybody who says Strip scars are huge is also being misleading. Here is the reality:
FUT (Strip) leaves a thin scar that extends from right to left in the back of the head. This scar may stretch, but most only remain between 1-3 mm wide. No matter the stretch or lack thereof almost all strip scars are concealed from the day of surgery by surrounding hair.
FUE- leaves tiny circular scars. The upside is that if the procedure is under about 1,200 grafts it’s difficult to detect the scars even with short hair. The downside is that the donor area may become significantly thinned to the point even the casual person standing in line behind you may notice. In FUE megasessions this is a virtual guarantee which is why patients who need great numbers of grafts should start with FUT (strip). It grows better, causes less donor damage, and is easy to conceal right after the procedure.
The mFUE technique leaves small “dashes” spread throughout the donor area that may be concealed by surrounding hair right at the end of the procedure.
Scarring is also impacted by the individual’s physiology. Some people will naturally scar more than others. Drs. Feller and Bloxham will create the smallest and least noticeable scar possible.
What is a typical surgery day like?
On the day of the surgery, you will arrive at the clinic at 7:45AM. One of the physicians will discuss the surgery to be performed in detail and answer any questions or concerns you may have. After doctor and patient have reached an agreement on what can be done, photographs are taken to be used for comparison after the hair grows. Please also refer to our pre-operative instructions.
You will then be taken to have your donor region anesthetized to ensure no pain during the procedure. Once the area has been numbed, your scalp will be tested to make sure you are free from pain.
If you are having an FUT (strip) procedure you will sit up in the chair and may use your smartphone. The doctor and staff will stand behind you and remove the strip. You will likely have no idea he’s doing anything while you text your family or just watch a movie. This part takes about 30 minutes.
If you are having an FUE procedure, you will be laying on your stomach and the doctor will remove grafts one by one using a punch tool. This process will take 3 or more hours depending on the desired number of grafts to be obtained.
Usually you will be given a lunch break to eat, stretch, use the bathroom, or just walk around. We order in food from local delis and restaurants. Your hair transplant day should not be used for dieting, so order something tasty.
No matter which procedure is used, once the grafts are out, they are placed under microscopes by an army of technicians who will dissect out the hair follicles and check for quality and damage.
The grafts are then re-implanted into the thinning areas. Then the scalp is washed and bandaged with something that looks like a tennis headband and you can go home. You will remove the bandage yourself the next day, and take a shower being careful to follow our care instructions.
What about after the surgery?
All patients are given postoperative instructions. General recovery instructions advise patients to sleep upright (usually at a 45 degree angle) for the first 3 nights. The new grafts will be locked in after 3 days, after which you can touch them freely.
It is normal for your recipient sites to scab over a few days. The scabs will eventually flake off and any redness or soreness will typically subside over the next two weeks.
Feller & Bloxham Hair Transplantation recommends using any holidays and/or vacation hours 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 have these removed for you in our Great Neck, NY office. If you live far away, we can give you a staple/stitch removal kit to take with you. Just ask your local doctor to do the removal.
Hair Growth Times
It’s important to remember that all patients are different and no two will “mature” in exactly the same way. 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
Additional maturing may take 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. Their assessments may differ from the chart above, but the general consensus will be that you need to wait at least 12 months before assessing your hair transplant results.