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FUT Hair Transplant

Strip Harvesting, most commonly known as Follicular Unit Transplantation (FUT) involves the removal of a strip from the safe donor area located at the back of the head. The strip is then dissected into individual hair follicles before being transplanted in the recipient area. Even though it may sometimes have its advantages, the FUT method is not preferred by most dermatologists as it leaves a linear scar at the back of the head. It also has a longer recovery period which might not be suitable for individuals looking to get back to work more quickly.

Understanding FUT Hair Transplant

For those on a quest to regain a full head of hair and renew their self-confidence, FUT hair transplant is a term that often surfaces in discussions about hair restoration. But what exactly is FUT Hair Transplant, and how does it work?

FUT, or Follicular Unit Transplantation, is a surgical hair restoration procedure designed to combat hair loss and restore natural-looking hair. At the heart of this hair transplant procedure lies the concept of utilizing the patient’s own hair to fill in areas affected by baldness or thinning hair. The FUT hair transplant process begins by selecting a donor area, typically the back or sides of the head, where hair follicles are resistant to the balding process. A strip of hair-bearing skin is carefully removed from this donor area. The skilled surgical team, like those at Civas Hair Transplant Clinic in Turkey, then dissects this strip into individual follicular units under powerful microscopes. These follicular units, also called FUs contain one to four hair follicles and they are the building blocks of the new hairline.

The FUT hair transplantation method is no longer preferred in the hair restoration community. This is mainly due to the large linear scar created at the back of the head. FUE hair transplant procedures, which are less invasive and cause minimal scarring, are preferred over FUT hair transplants.

What Are Follicular Units (FUs) in FUT Hair Transplants?

For years, the science of hair growth has been thought to involve individual strands emerging from the scalp. However, a closer examination reveals a fascinating truth: scalp hair actually grows in tiny little groups of 1 to 4 hairs each, known as “follicular units” or FUs. Surprisingly, even after doctors learned about the existence of these groups, they didn’t initially consider their potential in hair transplants.

To observe FUs, one can take a closer look by clipping the hair short, to approximately 1 millimeter, and examining the scalp under 30X magnification using an instrument called a densitometer. Under these conditions, the follicular units become readily visible. What makes FUs particularly intriguing is that they are complete anatomic and physiologic structures. Preserving them intact during a hair transplant procedure is crucial for ensuring their maximum survival and optimal growth.

Despite their significance, it’s important to note that FUs are very small structures, requiring precise handling. Only a skilled and experienced surgical team, like our team at Civas Hair Transplant Clinic in Turkey, can guarantee their preservation and protection from damage during the various phases of the hair restoration process.

Advantages of Follicular Units during FUT Hair Transplant

A major advantage of utilizing follicular units (FUs) in hair transplant surgery lies in the ability to keep recipient sites as small as possible. This small size enables the safe placement of recipient sites in close proximity on the scalp, enhancing both the natural appearance and overall hair density. Additionally, it allows for the transplantation of larger numbers of grafts in a single hair restoration session without causing harm to the scalp or jeopardizing its blood supply.

The number of hairs contained within each graft is also important. FUs, with their closely packed hairs, facilitate the transplantation of the maximum number of hairs into the smallest possible recipient sites, resulting in optimal fullness. The use of these compact units maximizes the density of grafts that can be transplanted in a single session and the number that can be employed simultaneously, contributing to successful and densely packed results.

Another advantage of FUs is that they replicate the natural growth pattern of hair, they ensure that transplanted grafts do not appear pluggy, contributing to a seamless and genuine look. However, it’s essential to emphasize that while FUs prevent a pluggy appearance, their proper placement in terms of direction and distribution is crucial for achieving a completely natural and harmonious outcome in hair restoration. Using grafts larger or smaller than follicular units can compromise the desired naturalness and density, respectively.

The FUT Hair Transplant Procedure: Step by Step

Step I: Administering Anesthesia Before FUT Hair Transplant

The first step in a FUT hair transplant is the administration of anesthesia. The patient is given local anesthesia to numb both the donor and the recipient areas. This is to make the hair transplant process as painless as possible for the patient.

A significant breakthrough in FUT hair transplant involves the application of tumescent anesthesia. Tumescent anesthesia refers to the expansion of tissues through the injection of fluids. In this method, highly diluted anesthetic fluid is injected into the fat layer of the donor area on the scalp. This innovation enhances the comfort and effectiveness of FUT hair transplant procedures.

This serves a number of purposes. Firstly, it helps reduce bleeding by exerting pressure on small blood vessels (capillaries). Secondly, it firms the skin, making it easier to control incisions. Lastly, it increases the distance between the follicles and the deeper scalp tissues, optimizing the surgical process for FUT hair transplants.

Additionally, this technique aids the surgeon in maintaining a superficial incision, thereby avoiding damage to the larger nerves and blood vessels within the scalp and preventing the cutting of the fascia. The fascia is a layer of fibrous tissue located just beneath the fat layer, providing essential support to the scalp. Avoiding damage to the fascia during FUT hair transplant is crucial, as it significantly reduces the risk of developing stretched scars after the procedure.

Step II: Prepping The Donor Area for FUT Hair Transplant

Before embarking on a follicular unit transplantation (FUT) hair transplant procedure, meticulous preparation of the donor area is essential. The donor area, typically located on the back or sides of the scalp, where hair follicles are genetically resistant to balding, plays a pivotal role in achieving a successful FUT hair transplant.

To ensure the success of the hair transplant surgery and minimize the scar from the donor incision, a narrow strip of hair from the donor region is first shaved. This strip is carefully selected to ensure minimal impact on the patient’s appearance post-surgery, allowing them to keep their hair relatively short after the procedure if desired. Moreover, a fine donor scar enhances the potential for harvesting (removing) a greater number of grafts in subsequent procedures. Once the strip is removed, the remaining hair conceals the incision, making it discreet and virtually undetectable.

Step III: Stereo-Microscopic Graft Dissection for FUT Hair Transplant

The most critical step in the FUT hair transplant procedure is the stereo-microscopic graft dissection. During this phase, the donor strip harvested from the back of the hair transplant patient is carefully examined and dissected under a stereo-microscope. In a successful dissection, the follicular units should be removed from the donor strip without being damaged. It is essential to maintain the vitality and integrity of the follicular units during this process as this will maximize hair growth.

Intact FUs not only ensure maximum growth but also contribute significantly to achieving hair fullness. Each intact unit contains the natural complement of 1 to 4 hairs, enhancing the overall volume and density of the transplanted hair. The donor strip, typically measuring approximately 1 centimeter in width and varying in length depending on the required number of grafts for the hair transplant, holds the key to these remarkable transformations.

On average, a patient’s scalp has approximately 90-100 follicular units per cm2 of donor tissue. Therefore, a 2000-graft hair transplant would require an incision of approximately 1cm (width) x 20cm (length).

Step IV: Creating Recipient Sites During FUT Hair Transplant

At Civas Hair Transplant Clinic, we prioritize precision and technique to ensure the best outcomes for our patients. The recipient sites in all of our hair transplantation procedures are meticulously crafted using lateral slits, also known as coronal or horizontal slits. This approach offers a distinct advantage by aligning the transplanted hair follicle within the follicular unit to mimic its natural growth pattern. This careful orientation provides our surgeons with the highest degree of control over the direction and angle at which the transplanted hairs will ultimately grow, resulting in a remarkably natural appearance after a hair transplant.

In addition to the strategic use of lateral slits, controlling the depth of incision is of paramount importance during the creation of recipient sites. By making incisions of limited depth, we minimize the risk of injury to the deeper blood vessels in the scalp. This not only ensures the safety of the hair transplant procedure but also allows us to place grafts more closely together, thereby maximizing the density of transplanted hair. Reduced tissue swelling after the hair transplant surgery and enhanced healing are additional benefits of this careful approach.

To achieve these precise recipient sites, we employ fine hypodermic needles or a series of custom-made, ultra-fine blades. These chisel-shaped blades are available in various sizes, differing by increments of one-tenth of a millimeter. This comprehensive range accommodates the diversity of grafts, from single-hair grafts to 4-hair follicular units, with blade sizes ranging from 0.6mm to 1.2mm. Our commitment to utilizing the most advanced tools and techniques ensures that each patient receives a tailored and exceptional FUT hair transplant experience, resulting in natural, long-lasting results.

STEP V: Implantation During FUT Hair Transplant

Implantation is a crucial phase in the FUT (Follicular Unit Transplant) hair transplant procedure, where the harvested hair grafts are delicately placed into the recipient sites created earlier. At Civas Hair Transplant Clinic in Turkey, our commitment to precision and expertise ensures that this step is executed with the utmost care to achieve the most natural and satisfying results for our hair transplant patients.

The recipient sites, crafted with lateral slits during the initial phase, serve as the precise map for graft placement. These lateral slits are meticulously designed to match the natural direction and angle of hair growth. This level of precision is paramount as it enables the transplanted hairs to seamlessly blend with existing hair, creating a remarkably natural appearance.

The meticulous placement of grafts not only guarantees a natural appearance but also maximizes the density of transplanted hair, ensuring that the final result of the hair transplant meets the patient’s expectations. This careful attention to detail, from the creation of recipient sites to the implantation of grafts, is a testament to our commitment to excellence in FUT hair transplant procedures. Using our expertise and advanced techniques, surgeons at Civas Hair Transplant Clinic aim to provide our patients with the confidence and satisfaction that comes from a successful and natural-looking hair transplant.

Dr. Ekrem Civas

Dr. Ekrem Civas

He is Board Certified in Dermatology and member of Fellows of the International Society of Hair Restoration Surgery (FISHRS).

Dr. Umit Akpinar - Hair Transplant surgeon

Dr. Umit Akpinar

He graduated from the Hacettepe University Faculty of Medicine department in 2015 with a degree as a high honor student.

Techniques To Minimize Scarring During FUT Hair Transplant

When it comes to minimizing donor scarring in FUT hair transplant procedures, several advanced techniques have been developed to ensure that patients not only regain their hair but also experience minimal scarring, enhancing their overall satisfaction.

One of the primary techniques used to minimize donor scarring during a strip excision in FUT hair transplants is the application of tumescent anesthesia. This specialized anesthesia not only ensures patient comfort during the hair transplant procedure but also helps in minimizing bleeding, reducing tissue trauma, and subsequently limiting the extent of scarring.

Another essential technique is undermining, where the surgeon carefully separates the layers of tissue beneath the donor strip. This meticulous approach aids in reducing tension on the incision site, contributing to a narrower scar and more efficient healing. Incorporating absorbable sutures into the closure process is another crucial technique. These sutures gradually dissolve over time, eliminating the need for suture removal and resulting in a more inconspicuous scar. Buried sutures and staples also play a vital role in minimizing donor scarring. These techniques ensure that the incision site is securely closed, further reducing the risk of visible scarring while promoting optimal healing after a FUT hair transplant.

The Use Of Trichophytic Closures in FUT Hair Transplants

One of the most advanced techniques in minimizing donor scarring during FUT hair transplants is the utilization of trichophytic closures. This method involves overlapping the edges of the incision in a way that allows hair to grow through the scar, concealing it further and making it virtually undetectable.

In a trichophytic closure, the surgeon makes the initial incision parallel to the hair follicles and then trims away either the top or bottom wound edge so that 1 to 2mm of the top of the hair follicles at that wound edge are removed. This meticulous trimming ensures that the incision aligns with the natural direction of hair growth.

During the “tricho” closure, the trimmed wound edge is carefully pulled towards the opposite edge so that the bottom parts of the cut hairs are pointing slightly towards the incision, rather than directly towards the surface of the skin. This innovative approach aims to encourage these hairs to eventually grow through the incision, further reducing the visibility of the scar.

The Role of Scalp Laxity in FUT Hair Transplants

Scalp laxity is a fundamental consideration in FUT hair transplants, and it plays a critical role in determining the extent of scarring that patients may experience. While the length of the donor incision is primarily dictated by the number of grafts required, the width or height of this incision is intricately linked to the individual’s scalp laxity—a genetic attribute that must be meticulously assessed during the initial evaluation of the hair transplant procedure by the surgeon.

Patients blessed with good scalp laxity enjoy the advantage of being able to harvest a wider strip of donor hair without the heightened risk of noticeable scarring. However, it’s important to note that individuals with excessively loose scalps may paradoxically face an increased risk of developing a wide scar due to the unique properties of their skin. Conversely, when scalp laxity is limited, attempting to harvest a standard-sized donor strip may prove impractical without subjecting the patient to undue tension and discomfort.

Achieving the delicate balance in strip width is of utmost importance. A strip that is too narrow may necessitate an unnecessarily long incision to obtain the required amount of donor hair, potentially leading to more conspicuous scarring. Conversely, an excessively wide strip significantly elevates the risk of a widened scar—a situation we strive to avoid at all costs during FUT hair transplants. To consistently achieve the minimum possible scar, it takes expert clinical judgment honed through years of experience.

Why FUT Hair Transplants Are No Longer Preferred

In recent years, the field of hair restoration has witnessed a significant shift away from FUT hair transplants, with many clinics, especially clinics in Turkey, and patients opting for alternative hair transplant methods. This transition can be attributed to several key factors that have reshaped the landscape of hair restoration.

One primary reason for the decline in FUT hair transplants is the emergence and widespread adoption of FUE hair transplant techniques. FUE offers several advantages over FUT, most notably the absence of a linear donor scar. Patients increasingly value the minimally invasive nature of FUE hair transplant, which involves the extraction of individual hair follicles directly from the scalp, leaving tiny, nearly imperceptible puncture marks instead of a linear incision. These smaller, scattered scars heal more quickly and are virtually undetectable, making FUE hair transplant a more attractive option for those concerned about visible scarring. Additionally, FUE hair transplant allows for shorter recovery times and less post-operative discomfort, further contributing to its popularity.

Another factor contributing to the decline of FUT hair transplant is the changing aesthetics of hair restoration. Modern techniques prioritize natural-looking results, and FUE hair transplants provides greater precision in graft placement, allowing for more nuanced and artful hairline design. This aligns with the evolving expectations of patients who seek not only hair regrowth but also a natural, undetectable outcome. As the field continues to advance and adapt to patient preferences and technological innovations, FUT hair transplants have become less common, with FUE and other advanced methods now at the forefront of hair restoration procedures.

Many hair transplant clinics in Turkey, including Civas Hair Transplant Clinic, have transitioned to offering FUE as the primary option, reflecting the global trend away from FUT procedures. This shift underscores the ongoing evolution of hair restoration techniques and the importance of keeping up with the latest advancements to meet the demands of patients seeking natural and discreet hair regrowth solutions.

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