FUT Hair Transplant—What Is Follicular Unit Transplantation?

Whether it’s after a shower or before you brush your teeth, thinking about what to do with your hair may have inserted itself into your morning routine. The uncertainty of thinking you’re not losing hair normally or that your hairline is receding can be enough to change someone’s whole attitude for the day, and it all happens in the second of doubt caused by their hair’s cooperation (or lack thereof). Where some people reach for the hair clippers, others search for answers.

Hair transplant techniques have been used since the early 1950s, evolving in the 1990s in Japan where a dermatologist named Masumi Inaba wrote about follicular units in a textbook and they began experimenting with this technique. At the time, hair implants used to look like “plugs” and looked unnatural on your head because surgeons weren’t able to transplant a hair follicle and arrange it in its direction of natural growth. Needless to say, hair transplants look significantly more natural and are safer than ever.

What You Need to Know Before You Get a Hair Transplant

1. Hair Transplant Techniques
2. Surgery Eligibility
3. Risks
4. Recovery

Hair Transplant Techniques

There are two main types of hair transplant surgeries, called follicular unit transplantation (FUT) and follicular unit excision/extraction (FUE). Both of these surgeries begin in about the same way; your surgeon will thoroughly clean the area, then use a local anesthesia to numb the area of the scalp that’s being harvested for grafts.  

FUT hair transplants are also known as Microscopically Dissected Elliptical Excision, or strip surgery. Entire strips of hair are transplanted from areas that are resistant to hair loss, such as the back and sides of the head, being replaced on the target areas you are experiencing hair loss that you and your cosmetic dermatologist have previously discussed. This technique is typically more cost efficient because the surgery is completed more quickly than the FUE procedure.

Follicular unit excision/extraction (FUE) is understood more colloquially as a follicular transfer. Similarly to a FUT procedure, a doctor takes a small graft of hair to transfer to an area of the scalp in need of more hair growth. Instead of taking a whole strip, the surgeon will extract individual follicular units less than one millimeter in diameter to relocate from a prime “donor area.” This technique takes a longer stretch of time because your doctor may procure hundreds of these small grafts of hair follicles, but the outcome yields much more natural-looking results.

Who is eligible to receive hair transplant surgery?

If you meet the following criteria, you’re eligible to receive hair transplant surgery:

• You have been losing their hair from male or female pattern baldness
• You have a stable amount of hair elsewhere on your head (such as the back and or sides)
• Your hair loss is on an area of the scalp that is due to trauma (such as a burn or cosmetic facelift)
• You’re a healthy individual
• If other, non-surgical hair replacement methods (such as Minoxidil) aren’t working for you
• You are willing to shave your head for the procedure

You shouldn’t receive a FUT or FUE if:

• You suffer from an autoimmune disease (such as a thyroid disorder, Lupus, and Sjogren’s syndrome)
• Your hair loss could be related to a vitamin deficiency
• You struggle with Trichotichamania, which is a disorder in which mental health issues propel you to compulsively pull out your hair
• You’re on blood thinners, or if you have an increased risk of blood clot
• You have asthma, diabetes, heart conditions, or MRSA
  

Risks

There are always risks with surgery, which is why it will be critical to feel confident in your choice of physician. Additionally, following all post-surgery protocols and aftercare instructions could reduce your recovery time, so consulting an experienced dermatologist before the procedure is an absolute must. 

The most common side effects of any hair replacement surgery is swelling and bleeding, which may occur post-surgery as the hair implant heals and fully recovers. With FUT hair transplants, scarring is more likely than FUE procedures, though you may have dramatically less linear scarring based on the amount of experience your surgeon has at the time of surgery. It is, however, possible that you’ll need an entirely different surgeon to do a FUE surgery after a botched FUT procedure to reduce the visibility of the scar with further hair implantation. Just remember that scar tissue holds hair less successfully, despite being a viable option, and you may notice more drastic scarring as you age and your skin becomes looser. 

“Shock Hair” is another unfortunate side effect that can happen two to eight weeks after the surgery when your hair reenters the resting phase. This condition mirrors the effects of Telogen Effluvium, which is a temporary form of hair loss. You’ll notice this impacts the recipient area, and lasts approximately six months when it does arrive, though most people see hair growth during or after this time period. 

Recovery

Recipient sites on the scalp take time to heal, regardless of how the hair is harvested or the number of grafts it takes to complete. Recovery time is dependent upon how quickly your body heals naturally and how efficiently you follow post-operative instructions. Extracted hair areas on the scalp will be sensitive.

• Avoid touching the surgery area/grafts
• Do not wear clothing that covers the area for extended periods
• You can shampoo the day after your surgery. Your doctor will explain how to properly do this.
• After 14 days to 2 months, you may notice the “shock hair” phase
• 4 to 10 months after the fact, you’ll notice new hair growth

Hair surgery, and follicular unit transplantation specifically, has come a long way since the 1950s. While placing your hair care in someone else’s hands can be a daunting, even scary, thought at first, the day you get your FUT hair transplant may very well wind up being the best of your life.