Every hair on the human body sprouts from the cellular anchor that extends deep into the dermis of the skin, called a follicle. Hair follicles are the body’s hair factory and gather together all the ingredients to grow hair and replace them once they finish their natural cycle and fall away every two to three years. Over time, hair follicles may become damaged or cease to work resulting in hair loss, commonly experienced on the head. One of the most common causes of hair loss, particularly in men, is androgenetic alopecia, also known as pattern baldness. However, in 1952 an American dermatologist named Dr Norman Orentreich revolutionised a way to battle pattern balding when he completed the first hair transplant surgery. Hair transplantation is a surgical procedure that takes healthy follicles from one part of the scalp and transplants it to another where hair no longer grows.
There are two types of hair transplant surgeries typically used. The first is called Follicular Unit Transplantation (FUT). Also known as the strip method, this transplant technique involves a thin strip of skin bearing thousands of hairs from the back of the head. The strip is then dissected into smaller follicular units that contain between one and four hairs. These units will then be implanted into a small cut made in the scalp at the desired location, while the strip’s harvest site is stitched closed.
The second form of transplant surgery is called Follicular Unit Extraction (FUE). This procedure involves individual follicular units being harvested using a punch extractor, a drill-like device that takes circular extractions. Each hair is then implanted into one of thousands of tiny cuts made into the scalp. Once implanted, the first two weeks following the surgery are vital as the hair grafts are not yet fully attached to the scalp. After a few weeks the transplanted hairs will often fall out and then start to grow back. By six months new hair typically begins to emerge and by 18 months the full results of the surgery should be visible.
Typically, hair transplant surgeries use healthy donor hair follicles found somewhere on the patient’s head. However, that’s not always the most viable option, for example: in patient with advanced androgenetic alopecia, studies have shown that hairs taken from alternative areas of the body might be an alternative donor source. The majority of hair that covers the human body is fine and short – known as vellus hair – whereas the hairs in from the beard, torso, extremities and pubis are known as terminal hairs and have shown some successful result in hair transplants. The anagen (growth) phase of terminal body hair is much shorter than scalp hair and therefore, the transplant regrowth is thinner and
shorter when compared to straight scalp transplants.
A surgeon uses a tool to punch out donor hair grafts, called follicular units, typically from the back or sides of the scalp.
Hair follicular units include only a few individual strands removed in random patterns to prevent strips of visible scarring.
Once extracted, grafts are cleaned, sorted and submerged into a solution to preserve them before implantation.
Extracted units are then implanted into very small cuts in the scalp in areas where regrowth is desired.
Follicular units are inserted into cuts made in the scalp and the donor strip is sewn or stapled together.
Follicular units are then dissected and prepped, ready to be implanted into the intended area.
The dissected strips are then further sliced into even smaller strips ahead of implantation.
A strip of skin is surgically removed in the donor zone, typically at the back of the head.