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Achieving the Natural Look
 The National Hair Institute performs both follicular unit grafting (FUG) and follicular unit extraction (FUE) as a simple walk in walk out procedure under local anesthesia in its clinic at Middle Park in Victoria. These procedures usually involve the movement of thousands of tiny hair follicles from the balding resistant areas at the back and sides of the scalp to the areas at the front, top and crown that are susceptible to hair loss.
Once the procedure is completed the patient can leave our clinic and depending upon which procedure they have had they may(FUG) or may not(FUE) need a thin headband type bandage covering the donor area at the back and sides of the scalp. The recipient area at the top of the head does not require any bandaging and the patient is free to wear a cap or bandana immediately after surgery.
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Follicular Unit Grafting (FUG)
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A patient is shown with his existing hair taped up to expose the donor region undergoing FUG with a linear strip of hair bearing skin being removed. |
Follicular Unit Grafting at the NHI involves removing a thin strip of hair bearing skin from the region at the back and sides of the scalp. once this piece is removed the the two edges are brought together and sutured closed. The patients hair directly above the incision covers the area so it is not noticeable.
This strip of hair bearing skin is then given to a team of surgical assistants who dissect this one piece into thousands of follicular unit grafts containing 1, 2, 3 or 4 hair grafts. During this process the grafts are kept suspended in a special solution that ensures they are kept cool and hydrated and can survive many hours outside the body.
As the graft dissecting continues tiny incisions are made in the scalp areas to be treated with very fine gauge needles. The surgical team are able to control all aspects of angle, depth and density to ensure a natural result. The grafts are then placed into these incisions with a very fine pair of tweezers. The 1 hair grafts are placed in the front hairline with the 2 hair grafts placed directly behind. This allows us to create a gradual hairline zone that mimics nature. The 3 and 4 hair grafts are then placed into the forelock region and through the mid scalp for maximum density.
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Follicular Unit Extraction (FUE)
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A patient is shown with his existing hair taped up to expose the donor region undergoing FUE with individual hairs being removed from the donor area. |
To perform an FUE procedure a large area at the back and sides of the scalp is clippered down to a #1. Now instead of removing a strip of hair bearing skin as in the FUG procedure the surgeon will make a tiny circular incision around each follicular unit. As each incision is made the graft is then carefully extracted one by one from the scalp. These are then given to the surgical team who will check them under the microscope and further trim them if required. The small holes from which the grafts are extracted are so small they are left to heal on their own. From here on the procedure is much the same as the FUG.
Following either procedure scabs are evident on the top of the scalp for about 7-10 days. Some minor swelling may occur in the forehead region 3 days after the procedure. Patients can generally return to normal activities within a couple of days after the procedure with some limitations on exercise, smoking and drinking. The new hair will begin to grow through about three months after the procedure with final result expected about 12 months after surgery.
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Hair Transplant History
If you could view hair under a microscope you would see that hairs do not grow singly (as is the common belief), but in naturally occurring groups of up to four hairs. These groupings are known as follicular units. This is how the hair used to grow in those areas where it has receded, and using these natural groupings is how we will replace it.
They are not to be confused with micro grafts. Micro grafts are dissected without the aid of magnification and whilst they can be cut into grafts containing one to four hairs they are not necessarily from the same follicular unit. The resulting growth rate and subsequent appearance are
neither dense nor natural when compared to the results achievable with follicular unit grafting.
The binocular stereoscopic dissecting microscope allows us to identify and dissect these follicular units whilst sculpting around the sebaceous glands and other appendages crucial for the grafts survival. The resulting grafts are the smallest possible grafts you can achieve that will experience a very high growth rate in excess of 95% in the hands of the right surgical team.
Most importantly with grafts of this size we are replacing the hair in those areas where it has been lost in the same way that it used to grow, in naturally occurring groups of one to four hairs. The follicular unit is the foundation for restoring a natural looking head of hair.
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