FUT (FOLLICULAR UNIT TRANSPLANT)

Follicular Unit Transplants, also known as FUT, is a hair transplant procedure often best suited to patients with a more reduced donor area or a more widespread thinning or balding pattern. This method allows for more hairs to be extracted per follicular graft, leading to greater hair density. In addition, it does not require the head to be shaved; rather the area where the skin is to be removed is trimmed.

FUT is generally suited to treat:

  • Patients who are suffering from male pattern baldness. According to the Norwood Scale classification for male pattern baldness, any patient with pattern number 3 or above usually benefits most from this procedure.
  • Patients over 25. Patients of “older age” are best to receive FUT as balding patterns can be more easily predicted. Below the age of 25, it isn’t easy to anticipate the surgery outcome, which can lead to patchy results and the need for multiple procedures.

Hair characteristics such as colour, texture and curliness may also affect results cosmetically.

  • Similar skin and hair colour have better results
  • High hair density in areas that have growth have better results
  • Curly or wavy hair will have a better cosmetic appearance as patches will be less noticeable.

The above-listed factors are not obligatory to qualify for a transplant. However, the best results will be seen if one or more of these are met.

THE PROCEDURE

  1. The donor region is assessed for suitability, the hair in this area is trimmed to harvest the follicles, and local anaesthetic is applied.
  2. A thin section of the scalp, averaging around 8-10 inches and containing hair follicles, is excised using a scalpel.
  3. This area is closed using sutures.
  4. The scalp strip is divided into smaller sections known as grafts. Each graft will contain between 1 and 4 hairs. The number of grafts varies with the extent of hair loss, type of hair, quality of hair, and hair colour.
  5. Using a needle or blade, small holes are made in areas of the scalp with low hair density, into which hairs will be transplanted.
  6. A process known as grafting is carried out, by which hairs a removed from the scalp section and implanted into the small holes created.
  7. Surgical sites will be covered with bandages or gauze, and your surgeon will discuss post-operative care.

PREPARING FOR THE PROCEDURE

Before the procedure, you will have a consultation with the surgeon. They will review and mark out both the donor area and the transplant area, keeping in mind: angle, orientation/direction, placement, and density to provide the most comprehensive, natural-looking transplant possible.< Your surgeon will discuss with you what to do before your surgery; commonly, it is advised that you:

  • Cease to smoke at least 24 hours before the surgery.
  • Abstain from alcohol from 3 days before surgery. If possible, try to reduce alcohol intake longer than this as it may lead to better results.
  • Avoid certain medications as these may affect the procedure or aftercare process. Such medications include:<
    • anti-inflammatories (at least two weeks before surgery)
    • blood thinners
    • Beta-blockers

Discuss the cessation of prescribed medications with your doctor and surgeon before surgery to receive specific advice.<

  • Do not get a haircut. Having your hair at a natural length will enable the surgeon to harvest them more efficiently at donor sites, assess areas that can be used, and trim them as needed to carry out the procedure. Also, it is advantageous as having longer hair may cover up sutures.
  • Massage the scalp 10 minutes per day. This practical step will soften the skin and improve blood flow to the scalp, aiding healing time following the surgery.

POST-OPERATIVE CARE

  • 3 to 4 hours post-op, the local anaesthetic will begin to wear off, resulting in feelings of pain or discomfort at the surgical area.
  • Minor scalp swelling may occur, which can be battled with painkillers such as paracetamol.
  • You may be prescribed antibiotics to prevent infection, or you may be prescribed anti-inflammatories to relieve swelling and pain.
  • Your scalp may start to feel tight or itchy, and some of your hairs may shed; this is normal and enables the new hair follicles to become established.
  • A Spray bottle will be provided to spray the transplanted areas every day.
  • Most people will be able to return to work within three days following the surgery.
  • Avoid touching the newly grafted hair follicles as this may damage them.
  • Do not drink alcohol or smoke for 48 hours following surgery, as this will interfere with the healing of the grafts.
  • Wait a few days post-surgery to wash your hair and use very mild shampoos.
  • Do not press, brush or comb down over the grafts for at least two weeks following surgery as the grafts will be unstable.
  • Do not exercise for a week post-op and reduce exercise for the following month.
  • As a result of this surgery, you may be left with a long scar where the scalp section was excised during the procedure.
  • Full results should be seen within 12-18 months.

BENEFITS OF FUT

  • This procedure tends to be quicker than FUE.
  • You can keep your hair long to cover up the resulting scar.
  • Less expensive.
  • Maximum fullness of hair coverage.
  • Higher graft quality.
  • Higher rate of follicle survival.

RISKS OF FUT

While steps are always taken to minimise risks, there is still a small chance that some side effects may occur, such as:<

  • Bleeding, if a graft is dislodged
  • Swelling
  • Pain
  • Numbness
  • Infection
  • Thinning of pre-existing hair or Effluvium
  • Keloid Scarring – enlarged raised scar that can appear pink or darker than skin colour; if you have keloid scarring or a family history of keloid scarring, please discuss with your surgeon.
  • Folliculitis (inflammation of the hair follicles)
  • Necrosis – tissues are damaged or destroyed, leading to permanent damage to the hair follicles
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