Frequently Asked Questions
- What are follicular units and why are they so important?
- How is follicular unit transplantation different from mini/micro grafting?
- How long will the transplants last?
- How noticeable will it be after the transplant?
- How long before I can exercise?
- How long does the surgery take?
- How soon will the hair start growing?
- What about stereomicroscopes?
- How much does the procedure cost?
What are follicular units and why are they so important?
Described by Dr. Headington in 1984, follicular units represent the way hair naturally grows from the scalp. Hair grows out in groups of 1-5 hairs, with hairless skin between these units.
Follicular unit transplanting consists of using stereomicroscopes to carefully remove these units intact from the skin to transplant to the bald areas. The hairless skin is discarded - this is important because, with newer techniques, no bald skin is removed from the recipient area to eliminate scarring that might occur.
Dr. Limmer was the inventor of this technique and wrote his first paper on this subject in 1994.
How is follicular unit transplantation different from mini/micro grafting?
To understand this, one must know some terms. A micro-graft is a graft containing 1-2 hairs and a mini-graft is a graft containing 3-6 hairs. Therefore, FU grafts are actually a form of mini/micro grafting. But that is where the similarity ends.
Mini/micro grafting does not respect the follicular units. They are prepared by removing the donor strip with a multi-bladed knife, which results in more hair transection than with a single bladed knife. After the strip removal, the grafts are prepared as cut-to-size using little or no magnification and with little respect for the natural follicular units.
This causes three problems: 1) more transection 2) transplanting the hairless skin and 3) less density in the recipient area due to the hairless skin being transplanted and the larger size of the grafts.
The main advantages of mini/micro grafting are that is faster for the surgeon and requires less skill and manpower for the assistants.
How long will the transplants last?
Assuming that the donor site was picked properly, they should last your lifetime. Grafted hair will retain all the characteristics from where it was taken. They are removed from areas that should never go bald. As a person gets very elderly and his overall hair thins, the grafts will also thin a little.
How noticable will it be after the transplant?
There are 2 issues here:
The first is the natural serum crusting that occurs at the base of the grafts after the transplantation. With frequent spraying of the scalp and gentle shampooing this can be kept to a minimum.
The second issue is redness. Some patients get no redness while others can have a little redness for 2-3 weeks. While spraying helps, redness appears to be a little bit of an individual characteristic.
Normally, transplants are hard to detect after 7 days, but a person with some hair to cover the grafts may have no problems at all. It may be desirable for a person to take off 7-10 days after the first transplant, particularly if he or she has advanced baldness.
How long before I can exersize again?
Light walking and light upright exercise can be resumed in 48 hours. Strenuous exercise should be postponed for 1 week and swimming for 2 weeks.
How long does the surgery take?
Most operations take between 4-8 hours. We normally transplant between 500 and 3,000 grafts.
This is exacting work and, therefore, requires considerable time - even though we have a team of 4-6 assistants, nearly all of whom are nurses.
How soon will the hair start growing?
Initially the majority of the hair in the grafts will fall out at 2-4 weeks.
Most transplanted hair will start growing at four months but recent evidence indicates that a few grafts may take 7 months or longer to start growing.
There will be a few grafts that never fall out and start growing right away - but this is unpredictable.
What about stereomicroscopes?
Even though they are considered the gold standard, stereomicroscopes are used by a minority of transplant offices in the world.
They are expensive and require more skill and manpower, but can give a 20% more yield from the grafts. All of our grafts are produced using stereomicroscopes.
How much does the procedure cost?
Most of our sessions run from $3,000 - $10,000 depending on the number of grafts required. The majority of patients will need from 1-3 sessions.
