Follicular Unit Transplant (FUT) is a strip procedure of hair transplant. It involves removing a linear strip of hair from the donor region of the scalp and implanting it in the recipient region.
The strip containing hair follicles is dissected under stereo-microscope and divided into grafts of 1-3 follicles. These grafts are then placed into incisions made on recipient region.
In one session, maximum 2000 grafts can be planted in the recipient region. But it was not always so. Previously, different methods were used for hair transplant.
History of FUT Hair Transplant
Hair transplant is a process which has been evolving continuously over the last 200 years from very primary technique to recent FUT hair transplant technique. But it was not till the 1930s, that modern era of hair transplant was evolved which showed the use of hair grafts and hair-bearing skin flaps or hair transplantation.
- In 1952, dermatologist Dr Norman Orentreich proved the relationship of ‘donor dominance' and ‘recipient dominance' by experimenting with free donor grafts to balding areas in patients with male pattern baldness in a successful surgery. From 1970s, plugs which are essentially large grafts which were used in hair transplant which had lots of limitations of technology.
- Punch graft method was popular during 1970-1993. The punch of 4mm was used to remove a cylindrical portion of skin with hair from the donor region and recipient area was punched out to accommodate the grafts. But it gave an unnatural look, abrupt hairline, large cuts due to punching.
- By 1984, mini and micrografts were used which was an improvement to previous methods. Micrografting is the older form of strip surgery which used small grafts rather than one long strip. It is good for reconstructing frontal hairline.
- In 1994, Dr Bernstein and Dr Rassman introduced stereo-microscopic graft dissection by which follicular unit could be obtained from donor strip in the donor region. This method takes more time and exceptional surgical skill but gives good results. By 2000, Follicular Unit Transplantation (FUT) became the mainstream method for hair transplantation.
Eligibility Criteria for FUT
- Perfect Donor Region
- The Flexibility of scalp
- You shouldn't be suspected with DUPA
- Your scalp must be free from Alopecia Areata
- You must not have Trichotillomania
FUT Hair Transplant Procedure
- Step 1 : The surgeon will check if your donor region is perfect or not. Analyse the condition of follicles, density of hair and sustainability of hair. He will estimate the number of grafts required for your hair transplantation.
- Step 2 : First, they will shave the donor region of your scalp to harvest the strip.
- Step 3 : Later surgeon will construct natural looking hairline as per your will.
- Step 4 : Then he will monitor anaesthesia to your scalp.
- Step 5 : After that surgeon will determine how many samples will be required to fulfil the requirement of the necessary quantity of grafts.
- Step 6 : The surgeon will carefully remove the strip from your donor region.
- Step 7 : The region from which the strip is removed will be closed by stitching.
- Step 8 : The strip will be dissected under stereo-microscope and good quality of follicular hair graft units will be extracted from it.
- Step 9 : Surgeon will start making incisions in your recipient region after considering the direction of your hair growth and insert follicular graft units in the incisions.
Post-care for FUT Hair Transplant
|Things to care for||Precaution|
|Swelling of forehead and between eyes||Massage the area and use ice packs for 3-4 times per day. Avoid bending down.|
|Graft care||Avoid contact with grafts until 6th day after surgery.|
|Donor care||Remove dressing before going to sleep. Visit doctor to remove stitches after 10-14 days.|
|Hair wash||Don’t wash your hair for 24 hours after your surgery.|
|Exercise||Don’t exercise for one week when grafts are becoming secure.|
|Diet||Avoid caffeine, alcohol, spicy foods, garlic, multivitamins for first 2 days to prevent bleeding.|
|Sun||Don’t expose your scalp to the sun for first 3 months.|
|Medications||Follow the medication prescribed by your surgeon.|
|Sleep||For the first 3 days use neck pillow while sleeping and keep your head at 45 degrees angle from mattress.|
What is the Recovery Time for FUT Hair Transplant?
After the Follicular hair transplant surgery, remove your dressing before going to sleep. Go to the surgeon for follow-ups.
- Visit surgeon after 10-12 days to remove stitches.
- The transplanted hair will fall out 2-3 weeks after surgery. This will make way for the growth of new hair. After 8-12 months you will notice a substantial amount of hair growth.
- There may be temporary numbness around the donor region which will recede in a few months. The average FUT hair transplant time to see the proper results is around 1 year.
- After your FUT surgery, it would be better to take a week off before you resume your work.
What are the side effects of FUT?
There are no major side effects of FUT hair transplant which can harm you. However, you may experience some minor side effects due to common surgical procedure.
The common side effects which you may experience are:
- Swelling of scalp
- Minor infection
What are the advantages of FUT?
- The look after new hair growth is natural.
- The trauma to the scalp is minimum.
- It can create a close fit for FUT grafts.
- Removing tissues in the recipient region is not required.
- It retains the elasticity of the scalp.
- Many follicles can be transplanted in a single session.
- It is more affordable than other hair transplant techniques such as FUE.
What are the risks involved in FUT?
- Limited donor site to the scalp.
- Experiencing numbness around the donor area.
- Leaves linear scar in donor region from where the strip is removed.
- Recovery is slow.
- The transplanted hair will shed after 2-3 weeks which is transitory.
FUT Hair Transplant scars
- In FUT hair transplant, as the strip is removed from donor region, it leaves a linear scar on the back of the head.
- The surgeon removes the stitches from the donor area of your scalp from where the strip is removed after 10-14 days of the FUT surgery. Your donor area will start healing and form a linear scar.
How many grafts can be transplanted in a single session of FUT?
- The clinics which specialize in Giga sessions, transplant 2500-3500 grafts depending on quality of donor hair.
- But mostly clinics transplant 2000 grafts in one session which gives optimum result. As the FUT technique requires precision; quality of the result may drop after transplantation of 2000 grafts.
How Much Time Is Required for One Session of FUT Hair Transplant?
It will take around 4-8 hours for a single session of FUT hair transplant. Time may vary depending on:
- The number of grafts which must be transplanted in one session.
- The number of surgeons operating the FUT process.
Survival Rate of FUT Grafts
- In FUT hair transplant, generally density of 20-25 follicular units per cm2 is used per session for ideal results. If one exceeds these densities, the survival rate of follicular units drops to low level.
- Then as per study 40% of them will survive and grow.
- 50 Follicular unit per cm2 will give good result than 20 follicular unit per cm2 but at the expense of 15% higher rate of limited donor hair.
What Are the Results of FUT Hair Transplant?
- After FUT hair transplant, your hair will shed after 1 month. The new hair will start to grow 3-4 months after hair transplant surgery. In the beginning, the new hair will be fragile and fine, but as it will grow longer, it will become thick and strong.
- After 6 months, you will experience substantial hair growth. Eventually, you will see the result of FUT hair transplant. Your hair will attain the same quality as your donor hair from which follicular units were harvested.
Who Can Get Benefit from FUT Technique?
- A patient who needs larger hair transplant which means the patient has large baldness and need transplantation of a huge number of follicular graft units.
- When large number of follicular graft units must be transplanted, FUT is assumed to be the best technique.
- As in FUT, a greater number of follicular graft units can be transplanted in one session compared to any other methods of hair transplant. The cost of FUT is also less compared to FUE.
Are there any alternatives to FUT technique?
Depending on your hair loss, scalp flexibility, the nature of your baldness, an alternative method for FUT can be FUE or PRP techniques
Why FUT Is the Best Technique?
- Follicular hair transplant (FUT) is a strip procedure of hair transplant in which follicular unit grafts are harvested. It is done by dissecting the strip under the stereomicroscope which has high magnification. The harvested grafts are of good quality and not damaged.
- The surgeon can estimate the number of grafts obtained from dissecting the strip. The resultant hair looks natural.
- If a person suffers from hair loss again after some years and he decides to do additional hair transplant; it will be possible if the prior treatment he had undergone was FUT.
- As in Follicular hair transplant (FUT), the surgeon will remove the previous scar and after treatment he will have only one scar in the donor region. Whereas in FUE, new scars will be created along with old scars.
- The growth rate of hair for FUT is 95% which is greater than FUE whose growth rate is 85%.