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Techniques of Hair Transplantation

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Techniques of Hair Transplantation

There are many techniques of hair transplantation. The choice of technique depends upon the requirement of the patient and his expectations.
All the techniques, when done properly and in expert hands, yield good results.


Follicular Unit Transplant (FUT)

It is also known as a strip technique. A linear strip of skin from the back of scalp is taken . It is then dissected to separate each follicle. These follicles are then implanted in the bald area of scalp. The area from which the strip is taken is sutured. The stitches are removed after 7 days.

Procedure

  • The surgeon given local ansethesia in the occipital (back of scalp) area and cuts out a linear strip of skin from the permanent zone.
  • The area is then sutured in two layers.
  • The strip is stored in a solution, mostly normal saline. Th technicians then make slivers ie create small strips out of the bigger strip. From these smaller strip, individual follicular units are separated. All these steps are done under  a microscope to improve precision and minimize graft damage.
  • While the strip is being harvested for follicle, the surgeon makes slits in the recipient area.
  • The follicles are then planted into the slits.

Advantages

  • Graft harvesting is faster
  • Larger number of grafts can be planted in a single session
  • Good choice in cases of advanced grades of baldness where we desire maximum harvestation

Disadvantages

  • Not suitable in patients with tight scalp.
  • Sutures are placed, hence the patient needs to follow up after 7 days for suture removal.
  • Not suitable in patients with tight scalp as approximation of wound edges become difficult.
  • There are chances of keloid formation or hypertrophic scar in patients susceptible to develop them. This can occur with any incision made.

Follicular Unit Extraction (FUE)

Hair in scalp are present in bunches or follicular units. In FUE, these follicular units are harvested directly. As the follicular units are small 0.7-0.8mm, there is no requirement of sutures in this procedure as the wounds heal spontaneously.

Procedure:

  • The bald recipient area is prepared by given local anaesthesia in a ring block manner
  • Slits are made following the direction of existing hair
  • The donor area (which is trimmed to 2-3mm length) is anaesthetized.
  • Grafts are harvested from the donor area with the help of 0.7-0.9mm punches. There punches pierce the skin and separated the graft from the surrounding skin.
  • The grafts once punched are extracted with the help of forceps.
  • These grafts are then stored in a normal saline solution.
  • After harvesting the desired number of grafts, they are planted in the recipient area.
  • As the wound created by punch is very small, no suturing is required. There is spontaneous healing of the donor area in 5-7 days.

Advantages:

  • No stitches required
  • Less chances of bleeding
  • Possible to keep shorter hair cut
  • Involvement of doctor in the process is higher
  • Grafts are outside the body for shorter time as compared to FUT.

Disadvantages:

  • Not suitable in patients with very lax scalp.
  • When the procedure is not done by experts, possibility of entering into the unsafe zone of temporary grafts is high
  • Expertise required to minimize transection of grafts
  • In cases of advanced baldness, there may be requirement to combine it with FUT for higher yield of grafts.

BEST Technique

BEST stands for bio-enhanced simultaneous transplantation. It is a refined version of follicular unit extraction. It ensures least graft transection, delicate graft handling and plantation all contributing to excellent results. In this technique, we transplant the grafts as soon as they are harvested in order to improve the survival of grafts. The process of extraction and plantation are performed simultaneously. We combine this process with bio enhancers which hasten the growth of grafts and improve graft uptake.

Advantages:

  • A faster technique. Able to harvest large number of grafts in a single session as plantation is done immediately which saves time
  • Grafts are outside the body for minimal time as extraction and plantation proceeds simultaneously
  • Minimal time of storing grafts in a solution
  • Combination with bio-enhancers and light therapy improves graft survival and growth.
  • Results are seen earlier than with other methods.
  • Delicate plantation with 0% injury to grafts.
  • Entire procedure done by expert doctors.

Points of Difference BEST Technique FUE
Graft survival maximum compromised
Graft storage 0-5 minus Few hours
Graft harvest Faster Time consuming
Shedding of hair after procedure Less More
Plantation Delicate, least trauma Can be traumatic
Doctor’s involvement 100% 60-70%
Outcome/ Result of hair transplantation Faster better results Slower results as compared to BEST
Points of Difference BEST Technique FUT
Pain No to minimal discomfort painful
Bleeding less More
Visible scar none Linear scar seen
Recovery after procedure Faster recovery Slow as large wound takes time to heal
Graft damage Nil to minimal higher
Doctor’s involvement 100% 50%
Outcome/ Result of hair transplantation Faster better results Slower