What is FUT Hair transplant?
Follicular Unit Transplantation (FUT) is a procedure where hair is transplanted from the permanent zone, the area in the back and sides of the scalp where hair is more resistant to balding, to the bald or balding areas of the scalp. This is accomplished using naturally-occurring groups of 1, 2, 3, or 4 hairs, called follicular units.
How is FUT done?
The procedure is done in the OPD under local anesthesia. Anesthesia is given to prevent any discomfort to the patient during the procedure.
After the patient’s scalp is anesthetized, the surgeon removes a strip of tissue from the donor area, an area within the permanent zone, and, once extracted, the donor strip is cut into many individual follicular units using microscopic dissection techniques. As these follicular unit grafts are being prepared, the surgeon makes tiny holes in the scalp, called recipient sites, where the grafts are placed.
Before the grafts are harvested, tiny “recipient sites” are made in the balding area of the scalp using a fine needle-point instrument. The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the appearance of the donor area and in the quality and quantity of grafts obtained with each technique. However, the decision to whether go for either of the procedures vary from case to case.
What is biostimulated FUT?
It comprises of hair transplantation by FUT along with 3 sessions of Platelet rich plasma therapy which simultaneously enhance residual hairs as well as transplanted hairs by presence of high concentration of growth factors directly near the hair roots and stimulation of STEM CELLS.
In this hair follicles to be transplanted are preserved in a special solution enriched with patient’s own growth factors and at the end of surgery this concentrated solution of growth factors is injected into the whole affected area.
Current status of FUT/biostimulated FUT
In present scenario, there is very limited role of doing Biostimulated FUT because of surgical morbidity of the procedure, less no. of grafts harvested, more scaring, greater risk of infection, increase downtime after the procedure and limited scope of customization of number of grafts.
So, we are not doing FUT/Biostimulated FUT procedure anymore for last few years.
FUT Hair Transplantation – Frequently Asked Questions
Follicular unit transplantation, or strip FUT, is performed to transplant follicular units into balding areas of the scalp. FUT differs from FUE in that a strip of scalp skin is removed from the posterior scalp also known as the permanent zone. The size of the horizontal linear strip varies based on the number of grafts needed. In hair transplant case where only 1000 grafts are needed, the width and length will be small. However, in a mega session where 3000 plus grafts are required, the maximum width and length might be reached depending on the density of hair within the permanent zone strip. Due to issues of scalp laxity and wound closure, a maximum width of 18-mm can be safely removed in most patients. Once the strip is removed, the wound is closed in two layers with dissolvable internal sutures followed by external staples or sutures. The strip is then processed and meticulously cut into natural groupings consisting of follicular units of 1 to 5 hairs. This preservation of the natural grouping maintains their anatomical structure and allows for a realistic post-transplant look.
Patients who do not plan to wear their hair in a short style are ideal candidates for FUT as the inevitable linear scar in the posterior aspect of the scalp will be camouflaged or hidden by longer stands of your own native hair.
The results from an FUT hair transplant procedure should last a lifetime as FUT uses your own hair from the permanent zone. There may be some natural thinning of the donor permanent zone as you get older but, since this is your own transplanted hair, it will likely be susceptible to this same process. Hormonal changes impact hair that is prone to balding but this should not affect the transplanted hair.
Depending upon the number of grafts needed, the procedure time could span 3 to 6 hours. Both FUT and FUE are an individual hair transplant process so the total surgical time can vary.
The linear scar where the donor hair was removed can vary in length depending on the number of grafts required and the density of hair within the strip. The length of time needed to heal your surgical wound varies from individual to individual. On average, your surgical wound will close within 7 to 10 days. Typically, staples are used for closure and they will be removed in our clinic at, or around, 10 days. As for the recipient site, there will be tiny crusts associated with the new hair grafts that may be visible for up to a week. The appearance of the recipient site is the same as what is seen after an FUE procedure. We encourage patients to wash their hair twice a day for the first 4 days to lightly remove the crusts. Afterwards, shampoo as you normally would. If the crusts persist after the first 5 days, allow the shampoo foam to sit on the recipient site for up to 15 minutes to help facilitate removal of the scabs.
Overall, the final results of transplanted hair should look natural in appearance to the point that others will not be able to discern if a transplant was performed. See some actual patient results on our before and after gallery page.
The cost of an FUT procedure varies among patients. Before determining the final cost of surgery, a complete examination of your scalp and hair will be performed by a hair restoration surgeon. The price of surgery depends on the number of grafts needed and the desired density to achieve your goal. When comparing the price of FUT verses FUE, the total cost for FUT might be slightly less.
The main advantages of FUT include: • Larger number of follicular units can be transplanted during one session as opposed to FUE • Less cost to the patient The main disadvantages of FUT include: • Horizontal scar on the donor posterior scalp • Slightly longer recovery time • Increased chance of donor wound complications • Greater pain and discomfort after hair transplant
Just prior to the start of surgery, patients are given a sedative which is followed by local anesthesia injections periodically throughout the day. In general, there is minimal to no pain during the actual procedure. Patients may experience some pain and discomfort after the procedure. Although the pain is more intense after a strip FUT procedure, the symptoms are self-limiting and should resolve within several days. We will provide pain medication after the procedure to cover any residual pain.
There are a few complications associated with strip FUT including: • Bruising/Bleeding • Swelling • Pain • Itching FUT differs from FUE in that there may be a greater risk of numbness, hypertrophic scarring or widening of the scar. The number one issue that patients may report is a tightening of the scalp in the back of the head. The tightening can be alleviated if patients perform a scalp exercise 10 times a day for a month prior to surgery. One other risk common to both FUT and FUE hair transplants is “shock loss”. This loss of hair after a hair transplant surgery can be reduced if patients use finasteride for 6 months after surgery.
The new hair will start to appear as fine, thin hair once it enters the growth phase 2 or 3 months after the hair transplant. Over the course of the next several months, the hair will become thicker and longer. After 10 to 12 months, coarse hair will be noticeable and the final results can be expected after 8 to12 months.
Patients are asked to return to our clinic the day after their hair transplant surgery for their first hair wash. During this visit, we perform and instruct patients on the proper hair wash technique and answer any questions about post-procedure care. After the hair is washed, the donor and recipient sites are examined by the physician and any thick crusts are removed. Patients should sleep at a 45-degree angle to reduce the incidence of swelling as well as use a neck pillow while sleeping to prevent any rubbing or movement of the grafts. Special attention must be paid to the posterior scalp surgical scar to avoid excess crust/scab buildup. Avoid bending or any hyperflexion of the neck while the wound is healing so that it does not reopen. After the 4th day, patients can resume their normal daily activities but should avoid strenuous work or exercise for at least 7 days. Patients need to avoid direct sunlight on the scalp for 6 months. Use protective outerwear such as a hat and/or apply SPF 30 sunblock to avoid sunburn on the scalp. If staples are used for donor wound closure, they will be removed in the clinic around day 10.
The final decision to have FUT or FUE depends on your hair restoration goals. If you are interested in restoring your hairline or covering a large balding area on the top and crown in only one session, an FUT hair transplant is something to consider. FUT is an excellent choice for providing a large number of grafts to cover bigger areas of the scalp in only one session. The residual scar is the other important factor to consider. If you do not plan to cut your hair short in the posterior donor area, a linear strip scar will always be covered with your own natural hair.
Although we cannot eliminate the scar from a FUT procedure, there are many ways to improve the visibility of the scar. The FUT scar could be repaired through simple scar revision, FUT transplantation into the scar or by other cosmetic procedures such as camouflaging the scar through Scalp Micropigmentation (SMP).