- Best Results10+- months
- Treatment Recovery5-9 days
- Procedure Time3-8 hours
- Skin SpecialistDermatologist
- Duration of ResultsLifelong
- AnaestheticBlocks, sedation
- Back to Work2-7days
Hair Transplantation FUT
FUT or follicular unit transplantation is a surgical procedure used to gather hair follicles from the back of the patient’s head. The surgeon uses precise techniques to remove a strip of skin that contains hair follicles. These follicles are then dissected under a microscope. Transplantation then occurs to the areas of baldness & or low hair density. This procedure, though useful, has been largely replaced with FUE or follicular unit extraction.
FactsFacts on FUT Hair Transplantation
- FUT or follicular unit transplantation is also known as strip harvesting hair transplantation
- This procedure gives equally good outcomes compared to newer FUE or follicular unit extraction methods
- The majority of hair transplantation is done via FUE
- Scarring post FUT is more as it involves formal excision of scalp
- Recovery times following FUT is longer than FUE, again in the context of the donor site
- The fundamental difference between FUE & FUT is in the donor site harvesting of hair follicles
What is the difference between FUE & FUT hair transplantation?
The majority of hair transplants are of the FUE method. Both FUE & FUT give very similar results as the implantation process is the same. Additionally, the number of available hair follicles are similar.
The fundamental differences are how the hair grafts are harvested. FUE is less invasive, gives a more homogenous appearance in the recipient site, & is associated with less side effects compared to FUT. Scarring post FUE is less compared to FUT.
|Donor Capacity||3,500 to 8,000 grafts||3,500 to 8,000 grafts|
|Regrowth Rate||Same (4 months+)||Same (4 mths +)|
|Post op recovery / discomfort, scarring||Quick, minimal scar|
|Long, 12 cm scar|
|Donor site||More homogenous|
How is FUT hair surgery performed?
There are four steps to undertake for follicular unit transplantation.
- Donor harvesting of follicles. The donor zone is identified & prepared. Surgical removal of a strip of scalp is performed under local anaesthesia. This strip measures 1-2cm in height & 18 to 23 cm long. It requires internal stitches to sew up the donor area.
- Microscopic dissection by a t With FUT Strip Harvest procedures, the donor strip is placed under the microscope which is designed specifically for hair restoration surgery. Then the donor strip is dissected into individual follicular units of one to four hairs.
- Recipient site preparation. Your dermatologist creates recipient sites in the proper angle, direction and orientation according to your pattern of hair growth. This involves creation of a suitable hair line, & future hair style, designed specifically for you.
- Graft transplantation. Individual follicular units are then placed into the balding and thinning areas of your scalp. This can be done with a microblade incision, or a special instrument called a Choi implanter.
Will I have a scar following FUT hair transplantation?
Yes. Unfortunately, this is the biggest drawback of FUT transplantation as this procedure does involve removal of scalp tissue. This means most patients are required to keep long hair to hide the scar. Scar length is typically 11 to 14 cm.
FUE hair transplant within the scar line can reduce the appearance of scars, however there will still be a colour difference.
How many sessions are required?
1-3 over a lifetime. It really depends on the stage of androgenic alopecia you are at. For younger patients a second stage procedure may be required in 5 to 10 years.
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Why does FUE transplantation look more natural compared to FUT hair transplantation?
It is all because of the donor site. An important concept to understand is that hair transplantation, as the name suggests, repurposes hair follicles from a high-density area to a low-density area.
With FUT a strip of tissue is removed from the scalp. This means hair density is significantly more in the donor area of the occipital region. With FUE, individual follicles are harvested from the occipital region, typically one in three to four ‘follicular units.’ The result is a more homogeneous density of the donor site.
How long is the procedure?
The advantage of FUT over FUE is a reduction in surgical time. This is because after donor site strip harvesting a team of dissectors will immediately start processing the harvested area. FUT takes 2-6 hours to complete, depending on the complexity of dissection.
Careful dissection under a microscope is required to reduce transaction rates. Once transacted, hair follicles are permanently lost & will not grow back, hence the meticulous work by a team of specialists.
Is the procedure painful?
No. We use local anaesthetic in both the donor and recipient sites. For most patients we give light sedation & muscle relaxants. You will be awake, but super chilled for the entire procedure. Most patients watch a movie on the iPad supplied, or listen to music/ read.
Post procedure pain is managed with paracetamol. Your recipient & donor sites will be sore for a few days post operatively.
What is the recovery like?
FUT has a longer recovery time compared to FUE in the context of the donor site. This is because the FUT excision strip requires sutures. Swelling & pain is more with FUT compared to FUE. As a guide-
- Restrict exercise for 10 days following FUT.
- Wound review on day 12 to 14.
- Altered sensation is common after FUT, generally settling in months to years.
- Raised scars are not uncommon after FUT (esp. In darker skin, younger patients). Higher tension can result in hypertrophic scarring.
Both FUE & FUT recipient sites heal at the same rate. Scabs fall off within the first 7 to 12 days.
How can the scar line be improved following FUT surgery?
Your surgeon can guide you through the revision process. Good surgical technique reduces the possibility of scars. Established scars following surgery can be treated with-
- Intralesional steroid injections.
- Fractional laser resurfacing.
- FUE to the scar line & or scalp micropigmentation.
- Re-excision of the original scar line.
When will I see the results following hair transplantation?
In three to four months, you will start to notice some growth. This increases over the next six to eight months. Maximal density is achieved around 12 months post- transplant.
Though big studies are lacking, the addition of PRP 4 to 8 weeks post-transplant can theoretically accelerate hair growth
Is FUT or FUE transplantation a permanent solution for hair loss?
To date, surgical transplantation of hair gives the most permanent solution for hair loss, however it is important to slow down hair fall in other areas. This is especially important for patients in the 20’s as hair loss is progressive. Your dermatologist will discuss treatment options including oral or topical minoxidil, PRP, lasers as well as hormone blockers such as finasteride & dutasteride.
Why do some people choose FUT over FUE hair transplantation?
The main factor is costs, which is directly related to the time taken to harvest the donor site. FUE is a tedious & meticulous process that involves extraction of each & every follicle. With FUT, the donor strip is harvested by the surgeon whilst dissection is performed by technicians.
97% of our patients choose FUE over FUT as the former gives a more homogenous outcome, looks natural & has a faster recovery time.
Are there any side effects with hair transplantation?
Side effects are rare following transplant surgery. FUT has a higher complication rate as this involves excisional surgery, as compared to FUE. Possible side effects include-
- Scarring at the donor site (strip harvest), including spread scars.
- Loss of sensation & pain at donor > recipient site.
- Infection (rare).
- Changes in hair density. As FUT is strip removal of the donor site, hair density is not as homogenous as FUE transplants.
Your surgeon will discuss the risks in more detail as it pertains to your procedure.
I am not ready for a hair transplant, are there other options?
Yes, however you must be realistic with your goals. Non-surgical options are best for early hair loss & or mild to moderate cases of androgenic alopecia. Your dermatologist will discuss options with you, including-
- Topicals that include minoxidil & or finasteride.
- Oral medications such as dutasteride, minoxidil or finasteride.
- Hair growth procedures such as microneedling, PRP, LLED & lasers.
- Natural supplements such as saw palmetto.
A sensible treatment routine with minimal side effects & low cost is daily use of minoxidil & finasteride lotion, & Platelet Rich Plasma injections. Book a consultation with a medical dermatologist for an assessment & treatment plan.
Why is it important to preserve remaining hair follicles?
Hair loss is progressive, hence the absolute need to slow down the loss of hair follicles. This especially applies to young patients. Medical therapy can slow down this process in 90% of patients. The aim of a hair transplant surgeon is to repurpose hair follicles & to preserve viable follicles- for life.
How do I know if I am a candidate for hair transplantation?
Book a consultation with either myself or my colleagues at Clinic Cutis. Dermatologists are experts in the management of hair loss disorders.
What patients are NOT suitable for hair transplantation procedures?
Careful timing of transplantation procedures is paramount for both efficacy in the short term & most importantly long term. You are not a candidate for FUT or FUE if you have-
- Alopecia areata that is still active or dynamic.
- Inflammatory disorders that are not controlled (FFA, lichen planopilaris, Folliculitis deCalvans). A 2-year quiescent time frame is required before hair transplantation. In some cases, your dermatologist may elect to perform a test spot.
- Early onset androgenetic alopecia in patients less than 25 years of age. *
*Transplantation in young patients is not an absolute contraindication as some patients are suitable candidates if surgery is conservative. All patients should be on medical treatments to preserve remaining follicles.
Davin’s Viewpoint: FUT hair transplants
Hair transplants have progressed a long way. The first transplants were performed by Dr Normal Orenteich, a famous dermatologist from New York. Hair plugs or punch grafts were the norm in the 70’s & 80’s, prior to the understanding of transplantation of individual units.
Australian surgeons led the way with FUE, which has essentially replaced FUT. The main advantage of FUT is the harvesting time of donor follicles. The strip harvest can be completed in under five minutes, however dissection times can be 1 to 3 hours, depending on the number of follicles & team members. As with all forms of hair transplantation, meticulous & precision is required to reduce transaction rates of hair follicles.
The other advantage of FUT is that the donor site hair can be kept long, though this is technically possible with FUE strip shaving technique or even no shave FUE. The compromise however is that patients who undertake FUT will not have short back hair in the future due to the presence of a surgical scar. FUE gets around this with individual 0.8 to 1.1 mm punch excision of the donor site. In fact, FUE can actually reduce the amount of scarring (at least the perception of scars) from FUT by adding hair follicles to this area.
As with all forms of hair transplantation, medical management is highly recommended. Your dermatologist will discuss options including PRP, microneedling, topical as well as tablets to help stabilize future hair loss.
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