The FUT hair transplant procedure involves surgically removing a thin strip of hair from the back of the head at the base of the neck, dividing the grafts, and relocating the hair follicles to the top and front of the head. The doctor performs this removal process. The hair at the back of the head is resistant to the chemical dihydrotestosterone (DHT). Because of this it is resistant to falling out of the scalp. This is why we often see men with only a wreath of hair at the back and sides of the head.
After the application of a local anesthetic, the doctor will proceed with hair transplant surgery. This starts with the removal of a small strip of hair at the back of the head from the“donor” area. The incision will be secured with sutures. The wound will quickly heal, and while it will leave a minor scar, this will be hidden by the hair at the back of the head which falls down over the scar area.
The doctor will then instruct his surgical team precisely how to divide the grafts. The strip is then dissected into very small follicular units or hair group grafts. These grafts may contain 1, 2, 3, 4 or more hairs. Each of these units is essentially an organ. They have a blood supply, are chemically regulated like other organs of the body and when transplanted will quickly return to homeostasis.
The doctor will then create small slits in the area in which the grafts will be transplanted. Thisinvolves both artistry and technical skill. The slits (or receptor sites) are created in such a way as to recreate the natural hair growth pattern. The specific depth, angle, direction, size and width are crucial to proper placement and growth of the transplanted hair. This is by far the most critical and time-consuming phase of the procedure.
Following this the doctor will supervise the placement and relocation of the grafts to the receptor area. It is important to note that the grafts can only be placed into the receptor site one way, similar to a square peg being fit into a square hole.
The relocation process is minimally invasive and is a minor surgical procedure, not much different from having a filling placed by the dentist. While there may be some discomfort during and after hair transplant surgery, there is rarely serious pain involved. Patients are awake and alert during the entire procedure and they can have a friend or spouse present.The time it takes to complete a hair transplant procedure varies according to the number of hair grafts implanted. Shower and wash and dry your hair thoroughly prior to the surgery. It is also important that patients remember NOT TO CONSUME ANY ALCOHOL or take ANY ASPIRIN for a period of 24 hours prior to the surgery. This may cause excessive bleeding during the procedure.
WHEN WILL MY HAIR START GROWING…
AND WHAT WILL IT LOOK LIKE?
Some people are concerned about how they will look after the procedure. Since hair restoration is a minor form of surgery, directly following the procedure it may be possible to return to normal activities fairly quickly, but we do recommend resting during the day of the procedure.
During the days following the procedure, the patient can return to work and recreational activities. We recommend refraining from strenuous activities such as weight lifting, racquetball or tennis for a week or two to avoid accidentally damaging the grafts. The hair can and should be washed gently with the fingers and a very mild shampoo.
After a few days, the redness will subside at the top of the head and the grafts will blend in with the existing hair.
During the first 1 to 3 weeks, new hairs will appear to be growing quickly. This in actuality represents the beginning of a phase known as “shedding,” the time when the hair follicles actually go dormant.
Following transplant surgery, the hair follicles go into shock, or a dormant phase. This is normal, expected and predictable. This phase typically lasts 3 to 6 months so you will not begin to see new hair growth until the follicle moves out of this phase and onto the next growth phase. Many patients get anxious waiting to see if the transplant was successful. However, if you know that this “shedding” is typical and normal it sometimes eases anxiety.
Typically, hair growth starts within 2 to 4 months. Hair growth occurs in cycles, with each cycle starting a few days or weeks from the previous cycle. Initial hair growth produces a smaller than usual shaft. This changes as the hair reaches about 1/2 inch in length. Most men actually prefer this slower hair growth process because it makes any change subtle and less obvious.
By 6 months, most people can see the effect of the process, and by 12 months, the growth and bulk will have reached 90% of its total growth. Hair can, and sometimes does, continue to mature for as long as another 24 months following surgery. For this reason, we advise patients to not evaluate the results until a full year has passed.
Surgical healing is also fairly fast. Within 1 to 2 weeks the specific sites that received donor“hairs” have healed. However, it might take many months for the hair to regain full strength.About half of our patients see results on the crown area within the first 1 to 2 weeks. And even when they do, the hair is just barely visible.
If you have previously had a Follicular Unit Transplantation, your previous obvious scars canmakeyou skeptical about what to expect with our procedure. If this is the case, we strongly urge you to speak with a patient of ours who is one or two weeks post surgery and ask them about their experiences. Most patients are all too glad to share their experiences and help you decide if this procedure is right for you.
Following hair transplant surgery,you should relax comfortably for a day, with only minimal activity. You should feel comfortable about returning to work in a day or two, providing your work does not involve strenuous physical activity. The recovery time following your hair transplant procedure is usually relatively brief, assuming that sensible guidelines are adhered to.Expect a call the day following your procedure to check up on you and see if you need to come to the office (most patients do not). For the first one to three nights after your surgery, plan on sleeping with your head elevatedat a 45-degree angle. This will help reduce swelling, which will help keep you comfortable.
DO NOT USE aspirin or aspirin-containing products for three to five days after surgery, and DO NOT drink alcohol during this time, either. These can result in increased risk of bleeding.If bleeding does occur, which is possible the night after surgery or even a few days following your procedure, it almost always stops with the application of firm, steady pressure for about 15 minutes. Use a gauze pad, apply pressure, and DO NOT lift the gauze during the 15 minutes. Pressure should be firm, but not so firm as to dislodge any grafts.If there is bleeding at the donor site, remember to gently lift any hair covering the area so
the hair doesn’t become matted and adhere to the donor area.
Should bleeding persist, contact your local medical authorities for additional guidance.Very rarely, a graft can be dislodged or combed out in the first few days following your procedure. If this happens, do not panic. You won’t lose more than a few hair roots, and as your transplanted hair begins to grow in, any slight loss of grafts will be covered up.
Discomfort following any surgical procedure is not unusual, and you may require medication to control your pain for the first one or two nights following surgery. While aspirin and similar products should be avoided, you can safely take prescription Tylenol 3, Vicodin, or Percocet according to your surgeon’s instructions.
For three days following your surgery, thoroughly moisten two or three pieces of gauze with saline solution (the office can tell you what proportion to use) and apply the gauze to the transplant site. Do this twice a day, for 30 to 60 minutes each time, for three days. This helps keep the area moist and speeds the healing process.Crusting will develop at your recipient site and may continue for 10 to 14 days.Apply an ointment like Bacitracin, Polysport, or Aquaphor to the recipient site several times a day. This, too, will keep the site from drying out and help to reduce crusting during your healing process. These products are greasy, so you may find water soluble K-Y gel to be a better choice.
Swelling may occur, especially after your first transplant, about two to four days after surgery. It most commonly develops on the forehead, and it will not cause any lasting problems. The pull of gravity may bring the swelling down to your eyelids, and in rare cases you may develop a black eye. It may be unsightly, but it’s temporary. You can reduce swelling by remembering to sleep with your head elevated about 45
degrees for about three nights. This can be easily accomplished by adding pillows on your bed, or by sleeping in a recliner.
Infection following hair transplant surgery is rare, but it can increase the recovery time required. You can reduce the risk by avoiding exposure to airborne dirt at work, home, or play for two weeks following surgery.Do not touch the donor or recipient areas without first washing your hands!Call the office to report any increased tenderness or redness at your surgical sites.
Refrain from strenuous activity, whether work or play, for a full week following your surgery.Refrain from activities like weight lifting, lifting any heavy objects, or swimming in chlorinated water for at least ten days, preferably for two weeks, following surgery.If your work isn’t strenuous, you may return to light duty the day after surgery, but most people take two or three days off. If you’re concerned about swelling and crusting at the surgery site, you may be more comfortable taking a full week off, especially if this is your first procedure. Keep in mind that crusting will be more noticeable if you have little hair. The crusting should fall off between 7 and 10 days after your surgery.
Your donor area will have sutures that will usually be removed 14 days after surgery.
The day after your surgery, you may wash your hair gently in the shower. DO NOT TOUCH your grafts, even lightly, for two or three days following surgery, and avoid letting the water strike the recipient area directly for at least five days. Clean the graft area by diluting shampoo in a plastic cup and gently letting the watery shampoo run over the surgery site.Rinse in the same way. After three days, you can gently touch your grafts with your fingertips to apply shampoo in the shower.Hair products like holding spray and styling mousse can be used a week after surgery, but remember to wash these products off daily. Be careful, when combing, not to dislodge your grafts. Avoid using blow dryers or other hair dryers for at least one or two weeks, and then only at lower temperatures for a week more. Salon services like cuts, colors, or perms should be delayed until all crusting has fallen away from your scalp.