The FU is identified anatomically as a small bundle consisting of 1 to 4 hair follicles, full-thickness as well as fine hairs, and the oil glands, muscles and connecting tissue that accompany and support hair follicles. These little groupings of hairs are called follicular units (FUs). Identifying an individual FU can be difficult when follicles grow at angles under the skin .
The identification of FUs is done by the hair restoration specialist using a microscope/ loop. The identification, harvesting and transplanting of FUs requires the training and skill of a specialist.
A recent development in surgical hair transplant surgery is to specifically use the FUs for transplantation. FUE is performed by using a punch-like 'circular scalpel' to score the skin and mid-dermis to a level of about 2 millimeters around a follicular unit, then gently extracting the FU from within the scored circle.
Single follicular units are often used to fill in a hairline, multiple FUs to provide greater density in the center of the scalp. The FUs are transplanted into the scalp by inserting them into small slits incised into the skin and underlying tissue with a small blade or needle.
There has been debate regarding the scarring left at the donor site by harvest of FUs. Single-strip harvest leaves a single, fine incision that usually heals in a few days. Follicular unit extraction (FUE) leaves small holes 1 to 2 millimeters in diameter at the site of FU extraction. These holes are not stitched but are rather left to heal on their own. Proponents of the FUE procedure claim decreased or complete lack of scarring .
Follicular unit transplantation is a newer surgical technique that continues the modern emphasis on achieving a 'natural' look from hair transplants. It is a technique that, like micrografting, uses 1 to 4 units to achieve an even distribution of hair coverage over the scalp and avoid the 'row of corn' appearance that was common many years ago.
Process of Surgery of FUE Hair Transplant
- On the day of Hair transplant surgery, please have a head bath and a heavy breakfast.
- We will click the pictures of you bald as well as the donor area.
- Then we trim and prepare the donor area from the back of the head.
- We make the patient lie down in prone position on the operating table. We then take utmost care to give local anesthesia with minimal discomfort in the donor area. The grafts are then extracted from the donor area with the help of 0.8 and 1 mm special micropunches. The extraction of follicles is done under magnification. The extracted grafts are then preserved in cool Ringer Lactate solution. Each follicle may be consisting of 1,2,3 or rarely 4 hairs.
- The position of the patient is changed to supine position. Then the recipient (bald) site is then prepared by giving local anaesthesia. The slits are made with the help of special blades 0.8-1 mm in diameter and the extracted hair follicles are then implanted into this area.
- Implantation of the hair follicles is the most skilful and crucial step in FUE. The hair follicles containing single hair are implanted in the front to give a natural hairline and subsequently followed by units containing 2-3 hairs to give density to the area.
- During the procedure we give a tea as well as a lunch break so the patient should not feel tired during the surgery. Infact during the surgery, the patient keeps on chatting and discussing about himself or herself that we become 'friends' with them.
- The transplanted area is covered with a loose cap. The patient is discharged to go on his own. He can go to the market, watch a movie or just do anything he wishes to do!
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