Many clinics that have been proponents of FUSS and subsequently embraced FUE have taken the position that a combination approach is the best method of achieving the ultimate number of grafts for any given case. The idea is that a patient should “strip out” using follicular unit strip surgery until it is agreed that the donor area can no longer provide additional strips without compromising the donor laxity resulting in a stretched or widening donor scar. This is where it is argued that FUE can take over to continue with more surgery to harvest additional grafts above and beyond what can be provided by FUSS alone. The logic is that the laxity is no longer a factor and viable donor hair can be extracted from outside of the traditional safe donor zone while still retaining non-DHT sensitive characteristics. Unfortunately, even with this approach, the FUE surgeon must take into account the one to one ration of reduced density throughout the donor zone. If this density is reduced too much then the cosmetic viability can be compromised thereby revealing the donor scar from the previous FUSS procedures. Regardless, combining the two procedures does allow for greater numbers of grafts to be harvested thus a satisfying outcome is more likely.
With patients lower on the Norwood chart the appearance of a “full restoration” is more likely with proper planning and care but it should always be remembered that a true full head of hair is not likely to be reproduced as each hair lost would have to be replaced. This is a mathematical impossibility if there is any expectation of achieving naturalness without the appearance of surgical intervention.
acial Hair Transplants
Facial hair transplantation has gained more popularity in recent years with beard hair transplantation seeing the biggest gains. There are several different kinds of facial hair transplant surgery available.
When patients are seeking beard, mustache and sideburn hair transplant surgery they are generally looking to thicken their existing facial hair or to construct a completely new beard, mustache or sideburns from scratch when they cannot be grown naturally. Beard and mustache hair transplantation in particular have seen an explosion in popularity since around 2014 due to the growing acceptability of strong, thick beards as seen in fashion trends. The process is simple; it involves one or both types of surgical hair restoration currently available known as FUSS or FUE. Hair is taken from the donor scalp of the patient and transplanted to predetermined areas of the face. The patient is usually given a mild sedative as their face is injected with painkillers and tumescence throughout the day. Once the procedure is completed the patient is free to leave as this, and all hair transplant procedures, are considered to be outpatient surgeries with no need for overnight stay. Beard and facial hair transplant procedures usually require more than one pass to achieve a desired density.