Some clinics that wish to take wider donor strips will also use “undermining” to surgically separate the upper dermal layers in the donor zone from the underlying “galea”. The galea separates the dermal layers from the musculature of the scalp and allows for the donor wound to more easily be pulled together. This helps to reduce tension of the donor wound closure which helps to prevent undesirable donor scar stretching.
Upon closure of the donor wound the doctor will use surgical staples or sutures or a combination of the two with removal expected roughly two weeks post-surgery.
With the donor strip removed the technicians are able to begin the dissection process. In order to do this the strip is cross-sectioned with medical razor blades or scalpels into fine “slivers”. These slivers are narrow enough so that the bundles and more easily be seen and further dissected. They are then handed off to the rest of the technician team so they can further dissect the tissue down to the bare follicular units.
The doctor usually starts making the incisions into the recipient scalp at this time. Some clinics will require that the recipient zone be shaved so that the doctor can better see where to make the incisions as it is thought to help minimize transection of the native follicles. Most clinics however do not require such shaving as transection can be avoided with the use of magnification to aid the doctor.
Once the doctor has completed the incision making process technicians will start to place the grafts into the recipient sites. Some doctors will work alongside their technicians during the process but most doctors leave the placement completely to the technicians.
Recovery from FUT generally requires approximately one to two weeks off from work and in most cases no strenuous activities such as weightlifting and sports for six to twelve weeks minimum. The duration of the recovery is solely for the benefit of the donor zone due to the fairly invasive nature of strip removal. The recipient area typically heals within two weeks and is free from risk of physical trauma thereafter. Once the donor zone has completely healed a linear scar will remain for life. The length and width of the donor scar will vary due to the size of surgery and healing characteristics along with physician skill. When performed properly and the patient has average healing characteristics the donor scar is easily concealed with moderately short hair styles.
Follicular Unit Extraction
Follicular unit extraction, more commonly known as “FUE”, is the latest hair transplant surgery available on the market. Since its first introduction in the early 2000’s it has slowly but steadily gained market share worldwide. For the first time in hair restoration history a new procedure was introduced and adopted that did not improve on the overall naturalness of a hair transplant. Instead, the only procedural change addressed how donor hair is harvested. With FUT the donor hair is harvested with a linear strip. With FUE, donor hair is harvested with small diameter surgical punches. This was the only major difference between the two procedures. In fact, in the first several years of the technique being available from various clinics, it was widely recognized that overall yield from FUE was actually inferior to properly performed FUT surgery. However, the demand for hair transplant surgery that lacked the lifelong linear scar of FUT was growing and combined with the online marketing push of clinics that were dedicated to the procedure, FUE gained market share parity with FUT in 2015 and is set to become the dominant procedure moving forward. FUE is the first hair transplant procedure in history to be introduced, marketed, and grown through the combined efforts of clinics and patients by way of the internet.