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What is understood under FUT (Follicular Unit Transplantation)?
FUT is a method in which a strip of the scalp is taken from the donor area - generally the back of the head. It then involves extracting from this strip individual hair follicles / follicular units under the microscope and preparing them for implantation. These Follicular Units, or FUs for short, grow in groups of 1 - 4 or sometimes even 5 follicles. The transplant material thus obtained is then implanted into a prepared recipient area. Hairs extracted this way retain their genetic information, growing again naturally in the recipient area after transplantation. To obtain the requisite number of hair follicles needed for the transplant to look natural, the patient's existing hair density in the donor area is determined as exactly as possible (density measurement). This is done by counting the number of FUs per square cm before FUT treatment and is the basis for determining the size of the strip of scalp to be removed. The strip of scalp (or any other area covered in hair) is then removed using a scalpel. This is done under local anaesthesia, meaning that no pain at all is felt.
The advantages: which patients are suited for FUT?
The biggest advantage associated with a strip extraction is the large number of FUs that can be made available during a single transplantation session. In contrast to Follicular Unit Extraction, many more hairs can be extracted within a much shorter period of time, thereby reducing effort. The FUT method is primarily suited to patients classified as Norwood III - VII, as these need many more hairs to be transplanted. Patients older than 30 - 35 are also deemed as being more suited, as the occurrence of the so-called stretch-back effect is less pronounced. FUT is also suitable for combined transplantations, for instance when scarring from a previous hair transplant needs to be corrected or at least decreased and when at the same time a hair transplant is to be performed.
The limitations of FUT
Type of scar and its development
The scar left by FUT at the back of a patient's head is very narrow, in most cases just 1 - 2 mm wide. The length differs. It is always a linear scar, and more or less visible. Its visibility is not just dependent on the hair surgeon's skill and experience and the technique he uses, but also on such individual factors as the patient's age, the type of skin, skin characteristics, skin tension and the healing process. How the scar develops is not foreseeable, even when past wounds have healed nicely.
Also needing to be taken into account is the fact that a linear scar can change through the healing process and the tension of the scalp (the so-called stretch-back effect). This can occur directly after the transplantation or in the course of the six following months. The wound is sutured or stapled, meaning that there are stitches or staples needing to be removed. Dependent on the size of the FUT scar, hair can often not be worn shorter than 10 - 15 mm without the scar being seen.
The operation, healing process and possible post-operation complications
Ideally, the donor area should be shaved before the operation, in particular when a high density-FUT or mega-session is involved. Exceptions can be made and should be personally discussed with Dr. Feriduni. Where only small transplants are involved, in certain cases no shaving is needed at all. Though very seldom, complications can occur during or after the transplantation, as is the case with any operation. These include scar pain and wound infections. In the donor area a feeling of numbness can occur, or tension can be felt. Moreover the healing process can last quite a long time (up to 2 weeks) due to the size of the incision. After transplantation patients should desist from active sport (bodybuilding, martial sports) for a period of about 6 weeks. Light sport activity such as jogging, swimming, cycling can be started after about 2 weeks, though care needs to be taken.
When extracting the donor hairs, hair follicles situated in the immediate vicinity of the cut may be damaged or injured. With the wound being sutured or stapled, this is another possible cause of damage to hair follicles. After the operation, swelling can take place. In some cases transplanted FUs may fall out.
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