Follicular Unit / Graft Survival Rate

A meticulous approach exercising utmost care is a prerequisite for any medical treatment. This is especially true for the extraction of hair follicles and their subsequent survival rate.

Extracted grafts are vulnerable to dehydration. Extracted FUs waiting to be implanted are kept in a physiological solution corresponding to the human body environment. When being processed under the microscope, they are always kept damp.

Generally speaking, grafts extracted vie FUE are much more sensitive, as the extraction technique leaves much less protective tissue around the hair follicles. This ultimately leads to a slightly lower survival rate. Damage to healthy hair follicles influencing their survival rate, as well as a worse rooting rate, are possibilities in both techniques when the work is not performed in an optimal manner.

Implanting Hair Grafts

Even when optimally extracted, grafts can still become damaged during transplantation. This in turn will mean that a lower number of grafts actually take root.

The incisions in the recipient area, into which the extracted and prepared grafts are implanted, also play a major role in any transplantation. Incisions are best made with scalpels or blades specifically adapted to individual patients – so-called customized blades. Using these, the hair surgeon can match the width, length, depth and angle of the incisions with the direction the patient’s hair grows in. The right incisions also help the grafts to quickly connect up to blood vessels and nerves, having a major influence on their survival rate and making the transplant look natural.

Post Hair Transplant Healing

The level of pain felt is dependent on a patient’s sensitivity to pain. Transplantation is always done under local anesthesia and is therefore in general completely pain free. One effect of the local anesthesia when using FUT is a feeling of tension on the scalp. This is however generally only minor and will disappear after a few days. Healing after FUE treatment is faster than after FUT and generally free of pain. A temporary numb feeling, which could last for several months in case of FUT, does not occur with FUE.

The swelling in the transplantation area or possibly around the forehead and eyes is dependent on the FU density / size of the area treated or on the number of transplanted hair roots. It occurs with both methods and generally lasts for 6 – 8 days.

Surgical Hair Transplant Conclusion

Both techniques – FUE and FUT – have very good success prospects, but: there is no one best or right method – each method has its own pros and cons.

The decision on which extraction method to use should be individually weighed up in consultation with the hair restoration surgeon. There are many factors needing to be taken into consideration. A hair surgeon must be in a position to assess future natural hair loss, the quality and density of existing hair, and in particular the hair structure. He must also be able to calculate the number of grafts needing to be extracted to fulfill a patient’s wishes, discuss alternative forms of treatment such as a medication-based therapy, and explain to the patient the pros and cons of each technique. In addition, comprehensive tests need to be carried out before any recommendation for any one extraction method can be issued.

An FUE is best for patients wanting to avoid a linear scar at all costs, and for younger patients only requiring minor treatment. Moreover, FUE is the right choice when transplanting body hair or when corrective / reconstructive hair surgery is involved.

FUE is also good for patients with (very) little donor hair, as well as for patients with a tendency to extreme scarring or patients wanting to wear their hair very short. Patients with a Norwood V or VI diagnosis should choose a combination of FUE and FUT to attain the highest possible number of donor hairs.

Though both extraction techniques basically allow the same number of hairs to be extracted, there is one major difference. In an FUT, under good working conditions, 4000 – 5000 FUs can be extracted in one operation session. The corresponding figure for FUE is 3000 – 3500 FUs. Using the FUE technique, a second operation is generally needed to achieve the same number of FUs. This can only take place some 6 months later.

At Katona Hair Restoration we will review all options with you and help you determine the right procedure to accomplish your hair transplant cosmetic goals.