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HAIR TRANSPLANT SURGERIES
EXPLANATION
What are follicular units?
Most people (including some doctors) believe that hair grows in single strands over the entire scalp. Not true. Look through a stereoscopic dissecting microscope at the Hair Sciences Center of Colorado and you'll see that hair grows in small bundles of one to four-and occasionally, five-hairs. These bundles, along with their support system (below-the-skin sebaceous glands, muscle and connective tissue) form what is known as a "follicular unit."
TYPES
FOLLICULAR UNIT EXTRACTION (FUE)
What is Follicular Unit Extraction (FUE)?Follicular Unit Extraction is a very new technique that may help to minimize scars in the donor area and to reduce healing time. Specifically, FUE is a method of obtaining follicular units from the donor area one at a time using a very small (one millimeter) punch (a surgical instrument used to obtain small samples of tissue). Surgeons performing this new technique select the follicular unit to be removed, the punch is then placed over the follicular unit and a small circular incision is made approximately half way down the unit's hair shafts. Next, the unit is grasped and extracted from the surrounding skin.
Inexperienced surgeons using this technique may damage more than 20-30% of the hair follicles. To minimize follicle damage, Dr. Harris has developed the SAFE System and the SAFE Scribe for the patient's benefit (see below for a description of the SAFE System).
FOLLICULAR UNIT HAIR TRANSPLANATION
What is Follicular Unit Hair Transplantation?
FUHT is a specialized surgical procedure in which follicular units comprise the grafts utilized in transplanting a bald area. This calls for the precise dissection of each follicular unit from the donor tissue using a stereoscopic dissecting microscope. As Dr. Harris will explain, several other important criteria separate this procedure from traditional "micrograft" procedures.
Once the units are prepared, they are carefully placed in thinning/balding areas in such a way as to achieve the most natural appearance. This means we rearrange the units-using one- and two-hair units to reconstruct the hairlines and three- and four-hair units to create density behind the hairline zone. This makes the results virtually undetectable.
What does the scar from FUHT look like? How long... how visible... what should I expect?
The scalp is very elastic. When the donor strip of hair is removed, the scalp on both sides is simply pulled together and sutured. The only evidence of surgery is a thin, horizontal line hidden under the hair on the back or side of the head. The scar usually resembles the crease of the palm of your hand. Immediately after surgery, the scar is hidden in your hair. It should not be visible unless your hair is lifted up. After healing, the scar is virtually impossible to find. The length of the scar will depend on the number of grafts needed. Larger sessions will require a longer scar and vise versa.
I like to wear my hair short in the back. Will the scars from the transplantation show through? After you have healed, you can cut your hair fairly short. Do understand, however, that scars will be detectable if your hair is so short that it does not layer or lie down in back. No matter how fine they are, scars do create some distortion in the skin.
Can I ever shave my head after FUHT? What would it look like?
If you are considering shaving your head, hair transplant surgery - of any kind - is probably not in your best interest. The point of hair transplantation is to not look bald. If you have had FUHT, shaving your head will reveal the small skin distortions that naturally accompany graft placement, and the donor area scar may be visible. However, if you have had FUE, there will be no donor scar, so in the event that you wanted to shave your head, it would be possible.
GENERAL HAIR TRANSPLANT SURGERY QUESTIONS
Are the end results of transplants using FUE better than those of FUHT?
No, the appearance of the transplanted area is the same.
How does FUE differ from FUHT?
The difference is in how the individual follicular units are obtained. In the standard FUHT the donor units are identified and dissected away from the donor strip using operating microscopes. The donor strip (a portion of skin) is surgically removed from the donor area and the incision from the procedure always creates a linear scar. In comparison, FUE creates small (less than one millimeter) scars where each unit has been removed. No strip of skin is removed.
What is the Harris SAFE System and Scribe?
Dr. Harris, HSC director and lead surgeon, has developed a proprietary method of Follicular Unit Extraction (FUE) called the Harris SAFE (Surgically Advanced Follicular Extraction) System. This patented breakthrough methodology is the most advanced hair replacement option currently available. The Harris SAFE System not only avoids donor-strip surgery - meaning there is less scarring and discomfort - but also minimizes graft trauma. The more grafts that survive, the better the outcome.
The SAFE procedure, uses a special instrument designed and patented by Dr. Harris known as the SAFE Scribe™. This new methodology means that individuals who were previously not considered good candidates for FUE-including African Americans and those with gray hair-have a viable option. Additional patient benefits include:• Virtually 100% of patients are candidate• Increased available donor hair due to less follicle damage• Increased donor capacity, as diminished scalp laxity is no longer an issue•More natural-looking hairlines are possible, because the surgeon can select hair characteristics in addition to the number of hairs for placement. Specifically, the finer hair found at the nape of the neck or behind the ear can now be selected and transplanted.• Decreased post-operative pain• Reduced healing time• No visible scarring• This system is available to FOX Negative® patients• Ideal for the patient who has been told nothing else can be done• African American and gray-haired patients will benefit significantly and become better candidates for the surgery due to less follicle damage
Contact the HSC office to determine whether the Harris SAFE System is right for you.
Is each follicular unit transplanted, irrespective of the number of individual hairs in that unit, considered to be one unit for purposes of your fees?
Yes. It is the same price whether the unit has one or more hairs.
Can hair from other areas of the body be transplanted on the head?
It can, but this is usually only done when a patient has exhausted the scalp donor supply. The patient must be aware that body hair is not the same as the hair on the head. It usually grows at a different rate and has a different texture. Hair from other regions of the body will grow when placed on the head, but may have a slightly different characteristic than the existing scalp hair. Hair obtained from other areas of the body should be harvested by follicular unit extraction (FUE).
Can you control the direction in which the transplants will grow?
Yes. Dr. Harris carefully selects where to place each follicular unit that is transplanted. He chooses the recipient sites to maximize the natural look of the final outcome, as each recipient site made by Dr. Harris directly determines the direction and angle of growth. The direction will follow the pattern of hair native to that region.
SURGERY CANDIDATES
How do I know if I'm a good candidate for hair transplants?
Most men and women in good general health are candidates for hair transplantation. Your personal situation is best determined through a private consultation with Dr. Harris. As noted previously, your consultation will provide plenty of time to have your questions about candidacy, options and outcomes answered to your satisfaction.
What can I expect in terms of density and fullness?
The word fullness rather than density more accurately describes the visual effect of what we perceive as "thick" versus "thin" hair. The concept of fullness is broader and more inclusive. Density (the number of hairs per square centimeter) is only one of several contributing factors involved in a positive visual appearance. Other contributors include hair shaft diameter, color, texture and curl. These factors may be of equal, or even greater importance, than density in achieving a "full" head of hair.
For example, in the early stages of balding, the "thin look" is caused by a process called miniaturization, whereby hair is reduced in size but not actually lost. Therefore, the density (the counted number of hairs/cm2) remains the same, although the person's look of fullness can be dramatically reduced. Depending on these factors, the results after initial surgery will vary from patient to patient.
How many hairs would you estimate I need to restructure my hairline?
The only way to give you an estimate is to assume that you are completely bald. Consider this: filling in small recessions usually requires around 500 follicular units. To fill in the frontal forelock and hairline can require from 1000 to 1400 follicular units. If you draw a line across the top of your head between your ears, the area to be filled in may require approximately 1600 to 1800 follicular units; and to reach the point at the horizon - called the vertex transition point - requires up to 3000 follicular units.
All of these quotes are approximate. Your personalized estimate will also depend on bone structure for placement of the hairline, your needs for density and the amount of hair already present.
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