HAIR RESTORATION TECHNIQUES
We offer two types of hair transplant replacement procedures, one termed Follicular Isolation Technique (FIT) (aka FUE) and the other Follicular Unit Grafting (FUG or FUT).
What are Follicular Units?
The hair in every person's scalp grows in tiny groups called Follicular Units. Although scientists have recognized this for some time, physicians performing hair restoration surgery largely ignored their existence. The Follicular Unit of the adult human scalp consists of 1-4 terminal (full thickness) hair follicles.
The Follicular Unit is very small and can only be identified under magnification. The instrument commonly used to measure these naturally occurring groups is called a Densitometer. It is a simple tool that is placed on a small area of scalp whose hair has been clipped closed to the skin surface. Its use should be an integral part of your hair loss evaluation. Follicular Units are best viewed under a microscope, where they are seen as well-formed structures in the skin.
Follicular Isolation Technique
Follicular Isolation Technique, referred to as FIT, is a technique co-developed by Dr. Rose. The procedure involves removing the naturally occurring groupings of hair (follicular units) one by one. With a FIT procedure, the donor hairs are isolated and removed with a one millimeter punch device which is often utilized with a specially constructed head positioning device co-developed by Dr. Rose.
The advantages of this technique include maintaining the donor area without any linear scar visible to the naked eye. In fact the donor area appears to heal faster than with traditional methods and the patient can wear his or her hair as short as desired, but not completely shaven without being concerned about a linear scar.
The technique is especially useful for young men who want to have a procedure, do not require large numbers of grafts,and wish to wear their hair very short.
In addition, the patients who have a limited donor area can also benefit from this procedure. Many patients who have been extensively harvested are not good candidates for further strip harvesting. For these patients, grafts that would otherwise be unavailable may be obtained in significant numbers. In most cases, sessions of 600-800 grafts can be accomplished quite readily in a single day.
How is Follicular Unit Grafting performed?
FUG or FUT : The key to Follicular Unit Grafting is to transfer intact Follicular Units from the permanent donor zone in the back of the scalp to the recipient (balding) areas. In order to remove Follicular Units from the back of the scalp with minimal damage , the donor tissue must be removed in one piece. This technique is called "Single Strip Harvesting." It is an essential component of Follicular Unit Grafting as it not only preserves the follicular units, but also it prevents damage (transection) to the individual hair follicles and insures maximum growth.
LEDGE Closure Technique
The LEDGE closure technique is another evolutionary achievement in modern day hair replacement technology developed by Dr. Rose. The LEDGE closure is a virtually non-scarring technique for minimizing the visibility of donor hair strip sites used in Follicular Unit Grafting (FUG or FUT). Dr. Rose presented this technique hair restoration surgeons internationally.
The closure is performed with minimal, or no tension and a single layer closure (instead of a two layer). Dr. Rose has stated "I think that more and more physician(s) are going to a single layer closure and a two layer closure is not "the norm". A single layer closure causes less trauma to the tissue and I feel that there is less scar tissue produced. At times a two layer closure may be necessary to attempt to take off tension from a wound."
The end result for the patient is that the technique allows hair to grow through the donor-area scar, providing added added camouflage, and patients who have undergone the procedure are able to cut the hair over the donor area very close, and in some instances, could have a nearly shaved head. You can look at the results for yourself:
We have been using the LEDGE technique for several years, when appropriate for the patient, and have had very encouraging results.
The second essential component of Follicular Unit Grafting is "Microscopic Dissection." In this step, the donor tissue (obtained with single-strip harvesting) is carefully subdivided into individual, naturally occurring Follicular Units under the careful control of a Dissecting Stereo-microscope. In the process, the non-hair bearing (bald) skin surrounding each Follicular Unit is carefully removed producing a tiny, compact graft, while avoiding damage to the hair follicles.
Complete stereo-microscopic dissection has been shown to produce an increased yield of both the absolute number of follicular units, as well as the total amount of hair, in upward of 25% when compared to other non-microscope techniques.
A major advantage of Follicular Unit Grafting (besides preserving follicular units and maximizing growth) is the ability to use small recipient sites. Grafts comprised of individual follicular units are small because Follicular Units are themselves small, but also because the surrounding non-hair bearing tissue is removed under the microscope and doesn't need to be transplanted. Follicular Unit grafts can be inserted into tiny sites in the recipient area, which heal in just a few days, without leaving any marks.
The very small sites permit many follicular unit grafts to be safely transplanted in a single procedure allowing the entire hair restoration process to be completed as quickly as possible. When performed by a skilled surgical team, Follicular Unit Transplantation can provide a totally natural looking result in one or two sessions.
The Downside of Minigrafing
Critics of this technique (Minigrafing - where a donor "Strip" is not used) point out that achieving maximum density at the expense of naturalness is not a desirable goal and feel that the same density can be better achieved by newer techniques. The major concerns with mini-micro grafting are that damage to the hair follicles caused by the multi-bladed knife will impair full hair growth. The lack of preservation of the natural hair groupings in the scalp (called follicular units) will produce less than natural results, and the larger wounds needed for mini-grafts take longer to heal and may result in permanent changes in the surface of the scalp.
In mini-micro grafting, neither preserving follicular units nor even keeping hair follicles intact are felt to be particularly important. Rather, the speed and economics of the procedure are the driving factors.
The Natural Hairline
Our doctors are specialist in creating natural hairlines and have written ground-breaking papers for peer reviewed journals on the subject for both men and women.