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FUE Hair Transplant

When it comes to the treatment of hair loss, especially in men, many assume that the treatment of choice for the best possible long term results is a hair transplant. In fact a hair transplant is the last option for hair restoration. It should only be considered once all other treatment options have been considered and exhausted. This is especially the case where the pattern and extent of hair loss is less severe. This applies to men as well as women.

However, for many, after years of toiling and grappling with tablets, foams, shampoos and PRP, the only option left is a hair transplant. This is a very big decision and it is very important that you consult the right clinic with the right expertise to achieve the best possible results for your money.

What is a hair transplant?

A hair transplant is considered to be a minimally invasive surgical procedure. It involves the ‘harvesting’ (extraction) of donor hairs from one part of the body and ‘grafting’ (implanting) them onto bare areas of the scalp. This is essentially moving hairs from thick hair bearing areas to areas with very little hair.

When should you consider a hair transplant?

There are a large number of factors that come into play when considering when and who is most appropriate for a hair transplant. As already mentioned a hair transplant is normally the last option for hair restoration. Suitable candidates normally have quite an advanced grade of hair loss with specific areas needing treatment. Examples include the hair line, the fronto-temporal corners or the crown, where various treatments have been exhausted. A consultation in clinic is extremely important before deciding on whether a hair transplant is the best way forward.


What are the most common techniques for harvesting donor hairs?

There are two techniques that have been developed for harvesting donor hairs for a hair transplant. The strip method, also known as FUT, was the first technique developed by hair transplant surgeons and is still the preferred choice for many old school surgeons. Follicular Unit Extraction, otherwise known as FUE, is a modern technique and the treatment of choice for the majority of hair transplant surgeons.

What is FUT and how is it carried out?

The strip method involves taking a strip of skin from the back of the head. The skin is taken to just below the base of the hair follicles and the individual hairs are cut up into small grafts with the use of a microscope. These individual hairs are then implanted into the areas needing grafting. This technique is carried out under local anaesthetic and is very labour intensive. The patient is normally left with a long scar at the back of the head which is normally covered by hairs growing just above the scar line. As a result it is not appropriate for men who wish to have their hair cut very short as the scar is often very visible. However, for women, this technique is sometimes more appropriate as the scar is hidden under long hairs at the back of the head. The rate of graft survival is slightly lower in FUT compared with FUE, but normally a larger number of donor hairs can be obtained.


What is FUE and how is it carried out?

Follicular Unit Extraction, FUE, is the procedure of choice for the modern hair transplant surgeon. This involves harvesting individual ‘follicular units’ (hairs) using a special automated punch device that cores out the hairs one by one. As a result it is not necessary to cut up the individual grafts in a separate process and hence the harvesting process is much quicker than FUT. This means that the donor hairs obtained are able to be transplanted onto the bare areas of the head much faster and often the graft survival rate is higher for FUE as compared to FUT. This technique is also carried out under local anaesthetic. Essentially FUE involves thinning out the back of the head to thicken up the top and make the distribution of hair across the scalp more even. The scars associated with FUE are much smaller and this is particularly suitable for men who are subsequently able to have their hair cut quite short.


Rejuvence Philosophy

At Rejuvence we specialise in the treatment of hair loss for both men and women and are able to provide a fully encompassing range of treatments. Hair transplantation is a fundamental component of this. We have extremely skilled and experienced hair transplant surgeons who will walk you through the entire process and will be close to hand every step of the way. Our technique of choice is FUE and we provide cutting edge PRP as well as the possibility of stem cell treatments.

We offer free consultations, where you will meet the operating surgeon and not a salesman trying to force through a sale. Our clinic is registered with the Care Quality Commission, and we abide by the rules and regulations of the General Medical Council. Your well being is our absolute priority and unlike as in Turkey, all our hair transplants are doctor-led as opposed to technicians who can’t speak any English. All this at an affordable price and at a clinic that you can trust.

Book your consultation today.

A healthy head of hair can be broadly divided into two zones. A full head of hair has approximately 120,000 hairs. The back of the scalp and sides normally have around 60,000 hairs. The top of the scalp normally has an equal numbeThere are a large number of factors that come into play when considering when and who is most appropriate for a hair transplant. As already mentioned a hair transplant is normally the last option for hair restoration. Suitable candidates normally have quite an advanced grade of hair loss with specific areas needing treatment. Examples include the hair line, the fronto-temporal corners or the crown, where various treatments have been exhausted. A consultation in clinic is extremely important before deciding on whether a hair transplant is the best way forward.r of hairs – around 60,000. The top of the scalp is most affected by hair loss, whether it be male or female pattern hair loss.
The hairs at the back and sides of the scalp are more resistant to hair loss processes as they develop differently to hair on the top of the scalp. They are much more robust and do not succumb to hair loss in the same way that hair on the top of the scalp does. As a result the most common donor site for hair transplants is from the back of the head followed by the sides extending towards the back of the ears. If further donor hairs are needed it is possible to harvest from the beard, just below the jawline, and finally the chest.

It is important to note that a hair transplant cannot recreate the same density of hair that was present before the hair loss process started. Once someone is able to see through to their scalp due to hair loss, they have normally already lost at least 50%. This means they have lost around 30,000 hairs. This number is much lower when it comes to the point of hair transplantation it self. An average hair transplant consists of between 2000 to 4000 hairs and hence it is clear that a hair transplant is essentially a natural camouflage procedure as opposed to truly restoring original hair density on top. However, this doesn’t mean that fantastic results are not possible if performed by a skilled hair transplant surgeon.

The donor hairs harvested, regardless of whether harvested using FUT or FUE, are implanted in much the same way. The areas to receive transplanted hair are marked out and a suitably attractive hairline is drawn onto the scalp. The implantation process involves making small slits in the scalp and the donor hairs are slotted into these slits. This is much like planting rice seeds in a paddy field. More recently innovative implanter devices have been designed – ‘Choi Implanter’ – that enable the surgeon to make the slits needed and slot in the graft at the same time. This makes the procedure much faster and can produce improved graft survival rates. This process is also carried out under local anaesthetic.

A hair transplant is a meticulous process and can take between 4 to 8 hours depending upon the number of grafts being implanted. In larger cases, often a second seating is needed the following day. The entire procedure is carried out under local anaesthetic and apart from the sting of the anaesthetic at the beginning of the harvesting and implanting phases of the procedure, the treatment is essentially painless. Patients are often able to have a nap during the harvesting process and watch a film in the treatment room during implantation.

With so many clinics, especially abroad in countries such as Turkey, it is important to understand what makes for a good result as opposed to just going to the cheapest clinic. There is a significant amount of skill and artistry involved on the part of the hair transplant surgeon in order to achieve a good cosmetic result.

The quality of results are dependent upon a number of factors. The harvesting process needs to be well planned and the resultant scars as small as possible. For FUT, if the donor site is not stitched properly, prominent and sometimes keloid scars can occur. For FUE it is important that the donor hairs are distributed evenly across the back of the scalp and as small a punch size as possible is used to avoid any obvious scarring and hence evidence of a hair transplant having been performed. The skill of the surgical team dictates how well the grafts survive. Individual grafts need to be harvested precisely, taking note not to cut across the roots of the follicles such that they can bed in well and survive.

The implantation process itself requires good planning and an accurate understanding of the direction of lie of the existing hairs on the scalp such that the newly grafted hairs grow out in the same direction and if possible are angled such that they provide as much scalp coverage as possible. This requires a wealth of experience and extremely accurate foresight. In addition it is important that donor hairs are not implanted together too densely as this may compromise graft survival. When implanted close to existing hairs, it is also important to match the angle of growth such that the roots of existing hair follicles are not damaged whilst new hairs are being implanted. Poor technique in this regard can result in good graft survival but further loss of pre-existing hairs. The net result is poor increase in density of hair coverage.

With the increasing popularity and success of platelet rich plasma treatments for hair loss, hair transplant surgeons have started preparing the scalp with PRP just prior to implanting the donor hairs. PRP results in a growth factor surge within the scalp as well as helping increase the blood supply (a process known as angiogenesis). Both these improve graft survival and it has been recommended by leading hair transplant surgeons that maintenance PRP sessions be conducted to ensure longevity of the hair transplant result. At Rejuvence we are keen to treat all our hair transplant clients with PRP before, during and regularly after the procedure.

More recently there has been a shift towards the use of stem cells in hair transplantation and generalised treatment of hair loss. At present purified stem cell sources are not easily available. The most common source of stem cells is ‘micronised’ (centrifuged and crushed) fat cells. They are known to be a rich source of ‘adipose derived stem cells’. The injection of micronised fat cells into scalp has been performed on its own but not combined with hair transplantation. At Rejuvence we are able to offer stem cells treatments alongside PRP for hair loss but as of yet are not combining this with hair transplants.

In the US there has been a rapid shift towards preparing the scalp with a substance known as A-Cell just prior to donor graft implantation. A-Cell has been found to yield excellent results if used solo or in combination with PRP. A-Cell is not currently available in the UK. It is derived from the small cells of the bladder of pigs. A-Cell usually comes in the form of a white powder. When mixed with water and injected into the scalp it forms a type of scaffold that hair follicles are able to anchor to. However, it is not all positive when it comes to using A-Cell. Some clinics in the US, specialising in stem cell treatments, have noticed that when combined with A-Cell there can be accelerated graft loss due to a type of alopecia areata as the scalp reacts badly. Overall the jury is still out when it comes to the use of A-Cell in hair transplantation and for hair restoration as a whole.

Prior to getting a hair transplant it is essential to prepare the scalp well with a few sessions of PRP. At Rejuvence we are able to offer Magellan TruPRP – a premium PRP treatment that delivers excellent results. It is also important to stop all blood thinning medication 2 weeks prior to surgery. All supplements, as well as minoxidil and propecia, should be stopped at least 1 week prior to your procedure. Afterwards, the aftercare instructions should be strictly adhered to. Smoking and excessive alcohol use before and/or after a hair transplantation can significantly hamper the final results. In addition maintenance treatments in the form of regular yearly PRP sessions and weekly Low Level Laser Therapy (LLLT) helps to maximise graft survival and keep your transplant looking great.

In cases where the extent of hair loss is quite widespread, and there is enough donor hair available, a second procedure maybe possible. In these cases, it is a particularly good idea to stage the transplant. This ensures the final results are as good as possible.

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