follicular unit transplantation

Hair Transplant Surgery has recently undergone revolutionary changes and developments.

The first generation of hair transplants led to unsatisfactory results because of bad scarring that gave an unnatural appearance.

The innovative transplants performed today by the best surgeons, are characterized by the use of combined techniques, which allow to minimize the problem of the scar, to maximize the growth of the grafts and achieve natural-looking esthetic results.

For individuals with sufficient donor area, hair transplant surgery is the most effective and less problematic response to the problem of hair loss.


In the last thirty years more than two million men and women have undergone surgery for baldness.

The surgical treatment of baldness involves the use of grafts of small groups of hairs present just as found in nature that are placed at a minimum distance from each other and in large numbers.

These follicular units are obtained through the dissection of the lozenge from the donor area making use of a stereoscopic microscope specifically designed for this purpose. During the transplant surgery, the surgeon creates the recipient sites through small incisions in the recipient area of the scalp. Once grown the transplanted hair will produce the best possible result in terms of naturalness and density.

We analyzed with detail the different phases of the intervention by the strip method, making use of explanatory videos also kindly provided by Hasson and Wong clinic.

Follicular Unit Transplantation step 1- Preparation of the recipient area, identification of the strip.

Dr.Hasson, in the process of Follicular Unit Transplantation identifies the donor area, shaves it down to a few millimeters, injects the anesthetic and designs the donor area removal strip. Permanent hair in the back of the head represents the area that is defined by the baldness surgeons as the donor area. The donor area is genetically resistant to the advance of the androgenetic alopecia process. The hair transplant consists on removing the grafts resistant to DHT from the donor and placing them in the areas of the head suffering from baldness.

For patients with enough donor area, baldness cosmetic surgery is the most effective and simple response to solve the problem of hair loss. The removal safe zone in the back of the head contains the strongest hairs of the scalp which are genetically insensitive to the genes of male pattern baldness. Hair follicles extracted from the safe extraction zone retain their characteristic insensitivity to DHT even when they are transplanted to bald areas of the scalp.



Follicular Unit Transplantation phase 2 – anesthesia, strip removal, dissection of the grafts and suture of the scar

The Follicular Unit Transplantation begins with the injection of local anesthetic in the donor area. The anesthesia will ensure that you do not feel any pain. Once the area is numb, the doctor will begin to remove the lozenge from your donor area. The removal of the strip requires about 45 minutes. During this phase of the intervention you will be lying face down on a comfortable table, very similar to a massage table.

Once the removal of the strip is complete, the surgeon will close the wound in the extraction area with stainless steel staples specifically designed for use in cosmetic surgery or with sutures. While the doctor closes the donor area, technicians will begin to separate the follicular units from the donor area strip.

The hairs in our scalp grow in small groups called follicular units, which can contain from one to five hairs each. It is important that the integrity of these groups remain unchanged during the dissection process. The extraction of follicular units from the donor area require a procedure divided in two stages: first, the fragmentation of the elliptical strip in small sections and subsequently the dissection of the follicular units from these fragments.

Both stages of this process are made through the use of a stereoscopic microscope for dissection. The use of these technically advanced microscopes has reduced transection of follicular units to the extent that it is now possible to obtain a 30% increase of follicular units extracted from the donor area. The motive is that now it is possible to directly visualize the scalp that it’s being dissected with a high magnification, rather than cut blindly through the lozenge removed as it happened when using the old techniques of hair transplant.


Follicular Unit Transplantation phase 3 – Preparation of the recipient area, preparing custom blades and slit incisions.

follicular unit transplantation

With the lateral slit technique the incision is made to fit perfectly in depth and dimension with the follicular unit that will be inserted, this is why custom blades are used (with a cutter invented by Dr. Hasson). The blades produce incisions ranging from 0.6 mm to 1.2 mm.

The incision for a single graft measures from 0.5 mm to 0.7 mm or 10 times the diameter of the hair, which varies between 60 and 85 microns.

For multiple grafts, the incision varies between 0.9 mm to 1.10 mm, depending on the caliber of the hair and other variables. This way can from 30 to 85 follicular units can be fitted into a 1 cm2 square.

During the Follicular Unit Transplantation, the bleeding is reduced because the incision is less deep and the blood vessels are less damaged.

The shaving of the recipient area is especially important to explore the theme here. If you want to know more about this subject click here.


Follicular Unit Transplantation phase 4- Placing of the grafts.

Technicians take care of positioning the graft inside the incision made by the surgeon. It is a job that requires great precision and proper training because the grafts are particularly fragile.

The grafted hairs will grow over the next 12-15 months. Here you can find a useful discussion on the dynamics of growth.



For more information about the strip technique I invite you to view





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