The basic surgical plan for hair restoration is that the candidate's own existing hair is relocated to bald zones. Surgical planning of modern hair transplantation has first of all developed the follicular grafting strategy. In this strategy, the naturally occurring groups of hair are selected in 2, 3, 4 and 5 hairs for each graft as the hair is plucked from the back of the scalp with a thin sheath of fatty tissue. This technique replaces the old methods wherein 1 hair graft consist of of 7-12 hairs making unnatural looking hair plugs.
The hair grafts can be harvested by two methods.
- Follicular Unit Transplant Strip Procedure (FUT)
A strip of skin can be removed from the back of the scalp which would contain the hair follicles stuck in it, in the procedure termed as Follicular Unit Transplantation. The skin is dissected under a microscope to separate the hair grafts. One 20cm strip of skin can commonly contain 1,500 to 2,000 hair follicular units. The area of the scalp from where the skin strip is removed, leaving an open wound which is closed and sutured into a fine linear scar that may be hidden underneath upper layers of hair. However, with poor planning of either the strip accuracy, wound closure and suturing can leave a more constant permanent scar.
- Follicular Unit Extraction ( FUE )
Individual hair grafts are extracted one at a time through a long strenuous process. This surgical option eliminates the need to remove any skin strip or skin cutting, with resultant potentials of no permanent scarring. The procedure is also minimally invasive with very less downtime and surgical fatigue. However, the surgical planning of this method is a critical factor, as the one at a time graft extraction presents the hair grafts to stay out of the body for longer period jeopardizing graft survival after the transplantation.
For accommodating the hair relocation on the barren zones, a person requires more than a sufficient donor reserve (enough hair at the back of the scalp). This is also beneficial for maintaining an even density all through the scalp area. However there are a set of many other factors which qualify the eligibility of a patient with the best potential credits for undertaking this surgery.
Assessing the baldness pattern of the candidates is required to understand the best technique possible for harvesting donor reserve hair, which is usually located at the back of the head. The faster you get to realize that the future baldness possibilities are well understood by glancing at the pattern of the current baldness pattern of the candidate.
The hair which is already affected by the genetic baldness beholds the characteristics of the recipient zone, which may come out gradually even after treatment. Infact, even if the transplantation is expensive, but taken from the affected donor region, the risk of persistent baldness still exists.
Proper assessment of the thickness and the healthy texture of the donor hair is required to understand the number of grapes required to achieve the best area coverage of the scalp.