Hair Grafts— Methods, Possibilities, Costs and Reviews

Hair transplantation is an autologous surgery wherein a person’s own hair at the back of the scalp is relocated onto bald areas at the front and center of the scalp to achieve an even coverage all over. The density and volume of the resulting hair restoration depend on how much hair the patient has to donate for the procedure.

There are two modern methods of extracting the donor hair— Follicular Unit Transplant (FUT strip excision) and Follicular Unit Extraction (FUE). The two methods differ by means how the donor hairs are extracted, while the final creation of the hair grafts and the methods of planting them on the recipient (bald) zones, are all the same. FUT removes a strip of skin from the donor zone and dissects that skin to yield hair grafts according to the follicular units, while FUE plucks them out directly from the scalp.

Follicular Grafting and Micro Grafts

It is now identified that hair growth takes place in a certain pattern, in naturally occurring groups of hair rather than the single strands as we see it. There are single hair follicles as well as 2, 3, 4 and a maximum of 5 hair follicles that are densely packed in a unit, termed as follicular units.

So now, each hair graft contains from a single hair follicle forming a single hair graft, and up to 5 hairs, forming micro grafts. Hair transplantation practitioners hadn’t known about the hair follicular units until the late 90s. The predated techniques of the 80s and early 90s used larger hair grafts, that were chunks of skin harvested through strip excision or punch grafting that went on to create hair plugs that looked like the bristles of a toothbrush rather than natural hair. But now, only follicular grafting concept is followed outdating the “mini grafts” as now referred to contrast with single grafts and micro grafts.

Types of Hair Grafts

The types of hair grafts are referred by the number of hairs each graft contains, which could be from one to 5 and sometimes, 6 hairs and anything more that that could be considered as an immigrant that is no more in use.

Types of hair grafts are classified as a single hair sprouting from one individual follicular unit, type two could be two hairs sharing one hair follicular unit, and a three or more hairs sprouting from a common unit. Hair graft numbers determine the placement of them in a row.

Creating Hair Grafts

The creation of hair grafts differ with FUT and FUE. The strip excision with FUT is done under a microscope in an open dissection process where the surgeon could see the hair angles and directions apparently. Hair follicles have the tendency to change directions that seem on the surface of the scalp and that which resides beneath. So the open dissection is an advantage, which with the FUE procedure is a risk factor. As the FUE procedure plucks out he hair follicular units, it is at risk that the hair graft could be damaged in the very way of extracting it, if it is pulled in the opposite direction.