Modern hair transplantation was introduced by Dr. Orentreich in 1950. He used a 4 mm round punch to remove groups of follicular units from occipital region and sides of the scalp where hair is permanent to areas that are thinning or bald.One of the most basic concepts in modern hair transplantation is the concept of Follicular Unit (FU).
Follicular units are tiny bundles of 1,2,3,4 or more hairs that occur in the human scalps. In the microphotograph you can see what a FU looks like. There are two ways to obtain FU, from the donor area of the sculp.
Firstly, FUT or strip method where donor harvesting is done by removing a part of the skin from the back of the head with elliptical incision followed by suturing.
The significant disadvantage of strip is the resultant linear scars and the high probability of postoperative pain and discomfort for the patient .
FUE is the method Dr Zontos exclusively uses in his daily practice and was introduced by Berstein and Rasmann in 2001.
In this technique a tool known as a punch is used to make a small circular incision in the skin around a FU, separating it from the surrounding tissue. The FU is pulled out directly using a pair of forceps.
This process may be performed manually or using a motorized punch, or more recently by a robotic system known as ARTAS. The healing process is very quick as you can see in the pictures. The donor wounds completely heal over a 7-10 day time period. The extraction process is repeated until the hair surgeon has harvested the desired number of grafts. The duration of the harvesting process varies from person to person and depends on the number of hairs required .Although most of the cases can be performed in one day ,in some very large sessions may take 2 or 3 consecutive days.
The Wand Computer assisted anesthesia system has been recently adopted by our clinic as the most efficient and safest way in anesthetizing the skin during a hair transplantation procedure .The state of the art digital platform for local anesthesia greatly increases patient's satisfaction , decreases anxiety and controls flow rate and pressure of anesthesia during the injection!
Greatly reduces anxiety
Controls flow rate
No retracting motion
Minimizes pain during anesthesia
1 day later
In FUE The donor wounds completely heal over a 7-10 day time period.
FUE is for everybody but it is ideal choise for...
Very short hair
Minimally invasive procedure
Tough skin (previous STRIP procedures
Patients who develop cheloids
Patients with limited donor area due to several strip methods
Patients with extreme fear of the FUT
Patients with not enough donor area, body hair transplant can become a good alternative
Athletes for speed recovery
The grafts are placed into the recipient sites where they will grow into healthy hair producing follicles. Recipients sites are made in the balding area using a specific surgical tool which quarantines a completely natural result while eliminating injury to the recipient area.
The FUE technique has been gaining in popularity over the last 10 years .A reasonable explanation of this is that FUE is a minimally invasive procedure compared to strip technique and is not associated with a permanent linear scar on the donor area.
However ,the strip supporters claim that FUE produces lower quality grafts ,because of the absence of adipose tissue around them .On the other hand ,strip produces grafts with enough perifollicular fat tissue and therefore of better quality .
In my opinion the base of the aforementioned claim is correct .However, this problem has been solved.
In our everyday practice we observed firsthand the quality of FUE grafts obtained either using manual or motorized punch by using a micro camera .The new technology punch in combination with vertical extraction technique, allows us to produce far better quality of grafts with enough amount of protective tissue ,while maintaining minimum skin injury .
In the following pictures on the left hand side, you can see intact FUE grafts produced with a manual punch ,whereas in the pictures on right hand side ,the grafts produced with a new technology punch ,have more protective tissue . It is well known in hair restoration community that the more the protective tissue the better the viability of the grafts and consequently the survival rate .
Appearance of grafts without protective tissue produced by a manual punch .micro photograph and naked eye picture.
Appearance of far superior quality grafts produced with new technology punch in combination with vertical extraction technique.micro -photograph and naked eye picture