Hair loss is majorly a problem related to men, referred as male pattern baldness. Men face permanent hair loss because of androgen reactions that start from as early as mid-20s. Androgen is a male primary hormone, which secretes a steroid called Dihydrotestosterone or simply, DHT.
The DHT destroys stem cells that are found in the dermal papillae of the scalp that cause hair follicles to grow. As stem cells get permanently destroyed by the DHT enzymes, the center and the front area of the scalp sees a greater effect as hair growth becomes weak, hair loss is triggered and receding hair-line emerge.
At large, the center and front of the scalp is prone to baldness, while the back of the scalp usually remain immune and sustain the same hair density all through one’s lifetime.
Hair loss might be a minor problem but men can be particularly sensitive about it, and find it emotionally difficult to cope up with. Even though men are the major recipients of hair loss and baldness, women can also be affected. Baldness in women is very rare, unlike women actually get profuse hair thinning.
So as long the back of the scalp is found to be immune against androgen alopecia/baldness, it carries the potentials of being the ideal permanent donor zone. Donor zone is the fundamental resource for the possibility of hair restoration. It is the hair in the back of the scalp that can be extracted and replaced into the recipient zone to cover bald patches and restore an even density.
There have been other hair restoration procedures, like scalp reduction, that actually cut short the bald areas of the scalp, which used to result in a lot of scarring and morbidity issues. The procedures are not performed anymore. Modern hair transplantation is the primitive choice of a well-designed procedure that yields naturalistic and viable results, with the concept of Follicular Grafting.
Follicular Grafting is a technique, which identifies the naturally occurring groups of 2, 3, 4 and 5 hairs, referred as follicular units and accordingly extracts them with a sheath of fatty tissue to cover the hairs essential moisture, thus a creating a natural environment for the hair replacement. Once the follicular units are dissected, it is then referred as a hair graft, which is ready to be planted into the recipient zone.
There are two methods or procedures of hair transplant surgery-Follicular Unit Transplant (FUT strip procedure) and Follicular Unit Extraction (FUE). The different procedures differ only by means of their process of extracting the donor hair from the back of the scalp. The rest of the procedure of creating the hair grafts, and placing them on the recipient zone is the same.
FUT: Follicular unit transplant or strip harvesting is the technique where hair is extracted from back or side of the scalp by removing a strip of skin, where hair is more resistant to baldness. After administering local anesthesia subcutaneously into the scalp, the surgeon removes a strip of tissue from the patient’s back of the scalp, with the skin strip containing numerous hair follicles. The donor strip is cut or dissected to yield hair grafts according to the individual follicular units of 2, 3, 4 and 5 hairs with a thin sheath of fatty tissue using microscopic dissection. The donor wound is closed and sutured into a fine line scar, which is most likely to be hidden underneath top layers of hair. The surgeon makes tiny holes in the recipient area and implements the hair grafts into it.
FUE: Follicular unit extraction procedure removes the follicular unit one by one directly from the scalp. This process is repeated until the hair transplant surgeon implemented enough hair grafts for the planned hair restoration. After that harvested follicles are placed into the recipient area. FUE rejects the need for cutting and suturing and the resulting scars. This is a scalpel free procedure, whereas it is not a scar-free procedure. The procedure results in pinprick specs of scars immediately after the surgery, which heals off beyond recognition within a week or so.