Dissection of Follicular Units for Hair Transplants Under the Microscope

Follicular Units Hair Transplantation

Follicular Unit Transplantation is a technique, in which hair is transplanted from the back of the scalp into areas affected by genetic balding (and some other types of hair loss), using only the naturally occurring, individual follicular units. This hair is considered permanent because it is not genetically programmed to go through the miniaturization process as is the hair in the front and top of the head. To remove follicular units from the back of the scalp without damaging them, the donor tissue must be removed in one piece. This technique, "single strip harvesting," is an essential to follicular unit transplantation because it not only preserves the follicular units, but also prevents damage (transaction) to the individual hair follicles. It is very different from the technique of using a multi-bladed knife that breaks up follicular units as this causes unacceptable levels of transaction of hair follicles.

Follicles under the microscope	Dissection of the donor strip into the follicular units

Another essential component of Follicular Unit Transplantation is "stereomicroscope dissection." In this technique all of the follicular units are removed from the donor tissue under total microscopic control to avoid damage. Complete stereomicroscope dissection has been shown to produce an increased yield (as much as 30%) of both the absolute number of follicular units, as well as the total amount of hair. (This procedure differs from minigrafting and micrografting in which grafts are cut using minimal or no magnification.)

Follicular units under the microscope
One hair grafts	Two and three hair grafts

An advantage of follicular unit transplantation (besides preserving follicular units and maximizing growth) is that it enables the surgeon to use small recipient sites. Grafts made up of individual follicular units are small because follicular units are small, and because the surrounding non-hair bearing tissue is removed under the microscope and therefore is not transplanted. Follicular unit grafts can be inserted into tiny needle-sized sites in the recipient area that heal in just a few days, without leaving any marks.

Incisions made for hair transplants	Incisions filled with follicular units

When performed by a skilled surgical team, Follicular Unit Transplantation can produce totally natural-looking hair transplants. They maximize the yield from the patient's donor supply to give the best possible cosmetic results. Because the tiny follicular unit grafts (and the very small wounds they are placed in) allow large number of grafts to be safely transplanted in one procedure, the total restoration can be completed in the fewest possible sessions