FUT Hair Transplant: Comprehensive Guide

This comprehensive guide provides you with an in-depth understanding of FUT hair transplant surgery, including, the ideal candidates, what to expect before, during, and after the surgery, the risks and complications, and the most frequently asked questions.

What Is FUT Hair Transplantation?

Follicular Unit Transplantation (FUT) is a minimally invasive procedure that addresses receding hairlines resulting from male pattern baldness. 

It involves removing small clusters of hairs, known as follicular units, from a strip in the donor area of the scalp. 

These clusters are then inserted into the recipient area, which is the bald region on the head. By replicating natural growth, the transplanted hair establishes itself in the recipient area of the scalp.

 The grafts used in FUT are very small, allowing for their insertion into tiny recipient areas on the scalp. This procedure is minimally invasive, resulting in a brief recovery period for patients. 

FUT is particularly effective in covering receding hairlines caused by male pattern baldness. Each group of hair, consisting of 1 to 4 hairs along with the follicle, is implanted into the scalp. 

With FUT’s smaller units, thousands of grafts can be implanted in a single session, providing patients with a fuller and natural-looking hairline.

Candidates For FUT Hair Transplant 

Preferred candidates for FUT hair transplant:

  • Ideal candidates for FUT hair transplant generally fall into the age group of 25 and above, as hair loss patterns are less predictable in younger individuals. 
  • The Norwood pattern of hair loss, commonly seen in men, tends to respond well to hair transplantation, making it a favorable diagnosis for FUT. 
  • Candidates with high hair follicle density are more likely to achieve better coverage and results with FUT hair transplant. 
  • FUT is particularly beneficial for treating hair loss at the front of the head, making it suitable for individuals experiencing frontal balding. 
  • Hair color plays a role in candidacy, and individuals with hair color similar to their skin color tend to be better candidates due to reduced color contrast. 
  • However, if a medical condition such as a thyroid disorder or alopecia areata is the underlying cause of hair loss, FUT surgery may not be a viable option for the individual.

The Science Behind FUT Hair Transplantation

Harvesting Follicular Units 

  • In FUT, all the follicular units from a strip of skin in the occipital area are collected. 
  • This results in a reduction of both the total number of follicular units and the size of the donor area. 

Hair Follicle Anatomy: How Hair Grows 

  • New cells continuously form in the hair bulb. 
  • These cells adhere to each other and undergo hardening. 
  • A full strand of hair develops from this cluster of hardened hair cells. 
  • As new hardened cells keep attaching to the hair from below, it gradually emerges from the skin. 

Principles of FUT Hair Transplantation 

  • Area of attachment of arrector muscle to the follicular unit is the tightest zone.
  • FUT involves the removal of a strip of skin (donor area) and cutting it to obtain follicular grafts. 
  • The obtained grafts are then implanted into small incisions or recipient sites on the scalp surface. 

Harvesting and Grafting Techniques in FUT 

  • Strip harvesting is the conventional technique used for removing hair and follicles from a donor site. 
  • It entails the extraction of a strip of skin containing the hair follicles, which is then dissected into individual follicular units for transplantation. 

Advantages And Disadvantages Of FUT Hair Transplant

Advantages And Disadvantages Of FUT Hair Transplant is as follows:

Advantages of FUT hair transplant 

  • Larger baldness areas can be effectively covered with fewer sessions of FUT hair transplant. 
  • FUT has a low resection rate, which means it yields better results in terms of hair growth and coverage. 
  • The outcome of FUT hair transplant provides a permanent and natural-looking appearance. 
  • FUT allows for a perfect imitation of normal hair growth, resulting in long-lasting and permanent outcomes. 
  • FUT is a time-saving procedure, as it can cover larger areas of baldness in a single session. 
  • The results of FUT hair transplant tend to be more natural in appearance compared to other methods. 

Disadvantages of FUT hair transplant 

  • FUT is a surgical procedure that involves scalp incisions, which may be a drawback for individuals who prefer non-invasive treatments. 
  • The recovery period for FUT is longer compared to Follicular Unit Extraction (FUE), another hair transplant method. 
  • FUT leaves a linear scar at the site where the donor strip is excised, which can be a cosmetic concern for some patients. 
  • There is a risk of scalp stretching associated with FUT hair transplant. 
  • The scars from FUT can become larger and more localized, which may make them slightly more visible compared to other hair transplant techniques. 

Step-By-Step Process Of FUT Hair Transplantation 

Step-by-Step Process of FUT Hair Transplantation: 

1. Scalp examination and suitability assessment

The surgeon examines the scalp to determine if it is suitable for hair transplantation. 

2. Marking the donor and recipient areas

The surgeon marks the areas from where the donor hair will be extracted and the areas where the hair will be transplanted. 

3. Donor strip removal

  • Using a scalpel, a small longitudinal piece of skin is surgically removed from the back of the scalp, which serves as the donor area. 
  • The incision site is closed with sutures. 

4. Division of donor piece into hair grafts 

The hair transplant team carefully splits the donor strip into smaller pieces containing hair grafts. 

5. Recipient site preparation and graft placement 

  • Small incisions are made in the recipient site where the hair will be transplanted. 
  • The hair grafts are inserted into the recipient site, considering the natural angle and density of the existing hair. 

6. Post-Procedure 

  • The surgical sites are covered with bandages or gauze to protect them. 
  • The patient can typically go home on the same day of the procedure. 

The number of grafts required for the hair transplant depends on factors such as the type of hair, the size of the transplant site, the thickness and growth of the hair, as well as the hair color.

Preparing For FUT Hair Transplant

Medications and lifestyle adjustments to prepare for FUT hair transplant:

1. Hair Length 

Maintain a hair length of 2-3 cm before the surgery to ensure that the stitches will be concealed after the operation. 

2. Flexibility Exercises 

Prior to the procedure, it is recommended to start flexibility exercises to prepare your body. 

3. Regaine Usage 

Cease the use of Regaine (minoxidil) one day before the surgery. 

4. Vitamins and Supplements

Discontinue taking any vitamins and supplements one week before the procedure. 

5. Alcohol Consumption

Avoid consuming alcohol for 48 hours before the surgery. 

6. Breakfast

Have a substantial breakfast before arriving for the procedure. 

7. Smoking

Refrain from smoking at least two weeks prior to the surgery, as smoking can hinder the healing process. 

8. Medications and Supplements

Two weeks before the procedure, stop taking medications or vitamin supplements that contain aspirin, ibuprofen, or herbs that increase blood flow or thin the blood. 

9. Topical Hair Treatment Products

Discontinue using any topical hair treatment products that increase blood flow to the scalp.

FUT vs. FUE

Understanding FUE Hair Transplantation

Follicular Unit Extraction (FUE) is a hair transplantation technique that involves extracting individual hair grafts from the back of the scalp using small punches. These grafts are then carefully placed into tiny holes created at the recipient site. 

Following the procedure, the scalp is bandaged for a few days. Over the course of three to four months, the transplanted hair will initially fall out but eventually start regrowing. FUE allows for the precise transplantation of hair follicles, resulting in natural-looking hair growth. 

Comparing FUT And FUE Techniques 

Factors / ParametersFUT Hair Transplant FUE Hair Transplant 
Recovery PeriodRequires less time to recover Recovery period can be more uncomfortable 
Stitches RequiredStitches are necessaryNo stitches required 
ScarringPossibility of visible scarringNo linear scarring 
Hair Length after SurgeryScar may require longer hair to cover Short hair is possible without a visible scar 
Donor Site Healing TimeDonor site healing time is longer Donor site heals faster 
Hair YieldLower yield of hairProvides a higher yield of hair
CostMore expensiveCheaper compared to FUT
Scalp ShavingRequires shaving of larger scalp sectionsNo need to shave larger sections
Procedure TimeTakes less time to performMore time-consuming procedure
Comfort during RecoveryRecovery period can be more uncomfortableMore comfortable recovery period
Visibility of ScarringScarring may be visibleNo visible scarring
Scar CoverageRequires longer hair to cover scarsScars can be covered with shorter hair
Recovery TimeRecovery time is longerShorter recovery time
Healing TimeHealing time is longerShorter healing time

These are the key factors and parameters to consider when comparing the FUT and FUE hair transplant techniques. Each procedure has its advantages and disadvantages, and the choice between the two depends on the individual preferences, expectations, and specific conditions of the patient.

Questions To Ask To The Surgeon For FUT Hair Transplant 

Before getting a FUT hair transplant you need to ask the following question to the surgeon:

  • Are the grafts dissected under a microscope? 
  • Do all technicians utilize stereo-microscopes? 
  • How long have the technicians been using microscopes to separate follicular units? 
  • How many stereo-microscopes are employed during the procedure? 
  • Does the hair transplant doctor employ a single-bladed knife to remove the donor strip? 

Additional inquiries to make: 

  • Can I see a minimum of 10 sets of before-and-after photos of previous patients? 
  • May I have the names and contact numbers of at least six patients whom I can speak to about their experiences with the physician and staff? 
  • Is it possible for me to meet patients with similar hair and skin characteristics as mine to observe the outcomes firsthand?

By asking these questions, you can gain a better understanding of the surgical techniques used, the experience of the technicians, and the quality of the surgeon’s work. 

Post-Operative Care And Recovery After FUT Hair Transplant

The post-op care and recovery process for FUT is as follows:

Post op care 

  • Sleep with your head elevated using a soft pillow for 7-10 days and avoid sleeping on your stomach. 
  • Refrain from engaging in strenuous activities, including gym workouts, for at least two weeks. 
  • Avoid direct sunlight exposure for at least two weeks following the surgery. 
  • Wait at least 5 days before washing your hair. 
  • Use mild shampoos and avoid harsh ones. 
  • Abstain from consuming alcohol for 7 days before the surgery. 

Recovery After FUT Hair Transplantation 

Initial Days After Surgery: 

  • Minor symptoms such as tenderness, itchiness, redness, numbness, and slight pain may be experienced, but these usually subside within one to two days. 
  • Some patients may have temporary swelling in the forehead area, which can last for a few days. 

Two Weeks After Surgery: 

Shedding of the transplanted short hair shafts is normal during this period as part of the hair growth cycle. 

One Month After Surgery: 

  • The distinction between the transplanted and native hair areas on the scalp will largely disappear. 
  • Resumption of pre-surgery exercise routine is possible. 

Three Months After Surgery: 

Small pimples may form at the sites of the transplanted follicles, indicating the emergence of new hair shafts. 

Four to Nine Months After Surgery: 

  • New hair growth typically begins, with around 60% of the new hair becoming visible. 
  • Initially, the new hairs may have a fine texture but will gradually thicken over time. 

12 Months After Surgery: 

The newly transplanted hair is fully grown, showcasing the final results of the procedure after a year.

Complications

Complications involving FUT hair transplantation:

Infection: 

There is a risk of infection at the surgical sites, requiring prompt medical attention to prevent complications. 

Wound Dehiscence: 

Wound dehiscence refers to the separation or opening of the surgical incision, which can lead to delayed healing and an increased risk of infection. 

Skin Necrosis: 

In rare cases, skin necrosis, which is the death of skin tissue, can occur as a result of compromised blood supply to the transplanted area. 

Intraoperative Complications: 

Intraoperative complications may include anaphylactic shock, vasovagal shock, drug interactions, uncontrolled bleeding during strip harvesting, bronchospasm, and other unforeseen reactions or complications. 

Edema: 

Postoperative edema, characterized by swelling, may appear on the third day after surgery, typically over the face. Proper management is required to alleviate discomfort and ensure proper healing. 

Anaphylaxis: 

Any patient experiencing early swelling over the face, with or without urticaria (hives), should be evaluated for a possible allergic reaction, such as anaphylaxis. 

Itching: 

Postoperative itching is common in both the donor and recipient sites. It is often caused by drying and crusting, requiring appropriate care and moisturization. 

Postoperative Effluvium: 

Shock loss or effluvium refers to excessive hair loss of non-transplanted existing hair from the recipient area. This is a temporary phenomenon and usually resolves over time. 

Cost Of Hair Transplant In India

The cost of a hair transplant in India depends on the number of grafts required and the technique used. For FUT, if the patient receives 500 to 2,500 grafts in a single session, the cost per graft ranges from Rs. 37 to Rs. 45. 

If a larger number of grafts, between 3,500 to 6,000, are transplanted using the FUT technique, it will require two sessions, and the cost per graft would be approximately Rs. 30 to Rs. 45.

FAQs 

Will FUT Hair Transplantation Leave Scars? 

Hair transplantation using the FUT method will leave some scarring on the scalp. The procedure involves surgically removing a strip of scalp from the donor area, typically located at the back of the head. However, with proper hair length, around 4mm, it is usually sufficient to completely conceal the scars resulting from FUT transplantation.

When Can I Go Home?

Following the surgery, the majority of patients are discharged on the same day. In cases where a sedative or general anesthesia was administered, there may be a groggy or disoriented feeling upon awakening. 

The effects of these medications can persist for up to 24 hours, making it unsafe to drive. Therefore, it is necessary to arrange for a family member or friend to provide transportation and take you home after the procedure.

Is FUT Hair Transplantation A Permanent Solution?

FUT Hair Transplantation offers a long-term solution for hair loss. The transplanted hair follicles, sourced from a genetically stable area of the head, maintain their inherent characteristics even after being implanted in the balding areas. 

As a result, they continue to grow naturally for the rest of a person’s life, providing a permanent solution to hair loss

When Can I See The Results?

After undergoing a hair transplant, you can anticipate the emergence of new hair at around 4 months following the procedure. Over the course of the first 10 to 15 months, this hair growth will gradually become denser and thicker. 

As time goes by, the transplanted hair will continue to grow in a similar manner to the hair from the donor area, resulting in a fuller and thicker head of hair.

When Can I Wash My Hair Again After My Hair Transplant?

It is generally advised by surgeons to wait approximately two weeks before resuming your regular hair care routine following a hair transplant. It is crucial to handle your hair with caution immediately after the procedure since the newly transplanted hair grafts are not firmly anchored yet.

 You may need to keep the bandage on for a few days before washing your hair. Initially, you might be instructed to gently wash it by hand. As the grafts become more secure over time, you can gradually transition back to your normal hair care routine.

When Can I Rub My Head After Hair Transplant?

It is crucial to avoid touching or rubbing the transplanted area for the first three days following the hair transplant procedure. It is important to refrain from scratching or washing the area during this time. 

The initial three days are highly critical, and caution must be exercised. Rubbing the head in any manner should be strictly avoided, as it can potentially dislodge the small grafts that have been inserted into the recipient area. 

When To Remove The Bandage After Hair Transplant

The bandage should be taken off within 24 hours following the hair transplant surgery. If there is any bleeding, it is advised to softly pat the area using a sterile gauze pad. 

Dr Vinod Pachade

Dr. Vinod Pachade is the founder and director of the PVR Aesthetica Cosmetic Surgery Center. He is the member of Association of Plastic Surgeons of India (APSI) and also the winner of Asia Book of Records.


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