What is a hair transplant?
A hair transplant is basically a redistribution of hair follicles from a place with dense hair to areas of hair loss. One follicle grows one hair, and each person is born with 100,000 to 150,000 follicles.
First, a little history of hair transplants. Decades ago, “plugs” were used as grafts. These were 4-5 mm round “punch” grafts taken from the back of the scalp. each graft containing 10-12 hair follicles. The hair did grow, but it looked unnatural like a toy doll’s hair or a “sprigged” lawn. This method required a second and third session months later to fill in between the first session of grafts. Plugs did not look natural at all, but according to patients, some hair was usually better than no hair.
Next, various flaps of hair-bearing scalp were rotated from the side and “swung” into the new position to create a hair line. It looked like a carpet and was not attractive at all and looked quite fake.
Finally, the idea of FUE (follicular unit extraction) came about, a monumental advancement in hair restoration. This is essentially taking 1 mm grafts of scalp containing from 1-4 hair follicles. The one hair grafts are used in the front hairline which appears natural. To achieve more density the multiple follicle grafts are used behind the hairline. When performed with care and skill, this looks completely natural and undetectable as a hair transplant. We learned from this that very small grafts containing 1 to 4 follicles can be made to look natural.
Next is how to harvest the grafts. The strip technique is done by taking a strip of hair-bearing scalp from the back of the head and under magnification, cutting the strip into the small grafts that are needed. The donor site is sutured up, leaving a linear scar. If the patient has long hair the scar is not noticeable. With short hair; however, it can sometimes be noticeable.
Unlike the strip method, FUE grafts are taken from the back of the scalp with 1 mm punches containing 1-4 follicles. This leave only a small spot where each graft is taken from and is hardly noticeable providing they are spaced properly. The problem is manual FUE is very slow, and usually only about 750 grafts can be taken per session. NeoGraft came into the picture and is an automated FUE, and up to 2500 grafts can be performed in one session. The downside of any FUE procedure is that you have to cut the hair very short at the donor site in the back of the scalp, and it can take 10-14 days for the hair to grow out enough to cover the donor site, If you have long hair (as some women have), it can take months for the hair to achieve the adjacent hair length. Some think this is not a problem because they can cover the area with the surrounding hair. Others don’t want to cut their hair in the back, so they choose the strip method.
The bottom line is both strip and Neograft methods have pros and cons. The strip will leave a linear scar that may be noticeable with short hair or when swimming. Neograft will result in a shaved area of hair which while temporary will be noticeable for about 7-12 days. The grafted area for both procedures will be the same. Both are performed under local anesthesia with no pain. Both are wonderful procedures and in most cases both men and women are elated and state that they have more self-confidence.