The Recipient Area | Strip Method | FUE method | Other Uses
Hair Transplant Surgery
Hair transplantation is a type of hair loss surgery, there are other hair loss surgeries available – click here to find out more
Hair transplantation is a minor surgical technique for hair restoration which reliably and consistently restores hair, even to a bald scalp. The male hair transplanting technique relies on the fortunate fact that even men who lose a lot of hair will not lose the hair above the ears and the back of their heads. There are many older men with this characteristic ‘horseshoe’ shape of remaining hair to prove this fact.
This is called the hair transplant donor area or Norwood Stage 7 in the classification of hair loss. For this reason, we work on the assumption that your hair loss will ultimately progress to Norwood stage 7 and only take hair from this region. This ensures that you will always have growing transplanted hair and that the donor area is always covered. In addition, this area is more densely packed with hair follicles than the rest of the head, even before hair loss starts.
Women can also be helped by a female hair transplant. Although the type or pattern of female hair loss is different to a man, the hair transplant surgery technique is just the same and just as effective. The hair transplant donor area is also the same.
Hair grows not as single hairs, like teeth in a comb, but in little bunches called ‘follicular units’. These form the basis of our ‘grafts’. Follicular units typically average two hairs, but they can be just one hair or even four hairs. Because Nature grows the hair this way, it makes sense to put the hair back in this way to achieve the most natural look (rather than splitting up all the follicular units into single hairs). This is called follicular unit hair transplanting or FUHT (Follicular Unit Hair Transplant). Firstly though, we need to remove the hair from the donor area before we can re implant it. This involves transplanting the whole follicle i.e. the hair bulb and surrounding structures from one part of the scalp to another. The process is similar to gardening on a microscopic level – if you are transplanting a daffodil bulb from one area to another, you can’t just transplant the leaves or flowers (hair) but you need the whole bulb, roots and shoots (the hair follicle).
The average number of follicular unit grafts that we transplant in a single session is typically around 2000 (equivalent on average to 4000 hairs). The actual number required by each patient varies depending on size of area, the donor density, the recipient density, hair type, age, potential of future hair loss etc. In some suitable candidates we can perform 3000 grafts or more in a single session which is known as a mega session follicular unit hair transplant.
Men’s hair is thicker, bushier and faster growing on the back and sides of the scalp, which is why men traditionally have a ‘short back and sides’ haircut. This means that we can transplant hair from this region and move it to where it is needed without the donor area looking thin too. There is obviously a limit to how much hair can be removed, but experience has shown that up to six sessions is a comfortable average. Female donor hair isn’t usually as thick or dense as a man’s so that limits the number of hair transplant sessions to usually three.
Because the hair that we remove from the donor area is genetically programmed not to fall out because of male pattern baldness (MPB) or female pattern baldness (FPB), the hair will continue growing on the bald scalp, just as it would have done if it had remained in the donor area. That is why hair transplantation can give you your own hair growing again, and that is why it won’t fall out again. This basic theory has been shown to be true for the past 80 years, since Dr Okuda (and others) in the 1930’s first discovered hair transplantation was possible.
There are currently two methods of taking hair from the scalp: the strip method of hair transplantation and the FUE method. Please note: the method of re-implanting the hair remains the same, irrespective of the method used to extract it.
As a side note, body hair transplants are also possible i.e. transplanting from a hairy chest to the scalp. However, this a very variable technique using the FUE method and results at best, are only additional to a good hair transplant performed using scalp hair first.
It is also important to understand that hair transplanting does not create new hair but redistributes the whole follicle from the donor area. It therefore cannot regenerate itself but much research is taking place into the technique of hair cloning or hair multiplication.
This is the area which we want to put the hair transplants back into. Usually this is the scalp – frontal, temples, hairline, crown etc but can be the body. We commonly perform eyebrow hair transplants and hair restoration for traction alopecia and also less frequently for the other causes of hair loss, as detailed at the bottom of the page.
The hair transplant surgeon applies local anaesthetic to the donor area we want to take the hair from. We then take a thin strip of that hairy scalp and individually separate all the follicular units (6. photo 3). These follicular unit grafts are then placed into pinprick incisions in the recipient area. The strip method of hair transplants is the “Gold Standard” as the most effective technique for transplanting hair and donor utilisation.
View a short video of a patient undergoing the strip technique
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Patient video (2mb)Patient video low bandwidth
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Patient video (12mb)Patient video high bandwidth
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FUE stands for Follicular Unit Extraction, a technique also variously known as FIT,
CIT, FUSE, DHI and Woods techniques. This technique uses a microscopic punch to
remove each individual hair graft, in the same way as an apple corer removes the
core of an apple. FUE is a relatively new technique, and only really established
itself in the early years of this century. It still has some way to go in its evolution.
Like all things, it has advantages and disadvantages, sometimes depending on patient
preference or characteristics.
Click here to see a short animation of the FUE technique.
Hair Transplant Surgery procedures
Although the information on this page is primarily about hair transplantation for scalp baldness, we also perform hair transplants for other areas. The technique of hair transplantation is the same whether it is transplanting scalp hair to a balding scalp or to restore eyebrows or moustaches.
• Eyebrow and Eyelash Hair transplant
Eyebrow hair transplants are now gaining in popularity rapidly. Once seen as the new celebrity surgery for Hollywood, overplucked eyebrows can be restored with a simple hair transplant procedure in three hours. To restore eybrow hair, the hair transplant surgeon takes hair from the regular donor area and re implants the hair follicle into microscopic pinpricks in the eyebrow. The surgeon has to be artistic, as he carefully chooses the arch of the eyebrow, the density and the angle of each hair as it is transplanted. Click here to eyebrow transplant gallery pic
Eyelash transplants are very similar but even more delicate.
• Beard & Moustache hair transplants
Beard and mustache hair transplants are performed in men either for congenital reasons (cleft palates) or because of trauma & burns. Gaps in the beard areas can be restored by using well established hair transplant techniques.
• Facelift and sideburn hair transplant
Similarly, where facelifts have removed the hair bearing skin from the sideburn area, we can transplant hair into the bald area, restoring the sideburns.