The surgical technique of moving required amount of hair from one part of the body called donor site to recipient site is known as Hair Transplantation. Hair transplantation process involves collecting hair follicles from the donor sites which are genetically programmed not to fall out to the recipient site where balding or thinning area of head. Surgical hair transplantation has evolved drastically from 1950's to today's more sophisticated technologies. The hair transplant procedure is the useful technique in cosmetic surgeries such as restorations hair follicles in male pattern baldness. The success of the hair transplant depends on the region of hair follicles selection and in male pattern baldness, the hairs removed from the horse shoe shaped fringe adopts to new place and will grow in grafted region in a normal manner.
In the older hair transplant procedure called Punch hair transplant technique, the donor site is clipped and local anesthetization was done for both donor and recipient sites. Plugs of scalp were done through circular punch having diameter of 4 to 5 mm in both sites. The plugs with hair are placed in bald regions. The donor sites are sutured depending on the need. The donor sites are completely covered with surrounding hairs, so that they are not visible even immediately after the surgery. The success of the technique was depending lot more on the procedure applied during the surgery and also the chance of getting good hair plugs. Sometimes the sutures were also clearly visible making this technique less attractive. The recent technique called Follicular Unit Extraction (FUE) extracts hair follicles from donor sites in few steps without making any scar in that region. In FUE, the hair follicles are removed with micro-punches of 0.6 to 0.8 mm of size, thereby making the scar size too small for reorganization. FUE technique overcomes the disadvantages of Follicular Unit Hair Transplantation (FUT) technique that was resulting in single linear donor scar.
FUE is a kind of hair transplantation technique which is a sutureless procedure of hair restoration. In FUE, hair follicles are removed from back head with the micro-punches and local anesthesia and grafted in the bald region. The extraction of hair follicles is the most time consuming procedure in the entire hair transplant technique. The extracted graft will consist of one to few hairs and are implemented similar to Follicular unit transplant technique. The follicular extraction depends on the principle that the tightest zone is the area of muscle and follicular unit attachment. The follicular units are held with varied tightness in skin dermis, and hence each patient has to be analyzed and FUE technique has to be applied carefully to patient wise. FUE technique has its own merits and demerits
The Major merits of FUE are as follows:
a) It involves less men power.
b) The procedure is less painful.
c) Less equipment required for the centre
d) Patient will have less post operative period in surgical centre.
e) Scars are not visible and hence can go for various hair styles including short hairs.
f) The hair follicles that are present in other parts of body can also be used as donor sites.
The following are the limitation of FUE:
a) FUE is a time consuming protocol and some time requires few breaks during the procedure.
b) FUE technique is improving and long way to achieve perfection for new surgeons.
c) Higher follicular transection rate is the principle concern for this technique.
d) The number of sittings required to complete the FUE is higher compared to FUT and other hair transplant techniques.
e) The cost of the FUE is higher when compared with FUT.
Because of the cost and less patients treated per day, the number of surgeons performing FUE is lesser. On the other hand, due the information available on net for this technique about less pain, no scars, and less post operative sessions, patients in more numbers are opting for FUE. FUE is a promising technique in the area of hair transplant surgery that promises a scarless surgery for patients. More research is required to make FUE technique much faster, less lengthy sessions and decreased price to make it an important alternative method for hair transplant surgery allowing higher number of patients to opt for this technique.
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