“Doctor, how is hair transplant done? How much time does it take? Are there any side effects? Can anyone make out that I have done the transplant?” There are two techniques of doing hair transplant- Follicular unit transplantation (FUT) and Follicular Unit Extraction (FUE). The latest addition is Robotic hair restoration. This article deals mainly with the FUE, the basics, procedure and side effects. It is our pleasure to have Dr Walia, a dynamic dermatologist with many years of experience in cosmetic dermatology and hair restoration to take us through the procedure of FUE- what are pre-op requirements, how the procedure is done and what to expect post-op.
Dr Walia is Director of Dr Walia Skin and Laser Clinic, Mohali. He has a keen interest in cosmetic dermatology and hair restoration procedures. He can be reached at https://www.drwaliaskinclinic.com
Follicular unit extraction or FUE is a hair transplant technique in which follicular unit are extracted from the donor area with the help of small punches and transplanted into the bald area may it be on your scalp, eyebrow or beard.
Before FUE Hair Transplant
We select patients for the procedure after:
- Detailed examination of hair loss: A detailed history is taken to determine the type, duration, progress, and family history of hair loss. The best scenario for doing FUE is once your hair loss is not progressing very fast and you still have a significant amount of hair left in donor area that is typically on the back of your scalp.
- Medical evaluation of patient: FUE is a minimally invasive procedure, but still we perform detailed medical evaluation along with routine blood test to rule out bleeding disorder, heart problems or major kidney or liver derangements. Medication that causes thinning of blood is stopped at least seven days before the surgery.
- Pre-procedure counselling: Finally, a detailed counselling regarding the procedure, amount of grafts needed, cost, precautions, etc. is done. We make a point to take pre and post-op picture of your bald scalp to monitor the outcome.
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On the day of FUE Hair Transplant:
We have listed major steps of hair transplant here:
- Hair wash: On the day of hair transplant you have to wash your hair thoroughly.
- Take breakfast: Unlike other surgeries, you should take breakfast because the procedure is lengthy and local anaesthesia is given.
- Photographs: Once you arrive at the clinic, pictures of your bald area, as well as the donor area, are clicked.
- Preparation of donor area: Occipital scalp (donor area from where the graft is to be taken) is trimmed and surgically cleaned.
- Anaesthesia: FUE is done under local anaesthesia and the patient remains conscious during the procedure.
- Extraction of follicular unit: Your hairs grow in groups of 1 to 5 hairs called as a follicular unit, and during FUE these follicular units are extracted either manually or with the help of a machine.
- Implantation of follicular unit: The extracted follicular units are kept in a special solution so that they remain viable until implanted into the bald area. Special precaution is taken to determine the pattern of hair growth in each patient so that the new hair growth looks natural.
- Duration: A team of doctors and trained assistants perform extraction and implantation of each follicular unit; still it might take 4-6 hours though sometimes it might take a full day to complete the procedure depending on the number of grafts to be implanted. But guess what? You can walk around during the procedure, and even eat a light snack if desired.
- Bandaging: Once the entire follicular unit are transplanted, the donor and recipient area are cleaned meticulously and a bandage is applied to the donor area.
After the hair transplant
The post-operative period is unusually uneventful, and you can join your work next day, here are the important precautions that you need to take:
- Antibiotics: We prefer to prescribe a course of antibiotics to our patients, to ward off little if any risk of infection.
- Painkillers: Painkillers might be needed for a day or two.
- Revisit on the second day: Patients are recommended to re-visit the clinic on next day for examination and cleaning of the donor and recipient area.
- Normal saline spray: You have to spray normal saline in the implanted area 2 hourly for first five days after the FUE hair surgery to prevent drying of the graft area. Scabs will form at the recipient area, which should not be removed, rather a saline spray will aid in the gradual falling of these scabs.
- Shampoo: You can clean your hair with a mild shampoo after three days without rubbing followed gentle rinsing.
- Post-operative swelling: In few cases, swelling may appear on the forehead after FUE surgery and might involve area around the eyes and cheeks. This is entirely physiological, there is nothing to worry about and it settles on its own without any further medication in a week’s time. You can hide this by wearing sunglasses and a baseball cap.
- Resume work: You can go back to work in a day or two.
- Avoid sun exposure: There might be some redness in the implanted area in the post-op period, but this is again part of the natural healing phase. Avoid direct exposure to sunlight for about three weeks. Wearing a cap is a good idea to hide the transplanted area and to protect it from sun, dust and pollution.
- Avoid strenuous activities: Strenuous activities like body building, soccer, swimming, etc. should ideally be avoided for three weeks.