Up to 85% of men and 40% of women experience hair loss. For many people, hair loss is difficult and affects the way they feel about themselves.
Fortunately, there are treatments that can help in many cases. This includes both surgical and non-surgical treatments. If you have looked into surgical hair restoration, then you may have heard about follicular unit excision/extraction (FUE). However, you may not have heard of follicular unit strip excision (FUSE) also often called follicular unit transplant (FUT). The FUT hair transplant is a common technique that allows hundreds to thousands of hair grafts to be transplanted over the course of a single-day procedure. If you’ve noticed your hair thinning, a pronounced bald spot, or a receding hairline, this procedure may be an appropriate treatment option for you.
Here’s a guide to how FUT transplants work.
What Is a FUT Hair Transplant?
An FUT (also known as FUSE) hair transplant is a type of hair restoration surgery. It involves relocating hair as individual follicular units or groupings of hair (called grafts) just as with other techniques such as FUE. The units can contain one to three (sometimes even four or five) hairs along with the surrounding supportive tissue.
The difference is in how the grafts are obtained. In an FUSE/FUT procedure, a strip of scalp (usually from the back and sides of the scalp) is removed. The size of the strip of scalp removed depends on the number of hair grafts needed, density of the donor area, and elasticity of the scalp in the area, among other factors. The area is then sutured back together which typically leaves a thin linear scar.
The strip is then divided into individual follicular units. Like with other types of hair transplant, each follicular unit is then placed into the recipient area (area where increased hair density is desired such as areas with thinning or balding) one at a time. Transplanting each follicular unit one by one allows the surgeon to create natural-looking hair patterns for an excellent aesthetic effect compared to older methods of hair transplantation such as punch grafting (called plugs).
A FUT transplant usually takes a full day. In most cases, patients are awake during surgery, and local anesthesia is used to numb the scalp.
Following the surgery, it is important to follow any post-operative instructions from your hair restoration surgeon to optimize your recovery and growth.
Depending on your degree of hair loss and future progression of hair loss, you may require one or multiple sessions. Make sure to discuss your individual case with your hair restoration surgeon.
Who Can Get A FUT Hair Transplant?
Individuals with certain types of hair loss such as patterned baldness or thinning (androgenic alopecia) are often good candidates for this type of hair transplant surgery. Other types of hair loss such as those from scar tissue from trauma or traction alopecia (from chronic pulling on the hair) can also potentially be good candidates for hair restoration surgery depending on a number of different factors. There are several other factors to consider.
In patterned hair loss, it may be advised to wait until a later time to have a hair transplant in young individuals (such as those under the age of 25-30). This is because the degree of further hair loss progression may remain unknown, so monitoring the hair loss over time may be recommended. In some cases where there was another cause of hair loss (such as scar from trauma or traction alopecia) or where the hairline shape change is desired in the absence of hair loss, hair transplant may be appropriate even at younger ages. Make sure to discuss this with your hair surgeon.
Adequate Donor Density
Individuals who have adequate hair density and thickness in the donor area are generally better candidates with better surgical outcomes than those with thin donor hair. A hair transplant does not make more hair or make the hair thicker. It is moving hair from one area (the donor) to the area where increased hair density is desired. If the hair being moved is thin or weak, then this can make the hair transplant have less of a result and limit the amount of donor hair that can be taken without noticeable scarring. This is why it is always important to go to a hair surgeon for a consultation so that they can do an examination including evaluating the donor area.
Pattern and Degree of Baldness
There is limited donor supply. It is important to discuss the areas that are of highest priority to you as in some cases not all areas of balding or thinning may be able to be addressed (if there is more recipient area need than donor supply or if future hair loss progression is projected). Thus it is very important to have a consultation with an experienced surgeon who can help come up with a plan for you not just for the short term but for the long term. It is important that you understand this plan and are okay with what areas can (and cannot) be addressed with the surgical plan. They may also recommend non-surgical therapies to help maintain your existing hair to help decrease further hair loss and even thicken and strengthen the existing hair.
It is important to inform your surgeon of any medical conditions that you have and include pertinent details as to how those conditions are managed and controlled. For example, in those with diabetes mellitus blood sugar control prior to surgery is often recommended for the best results and to avoid complications healing. In those with high blood pressure, blood pressure control is recommended to avoid increased blood pressure and bleeding during the procedure. If you are on a blood thinner, your surgeon may want medical clearance from the doctor prescribing the blood thinner for you to be able to come off the blood thinner for a certain amount of time before and after the procedure. Any skin cancers or inflammatory conditions on the scalp like psoriasis and dandruff should be well controlled prior to undergoing hair surgery. This is why it is important to inform your hair surgeon of any medical conditions you have and any medications or supplements that you take during your consultation as this is all relevant in determining if you are a surgical candidate and if there are any measures or clearances that are required prior to surgery.
Patients who have realistic expectations for their hair after transplant and understand that hair transplants do not prevent further hair loss progression and have limitations often in what can be achieved and that long term planning is required are generally good candidates for hair transplant surgery. These patients understand that they may need to be compliant with any recommended non-surgical maintenance therapies to decrease further hair loss and thicken existing hair. It is also important to understand that more than one procedure may be required to achieve the desired density.
Who Should Not Get an FUT Hair Transplant?
As with any medical procedure, there are some people who shouldn’t have this type of hair transplant surgery. This includes individuals who have:
- Unusual hair loss patterns
- Active autoimmune or other inflammatory types of hair loss
- Active infections or malignancy on their scalp
- Unrealistic expectations for surgery
- Certain mental illnesses such as body dysmorphic disorder
- Excessive hair breakage
- Excessive hair shedding
- Donor site miniaturization (thinning)
- Inflammation of the scalp such as uncontrolled psoriasis or dandruff
- Uncontrolled medical conditions
- Wear their hair too short to cover the linear scar
- Plan to potentially shave their head in the future (as the linear scar would be visible)
Even if a hair transplant procedure isn’t right for you, there may be other non-surgical therapies that may be appropriate for you. To find out more, make an appointment with a dermatologist or hair restoration surgeon.
Potential Benefits of FUT Transplants
Many people who opt for hair transplant surgery have been dealing with hair loss for years. One of the biggest benefits of having the surgery is the high success rate in increasing hair density in areas with little to no existing hair compared to other procedures for many types of hair loss.
Additionally transplanted hairs often grow in the area long term and are less prone to thinning and loss from patterned hair loss than non-transplanted hair.
Advantages and Disadvantages of FUT Transplants
The advantages of FUT compared to FUE specifically include the ability to take the grafts from the strongest area of the donor with the lowest likelihood of future thinning and loss, the ability to minimize the area of the donor needing to be shaved on the day of surgery, and the ability to get the highest number of grafts over someone’s lifetime (by starting with FUT procedures before starting with FUE procedures). Disadvantages of FUT compared to FUE include that it leaves behind a linear scar and more associated tenderness in the days after the procedure. It is important to discuss the advantages and disadvantages of FUT and FUE for your specific case with your hair restoration surgeon during your consultation.
Risks of FUT Hair Transplant Surgery
Overall FUT hair transplant is a relatively well-tolerated and low-risk procedure compared to other cosmetic surgeries. However, any time the skin is cut, there are always potential risks. The risks with FUT include the following:
- Numbness of the scalp
- Epidermal cysts or ingrown hairs
- Anesthesia complications
- Poor Growth
It is important to discuss risks at great length including the risks in your individual case with your hair restoration surgeon, so that you fully understand the risks, benefits, and alternatives of the procedure before deciding if you want to move forward with it or not.
FUT Transplant Costs
Hair transplant surgery is usually considered a cosmetic procedure, so it’s rare for insurance companies to cover the costs. There are exceptions to this, especially if hair loss is the result of an illness, trauma, or injury or if it is being pursued as part of gender-affirming care.
The price for hair transplant surgery varies widely. The cost depends on who’s performing the surgery, the type of surgery, the geographic location and standards of the clinic, and how much hair is transplanted.
In fact hair restoration surgery price can vary greatly and can often range anywhere between $3,000 to $30,000.
Many clinics have financing options to help assist individuals with affording this procedure.
Are You Ready for a Long-lasting Hair Loss Solution?
If you’re tired of dealing with hair loss and are looking for a long-lasting solution, Hair Transplant such as an FUT procedure may be an appropriate solution for you. If you are ready to take the next step and find out if you are a candidate, we would recommend having a consultation with a hair restoration surgeon.
At Root Hair Institute, we know what a sensitive and personal issue hair loss can be. We’re committed to providing compassionate and effective hair loss solutions for our patients.
If you are in the greater Seattle area or would be willing to travel here for your procedure, we would love to talk to you about your hair loss. Contact Root Hair Institute today to schedule a consultation.