What is Hair Transplantation ?
Advantages of Hair Transplant by FUE
Patient Selection for Hair Transplant
Planning of Hair transplant surgery
Process of Surgery of FUE Hair
After the surgery
What is Hair
FOLLICULAR UNIT TRANSPLANTATION
Grow ten years younger today
Preface : The field of hair restoration has had a chequered
history, from the days of punch
grafting to the present day techniques of follicular unit
hair transplantation, the field has
seen a number of new advances.
History Speaks - Milestones in Follicular Unit
Transplantation : Hair loss due to disease,
scarring and in particular androgenetic alopecia, seems to
have troubled members of the
human race since the dawn of history.
Modern cosmetic hair transplant surgery dates from the work
of New York
Dermatologist Norman Orentreich in the early 1950s. By 1970,
the technique known as
"punch grafting" was being performed by small numbers of
dedicated practitioners in
many countries of the world. Orentreich's 4.0 mm punch graft
method remained the basic
procedure until 1975, although some surgeons used
smaller grafts at times.
Hair Restoration Techniques : From the 1960s into the mid
1990s, transplanted hair
appeared unnatural because surgeons used unnaturally large
appearing hair grafts
consisting of 10-25 hairs each. That era is over. Hair
naturally grows in 1-4 hair follicular
Follicular Unit Transplantation is the redistribution of
naturally occurring follicular
groupings from the posterior scalp (donor region) into the
region of thinning hair in the mid
frontal scalp (recipient sites). The groupings are removed
from the donor area by an
elliptical excision and are carefully dissected using
appropriate lighting and magnification.
The donor tissue is separated into follicular units, which
are then re-implanted into
recipient sites created by some specific slit making
instruments. Follicular unit transplantation is also used to
correct unnatural-appearing plug like
transplants, repair eyebrows, and redistribute hair in
persons with inactive scarring
Key factors to consider in candidate selection include:
Donor density in the posterior scalp,
Caliber of hair,
Extent and rate of hair loss, and realistic expectations.
Extent & rate of hair loss
In an era in which male and female pattern hair loss can be
halted with minoxidil
and/or finasteride (for men), transplantation should be
performed in patients who have
enough space between thinning existing hair.
The net perceived density of a hair transplant is equal to
the number of hairfollicles
transplanted minus ongoing hair loss. All patients must
understand that ongoing hair loss
will affect the perceived density ofthe transplant.
Follicular Unit Extraction
Follicular Unit Extraction (FUE) is a method of obtaining
donor hair for Follicular Unit
Transplantation (FUT), where individual follicular units are
harvested directly from the
donor area. A ).85 mm punch is used to make a small circular
incision in the skin around the
upper part of the follicular unit, which is then extracted
directly from the scalp. Because FUE does not leave a linear scar, it may be appropriate for
patients who want to wear their
hair very short. The procedure is also useful for those who
have healed poorly from
traditional strip harvesting or who have a very tight scalp.
Hair Transplant by FUE
Selection for Hair Transplant
Age: 23 yrs. or older
Inadequate response to medication
Significant hair loss
Other causes of hair loss have been ruled out
No medical contraindication to surgery
Reasonable patient expectations
Hair transplant surgery
Once you decide to undergo hair
transplantation from us, we will fix an appropriate date
which is convenient to you. You will be required to
undergo some routine blood tests. A file folder containing
your medical records, pre-op instructions, basic facts
about the procedure of Hair Transplant, post-op
instructions will be made.
On the day of Hair Transplant surgery, please have a head
bath and a heavy breakfast.
Once you arrive at our clinic, we will click the pictures of
you bald as well as the donor area. Then we trim and prepare
the donor area from the back of the head for transplant it
to the bald place (or place of implant like moustache,
of Surgery of FUE Hair Transplant
We make the patient lie down in prone position on
the operating table. We then take utmost care to give local
anesthesia with minimal discomfort in the donor area.
The grafts are then extracted from the donor area with the
help of 0.8 and 1 mm special micropunches ( in case of FUE )
or a full skin thickness strip is taken up till the depth of
hair follicles ( in case of strip method ) . The extraction
of follicles is done under magnification. In the strip
method a further dissection of the strip is done under the
microscope up to the level of hair follicles. The extracted
grafts are then preserved in cool Ringer Lactate solution.
Each follicle may be consisting of 1,2,3,4 or rarely even 5
The position of the patient is changed to supine position.
He can watch a movie or TV depending on his choice. Then the
recipient (bald) site is then prepared by giving local
anesthesia. The slits are made with the help of special
blades of 0.8-1.5 mm in size and the extracted hair
follicles are then implanted into this area.
Implantation of the hair follicles is the most skilful and
crucial step in FUE. We discuss in detail again the hairline
creation as it is the most creative work in this whole
procedure and utmost care is taken to ensure a natural look
in this area after hair will grow. The hair follicles
containing single hair are implanted in the front to give a
natural hairline and subsequently followed by units
containing 2-3 hairs to give density to the area.
During the procedure we give a tea as well as a lunch break
so the patient should not feel tired during the surgery.
Infact during the surgery, the patient keeps on chatting and
discussing about himself or herself that we become “friends”
After the hair surgery procedure is done, the patient is
again shown the transplanted area and a simple dressing in
the donor area and front on forehead is given to prevent any
The transplanted area is covered with a loose cap. The
patient is discharged to go on his own. He can go to the
market, watch a movie or just do anything he wishes to do!
After the surgery
You are required to spray normal saline in the implanted
area hourly for first 5 days after the surgery to prevent
drying of the graft area.
It is recommended that the patient (if he is in-station)
should turn up the next day for review of the donor area,
cleaning of the area and fresh bandage if required. The
dressing on the forehead is usually removed. If he cannot
turn up, he can remove the bandage on his own also.
Small crusts start appearing in the donor area. There is
nothing to worry about as the scabs start falling and the
hair start growing in the donor area again .
Swelling may appear on the forehead within 24 hours after
surgery. If it does come, then it may increase for about the
3 days, come around the eyes and cheeks and may take about 4
to 5 days to settle down. This is totally physiological,
there is nothing to worry about it as it occurs because of
the gravity and settles on its own without any further
You can clean your hair with a mild shampoo 3 days after the
implantation without rubbing them and then alternate days
till tenth day and after that you can wash the area
normally. For in station patients we only demonstrate the
way how to take the head bath as utmost care must be taken
for not touching the grafts while doing that.
There might be some redness in the implanted area in the
post-op period but this is again part of the natural healing
Avoid direct exposure to sunlight for about 3 weeks.
Avoid the following strenuous activities for 3 weeks like
Body building, soccer, swimming, running etc.
Dr Prashant Agrawal
Dr Prashant Agrawal is The Consultant Dermatologist ,
Cosmetologist and Hair Transplant Surgeon at GBH American
Hospital for past five years. He has a vast experience
treating the patients having complaints regarding their hair
fall and baldness. He has got the training in Hair
transplant from world’s most renowned Hair Transplant centre
at Israel. He is one of the pioneers in Rajasthan in FUE
technique. He also owns the Fellowship of reputed American
Acadamy of Dermatology (USA).
Dr Guru Bhushan
Dr Guru Bhushan is the Consultant Plastic and Cosmetic
surgeon at GBH American hospital and needs no introduction
in the field of plastic surgery. He has been a well known
figure in the filed for past ten years and has worked in
many reputed institutions and hospitals like Safderjang
hospital, Delhi. He has attended many national and
international conferences and seminars on aesthetic
surgery including Hair Transplant.
Dr Priya Agrawal
Dr Priya Agrawal is the Consultant Dental surgeon at GBH
American hospital. Apart from doing cosmetic and aesthetic
Dental surgeries, she has a huge experience in Follicular
Unit Extraction and expertise herself in implantation.
Q. What is hair transplant?
A. Hair Transplant is the only permanent method of hair
restoration in which one’s own hair from the back and sides
of the head are extracted and implanted on front in the bald
Q. Who can undergo hair transplant?
A. i) Age of the patient should be 23 yrs or older.
ii) Inadequate response to medications.
iii) Significant hair loss.
iv) Other causes of Hair Loss have been ruled out.
v) No medical contraindications to surgery.
vi) Reasonable patient expectations.
Q. Can females undergo hair transplant?
Q. What are the techniques of hair transplant?
A. Nowadays,Hair Transplant is being done by Follicular
unit technique which involves two ways of hair extraction –
STRIP method and FOLLICULAR UNIT EXTRACTION ( FUE).
In the STRIP method,a strip of skin from the back of head
(donor area) is removed with the help of scalpel. The gap at
the back of head is then sutured together. The strip is then
divided into grafts containing one ,two or three follicles.
FUE – Follicular Unit Extraction: A stitchless method of
hair restoration in which hair root (follicles) are
extracted from the back of head under local anaesthesia with
the help of special micropunches and implanted in the bald
area. In this procedure, no scalpel is required which is
used for cutting skin in the ‘strip’ surgery. The entire
procedure is done by the surgeons and not by technicians.
Q. What is the difference between FUE and Strip method?
A. Both are methods of hair extraction where in one case
whole strip of hair bearing skin is removed and defect
sutured back whereas in FUE individual follicles are
Q. In which cases is FUE better than STRIP Technique?
A. FUE can be done in all cases.
It is most useful for people who keep small hair or shave
their head or have tendency of hypertrophic scars because
they will not have any visible scars (As they are only
This is the only method by which adequate cover can be given
for NH Gr VI-VII as the hair can be extracted from the head
as well as the body in multiple sittings.
In the strip technique, the number of hair are limited as
only those hair which are removed in the strip can be used
It is also the preferred technique for eyebrow or moustache
transplant or in patients having tight skin.
It is ideal for revision cases i.e. those who have already
undergone surgery by strip method.
Multiple sittings can be given on consecutive days or later
on to give “add-on” hair.
Q. What is the difference between hair and follicular
A. Hair grows naturally in follicular units of one, two
or three groups which if extracted together grow in a very
Q. Does it hurt?
A. Hair transplant is done under local anaesthesia all
over the world which is administered with very fine insulin
syringes which hurt minimally. Also we administer nerve
blocks which cut down the number of pricks considerably and
lead to prolonged anaesthesia.
Q. What is the time gap between individual sittings?
A. Individual sittings of FUE can be planned according
to the time available. They can be done even on consecutive
days or few days or a week apart whereas in the strip , you
have to wait for 6-12 months.
Q. What is the difference in the post-op precautions of
A. In STRIP method, sutures are put at the back of head,
so special precautions like sleeping in a particular
position, refraining from exercise, avoiding strenuous work
etc. are required till the stitches are out.
In FUE, the patient walks out of the clinic ,rests for a
while and is free to follow daily routine from next day.
Even the bandage at the back of head is out the next day. As
there are no sutures there is minimal pain post operatively.
Q. Is there any difference in the no. of follicles
extracted by these methods?
A. Yes, the number of follicles extracted in STRIP
method is definitely more in one sitting as compared to one
sitting of FUE .But even one sitting of strip is usually not
sufficient for most of the cases which means multiple
sittings and multiple scars. FUE is virtually free of scars
(As they are only Microscopic) and patient can undergo
multiple sittings without much discomfort.
Q. What about the scarring?
A. Scarring is definitely more in STRIP method and
sometimes numbness and abnormal sensation persists at the
back of head.
Q. What about the healing period?
A. Healing is much faster in FUE and patient is active
and mobile immediately after surgery on the same day only
whereas in STRIP a resting period of at least a week is
Q. When will the scabs fall off?
A. The scabs at the back of head and at front fall off
after 7-10 days and one cannot even make out the sites from
where the grafts have been taken after 2 weeks.
Q. When can one see the final results?
A. The hair start regrowing after 3-4 months. Full
growth is usually appreciable after 10-12 months.
Q. What is the life of transplanted hair?
A. It is lifetime as the donor area is the permanent
Q. Why is it costly than the Strip method?
A. FUE the world over is more costly than STRIP as it
involves more hardwork and more time period is spent. Also
the entire procedure is performed by the surgeons themselves
unlike STRIP method where the assistants do upto 75% of the
Q. How many hair are required to cover the bald area?
A. It depends on the bald area as well as the density
required by a patient. You can send in your pictures in
front-on, sides and from below view for free online
consultation and we can advise you regarding the same.
Q. Do the transplanted hair look natural?
A. The look is definitely natural as transplant is done
by FOLLICULAR UNIT method where naturally growing groups are
taken out and implanted as compared to the outdated punch
transplant where the look was not natural.
Q. What is the role of Finpacea?
A. Finpacea is a medicines for androgenetic alopecia
which definitely work as long as one takes the medicines.
Also complete regrowth is not observed. Hair again start
falling once medicines are stopped.
Q. Can we do hair transplant if the patients is suffering
from some medical condition?
A. The patients having blood disorders, immunocompromise
conditions (hepatitis, cancer, uncontrolled diabetes, etc)
are usual not taken up for surgery.
Q. Why come to GBH American Hospital?
A. Because the surgeons at GBH American Hospital are trained by
international pioneers in the field of Hair restoration
surgery, they keep themselves update about the latest
developments by attending national and international
conferences and firmly believe in honesty and hard work.