A Complete Guide to Follicular Unit Transplant (FUT) Strip Surgery
Hair transplant surgery can be transformative for both men and women who feel self-conscious due to significant hair loss and want to restore a healthy, full head of hair. But if you’re considering the procedure, you probably have more than a few questions about how the process works, when you will see results and what to expect during and after the procedure, among others. Read on for our complete guide to Follicular Unit Transplant (FUT) Strip Surgery with our team here at the Toronto Hair Transplant Centre.
What is a Hair Transplant?
To begin with the basics, let’s break down what a hair transplant entails. This surgical technique involves a skilled surgeon carefully extracting hair follicles and implanting them precisely into the area of your head where the hair is thinning or completely gone. However, the surgery is about more than just restoring your hair. It is also about improving your look and your self-esteem.
In other words, a qualified hair transplant surgeon should have not just a knowledge of proper surgical techniques and anatomy, but also the attention to detail required to place each hair follicle in the precise location and direction that will complement your facial proportions and give you a totally natural-looking result. For this reason, in the hands of a talented surgeon such as the Toronto Hair Transplant Centre’s Dr. Huber or Dr. Jones, hair transplant surgery is both an art and a science.
Why Do People Lose Their Hair?
By the age of 50, approximately 50 percent of men and 25 percent of women have experienced some form of hair loss.
Though there are many misconceptions surrounding why men lose their hair, the real culprit behind male-pattern hair loss is a one-two punch of genetics and the male hormone dihydrotestosterone. This type of baldness usually begins with a receding hairline that progresses until it results in a bald patch on top of the head.
Female-pattern hair loss is the result of overall thinning of hair across the entire scalp due to increased hair shedding, reduced hair volume or both. It’s rare for women to bald following the male pattern, unless their bodies produce too many male hormones. Researchers have yet to pinpoint the exact cause of female-pattern hair loss.
If you’ve begun to lose your hair, you may be wondering what you can do about it. If you are picturing the unsightly and unnatural-looking hair plugs that were common in the 1970s and ‘80s, rest assured the hair transplant industry has improved by leaps and bounds since then.
What Types of Hair Transplant Procedures Exist Today
The latest techniques for hair transplantation are permanent, virtually undetectable and involve removing hair from a donor site on your head or body and inserting them into your balding areas.
Broadly, surgeons use two methods of removing the graft from the donor area: follicular unit transplantation (FUT) and follicular unit excision (FUE). With the FUT method, the doctor cuts a strip of hair, usually from the rear part of your head, and then dissects the strip into individual grafts before inserting them into the balding areas in a natural grouping of one to four hairs at a time.
Strip surgery is often the best choice for patients with extensive hair loss who require a large number of grafts within a relatively short period of time. It is the best way to get the maximum number of healthy grafts within the same day.
Though the procedure does leave a linear scar across the back of the head, the scar is usually very fine. While this can become visible if someone wears their hair very short, it is usually covered by hair and hidden from sight. In addition, a highly experienced surgeon such as Dr Huber or Dr Jones can easily plan your new hair growth so that it hides the scar.
As you can see from our many patient case studies, we have successfully performed FUT strip surgeries on patients with up to 4,200 grafts at a time here at the Toronto Hair Transplant Centre.
For balding men who have a horseshoe pattern of hair around the back and sides of their scalp, there is often an area where the hair looks a bit thicker and a bit healthier than the surrounding hair. This is the “sweet spot” of the donor zone. FUT strip surgery is not only a very reliable procedure; it is also the best way to extract hair from this high-density area.
On the other hand, the FUE technique of hair transplantation involves taking individual bunches of hair – usually one to four follicles at a time – from a donor area with a special punch-shaped scalpel and inserting them into the receptor site. It is a more time-consuming procedure and is therefore usually correspondingly more expensive to undergo.
Advantages of FUT
- High Follicle Survival Rate: Though technology has advanced faster and more significantly in the past couple of years, the survival of the hair follicle remains imperfect up to a certain extent. Among the procedures available on the market, FUT has the highest rate of follicle survival – up to 100 percent. Though it is the goal of every patient to have a successful hair transplant, the success becomes more urgent when the patient has limited available hair for the procedure. Every follicle should count for such individuals.
- More Budget-Friendly: The FUT approach to transplanting the grafts has made it the most economical option available for hair transplant patients today. That is because surgeons typically add up the price of hair transplants on a per-follicle basis. Simple math will tell you how much cheaper it can be when you need a lot of hair for your procedure.
- Time Maximizer: Hair transplants can be very time-consuming, and on occasion, can take even more than one session because of the sheer number of follicles involved in the procedure. The FUT method significantly reduces the time you have to spend in surgery, which makes it the perfect procedure for anyone whose busy lifestyle does not allow them the luxury of downtime and requires them to resume their daily routine as quickly as possible. In addition, most patients prefer to be as discreet as possible about receiving hair transplant surgery, and being away for a long period of time can reveal your closely guarded secret.
- Top-Notch Hair Quality: All hair transplant patients want to achieve the most natural-looking results from their operation. The quality of the hair from FUT has made this technique an industry standard because the donor areas from FUT are healthier compared to those obtained with the FUE method.
Who Is a Good Candidate for Strip Surgery?
What do leading hair transplant surgeons like Dr. Huber and Dr. Jones look for when they are assessing the candidacy of a strip surgery patient? Obviously, the first criterion is the extent of the patient’s hair loss, as well as the supply of donor hair. Patients with severe hair loss and insufficient donor reserves may not be good candidates for the procedure.
The next thing to evaluate is patient expectations, as well as any risks and downsides to the procedure. Finally, a hair transplant physician will gauge your skin type and its laxity; density, texture and colour of the donor hair; your lifestyle choices; and your projected likelihood of future hair loss. All these factors work together to determine the potential for success or failure.
Can the Same Person Have Both FUT and FUE?
Yes. FUT may be used first to maximize the yield of the initial procedure(s), but then in subsequent sessions, the scalp may become too tight to perform further FUT/strip procedures, or the donor scar may become wider than anticipated. In the former case, the physician can switch to FUE for subsequent sessions. In the latter, the surgeon may use FUE to harvest follicular units and then implant them into the widened scar, camouflaging it.
If FUE is performed first and the yield is lower than what the doctor deems acceptable, the patient may consider switching to FUT, either for the remainder of that procedure or in subsequent surgeries.
How to Prepare for Your Hair Transplant
After your one-on-one consultation with Dr. Huber or Dr. Jones to determine if you are a qualified candidate for FUT surgery, you will receive detailed instructions to prepare yourself for the day of your procedure. It is essential to follow all these directions carefully to ensure you get the best results and a healthy healing process.
Here is an example of some of the things we will ask you to do before the surgery.
Before the Surgery
- If you are a smoker, you will need to quit at least two weeks before your procedure. This includes any other products that contain nicotine, such as smokeless tobacco, cigars, gums, patches and e-cigarettes. Nicotine restricts the blood vessels, which can cause complications with your healing. We also suggest you continue not using nicotine throughout your entire recovery period, not just because it slows down your healing process, but also to benefit your overall health.
- We also suggest you not drink alcohol, which thins the blood and can cause excessive bleeding. Because alcohol also dries the skin, it can mean your scarring will be worse, which is of particular concern if you opt for an FUT hair procedure.
- Regardless of whether you choose FUT, FUE or a combination of both procedures, leave your hair as long as possible on the back and the sides of your head. Longer hair will help cover the horizontal incision from FUT and the punch-shaped scars from FUE.
- Tell Dr. Huber or Dr. Jones about any medications you are taking, including vitamins or herbal supplements. We may ask you to stop taking these products to minimize your risk of healing complications.
On the Day of the Surgery
- Unless we tell you otherwise, do not eat or drink anything after midnight on the night before your procedure.
- Do not use any hair products on the day of your procedure, other than your regular shampoo.
- Wear loose, comfortable clothing. We suggest a button-down shirt so you won’t have to pull anything over your head when you change clothes, which might dislodge your hair transplants.
- Avoid caffeine before your surgery.
- Arrange for someone to drive you home after your procedure.
During FUT Hair Transplant Surgery
- Trimming the donor area: Before beginning surgery, the doctor will trim the hair in the donor area.
- Anesthesia: We will use a local anesthetic to numb your scalp and minimize discomfort during the procedure.
- The hair transplant: The doctor removes a strip of hair follicles from the donor area and relocates them into the balding areas. Dr. Huber or Dr. Jones must choose the location of donor tissue precisely, as the survival of grafts after surgery depends on the properties of the donor follicles harvested from this area. The ability to conceal the scar as much as possible is also of utmost importance.
- Donor hair dissection: The doctor next divides the extracted strip into slivers to separate the hair follicles in groupings of one to four hairs to be implanted.
- Donor area sutured: The doctor secures the donor area with sutures.
- Hiding the stitches: The doctor hides the sutures in the donor area by combing your hair over them. Either the doctor, a nurse or the patient can remove these sutures a week to 10 days after your surgery.
- Healing from hair transplant surgery: The incision marks heal naturally and the redness in the recipient area fades away within a week.
Recovering From Hair Transplant Surgery
An FUT hair transplant not only produces natural-looking results, but the recovery time is also minimal and usually straightforward.
A hair transplant is a minimally invasive procedure performed on an outpatient basis. The entire procedure can be completed within one day. If you choose, you can return to work the day after your surgery, though that is a personal decision depending on how you look and feel. We will prescribe you with a course of antibiotics to prevent infection.
You will be able to see the shape of your new hairline immediately after the FUT transplant is complete, with the follicles implanted in their new position. However, you should also expect some degree of tenderness, soreness, redness, scabbing or swelling – though for most patients, these side effects are minor and fade within a week.
The doctor will send you home with detailed post-operative advice about how best to take care of your transplant. These instructions might include sleeping with your head elevated, or restrictions on bathing or washing your hair.
Your Hair Transplant Timeline
It may take several months before you will begin to grow the thicker, fuller head of hair you have always wanted, but don’t get discouraged. Patience is critical to your recovery process.
Here is an extensive timeline of what you can expect in the year following your hair transplant surgery, and what you should do to make the most of your results throughout that year.
The Day After a Hair Transplant
The day following hair transplant surgery is the most crucial time for the results. You will be able to remove the bandage from the donor area and carefully wipe off any dry blood with a wet washcloth. Scabs should have formed over the transplanted grafts by this stage, so it is vital you treat this area gingerly and avoid any rubbing, scratching or picking.
The First 7 to 10 Days
Continue to care for your transplanted grafts and follow all post-op instructions during this period. During this phase, the donor area will heal, new hair will already start to grow in and you will no longer experience any swelling or redness.
You will have scabs in the recipient sites. By the end of the first 10 days, these scabs should have fallen off, and you will be able to clearly see what the transplant site will look like, as well as assess the extent of your scarring.
Weeks 2 to 3
If you aren’t prepared for this stage of the recovery process, you may be alarmed when you see your newly transplanted hairs beginning to fall out about two weeks after your surgery. However, this is a totally normal part of the healing process, and it doesn’t mean the grafts are dying or failing to take hold. It’s a natural step in the hair-growth lifecycle for old hairs to fall out. While your scalp is shedding the hair shafts themselves, your new follicular units will remain completely undamaged, and in fact, new hair shafts should be beginning to come in.
The next few months following your hair transplant surgery are the first stage of the growth phase for your newly transplanted hairs. You will start to notice new transplants beginning to emerge from your scalp, though they may appear to be finer than the surrounding hair. If you experienced any redness or irritation in the donor area, you will see it resolve by this point.
During this phase, you’ll start to notice a considerable amount of new hair growth. Toward the end of this period, your new hair will begin to become thicker, and you will be able to cut, colour or style it hair however you choose. The donor area will be completely healed by this stage.
9 Months Later
By this point, roughly 80 percent of your new hairs will be growing in, and you should have a very clear indication of what your final result will look like.
One Year Later
By the time a full year has passed since your hair restoration surgery, your transplant process will largely be complete. Some people may continue to grow new hairs even after a year, but for most patients, the one-year anniversary represents the end of their journey. As the hair grows longer, it provides a fuller appearance, since the volume of hair at the transplanted area will increase. After a year, patients who suffered from very advanced hair loss can now get another hair transplant, if they so choose, to add density to the same area that was transplanted the first time.
Watch Our Case Studies and See Our Results for Yourself
Our doctors here at the Toronto Hair Transplant Centre are highly qualified hair transplant surgeons who personally perform every hair transplant surgery themselves at our state-of-the-art clinic in Oakville. With the many advances made in hair transplantation techniques, our doctors have been able to help patients from all over the world look and feel better by restoring their naturally growing hair.
You can see for yourself the outstanding results we have achieved by viewing the many case study videos of actual procedures completed here at the Toronto Hair Transplant Centre – performed for people just like you.