• Modern hair transplantation techniques were first described in Japan in the 1930’s. The procedure, in its more crude form, was popularized by Dr. Orentreich in the 1950s (1). Over the last century the procedure has been refined, and now individual follicular units are transferred with less invasive incisions made on the balding scalp.

• Is a surgical technique that takes hair from one part of the scalp with ample and stable hair (typically back of the head) and moves it to an area of thinning or balding

• Can be used for management of pattern alopecia, traction alopecia, and in special cases scarring alopecia

  • If indicated, when treating primary cicatricial alopecia the hair loss condition should be treated and/ or stable for at least one year.

• Can be performed in men and women of all racial and ethnic backgrounds.

• Follicular unit transplant- FUT

  • Also known as the strip harvesting technique

  • 1st described in the mid-1990’s (2, 3).

  • Involves excision of a strip of skin from the stable portion of the posterior scalp (donor area). Individual 1-4 follicular units are then microscopically dissected from this strip and are transferred to tiny slits on the balding scalp (recipient area).

  • A linear scar is left, although typically very thin (4).

• More than one procedure may be necessary to obtain the desired result.

• May also be combined with FUE depending on the individual’s needs and the surgeon’s preference.

• May also be combined with scalp micropigmentation to improve the scalp coverage

• For many people, it is essential to make sure medical therapy is continued in order to obtain maximal results.

• Afro-textured hair FUT

  • Special care must be taken with afro-textured hair FUT. 

  • The curved follicle is susceptible to transection during graft processing 

  • Patients of African descent are more susceptible to hypertrophic scar and keloid formation, thus monitoring of the donor area is important.

  • In general, patients of African descent have less follicular density (5), reducing the number of follicles available for transplant 

  • The coiled hair shaft may allow for more coverage

REFERENCES: HAIR TRANSPLANTATION

1. Orentreich N. (1959). Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Science, 20(83), 463–479

2. Berstein RM, Rassman WR, Szaniawski W, Halperin AJ. Follicular transplantation. Int J Aesthet Rest Surg. 1995;3:119‐132.

3.  Limmer BL. Elliptical donor stereoscopically assisted micrografting as an approach to further refinement in hair transplantation. Dermatol Surg. 1994;20:789–93

4.  Marzola M. Trichophytic closure of the donor area. Hair Transplant Forum Int. 2005;15:113–6.

5. Madu P1, Kundu RV.  Follicular and scarring disorders in skin of color: presentation and management.  Am J Clin Dermatol. 2014 Aug;15(4):307-21.