BACKGROUNDFollicular Unit Transplantation (FUT) is performed using large numbers of naturally occuring individual follicular units obtained by single-strip harvesting and stereo-microscopic dissection. Donor wound scarring from strip excision, although an infrequent complication, still concerns enou

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Follicular unit extraction: minimally invasive surgery for hair transplantation.

The logic of follicular unit transplantation

Modern hair restoration surgery is based on a technique known as follicular unit transplantation, in which follicular units are the exclusive structures used as hair grafts. In Part 1 of this 2-part review, we describe how the techniques employed in hair transplantation have evolved into their present forms. Anatomic concepts of specific relevance for dermatologists are discussed, including the distribution and ex vivo morphology of scalp follicular units. Male androgenetic alopecia and female pattern hair loss are the most common reasons for hair loss consultations with dermatologists and will be the primary focus of this review. However, because not all hair disorders are suitable for transplantation, this review will also describe which scalp conditions are amenable to surgery and which are not. Guidelines are provided to help dermatologists better define good and bad candidates for hair transplantation. Other conditions for which hair transplantation surgery is indicated are reviewed.

Hair transplantation: Basic overview

BACKGROUNDThe field of hair transplantation has evolved considerably over the last quarter century. Performed correctly, the cosmetic results of contemporary hair transplantation are virtually undetectable in women and men. Large, pluggy “punch grafts” have been replaced with natural-appearing folli

Contemporary hair transplantation

Follicular unit extraction (FUE) is a method of producing follicular unit hair grafts that involves removing the grafts individually from the scalp. The advantages of this technique over the conventional strip harvest are that it does not leave a linear scar, and the procedure produces little or no postoperative pain and discomfort. There are some disadvantages such as increased surgical times, graft fragility, and higher cost to the patient. This article describes the instrumentation and surgical methodology of FUE. It also presents some surgical difficulties and how to minimize their impact. Indications and patient candidacy are also discussed.

Follicular unit extraction.

Back to the Future with the “Dissected-Punch Technique”

Previous attempts at classifying small graft transplants have focused mainly upon graft size and have not taken into consideration other technical factors involved in graft production that may influence the outcome of the surgery. The proposed classification attempts to consider these factors by including various technical aspects of harvesting, dissection, and placement, all of which impact the quality and quantity of the small grafts used in the procedure. By standardizing the nomenclature, as well as the description of the other factors involved in the surgery, communication between physicians and patients may be facilitated. In addition, different procedures may be more accurately studied and compared.

Standardizing the Classification and Description of Follicular Unit Transplantation and Mini-Micrografting Techniques

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Follicular unit extraction: minimally invasive surgery for hair transplantation.

Back to the Future with the “Dissected-Punch Technique”

Standardizing the Classification and Description of Follicular Unit Transplantation and Mini-Micrografting Techniques