Follicular Unit Transplantation (Strip Harvesting)
Hair loss is a common problem that can affect either men or women, and can be caused by a variety of issues such as stress, diseases, medical treatments, and genetics. Strip harvesting in the follicular unit transplantation (FUT) method removes a strip of hair, generally from the back of the head. This strip is then dissected into smaller segments in order to implant individual follicles. Although there is a strip removed, the scar is easily covered by existing hair.
Follicular Unit Transplantation (Strip Harvesting)
- avg. recovery
About the Procedure
Strip harvesting for hair transplant is a safe and effective way to treat patients with balding or thinning hair. Unfortunately, this method does create a scar from the dissected donor area of the scalp. Alternatively, the follicular unit extraction (FUE) method does not require a piece of scalp to be harvested before transplanting individual hairs. Your hair transplant surgeon will help you determine which method would be best for your individual needs. When designing the strip to be harvested there are a few guidelines to follow. The upper boundary of the strip should be at least 2 cm below where crown thinning is predicted to occur. The lower boundary should be about 2 cm above the nape of the neck. The maximum length usually ranges from 24 to 30 cm depending on the size of the candidate's head. Depending on the donor scalp laxity, a safe strip width will generally vary from 10 to 25 mm. Once the appropriate dimensions are determined, the donor site hair is trimmed to a length of 2 to 3 mm. There is no need to trim beyond the strip as longer hair above the harvest site is valuable to hide the incision. Next, the upper and lower edges of the donor site are marked. The area is then injected with local anesthesia containing epinephrine. For the donor strip technique, it is extremely important to visualize the hair follicles and remain parallel to the existing hair shafts in order to avoid transection. The upper and lower incisions are then made and the strip is sharply dissected from the underlying tissue, staying in a plane just beneath the follicles. The incision is then closed without tension. Occasionally, telogen effluvium (temporary thinning of the hair) occurs at the donor site however it should resolve in 4 to 6 months. Tiny incisions are then made in the recipient area in an irregular pattern that mimics the way hair grows naturally. The micrografts that have been dissected from the donor area are then carefully placed in these tiny incisions. They are placed in varying densities, with the smallest one- to two-hair grafts placed in the front of the hairline, and three- to four-hair grafts placed behind them. Immediately after the transplant, there will be hundreds of tiny incisions with short hair stubble sticking out from the new grafts. In two and a half to three months, the new hair will start growing in, and will grow at the normal rate of one-half to one inch per month thereafter. For eyebrows the same process is performed but with a smaller graft. Although they vary in size depending on the number of grafts needed, a graft typically varies in length and width from about 3 to 6 cm and 10 to 15 mm, respectively. Special care is taken to only transplant single grafts, transplant in the direction of the hair growth of the eyebrows with respect to the hair's natural curl and wave, and transplanting at an angle that is very flat to the skin.
Strip harvesting seeks to reverse hairloss created by thinning hair, bald spots and receding hairlines. Hair loss caused by medication, stress or medical treatment cannot be addressed by strip harvesting.
What to Expect
Strip harvesting removes a strip of hair from the back of the scalp in order to dissect individual follicles for transplantation. Here is a quick guide for what to expect before, during, and after a strip harvesting hair transplant.
- Stop using topical hair treatments for 2 weeks
- A prescription shampoo may be recommended
- Stop taking blood thinning medications for 2 weeks
- No alcohol 3 days prior
- No smoking 1 week before and after
- Patients with light hair will dye hair 3 days prior
- Hair in donor area will be cut short
- Donor area is then injected with local anesthesia
- Entire donor area is excised from the scalp
- Incisions are closed with sutures
- Individual hair follicles are dissected from donor strip
- Hairs are implanted into the scalp in thinning areas
Start shampooing the donor site 48 hours after strip harvesting hair transplant surgery. Light exercise can be resumed in 5 days and a regular exercise routine can be resumed 2 weeks postoperatively. However avoid heavy weight lifting or any exercises that can stretch the back of the neck for 1 month.
The ideal candidate for strip harvesting hair restoration surgery has thinning hair, bald spots, and/or a receding hairline. For successful hair restoration, candidates must have adequate amount of hair growth or follicles used for transplantation.
Not Recommended For
Strip harvesting is not recommended for patients with poor donor sites or who have hair loss as a result of medication, stress, or medical treatment as these can be reversed.
Side effects from strip harvesting may include hemorrhage, infection, telogen effluvium, itching, scarring, cysts, bleeding and swelling.