Sugical Hair Restoration: The Only Lifetime Solution to Hair Loss Problems

Today, hair transplantation is a very refined outpatient procedure that can produce full and natural looking results, even after only one hair transplant session. When performed correctly, not even a hair stylist will detect that a person has had a hair transplant. However, it is critical that the hair transplant procedure be performed correctly to achieve such natural results. To do so requires a hair restoration clinic that can perform both Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) at the highest levels of skill, experience, and dedication. Manzanares Hair Restoration Center is in the forefront of this surgical hair restoration.

Follicular Unit Transplantation (FUT)

A great hair transplant is the result of using a state of the art surgical procedure and performing it with great skill and artistry. Today, the acknowledged "gold standard" in hair transplant surgery is called Ultra Refined Follicular Unit Hair Transplantation.

This relatively new hair transplant procedure enables a patient to achieve extremely natural results because it recreates and mimics the way a person's hair grows naturally, hair for hair.





The concept of follicular unit transplantation is to relocate hair and their respective follicles from the donor area (the safe zone in the back and sides of the head) to the recipient areas (front, top or crown of the head, eyebrows, eyelashes and facial hair).

Transplant operations are performed on an outpatient basis, with mild sedation (optional) and injected topical anesthesia, and typically last about four hours. The scalp is shampooed and then treated with an antibacterial chemical prior to the donor scalp being harvested.

In the usual follicular unit procedure, Dr. Manzanares harvests a strip of skin from the posterior scalp, in an area of good hair growth. The excised strip is about 1-1.5 x 15-30 cm in size. While he is closing the resulting wound, surgical assistants begin to dissect individual follicular unit grafts from the strip by utilizing the stereoscopic microscopes for magnification. Working with stereoscopic microscopes (binocular microscopes), they take great care to remove excess fibrous and fatty tissue without damaging the vital follicular cells that will produce the patient’s first crop of new hair. Each of those graft may contain a single, two, three or four hairs.

This type of dissection approach allows us to transplant thousands of follicular units and ultimately thousands of hairs in one surgery at one time. A session may vary from few hundred grafts to more than 5,000 grafts in one procedure.

Dr. Frank then uses a fine needle to puncture the sites for receiving the grafts, placing them in a predetermined density and pattern, and angling the wounds in a consistent fashion to promote a realistic hair pattern. Then, the final part of the procedure is to insert the individual grafts in place.

We currently employ, on all patients, a unique way of removing the strip and closure, known as the trichophytic scar. The advantage of this scar closure technique is to allow the hairs at the closure point to grow right through the scar. This will add camouflage to the scar and reduce its visibility.

Follicular Unit Extraction (FUE)

Follicular Unit Extraction (FUE) represents a major advancement in the way surgeons harvest individual hair follicular units for transplantation. Instead of removing a strip of hair-bearing skin from the donor site, this revolutionary technique allows surgeons to extract individual follicular units from the back of the scalp or the body without the use of a surgical scalpel.

Scalp hair grows in naturally occurring groups called follicular units. Each follicular unit contains from 1 to 4 hairs. In Follicular Unit Transplantation (FUT), a single strip of skin is harvested from the scalp in the back of the head and then, using special microscopes, the strip is dissected into individual, naturally occurring follicular groups of 1 to 4 hairs. The disadvantage of this technique is that it produces a linear scar in the donor area, although the scar is generally very fine and can be treated easily.

With the FUE procedure, 1, 2, 3, and 4 hair follicular unit grafts are carefully extracted one at a time using a tiny punch of one millimeter or less rather than by donor strip of FUT. Often the surgeon requires the patient to buzz cut a portion of their donor area so that they are able to see the patient’s scalp.

The follicular units are extracted by placing the punch around a single follicular unit and cutting a small circle through the skin around that follicular unit. The follicular unit is then gently pulled up and away from the loose tissue underneath the skin.

The small hole left behind after the follicle is extracted then heals over the following week. Normally, this small round incision contracts as it heals making the resulting round scar smaller than the size of the 1mm punch that made the incision. The FUE patient ultimately ends up with hundreds of small round white scars, which are normally not detectable once the patient’s hair grows out.

Although follicular unit extraction is a great surgery, not all patients are good candidates for it. During the consultation, this option is explored in depth where the pros and cons of this type of surgery versus the strip surgery are discussed. The following cases might suffice the requirements of the procedure:

• Patients with limited hair loss or those who require small sessions
• The treatment of small cosmetic areas, such as eyebrow and eyelash restoration
• Athletes who must resume full activity soon after the procedure
• Patients who tend to heal with wide scars
• Patients with very low donor supply, a scarred donor area or very tight scalps
• Selected repair procedures

Below you will find some of our patients at Manzanare Hair Restoration Center in their before and after image testimonials:

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