Pros & Cons of Surgical Hair Restoration

Hair Restoration Treatment in Gurgaon

A hair transplant is the gold standard when it comes to the restoration of hair. Be it redesigning the hairline or restoring the density, surgical restoration offers a permanent solution with the most promising outcomes. With the current advances, experts can offer solutions for the extensive degrees of hair loss with minimum downtime. Not only has surgical hair restoration become easily accessible in the present scenario, but it has also become cost-effective. This has made hair transplantation the most effective and used hair restoration treatment in Gurgaon. With these points in mind, we must understand a few key technical aspects of hair transplant.

Primarily, there are 2 techniques of hair transplant, namely Follicular Unit Transplant (FUT) and Follicular Unit Extraction (FUE). In both methods, follicles of hair are extracted from the donor area, usually the occiput, which is genetically programmed to have stronger lifelong hair growth and transplanted to the recipient site under magnification using micro-incisions and micro forceps. The key difference between the two methods lies in the method of extraction, donor site and processing methods.

FUT also known as Follicular Unit Strip Surgery (FUSS) is also commonly propagated as “surgical hair transplant”. It consists of harvesting a strip of tissue bearing rows of hair follicles from the donor area as a single unit using a scalpel knife, processing of the strip into follicles by manual slicing under magnification followed by transplantation. The donor area is closed using a special technique called “trichophytic closure” where the goal is to camouflage the scar to the maximum. The procedure is done under local anaesthesia comfortably. Depending on the type of closure done by the surgeon, the donor area may require the removal of sutures after a designated healing time.

Many people who opt for hair transplants are often concerned about the donor area scar in the FUT procedure. The length of the scar is proportionate to the density of the donor area, the demand of the recipient area and patient-specific factors which can affect the healing of the scar line. If the procedure is performed by an experienced hair transplant surgeon, the resulting scar is barely visible and adequately hidden within the fall of the hair. It is important to mention here that people who wish to keep a shorter crop or have a thinner hair profile, in general, may show a curvilinear scar in the occiput area. In a few cases, it has been seen that the scar may stretch or become wider than intended and be more obvious.

Follicular Unit Extraction is often marketed as a “non–surgical’ hair transplant. It involves the utilization of micro-punches, manual or motorized, to harvest individual follicle units from the donor area. The procedure is done under magnification and requires considerable training to avoid the transaction of roots of hair during the harvest. The extraction yields follicular units, which may contain single or multiple hair follicles. The donor site is left with multiple puncture marks under a millimetre and looks like tiny white dots once healed. No stitches are required on the donor site. These tiny scars hide adequately within the donor area once the surrounding hair grows back.

In a few cases, due to high requirements, multiple harvesting, thin hair, generalized low density, or poor scarring tendency, the dots may be visible as stippling within the donor area. Patients have different cases and expectations with their hair transplant. Thus, at our clinic to provide the best hair restoration treatment in Gurgaon, our expert surgeon, Dr. Shilpi Bhadani, performs a detailed diagnosis and consultation with the patient before deciding on which technique should be used to get the best outcomes.

Pros and Cons

Both procedures have their own merits in their own standing but as no procedure is perfect, both FUT and FUE have some finer points which need to be considered before a decision is made by you and your surgeon about the type of procedure most suitable to your needs.
Here are some factors which influence the choice of procedure.

1. FUT

Pros:

Offers a comparatively larger yield and is especially beneficial in cases of larger follicular requirement cases, which is often the primary objective of a hair transplant.
It is usually a shorter duration procedure if measured in terms of giving a higher follicle yield for the given time. Depending on the requirement, it is anywhere between 5 – 12 hours.
The procedure does not require extensive part preparation or shaving of the entire scalp and the donor scar is well hidden within the surrounding hair growth from the beginning.
It is usually a more cost-effective procedure
This can be followed by FUE if needed

Cons:

Carries an inherent surgical risk of infection, bleeding, and suture site gaping and needs meticulous technique by an expert surgeon for best results.
Has a relatively higher pain score and swelling post-procedure. Although medications prescribed do help in counteracting the former, but it does take some time for the patient to be completely comfortable.
The recovery period for the scar is longer than the FUE method and requires a follow-up visit for the removal of stitches depending on how the incision was closed.
Needs technical expertise on the part of the surgeon to camouflage the donor area adequately using the “trichophytic closure” technique.
A long curvilinear scar may need longer hair length to hide it adequately.

2. FUE

Pros:

The donor area has a shorter recovery period of 1 week.
There is negligible to very little visible scarring in the donor area and is suitable for people who wish to keep a shorter crop of hair.
In case of poor scalp donor area density, the technique offers the advantage of extracting grafts from various body parts, like the beard.
The recovery period has a minimum pain score and reduces the need for analgesics and antibiotics.
There is no requirement for stitch removal.

Cons:

The yield is comparatively less as compared to FUT as surrounding hair follicle units need to be spared to maintain density and avoid scarring alopecia post-procedure
The procedure is more expertise-dependent to maximise the yield of units with viable hair roots and minimize the cutting base of hair while harvesting.
The average procedure time is 8 – 10 hours and above due to individual follicle harvesting techniques.
It usually has a higher cost per unit as compared to FUT.
FUT cannot be planned after FUE.
Needs shaving of the entire scalp for proper harvesting of follicular units.

The age of the patient, the extent of baldness, donor area density and expectations of the patient play a major role in deciding the type of procedure. In some cases where skin thickness is higher or hair roots are more fragile, FUT becomes a default choice. In some cases, a combination of both surgeries or sequential surgeries may be essential to achieve a complete result. These mega sessions are planned in case of large areas of alopecia which need more than 4000 grafts. Here it is essential to note that post one session of FUT, a second FUT or FUE can be easily planned but in cases where FUE has been done in the first session, only a second FUE can be planned along with harvesting from beard or other parts of body to preserve the health of donor area.

In both procedures, the donor site is something which has variable acceptability and in specific cases where donor site scarring is poor an additional camouflage procedure may be required. An upcoming technique called Scalp Micropigmentation can be used to improve the scar in case of prominent visibility. In Scalp Micropigmentation, a relatively novel method, tattooing with a specialized microneedle blade in a stippled manner is used to give an impression of hair follicles. This helps in further making the scar almost invisible within the adjacent hair. However, it must be kept in mind that this technique is not as commonly available everywhere and has its own limitations in terms of technical expertise, pigment failure, fading and the need for touch-up sessions.

In the end, no matter which procedure is preferred, it requires considerable technical expertise and training. It is not only about harvesting and processing the grafts but also about planning the angle of implants, density, hairline, parting preference and performing the procedure with utmost meticulousness to match the expectations of the patient. It needs an honest dialogue between the surgeon and the patient to set the expectations right and match the correct procedure and timeline for the most optimum outcome.

To know more about the most effective hair restoration treatment in Gurgaon, schedule an appointment with Dr. Shilpi Bhadani, SB Trichology unit of SB Aesthetics, Gurugram, call us on +918130134693 or Contact Us online.