Do Hair Transplants Look Natural?

FUE & Strip Harvesting Are the Basis of Today’s “Natural Look” Hair Transplants

The answer is a resounding yes. FUE & Strip Harvesting Are the Basis of Today’s “Natural Look” Hair Transplants

Pioneered back in 1988, follicular unit extraction (FUE) & strip harvesting have become today the most successful means of correcting hair loss. The name of these techniques derived from the term ‘follicle,’ the hair follicle cell being the biological engine of hair growth.

‘Extracting’ means removing an existing healthy follicle from one part of the scalp and ‘transplanting’ it to another part of the scalp that has lost hair.  FUE & strip harvesting  are just two different ways of employing this basic, and powerful, technique.

The basic technique works to restore lost hair because the causes of most hair loss lie not in the scalp but in the follicle itself.  For example, in the case of “androgenetic alopecia,” the most common cause of baldness, too much of the male hormone dihydrotestosterone, or  DHT, can cause hair follicles to shrink and eventually stop producing hair.  However, this happens only to some hair follicles.   By replacing those damaged follicles with healthy ones, you can start growing hair on new areas of the head.

These techniques represent a significant advance in both the science and engineering of surgical hair restoration technology.  They are both sophisticated & delicate techniques requiring the precision use of microscopically sized instruments.

So how do these two hair restoration procedures create a “natural look?”

It all starts with the follicular unit, the single hair cell. It is what makes your hair unique. It determines everything about a single strand of hair, from its thickness and texture, from its color, from how curly it is, to how fast it grows and how it is orientated relative to the surface of the scalp.  Who knew one hair could be so complicated!

The success of FUE & single strip harvesting in creating a natural look rests on knowing how to identify groups of follicular units that form the basis of how your hairs are naturally grouped.  These techniques are not as simple as just transplanting follicular units one at a time. The surgeon must know how many follicles to remove and from where, and the surgeon must know how to distribute the follicles in the bald area, controlling such variables as hair direction, angles and grouping of follicle.

A further challenge is knowing where to transplant these units in the balding area. All these variables must be controlled by the surgeon to create a natural hairline and natural looking distribution of hair in a previously bald area of the scalp.

Hair Transplants | They Take Skill . . . And A Lot Of It.

The follicular extraction and transplantation procedure is intricate. Mastering these techniques takes considerable time and training, and having prior surgical experience is extremely helpful. In the hands of a skilled surgeon, it can be almost impossible to tell if a person has had this type of hair transplant if you’ve never met them before, and even if you have, it can be very hard to distinguish the treated area of the head with an untreated area. The goal is nothing short of trying to recreate hair on a bald part of the scalp in a way that it looks like it was never lost in the first place.

What’s the Difference Between These Two Techniques?

FUE, or “follicular unit extraction,” and strip harvesting are two ways to transplant healthy follicular units into the part of the scalp that’s lost hair.  The latter is simply the process of removing a tiny strip of scalp that has hair and then from that strip “extracting” healthy hair follicles.

Follicular unit extraction is almost the same thing but instead of getting the healthy hair follicles from a donor strip that’s been removed from the scalp, the surgeon directly extracts follicles from the scalp.  Both method of obtaining follicles are quite labor intensive, but both result in absolutely one of the best hair transplants available on the market today.

What Are The Relative Advantages & Disadvantages?

In the evolution of hair transplant technologies, single strip harvesting came before follicular unit extraction.  The reasons hair transplant researchers developed follicular unit extraction was to avoid the thin scar that comes from removing a donor strip of follicles from the scalp. While it is tiny, it is there, and the scar can be visible, close up, in persons with very short hair.  FUE was designed to avoid a scar. However, it’s not the case that follicular unit extraction is a scarless procedure. It’s just that the individual extraction process leaves individual scars that are really too tiny to see, and so you can wear your hair quite short and no one will detect that you’ve had this type of hair transplant.

The advantage of single strip harvesting over FUE has to do with how difficult it is to obtain the best follicles.  With single strip harvesting, it’s usually easier/faster for the surgeon to harvest the needed follicles. The skilled follicular extraction surgeon can achieve the exact same result using follicular unit extraction, but it’s usually more work for the surgeon and it takes longer. For this reason, FUE can be more expensive.

In the end, which technique is right for you depends primarily on how short you want to wear your hair and the particular characteristics of your scalp. This latter factor, scalp type, turns out to be an important deciding variable. Some scalp and hair types are contraindicated for follicular unit extraction.  The only real way to determine which technique is best for you is following an extensive discussion with the surgeon.

The Bottom Line

Modern follicular transplantation techniques like FUE & single strip harvesting have all but revolutionized the hair transplant. Today it is now possible to have a hair transplant that looks so natural it will fool anyone except a trained hair restoration specialist, and even he or she would have to do a close inspection to tell.

It is, however, not enough for a hair restoration specialist to be technically proficient with either technique — they have to be at least that.

While the technique allows the surgeon to transplant hair follicles at will, it can’t tell him or her which follicles to extract, how to extract them, or where to place them in order to create a natural look.   Only a well trained, experienced and confident hair transplant surgeon will produce the best results.

In the same way that one would have no idea how to paint as Di Vinci painted even when one has the exact same tools, the inexperience surgeon, or one who lacks an “eye” for the work, will not be able to create a truly natural look even though he or she understands the basic “mechanics” of  these two powerful techniques.

This is why, in addition to making sure a surgeon has great medical training, experience, and specific training in these two techniques, you need to review testimonials and look at before and after pictures.

© 2013, Anapelli Hair Clinic

John Frank, M.D. | IAHRS, ABHRS, ISHRS, AHLA, XM Radio: ‘The Bald Truth’, Last update: May 20, 2013, NYC