Summer 2018

40 Hair transplant surgery can transform the appearance of a balding man and can restore confidence in a woman losing her hair through female pattern hair loss. It can also be used to restore hair to the scalp where it has been lost through trauma, burns or surgery, and to other hair bearing areas such as eyebrows where it has been removed, never existed or destroyed by some dermatological conditions. Hair for transplanting is traditionally taken from the back and sides of the head by one of two harvesting methods, either Strip Follicular Unit Transplantation (Strip FUT) or FUE. Body hair, in particular beard hair, can also be harvested using the FUE method. There are proven and licensed medical therapies to slow down or stop male pattern hair loss and new drug therapies are in research phase. Several drugs are prescribed off-licence for women with thinning hair. In terms of surgical hair restoration, there are pros and cons of both methods of donor harvesting. In Strip FUT, a strip of scalp skin is removed from the back and or sides of the scalp and then dissected into the naturally occurring follicular units that have 1-4 hairs and are known as ‘grafts’. The main advantage of Strip FUT is the higher numbers of grafts per operation achievable in a day and potentially over multiple procedures. Shaving of the scalp is not required, it is less time consuming and usually cheaper in clinics that do both types of surgery, the grafts are usually better quality and there is a lower transection rate due to microscope visualisation of the graft dissection. The Strip FUT disadvantage that puts most patients off is the linear scar, but the likelihood of post-operative pain and the 10-14 days to heal also deters patients from choosing this method. It is not possible to perform when the scalp is extremely tight since wound closure after removing a strip of skin might not be possible, more staff are required to dissect follicular units from the strip, and more surgical skill is required to remove the strip of scalp skin and close the resulting wound. Strip FUT is indicated for patient preference, those who don’t want to shave the donor area including women and transgender patients, and when there is a donor size limitation combined with advanced balding as more hair is available for transplanting. This is because every hair within the strip is utilised, whereas in the FUE technique extraction sites must be scattered over a wide area to avoid creating bald patches. FUE has traditionally stood for Follicular Unit Extraction. However, it recently has been redefined by the International Society of Hair Restoration Surgery (ISHRS) as Follicular Unit Excision, in order to highlight that this is a surgical procedure with an incision step where a cut is made around the follicular units, and an extraction step where the follicular units are removed from the donor location. FUE is often touted as the more modern technique but in fact was first performed in Japan in the 1930’s. Certainly, this method has become more refined with smaller punches available to incise around the follicular units, vacuum assisted devices that remove the follicular units, and a robotic device that utilises complex software to identify follicular units and accurately incise the skin around them. The main advantage of the FUE method over the Strip FUT method, is the absence of a linear surgical scar. Instead, small scars 1mm or less in diameter are left from each extraction site. Since it is less invasive, there is less post-operative pain and faster healing. Disadvantages of the FUE technique include that it is time consuming and tends to be charged at a higher price per graft by most clinics that offer both techniques. The Farjo Hair Institute is one of the UK’s premier centres of excellence, and one of the most revered brands in hair transplant surgery around the world. Greg Williams – Hair Transplant Surgeon, provides us with an overview of the company featured in LUXlife Magazine’s Ones to Watch for 2018 as the Best for Cosmetic Surgery and Aesthetic Treatments. Before After Giving you the Confidence to be Yourself 1712LU14