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Hair transplantation

Hair transplantation in the present era, medical technology has advanced significantly, and many people with severe hair loss problems due to genetics are seeking hair surgery methods like hair transplantation to permanently address their baldness. Some individuals who do not have significant hair loss issues but desire a more balanced facial appearance also show interest in undergoing permanent hair transplantation. Among the various hair transplantation methods, Follicular Unit Extraction (FUE) is becoming increasingly popular and widely discussed. In this article, the doctor will introduce and explain the different methods of hair transplantation, along with their respective advantages and disadvantages.

Currently, there are two international methods of permanent hair transplantation according to the definition of The International Society of Hair Restoration Surgery (ISHRS). They are FUT (Follicular Unit Transplantation) and FUE (Follicular Unit Extraction). These two methods differ in the way hair grafts are obtained from the donor site, which is usually the back of the head.

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FUT (Follicular Unit Transplantation)

FUT is a hair transplantation method that involves surgically removing a long strip of scalp from the back of the head, also known as the ‘strip.’ This strip is then dissected to separate individual small grafts, known as ‘follicular units’ or ‘grafts.’ These grafts are subsequently transplanted to the desired area, and they can consist of either short or long hair, depending on the patient’s preference.

The advantages of FUT (Follicular Unit Transplantation) hair transplantation are:

  1. Allows for a high quantity of grafts, with the maximum number ranging from approximately 5000 to 8000 grafts.
  2. Suitable for individuals who do not wish to cut their hair short, such as women.
  3. Suitable for individuals with advanced hair loss where the remaining hair at the back is not extensive.”

The disadvantages of FUT (Follicular Unit Transplantation) hair transplantation are:

  1. Long linear scars on the back of the head, making it impossible to wear short hair.
  2. Not suitable for professions that require short hair at all times, such as military personnel, police officers, or models.
  3. There is a possibility of developing hypertrophic or stretched scars in some individuals, which can lead to confidence issues.
  4. There is a risk of severe complications, such as injury to deep nerves or serious infections in the scalp area.

FUE (Follicular Unit Extraction)

FUE hair transplantation method is a non-surgical procedure that involves moving hair follicles from the back of the head using small punch tools to extract individual grafts. These grafts are then transplanted to the desired area.

The characteristics and preparation of the back of the head after the FUE method can be broken down as follows:

Shaven FUE

Shaven FUE in this method, hair follicles are moved one by one after shaving a large strip of hair from the back of the head.

Advantages of Shave FUE:

  • The doctor can see a wide area on the back of the head, allowing for more even distribution of grafts and better results in the long run.
  • Suitable for individuals who prefer short hairstyles, such as military personnel, police officers, and models.
  • The procedure requires the shortest time compared to other FUE methods.
  • Allows for a high quantity of grafts, making it suitable for individuals with extensive hair loss, including men with a high hairline and women seeking hair restoration for facial framing purposes.
  • Achieves the highest hair density since the short hair grafts can be placed close together, providing a more natural look.
  • The post-transplant care and cleaning are easier, reducing the risk of infection.

Disadvantages of Shave FUE:

  • Requires cutting the hair short. In the case of men, the scar on the back will become less noticeable as the hair grows back in about two weeks. In the case of women, clinics have techniques to conceal the scar, allowing normal lifestyle activities.

Microstrip shaving is a method of cutting short hairs into small rows, and it is not recommended because in the long run, it can cause white scars in several stages. When cutting the hair short, it becomes evident that the hair has been thinned out in multiple steps, leading to limitations in further short haircuts. Additionally, this method also imposes restrictions on undergoing a second or third hair transplantation in the future, as the donor site at the back of the head has already experienced significant hair root relocation in each step, making it much more challenging to manage the remaining graph for future use. However, Microstrip shaving can be an option in cases where the graph hair does not exceed 600-800 graphs.

(Reference: Jae Hyun Park, Practical guide to hair transplantation)


Microstrip shaving


Microstrip shaving hair surgery

Non-shaven FUE

Non-shaven FUE is a hair transplantation method where hair roots are extracted individually without the need to cut the hair short. The extracted hair roots will be short hairs.

Advantages of Non-shaven FUE:

  1. Suitable for those who don’t want to cut their hair short.
  2. Suitable for those who need a smaller quantity of graphs, not exceeding 2000 graphs.
  3. Provides high density similar to Shave FUE, as the short hair roots allow for closer placement and easier direction control, resulting in more natural-looking outcomes.

Disadvantages of Non-shaven FUE:

  1. More expensive compared to Shave FUE.
  2. Requires a longer procedure time than Shave FUE.
  3. Not suitable for individuals requiring a large number of hair graphs. As the hair is not shaved at the back of the head, the process of extracting hair roots becomes more challenging, leading to less uniform distribution of extraction sites. In contrast, Shave FUE allows the physician to see all hair roots in a wider area, making the extraction planning more efficient.


Long hair FUE

Long hair FUE is a hair transplantation method where long hair roots are extracted individually without the need to cut the hair short.

Advantages of Long hair FUE:

  1. No need to cut the hair, making it suitable for individuals who cannot or do not want to cut their hair short.
  2. Clients can see the finished look immediately after the procedure, creating a high level of satisfaction and confidence.
  3. Recommended for individuals who need a smaller quantity of graphs, generally not exceeding 1500 graphs, such as for slightly adjusting the hairline or covering small scar areas.
  4. Particularly suitable for eyebrow transplants, as it allows for precise positioning and a more natural appearance compared to Shave FUE.

Disadvantages of Long hair FUE:

  1. The most expensive hair transplantation method due to the extended procedure time and complexity involved.
  2. Not suitable for individuals requiring a large number of hair graphs.
  3. The procedure takes the longest time, approximately three times that of Shave FUE.
  4. Provides the lowest density compared to other FUE methods, making the final result look less dense than natural hair, especially one year after the procedure.
  5. Requires careful post-operative care and cleanliness, as long hair roots can tangle and result in graph dislodgement during the first three days after the transplant.
  6. Two weeks after the transplant, some shock loss of transplanted hair may occur, similar to other hair transplant methods.


long hair fue

long hair fue

What is the best method of hair transplantation ?

There is no one-size-fits-all best method for hair transplantation. Each method has its own advantages and limitations. Therefore, the choice of the most suitable hair transplant method depends on the individual’s needs and considerations of their specific circumstances. It is not the case that using the same hair transplant method will yield identical results everywhere. The outcome depends on the expertise of each clinic, hairline design, hair root extraction technique, choice of hair root extraction devices, graft preservation methods outside the body, hair root orientation by the physician, and every detail that contributes to the survival rate and overall aesthetics of the grafts.

One must understand that hair roots are a limited resource. Hair transplantation involves the process of relocating and transplanting hair roots, which requires expertise; otherwise, the transplanted hair roots may not survive, leading to permanent loss of those roots. Hence, hair transplantation should not be solely considered based on lower costs but rather should be thoroughly evaluated from multiple aspects before making a decision. It is essential to focus on viewing long-term results rather than immediate post-transplant outcomes.

Kesa hair clinic is a comprehensive hair clinic that provides a range of hair services, primarily specializing in FUE hair transplantation. However, we have unique techniques  “NNN” to produce distinct results. They emphasize natural-looking outcomes, high density, small scars, and quick recovery.”

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