Hair Restoration (FUE – Follicular Unit Extraction) Questions

Serving Albany, Saratoga Springs, Schenectady, and Troy, New York

What it the cause of  hair loss?

The most common cause of  hair loss is genetic predisposition. Men and women inherit the gene that triggers  hair loss from either or both parents. Men are most commonly affected by the inherited gene because the male sex hormone, testosterone, activates programmed hair loss. Currently there is no known method of stopping this type of hair loss. The age of onset, extent, and rate of hair loss vary from person to person. Severe illness, malnutrition, or vitamin deficiency can accelerate this process. When applied incorrectly, permanent hair color and chemical relaxers can also contribute to hair loss by damaging the hair follicle to the extent that hair loss can be permanent. There is no evidence that  wearing a hat, excessive shampooing, lack of blood flow, or clogged pores contribute to hair loss.

Do hair transplants really work?

Yes. The transplanted hair is removed from one area of the body (donor site) and transferred to another (recipient site). The transferred tissue is not "rejected" as it is your own tissue. The transplanted hair maintains the characteristics of the  donor site including color, texture, growth rate, and curl, after transplantation and regrowth. Originally, large circular grafts containing 15-20 hairs were transplanted resulting in noticeable and unnatural results. Over years, instruments and techniques have been developed that allow us to achieve truly natural results by transplanting small grafts very close together. We have found that hair grows from the scalp in groups of one, two, and three hair follicles called follicular units.  Hair is transferred in these small follicular units. Dr Falk is able to place these grafts closer together to produce denser and more natural result.

What is follicular Unit Extraction or FUE?

Follicular unit extraction is a new way of harvesting small follicular unit grafts. Traditionally follicular unit grafts were harvest by means of a strip graft from the back of hair baring scalp. This approach is still practiced and is efficient for large grafting sessions. However, the down side to this approach is a long linear scar which is unavoidable. FUE on the other hand, avoids a large scar by harvesting the follicular units directly from the donor site using small punches. These punches are no greater than one millimeter in size, so small that the biopsy site heals without the need for suturing. The grafts are taken from the fringe of the hair line. When healed these sites are virtually undetectable, so that there is no limitation in hair styles or concern about detection.

Why aren't more people doing FUE?

Follicular unit extraction takes more time and expertise than standard strip grafting. For this reason, it has been slower to be adopted. This is a technique for the very discriminating client, and generally not performed by large franchise operations.  Dr. Falk believes that the extra effort is well worth it. “Personally, I would not want a standard strip graft for myself, and so I have a hard time advocating it for my patients.   That is why I am so enthusiastic about FUE. There is no donor site scar.” New  technology such as the NeoGraft, and the A-Z extractor have made harvesting of FUE grafts more efficient and have enabled hair restoration physicians to perform full scalp  restoration using exclusively the FUE method.

What can be expected after hair restoration surgery?

The post-operative course will be minimized by adherence to the instructions given after surgery. Small scabs will form on the scalp at the graft sites. These scabs disappear in 4-7days. Shampooing can be resumed 24 hours after surgery. It is recommended that you take at least two days off work after surgery. A baseball type cap can be worn at anytime after surgery. Patients should avoid strenuous physical activity for a minimum of  five days after surgery. Don't be surprised if your new hairs begin to shed. Typically the grafted hairs will shed in 2-4 weeks. New growth  begins in 3-4 months and length will increase approximately 1/2 inch per month.

Are hair transplants painful?

Most people are surprised at how little pain there is during the procedure. Some discomfort is to be expected as the anesthetic is injected into the scalp. Once the skin is anesthetized, there is no pain. If the numbing medicine wears off during the course of the procedure, more is injected to re-anesthetize the area.

What will it look like after the procedure?

The grafts form small scabs in the days after the procedure. If one has enough surrounding hair, these scabs can be camouflaged with creative styling. If not, the small scabs may be visible but do not attract much attention. By keeping the scalp moist, the scabs usually come off in about a week or so.

When can I return to work?

Depending on the type of procedure you have done and the type of work you do, it is often possible to go back to work in two days. We like to schedule surgery at the end of the week so that you can easily recover over a weekend and be ready for work the following Monday.

What is the cost of  hair transplant surgery?

Hair transplantation is more expensive than a hair piece or some alternative treatments. However considering that the results are permanent, most people consider it a good investment in their future happiness. The price for hair transplantation is calculated based on the number of grafts and the technique being used.  Follicular unit extraction is more expensive than strip grafting, and one can expect to pay between $8-10 dollars per graft.

How many sessions will be required?

The number of the sessions will depend on the 1) area of scalp treated 2) the number and size of grafts used and 3 )the density which the patient desires 4) the individual characteristics of the patient. Coarse hair will provide a more dense look than fine hair. The estimate of the number of sessions can be discussed during the consultation with Dr. Falk.

After using Propecia® (finasteride) for a prolonged period, would cessation of use of the drug result in the same sudden rapid hair loss off all hairs that would have been lost without the use of the drug, like suddenly stopping use of Rogaine® (minoxidil)?

The hair would be lost until the point where an individual would have been without treatment. However, the hair loss is not sudden and will take several months to a year after stopping the medications. That is why missing a day or two of treatment, athough not recommended, is generally not harmful.

What are the possible harmful effects of Propecia and Rogaine? Especially in regards to women handling Propecia and/or a man taking the drug while trying to have a baby? Can the man cease taking the drug until he has fertilized a child?

There are no known harmful effects of either medication when used as directed by the manufacturer. Follow all package instructions. Propecia would be potentially harmful to a developing male fetus in a pregnant woman if the drug entered her body. This would require her to ingest the medication, so she should not handle broken or crushed tablets. The amounts of drug in a male's semen have been studied and found to be insignificant. The man can certainly cease treatment during conception efforts, but this is not necessary.

If you would like more information about hair loss and restoration, or would like to schedule an appointment for a consultation with Dr. Falk then please do not hesitate to contact us at The Center for Facial Plastic Surgery and Laser Skin Care.