What can I expect?


Follicular units are distinct groupings of usually one to four terminal hairs. The follicular unit is thus a naturally occurring physiologic, as well as an anatomic entity.

Follicular unit transplantation offers the surgeon the ability to transplant the maximum amount of hair with the minimum amount of non-hair bearing skin. In this way, recipient wounds are kept small, healing is facilitated, and with proper technique, large numbers of grafts may be safely moved per session. The use of these units helps to ensure that the cosmetic result of the transplant will appear completely natural.

In contrast to follicular units, micrografts (1-3 hairs), and mini-grafts (3-6 hairs), are small grafts cut randomly from donor hair, not specifically as individual intact follicular units. These multiple units will contain extra skin that will demand larger recipient sites, which, in turn, causes more wounding to the recipient bed and may limit the number of grafts that can safely be transplanted in a session.

Although, it is hard to argue the superiority of the follicular unit technique in theory, in practice, follicular unit transplantation is tedious, demanding on the physician and staff, and requires a relatively high degree of expertise to be properly performed. All surgeons listed on this site utilize this technique and work with highly trained technicians who specialize in this procedure.

The evolution of microscopic dissection and follicular unit transplantation has been that this procedure can be practical for other parts of the body including eyebrows and eyelashes. It has also become much more viable as an alternative for female pattern hair loss which is usually more diffuse.


expect1During hair transplantation, a strip of hair filled with follicular units is removed from the back of the scalp and then placed into the front of the scalp where it is balding. The follicular unit of hair is removed during transplantation in a narrow strip and then that area is sutured so that nothing is left open. After healing, this leaves a thin white line scar that is not visible unless you shave your scalp. The follicular units of hair from this strip will grow wherever it is planted just as it did in the back of the scalp. This is known as donor dominance. The replacement hair from transplantation will last a lifetime. It is not susceptible to male pattern baldness. The replacement hair from this strip can be dissected down to many different sizes of grafts.

Follicular unit hair transplantation is the logical end-point of over 30 years of evolution. Hair transplantation began with the use of traditional large plugs and has culminated in the movement of 1-4 hair follicular units, which mirror the way hair grows in nature.

Hair grows naturally in groups of one to four hairs in each pore. These groupings of hair are called follicular bundles or follicular units and can be seen with the unaided eye by closely examining the scalp. There you will see them naturally occurring, with one to four hairs coming from each pore. If this follicular unit of hair is undisturbed during hair transplantation, it will grow much better than if it is damaged or cut.


The key to follicular unit hair transplantation is to identify hair groupings, dissect the follicular units of hair from the surrounding tissue and then place these units in the recipient site in a density and location appropriate for a mature individual. Introduction of follicular unit hair transplantation and the use of the binocular microscope can increase the growth of replacement hair up to 20%.

The use of the binocular dissecting microscope allows technicians to microscopically observe and dissect each follicular unit of hair without damage. The use of the binocular microscope in transplantation is much more precise, but more difficult and time consuming. Whereas hair transplantation formerly took two to three hours, now it may take up to six or seven hours and requires many more technicians. Because of the increase number of technicians, quality control is essential. There are certain check points during the transplantation to ensure perfect grafts and precise gentle planting of each graft. Routine random checks are made of the grafts during microscopic dissection and during the replacement. There is not a more precise method of graft preparation. We feel the extra effort is well worth the increased hair growth and improved naturalness.

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