Scientific Area

Hair transplant and autotransplant: fut and fue

CATEGORIES SCIENTIFIC AREA

Scientific collaboration between Professor Marco Toscani and Dr. Pasquale Fino, Chair of Plastic, Reconstructive and Aesthetic Surgery, Umberto I Health Center – “Sapienza” University of Rome

Cures and surgery for baldness are related to the degree of hair loss, type of situation around the donation area and the patient’s expectations. Thus, no surgical treatment is guaranteed to work for all situations.

Two avant-garde techniques are available: F.U.T. And F.U.E.

Autotrapianto dei capelli con tecnica F.U.T.

Cures and surgery for baldness are related to the degree of hair loss, type of situation around the donation area and the patient’s expectations. Thus, no surgical treatment is guaranteed to work for all situations.
Two avant-garde techniques are available: F.U.T. And F.U.E.
The F.U.T. (Follicular Unit Transplantation) autotransplant makes use of a sample of a strip of scalp taken from the occipital region, the ideal donation area because it is not subject to hormonal influences that facilitate hair loss.
The donation area is sutured using a particular technique which, by respecting the angle of hair growth, leaves a very thin linear scar (around 1-2 mm) that is easily disguised and often cannot even be found (aesthetic scar).

Trapianto dei capelli con tecnica F.U.E.

As soon as the strip of scalp is taken, it is “processed” by highly specialized personnel who divide the sample into thousands of follicular units of 1, 2, 3 or 4 bulbs, with the aid of optical stereomicroscopes.

The grafts thus obtained are then counted and aligned according to their size and passed on to the surgeon, who will then carry out the transplant in the designated micro-incisions made in the receiving area.
The F.U.E. (Follicular Unit Extraction) technique is a method listed as minimally invasive hair thickening, because it does not require the use of strips of scalp taken from the nuchal region; The downside is that, in order to apply the F.U.E., it is necessary to cut hair down to the root and this is often not readily accepted, especially by women.
Moreover, as it is slower than the F.U.T., this technique has the disadvantage of not allowing a large number of grafts per unit of time. The F.U.E. Technique leaves punctiform scars that may be noticeable solely under careful observation. Follicular units are extracted from the donation area (occipital or parietal) with a special 0.8/0.9/1.0 mm instrument, via a minimally traumatizing technique. The open holes generated for the hair follicle extraction by the micro scalpels close up by themselves in a few days and do not require stitches, resulting in thousands of off-white one millimetre micro-scars in the donation area.

Come avvengono gli interventi di trapianto e autotrapianto dei capelli con tecnica FUT e FUE?

The follicles are immediately transplanted to the receiving area, via special transplant instruments. The F.U.E. is particularly recommended for patients with hair loss in small areas or limited aesthetic regions such as the eyebrows, eyelashes and moustache; patients with insufficient scalp elasticity for strip excisions; patients that tend to suffer from the forming of large, thick or keloid scars; or when the body or beard serve as donation areas. The F.U.T. and F.U.E. techniques may be combined to some extent, in order to increase the capacity of the donation area and allow for the extraction of more grafts.
The operations are conducted in an operating room under local anaesthesia plus a mild sedation performed by an anaesthesiologist who will be present throughout all stages of the operation, thus allowing the patient to face the procedure as calmly as possible.

At the end of the operation, the patient will have neither head wraps nor bandages, will be welcomed by in a comfortable recovery room and may go home as soon as he/she receives permission from the anaesthesiologist.
The next day, a shampoo will be performed by specialized personnel, all the grafts will be checked and directions and instructions will be provided concerning cleaning treatments to be performed at home.
After approximately 12 days, the stitches in the donation area will be removed by the surgeon.
The transplanted hair will begin to crop up after around 3 months, and will grow approximately 1 cm per month; after 6-8 months the hair will have grown by 80%. After a year, the patient will be able to enjoy the final result.
Alternatives to surgery are medical drug therapies and vitamin supplements that slow and block hair loss, and the P.R.G.F. (plasma rich growth factor) or P.R.P.H.T. technique that uses the growth factors present in blood platelets of the patient, which, are immediately injected into the scalp after they have been activated, and will stimulate the stem cells present in the miniature or resting bulbs to produce thicker and stronger hair.

Hair follicles and bulbs

A hair follicle is a formation of epidermal origin, anchored in the dermis and consisting of a hair and its sheath.
The formation of hair follicles occurs early. They begin to appear as early as the second month of gestation. These follicles will continue to form for the entire duration of the pregnancy. At birth, the baby will indeed have the entire supply of follicles with which it was genetically equipped and from this moment on, no others will form.

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Hair loss: manifestation, causes and prevention

A shedding of hair is considered physiologically normal when hair loss is limited to around one hundred hairs per day. During an individual’s life hair grows, falls out and regrows around twenty times. Each cycle, especially for females, may last up to six years and if hair loss is found within this time frame, it is considered absolutely physiological.

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Dandruff or pityriasis

Dandruff is a scalp condition that usually arises between the ages of 10 and 25. It may improve between the ages of 45 and 55 or may continue during old age.
Its cause is a result of an accelerated turnover of epidermal cells, which following an increase in migration speed, are unable to reach complete maturity before detaching. Whitish-yellow flakes (masses of corneum cells) form and detach, gathering in patches or often spreading evenly across the scalp.

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Seborrheic dermatitis

Seborrheic dermatitis is a very common scalp condition characterized by the presence of yellow and oily flakes on the skin.

It is associated with erythema, small scaly, and intense itching.
Seborrheic dermatitis is a well-known condition but is still not easily identifiable. Many men and women starting from puberty have oily, greasy, shiny and thickened skin with large hair follicles, especially noticeable around the nose and mouth, forehead, torso, scalp (affected by so-called oily dandruff).

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Seborrheic alopecia (seborrheic hair loss)

Seborrheic hair loss is a form of premature hair loss that generally afflicts men in their youth (onset between 20 and 30 years of age), mainly affecting the frontal region and the crown. The cause, as the name of the condition suggests, is related to an excess production of sebum that provokes or accelerates hair loss.

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Life cycle of hair

The life cycle of hair and its subsequent growth occur at a speed of 1-1.5 cm per month. Hair is a living element that follows a follicle cycle with an average duration of 2-6 years. In humans, unlike other mammals that are subject to a periodic change, this cyclic evolution is not synchronous (therefore each hair is independent from the others).

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