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written by Dr. Thomas Whitfield DPhil

Considering a Hair Transplant?

Hair transplantation is currently the only method of restoring terminal hair growth to customers with heavily established baldness. Although the process still has many limitations, recent advances in medical technology have made hair transplantation much more desirable. So long as a reputable surgeon performs it, a hair transplant can provide noticeable and natural results.

There are two primary methods of hair transplantation surgery, defined in terms of how hair follicles are harvested from the “safe zone” donor area:

1. Strip (FUT, FUSS) – A hair-bearing strip of scalp is surgically removed from the back of the patient’s head. This strip is microscopically dissected into grafts (small pieces of tissue) that are subsequently transplanted into balding areas. The Strip method of hair transplantation results in an unavoidable linear scar that spans from ear to ear. These scars are easily concealed by existing hair, but are clearly visible if hair is shaved down. This treatment has an approximate recovery period of 2 weeks.

2. Follicular Unit Extraction (FUE) – Hair follicles are individually removed from the patient’s donor area with tiny punches typically .7 mm to 1.2 mm in diameter. These follicles are then inserted into the patient’s recipient (balding) area. Since this micro-removal harvests hair follicles one by one, the resulting scars resemble miniature dots. These scars, like those that form after Strip excisions, are usually concealed by existing hair. This treatment has an approximate recovery period of 7 days.

Although this method is superior in many respects (more hair is available for harvest, shorter down-time, less-visible scarring), it does have several caveats. In general, FUE procedures last longer, cost extra, cause more scalp trauma and have higher graft transaction rates.

Make no mistake; both methods of hair transplantation are invasive surgical procedures. Like any other operation, there are many important risks and considerations – results cannot be 100% guaranteed.

The practice of hair transplantation has come a long way from the “plugs” of yesteryear. Ultra-refined techniques are employed by many surgeons across the globe and patient satisfaction has increased dramatically. Nevertheless, this process must be researched extensively before the decision to undergo a hair transplant is ultimately made.

Dr. Whitfield answers your questions.

question: Dr. Whitfield, have you heard about the ACell ECM products that are being used for hair transplant repair cases? What is your personal opinion about this procedure? Thanks in advance, Markus N. – sent via email


answer: Thanks for this question. I find new treatments such as this to be extremely interesting.

Yes, I am aware of ACell, and like many other doctors I am quite optimistic about the potential of this technology to assist in scar repair and donor remodeling. There is still a lot of research to be done however, before I pass final judgment. Further documentation is important in order to build up a satisfactory clinical profile for this new surgical process.

One of our writers actually conducted an interview with one of the doctors investigating this technique (available here) where you might be able to find more information. Also, Drs. Cooley and Hitzig will be reporting their findings at this year’s ISHRS conference.


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Thomas F.A. Whitfield, DPhil, is an internationally recognized expert on potassium ion channels, former scientist of the University of Oxford's Department of Biochemistry and member of TRX2's Scientific Advisory Board.