Hair transplantation was performed and published by American Dr. Norman Orentreich in 1959 for the first time. Following years, the results were not that successful because the hair was transplanted in large patches or clusters, and researches to obtain more natural results continued to be made. More natural results from hair transplantation could be obtained when micro and mini grafts were defined. FUT or “Follicular Unite Transfer” played an important role in hair transplantation which was started to be performed in 1980’s.
Separating hair follicles that are coded for not shedding for lifetime on the skin island which is extracted from the back and sides of the hairy skin under local anesthesia is the basis of this method. The hairy skin area where the extraction has been performed is closed with stitches. Thus, an apparent scar which is about 25-30 cm in length and 2-4 mm in width, varying based on skin elasticity, remains on the neck of the people who undergo an operation with FUT method. Mini grafts, cut from the skin flap which is extracted from the back of head by using cold scalpel surgery and prepared under microscope, generally involve 1-4 hair follicles. In 1970’s and 1980’s when hair transplantation had recently started to be performed, hair was extracted and transplanted in patches with pencil eraser-wide “punches” and the results were unnatural and bushy. After this method started to be practiced, better hair transplantation became possible with micro and mini grafts and hair transplantation became popular.
In this method, it is important that grafts are prepared without getting any damage with a stereo-microscopic and demanding study and cooled and preserved in a special solution while the patient is waiting. When the area where hair transplantation is to be performed is prepared, local anesthesia is performed first and holes where the grafts are to be placed is opened with very thin and delicate surgical blades then. The important point here is to place each hair shaft considering the natural growing direction and the appropriate depth. It is necessary for a natural result. This practice really requires expertise, experience and patience.
In hair transplantation by FUT method, the surgeon can get among the existing hairs and hair transplantation can be practiced without cutting any hair.
Normally, hair roots grow in tube-shaped anatomic structures inside the skin where one or a couple of hair roots exist together. These structures are called “hair follicle”. During transplantation, follicular units with a single root are transplanted on to the front areas and follicular units with 2-4 roots are transplanted on to rear sides; these multiple grafts (with 3-4 roots) are more effective in regard of covering.
Nearly 10-15% of the hair roots inside the hairy skin are almost always in the resting period (telogen phase) and the extracted grafts may involve hair roots that cannot be seen but that will be grow in time. Amount of the new hair that will grow after transplantation may increase because hair follicles involve hair roots that cannot be seen and that are newly blossoming at the beginning of the anagen phase. However, it must be remembered that nearly 10-15% of the hair roots may be lost due to nutritional and other problems after each hair transplantation session.