Strip harvesting is one of the two modern methods for procuring donor grafts (the other being Follicular Unit Extraction (FUE) discussed in the following section). The primary benefit in both techniques is that they render much smaller follicular units, greatly improving aesthetics and producing an indistinguishably natural look. Both fut and fue work with the natural follicular unites making the newly placed hairs appear completely natural in the hands of a good surgeon.
FUT hair transplant is a minor surgery done under local anaesthetic and is an outpatient procedure, meaning that the patient goes home straight after the procedure to recover. The fut hair transplant involves carefully removing a thin strip of hair from an area of dense donor hair, which is from the back of the head and sides. This hair does not suffer the same genetic issues that cause hairs on the top of the head to thin and disappear. In other words, the donor hair will continue to grow once in its new location.
Once the surgeon has removed the strip he carefully stitches back together the “vacancy” left at the back of the head from the strip extraction. The normal strip with is about 1 – 1.5cm in with when extracted, depending on the patients skin elasticity, the greater the elasticity the more hair the surgeon can safely extract. More elasticity will also help for quicker healing, many clinics give their patients instructions how to work on the scalp elasticity by doing simple scalp exercises. The length of the strip varies depending on how much hair is to be extracted, the density in the donor area and other characteristics; it’s not uncommon that they are between 20 and 30cm in length. Most surgeons agree that trichophytic closure is the best way to close the wounds and patients should make sure that their surgeon will use this technique for less visible scarring.
Next these strips are cut down into follicular units (fu’s) by a team of technique using magnification which yields an increase in the number of fu that can be removed from the strip and makes sure no hair goes to waste.
After the surgeon has closed the donor area he will start making the incisions to the recipient area, these are done by using a tiny micro blade that is usually 0 .8 – 1mm in size, smaller blades in the frontal line where the singular grafts will be placed and bigger incisions where the multiple grafts are going to be placed.
The hair is planted into the area of baldness where the least density occur, the most widely accepted technique is using a jewellers forceps that handle the grafts carefully and slide them into the slits made with the micro blade. Some variations such as using implanters are on the market but not widely used and it’s hard to see any real advantages to these over the normal placing using the jewellers’ forceps in the hands of a trained assistant or surgeon but many clinics try to distinguish themselves by promoting this as something exceptional or different even though it isn’t.
Stitches will usually be removed 10-14 days after a fut hair transplant, only a few clinics still use staples to close the “vacancy” usually because they are being very aggressive on the size of the strip that is extracted from the donor area, getting more hair in so called giga- sessions some clinics don’t come without its setbacks, usually creating a bad scarring in the donor area and considerable discomfort for the patient.
With accurate placement and a skilled physician, the hair will then grow evenly and look completely natural as it is natural hair that has been moved from one place to another, very much like gardening a plant is taken from the back garden and placed into the front where it will keep on growing. Most importantly, these new hair follicles are not genetically inclined to die (because they come from the area of the scalp with the most resilient follicles), so the hair will grow throughout the patient’s lifetime. This is truly a revolutionary leap in the affliction of baldness.
An advantage of strip harvesting against fue is the relative speed of the process. An experienced surgeon with assistants can usually achieve as many as 3,000 grafts in a session of six to eight hours, as long as the patient has sufficient donor area.
Assistants play a very important role in strip harvesting. During the procedures, up to six assistants are working to augment the surgeon, freeing him or her to engage in the more exact operations. Much of the assistants’ work involves caring for and dividing the follicular units, preparing them for placement, and actually placing the grafts in the donor area.
The wide majority of patients who’ve had strip harvesting procedures performed have very minimal scarring in the donor hair area, and it may only be a concern for patients who wear their hair very short. The trichophytic is a surgical technique adapted from other areas of plastic surgery, its basically trims and closes the edges of the “vacancy” in such a way that the hair will grow through the scar that is left, camouflaging it completely as long as the patient keeps a relatively short hair style.
The degree of scarring is in large part a function of the skill of the surgeon as well as the elasticity of the scalp but having said that some people simply scar badly and no matter what surgical procedure they do; scarring can be prominent even in the hands of the most experienced surgeon.
Some improperly trained surgeons will use double or triple-bladed scalpels which make it easier for a less experienced surgeon to extract the right size of donor tissue but this will increase the wastage of grafts and can increase scarring as well as being a implication that the surgeon isn’t really experienced handling a surgical blade. This is why it is always important to be diligent in your selection of a client and surgeon, ask questions to make sure that they are skilled in the latest techniques.