Hair implants, intended to repopulate areas with alopecia, are becoming increasingly popular. A hair transplant or implant is a simple intervention that basically consists of extracting hair follicles from areas where the hair does not fall out and implanting them or transplanting them into those areas where it has fallen out. There are basically two types of procedures for this purpose, and depending on the type of alopecia of the patient, professionals will recommend one or the other, because the result of both is the same.

The FUE technique (Follicular Unit Excision) is the most advanced of the micrografts and consists of extracting follicles one by one or in small groups of 1 to 4 from a populated area of the patient and inserting them in the area where the alopecia is suffered. The ‘donor areas’ are usually the temporal and occipital scalp, and they are extracted so that these areas maintain their appearance in terms of hair density. In this process, follicular units of 1, 2, 3 or 4 hairs are selected, or even if it is the case, 5 or more, depending on the region where they are going to be implanted and the necessary density you want to achieve. Depending on the alopecia of the repopulated area, one or more sessions will be needed, since in each session about 3,000 follicles are transplanted. For this reason, and because it is necessary that there are widely populated areas, FUE is not indicated for total baldness.

To carry out this type of implant will require local anesthesia to avoid the pain of micro-incisions and the intervention will last between four and eight hours, depending on the size of the area to be covered.

As for the advantages and disadvantages of this technique, we found:

  • A fast recovery that allows to make normal life once the operation is finished. It will only require a preventive treatment of antibiotics and painkillers in case there is pain.
  • It does not leave evident scars, or those are almost imperceptible.
  • The results are definitive and there is no rejection.
  • There is no loss of sensitivity in the following months.
  • It is the most effective procedure, but also the most expensive.

Within this technique, there is an even more advanced one, the Choi Pen, which is an instrument -a kind of pen- that is used to implant follicles in a faster way and making even smaller incisions, so the recovery is even faster, with less risk of infection and higher success rate.

The technique of Follicular Unit Strip Surgery (FUSS) is more aggressive than FUE, since it consists of removing a strip of the patient’s scalp by surgical cutting and then removing the follicular units from the strip by cutting. The strip usually measures between 15 and 20 centimeters and the small fragments or micro follicular units contain between 1 and 4 hairs. Subsequently, these follicular units will be implanted in the alopecic areas” through micro-incisions. This type of surgery requires general anesthesia and has a slower recovery period due to the healing of the cut performed, which, on the other hand, will leave a scar more or less evident in the occipital region that can be concealed by the growth of the patient’s hair. In total, the process can take about eight hours and, after the operation, the patient should return after two weeks to remove the stitches. The FUSS technique is especially indicated in cases of alopecia of large extensions and in some cases it can be complemented with some FUE sessions. About 3,000 follicles are inserted in each session, and several sessions may be necessary to obtain the desired effect. Due to these disadvantages, it is performed much less than hair transplant with FUE technique.

The advantages and disadvantages of this technique are

  • A high number of grafts are obtained in a single session.
  • The cost is lower
  • It is suitable for virtually any candidate, even with severe alopecia.
  • The post-operative period is a little longer and more uncomfortable. Antibiotics will be prescribed as a precaution, and painkillers if necessary.

As far as effectiveness is concerned, in principle there is no one technique better than another. The form of extraction of the follicular units from the donor area varies, but the final result can be the same with both techniques depending on the experience of the hair surgeon. In both techniques, the transplanted or grafted hair falls out soon after and gives way to new hair growth, so the final result is gone after a few months. In addition, it is advisable to take some precautions, such as avoiding the sun or not bathing in beaches and pools for a few days.

These treatments can be complemented with tricopigmentation, the injection of a small amount of pigment in the superficial layer of the scalp to cover small unpopulated areas, such as small scars, in the recipient area to give a greater sensation of density or also in the donor area, to visually compensate for the donated hairs.

Complications or rejections in both cases are very rare, and only in very specific circumstances these techniques are contraindicated, such as in case of cardiovascular diseases or previous badly done surgeries.

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