What to Expect on the Day of your Follicular Unit Grafting Procedure

For traditional follicular unit grafting with donor strip removal, the hair restoration procedure is fairly straight forward. When you arrive at the office, Dr. Verret will sit down with you and answer any last minute questions you may have. He will then take preoperative photographs and mark the hairline design that will be achieved during surgery. This is the time when you and he will ensure that your goals are the same. Once this is completed, you will place one of our provided robes on and the procedure will begin.

Using local numbing medicine, the donor area is injected. The donor area can extend from the top of one ear to the top of the other around the back of the head. It is usually 1-2 centimeters wide. The width and length of the donor area will depend on the number of grafts needed, the density of the donor site, and the laxity of the scalp. For patients with a previous hair transplant and scar from a previous donor site, the scar is incorporated into the new donor site so that the end result is only one scar. The donor site is then harvested down to the fat under the skin. The edges of the wound are brought together and the skin is closed with either staples or sutures. The key to closure is ensuring that there is minimal tension on the wound edges. Some have described techniques of beveling the edges to allow for hair growth through the incision line. Dr. Verret employs this techniques, called a tricophytic closure. Even with beveling the edges of the incision, if there is tension on the wound the scar will widen over time. Dr. Verret does his best to ensure this does not happen. The sutures or staples placed may require removal in 10-14 days or may be allowed to dissolve on their own for patients coming from out of town.

Once the donor strip is harvested, it is passed off to be dissected by our highly trained and experienced hair technicians. Individual grafts, or follicular units, are created. Depending on the hairline design required, single or multiple unit grafts are created.

After closure of the donor site, patients can usually take a break. At some point just before dissection of the donor tissue is complete, making incisions at the recipient sites is undertaken. If the area to be implanted is at the front of the hairline, regional anesthesia of the forehead can be undertaken by numbing the major nerves which feed the forehead and frontal part of the scalp. Once the area to be transplanted is numb, small stab incision are made with specially designed knives. Even after initial design and drawings are done, the angle of the blade while making incisions is crucial to ensure that the transplanted hair will grow in a naturally appearing direction.

The dissected hairs are then implanted, often using magnification and specially designed forceps to ensure that the hair follicle is not damaged during transplantation. The implantation phase of the follicular unit grafting procedure can take several hours. Patients are welcome to take breaks during the procedure to stretch their legs, use the restroom, or partake of snacks.

At the end of the procedure, patients are welcome to place a baseball cap on their head and drive themselves home as long as no sedatives are used. Most patients will not require any type of sedative, such as valium, though it can be prescribed if anxiety is a concern. No special bandages are placed unless requested by the patient or a long drive is anticipated to absorb any oozing which may occur.

All of the procedures are performed in our state of the art procedure room which is equipped with a flat screen HD television, satellite receiver, and DVD capability. Patients are encouraged to bring DVDs to enjoy while undergoing their procedure. Patients should have a light breakfast before coming to the office. Light snacks will be available throughout the day and for longer procedures expected to last into the afternoon, lunch will be provided.