AGA Treat Rev 65　FUT Method - Using a scalpel

Well then, there are several methods for autologous hair transplantation.

Among them, the most popular ones are the "FUT method" and the "FUE method." Let's now explain the essence of these methods. While their English initials are quite similar, there are substantial differences between the two.

Autologous Hair Transplantation Methods 1: FUT Method - Using a scalpel

FUT stands for Follicular Unit Strip Surgery, where Follicular Unit refers to the unit of hair follicles, and Strip Surgery indicates the procedure of stripping the tissue in a band-like fashion. In Japanese, it translates to "a surgery where follicular units are stripped in a band-like manner." Hair does not grow individually but rather in groups of 1 to 3 follicles in a single hair follicle. Including surrounding tissues like sebaceous glands and arrector pili muscles, the minimum functional unit maintaining a normal hair cycle is called a follicular unit.

Despite being called transplantation, merely extracting and transplanting hair will not ensure its healthy growth. To promote thick hair growth, it is necessary to transplant the follicular units individually. The cluster of hair extracted follicular unit by follicular unit is referred to as a "graft." In the FUT method, particularly in cases of male pattern baldness, a strip of tissue about 10-20 cm in length and 1 cm in width is excised from the back of the head, where hair is sufficiently in the growth phase.

Subsequently, the excised strip of tissue is meticulously examined under a microscope, and the grafts are dissected. Trimming is then performed to remove excess tissue. In both FUT and FUE (discussed later), the harvested grafts are soaked in an American-made tissue culture solution called "Hypothermosol," maintained at a temperature of about 4 degrees Celsius, to preserve their "freshness" as much as possible until transplantation. Hypothermosol, with a salt concentration matching that of human bodily fluids, is better at preserving the freshness of the grafts than traditional saline solutions. Some cases have shown successful transplantation of grafts stored in Hypothermosol for up to three days (though in practice, transplantation occurs within a few hours of harvesting).

Once the grafts are ready, they are strategically implanted into areas of concern, such as the hairline, frontal area, and crown, based on a pre-determined design while considering the overall balance of the head. As mentioned earlier, hair does not grow individually but in groups of 1 to 3 from a single follicle. The harvested grafts also consist of those with a single hair, two hairs, or three hairs.

The hairline, for instance, only has one hair growing from each follicle. To create a natural appearance, grafts with a single hair are transplanted to the hairline. For the frontal area, grafts with two hairs are used, and for the crown, grafts with two and three hairs are transplanted, creating a gradient in volume for a more natural look.

The donor area, where the strip of tissue is excised from the back of the head, is then sutured together vertically. The scalp in the back of the head provides sufficient flexibility, allowing for the band-like excision to be stitched without issues. Growing the hair at the back of the head slightly longer before the surgery helps cover the surgical scars, making them less noticeable.

It is said that with the FUT method, the maximum number of grafts that can be harvested and transplanted at once ranges from 2,500 to 4,000 (corresponding to an average of 5,000 to 8,000 hairs). Additionally, through multiple sessions, the maximum number of grafts that can be harvested and transplanted is around 5,000 to 7,000 (equivalent to 10,000 to 14,000 hairs).

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