FUT Hair Transplants

Hair loss, also known as alopecia, refers to total or partial loss of hair, usually from the scalp or the entire body. It affects up to 70% of men and 40% of women. Many treatment options exist for this condition.

Follicular unit transplantation (FUT) is one of the minimally invasive surgical procedures aimed to restore hair loss. It is considered a highly successful procedure, with a short recovery period and few complications. In this procedure, the small clusters of naturally occurring hair follicles are removed from the donor region of the scalp and transplanted into the recipient (bald) region. As a result, FUT produces a natural-looking appearance.

What is FUT?

Follicular unit transplantation (FUT) represents an advantageous hair transplant procedure, providing high-quality, natural-looking, and discreet results.

Hair normally grows in clumps of one to four hair follicles separated by intervening soft tissue. These groups of hair follicles are known as follicular units. In the FUT procedure, a strip of hair with the planned number of hair grafts are removed from the patients donor area (usually at the back of the head). The hair follicels are then separated from the strip using microscopic dissection in a way that most closely resembles naturally occurring hair.

The earliest known hair transplant was performed in 1822 in Germany when one medical student and his teacher moved the hair from one area of the head to another. However, it wasn’t until 1939 that the modern hair transplant was first performed. The first modern hair transplant technique was known as the “punch technique” and was developed by the Japanese dermatologist. Unfortunately, these first attempts gave poor results, unnatural and hair plug-like appearance.

In order to improve the surgery results, new surgical techniques were advanced and refined over the decades, and the FUT procedure was introduced in 1995. It was at this time the surgeons of the world first were able to transplant individual hair follicles. This is something that produces more natural results. Although the method was initially met with skepticism, the FUT technique soon became the “gold standard” for surgical hair restoration. Superseded by other transplant methods in some areas (See. FUE and DHI), the improved follicular unit transplantation (FUT) technique is still often the best option for large graft transplants.

Not any medical professional can perform FUT. It takes many years and training to develop the skills required by the specialist, esthetic surgeon to perform this type of hair transplant.

Procedure and timeline

Once you decide to undergo the FUT procedure, the first step is choosing the clinic that best meets your requirements and preparing for the procedure. After the procedure itself, there is a recovery period. It is very important that patients follow the pre-and postoperative instructions to ensure optimal results. We will shortly describe the process, step by step.

• Week 1 – 2: Consultation and planning of the procedure. After contacting the clinic of your choice and met with a specialist doctor. The doctor will discuss all aspects of the procedure with you, assess your hair texture and the donor area’s density. Discussing how many follicular unit grafts will be transplanted is also an important aspect of planning a hair transplant to maximize the aesthetic effects. Depending on the graft numbers, more than one transplant session could be planned. If you are satisfied with this meeting and reach the agreement, your surgery dates will be booked. The surgeon will give you the preoperative instructions, including cessation of smoking, stopping any medications like aspirin and anti-inflammatory drugs, and massaging your scalp.

• The procedure: 4-8 hours. The Surgurys first step is anesthesia. This procedure is performed under local anesthesia, meaning that the patient is awake during the procedure. The hair in the donor area is being trimmed to enable easier access. In FUT, a surgeon will cut a strip of skin from the scalp, either from the back or one side of the head, and then extract individual hair follicles. He or she will close the area from which the scalp was removed with stitches. The strip size depends on the graft numbers, which will then be inserted into the bald parts of your scalp. The doctor will then inject an anesthetic into the donor area, making it numb, and then remove or extract hairs one by one. During this procedure, the surgeon will use a microscope to prevent damage to the hair follicles. The hair follicles are removed in strips for micro-dissection before implantation into the recipient (bald) area. He will also inject the local anesthetic into the recipient area and, using the “micro-needle”, implant the follicular units into the bald area. In one session, a maximum of 4 000 hairs can be transplanted. The FUT procedure takes between 4 and 8 hours.

• 1-2 days following surgery. You can go back to your everyday activities from the very next day. However, you can experience scabbing and redness in the recipient area, and some swelling may appear on the forehead. You can also experience some discomfort in the donor area. 

• 2-6 days following surgery. During this time, you may notice some facial swelling as well. The donor and recipient areas start to crust, and it is very important not to touch the grafts until day 6. 

• 5-10 days following surgery. In this period, you can usually wash your hair with directly running shower water. You will become scab-free by day 10 when the grafts are permanently in place and cannot be dislodged. The potential residual crusting may be gently scrubbed off.

• 2-3 weeks following surgery. The newly transplanted hair begins to shed, and the sutures start to absorb. By the end of week 3, the patients may get haircuts. 

• 1 month following surgery. The follicles are in a resting phase, and you will look almost the same as you did before the FUT procedure.

• 2-5 months following surgery. The transplanted hair starts to grow, initially as fine hair. However, over time they will begin to thicken.

• 6-9 months following surgery. The transplanted hair becomes groom-able and continues to grow and thicken.

• 10-12 months following surgery. The final results are visible.       

What does a FUT cost?

The price of a hair transplant ranges from £1000 to £30 000 per session in the UK according to the NHS. When researching private clinics we typically find that the cost of a hair transplant surgury range goes between £2,5 and £5 per graft.

Since the FUT surgury method is a relatively fast procedure compared to the alternatives FUE and DHI, the cost often lies in the lower end of this spectrum.

If you choose to do the FUT procedure in Turkey, a 1000 FUT graft procedure will typicalliy lie between £1160 and £1750. However, worth to keep in mind are the extra indirect costs affecting those who partake in the procedure abroad. Although the price of the surgery itself is lower in Turkey, you will have additional costs such as flight costs, accommodation costs, and living costs for being abroad (Taxi, food, etc.) In the end, the most important consideration is choosing the clinic that meets your requirements.

You should also consider the costs of your sick leave or your the alternative cost of not working.

Can the procedure be done for all hair loss types?

Not every type of hair loss is a good candidate for a FUT. To be eligible for the FUT procedure, you first have to have enough donor hair left on your head (or body in the case of a body to head transplant) to be used as a graft for the FUT.

The best candidates for the FUT procedure are typically men with male pattern baldness, also known as androgenic alopecia. This condition in men usually occurs in the Norwood pattern or an M-shaped hairline with hair loss at the temples. On the other hand, in women, this condition appears in the Ludwig pattern, which causes hair loss along the hair part or hair thinning at the top of the head. FUT is mainly performed on people over the age of 25.

FUT is often recommended for those patients that need a larger amount of hair for a highly noticeable receding hairline to add heavy density or coverage for excessive crown balding. Besides restoring thinning hair on the scalp, it is also possible to transplant the hair from the donor area of the head into the beard or eyebrow area using the FUT procedure.

In cases of other medical causes of hair loss, such as a thyroid disorder or alopecia areata, FUT surgery is probably not an option.

FUT clinics in the United Kingdom vs. Turkey

You can choose to do the FUT procedure domestically or abroad. The procedure itself does not differ. However, the cost, the surgeon’s capabilities and experience make the difference.

FUT is performed as outpatient surgery, meaning no hospital stay, both in the UK and Turkey. You come to the clinic in the morning and go home in the afternoon. Furthermore, local anesthesia is used to perform this procedure in both countries.

Although the price of the surgery itself is lower in Turkey, you have to keep in mind all the additional costs, including travel costs, accommodation, insurance, follow-ups, etc. Besides, like all other surgical procedures, FUT carries certain risks, such as the damaged hair follicles yielding poor hair growth, infection, healing difficulties, skin darkening, and scarring.

Therefore, you might require additional follow-ups and treatments by your surgeon, so you should think about this aspect as well. In the end, you should choose the clinic that meets your requirements and the surgeon who is highly experienced to perform FUT, whether in the UK, Turkey, or any other country.

Follicular unit transplantation vs. other procedures

As mentioned above, many treatment options exist for hair loss, depending on the hair loss type, condition, or the patients’ wishes. There are non-surgical and surgical procedures.

Besides the FUT procedure, you can think about the follicular unit extraction (FUE) procedure, direct hair implantation (DHI) procedure, and platelet-rich plasma (PRP). Of course, you should discuss with your surgeon which type of procedure suits you the best.

FUT vs. FUE

These two modern hair transplant procedures have similar implantation processes, and they both provide natural-looking results. Also, both of these procedures are painless and are performed under a local anesthetic. However, there are some differences between these two procedures. Primarily, how the hair follicles are extracted from the donor area differs between the two. However, other differences should be considered between the two procedures when deciding which one is better for you:

• FUT is more suitable for patients requiring a considerable amount of grafting, while FUE is the option for people who need a small number of grafts;
• In FUE, there is no linear scarring like with FUT, so shorter haircuts are an option. However, you can keep the hair long with FUT, which may cover up the linear scar.
• FUE has a shorter recovery time than FUT. However, FUT has a shorter time in surgery.
• FUT is usually less expensive, as compared with FUE. In FUE, the follicles are removed individually, which makes this method more expensive due to more time being used in surgury.

FUT vs. DHI

DHI is an advanced version of FUE. In DHI, the hair follicles are extracted manually, one by one, using titanium-tip single-use instruments, and implanted using a DHI implanter by single-step implantation. Strict protocols have to be followed in this hair transplant procedure. DHI differs from FUT in few aspects: 

• FUT allows a greater amount of grafting than DHI, in which the follicles are transplanted one after one. DHI is a better option for localized and smaller areas;
• DHI is less invasive, as this procedure does not involve cutting into patients’ skin;
• FUT leaves a linear scar, while there are no traces or scars following DHI;
• DHI is a much more time-consuming procedure;
• FUT is less expensive, as compared with DHI;
• DHI has a shorter recovery time than FUT.

FUT vs. PRP

PRP therapy is a hair treatment that promotes hair regrowth. This is actually a non-surgical solution for those who are not ideal candidates for hair transplant surgery. In this procedure, the patient’s blood is extracted, separated into blood and plasma factors, gets factors and components to aid in hair (re)growth, and then gets reinjected into the scalp. The PRP treatment can be applied alone or in combination with other hair loss treatments. 

It is difficult to compare FUT with PRP, but the main differences are:

• Indications for FUT and PRP differ. PRP is aimed at those who are not candidates for the surgery. However, PRP helps patients with alopecia areata, traction alopecia, and female patients who want to have denser hair;
• FUT is effective with significant balding or thinning areas on the scalp, while PRP is not effective for the large areas;
• PRP is a less invasive procedure than FUT and requires less in-surgery time. However, more sessions could be required;
• PRP treatment is less expensive than the FUT procedure.

Risks and considerations

Like any other surgical procedure, FUT carries certain risks. Although this surgery is highly successful, generally safe, and most people react to the hair transplantation very well, complications may arise. 

Possible risks include: 

• Damage to the follicles which could result in poor hair growth;
• Infection following the procedure, which is very rare, as the antibiotics are prescribed both before and after the procedure;
• Poor wound healing;
• Noticeable scarring;
• Changes in the skin pigmentation, skin darkening;
• Unnatural-looking results;
• Bleeding;
• Pain;
• Swelling;
• Numbness;
• Itching;
• Reaction to local anesthetic.

Before you undergo the FUT procedure, the doctor will perform a full medical examination to determine whether you are a good candidate for a FUT transplant. The doctor will take into consideration your existing medical conditions, your age, the quality of the hair in the donor area, and considerations about future hair loss. Choosing the clinic and skilled surgeon who meets your expectations is essential, so is good pre-and postoperative care.