Hair Transplants: All You Need To Know About FUE and FUT
Written by Ann-Marie D’Arcy-Sharpe / Medically reviewed by Dr. Shimona Garg
- Recovery time of up to 3 weeks
- Visible scarring after procedure
- Additional treatments are needed
Usually multiple surgeries
What Is a Hair Transplant?
What Is a Hair Transplant?
A hair transplant is a surgical procedure used to treat hair loss. The surgery involves moving healthy hair from the back of the scalp or a donor area of the scalp to the balding region. (1)
During a hair transplant, tiny grafts are taken from the donor area. The size and location of the grafts taken will depend on the type of hair transplant a patient receives. Hair follicles are then extracted from the grafts and implanted into the balding area of the scalp. Once they heal in position, they should continue to grow healthy hair. (1)
In general, hair transplantation is a safe and effective way to treat hair loss. It’s often used to treat androgenic alopecia, the most common form of hair loss. Hair transplantation is particularly beneficial for those who have tried other hair loss treatments, such as topical and oral medications, without success. (2)
Is a Hair Transplant a Hair Graft?
A hair graft is a component of a hair transplant. Hair grafts are the areas of skin containing healthy hair follicles. Grafts are extracted during the transplantation procedure. Hair follicles taken from each graft are transplanted onto balding areas of the scalp. (1)
What Is FUT?
FUT stands for follicular unit transplantation. FUT is one of two primary hair transplantation techniques. The other technique is known as follicular unit extraction (FUE). (2)
FUT hair transplants are minor surgical procedures. In this procedure, the surgeon extracts a strip of skin with healthy hair growth from the side or back of the head. This strip is typically no longer than 1 to 1.5 centimeters wide. Local anesthetic is used to ensure the patient’s comfort. (2)
The surgeon then places the strip of skin under a microscope and extracts healthy hair follicles. (2) These follicular units are placed into chilled saline to keep them healthy and ready to use. The wound is closed and will heal into a linear scar. (2)
The balding area of the scalp is then prepared. Recipient sites, where the surgeon will implant the hair follicles, are created carefully using small blades or needles. These sites are planned out meticulously to produce a natural hair pattern. Each hair follicle is then implanted into the prepared areas. (2) FUT recovery may take a few weeks, and detailed instructions are given to patients so that they take care of their transplants properly. (1)
Transplanted hairs typically take around 3 to 4 months to grow. During the first 2 to 8 weeks, you may experience an increase in hair shedding. Fortunately, the new hairs will typically grow back thicker and healthier.
Depending on the extent of the hair loss, patients may need multiple sessions to achieve the hair density they desire. Each transplant can take between 9 and 18 months to reach the desired length. (3)
What Is FUE?
FUE stands for follicular unit excision or extraction. FUE is one of two main hair transplantation techniques. The other technique is called follicular unit transplantation (FUT). (2)
FUE is a minimally invasive, effective surgery used to treat hair loss. During FUE hair transplants, a small punch tool is used to extract the hair follicle unit. This device typically has a width between 0.8 and 1.2 millimeters. The tool is repeatedly moved back and forth, going no deeper than 4 millimeters into the scalp. Local anesthetic is used to make sure the patient doesn’t feel the procedure. (2)
This procedure can be done manually or, in some cases, can even be done by a machine specifically designed to carry out the excision. The extraction sites will heal into tiny, round scars. (3) The follicular unit is then either transplanted directly into the balding area of the scalp or is placed in a saline solution until the recipient site is ready. (2)
During the FUE procedure, the recipient sites are prepared using small blades or needles. The sites are carefully arranged so that each of the follicular units will look natural and match the rest of the patient’s hair as they grow out. (2)
Recovery will take a few weeks. Patients typically start to see results after 3 to 4 months, with peak growth commonly seen between 9 and 18 months. Repeat sessions may be required depending on the size of the balding area and the patient’s desired hair density. (3)
Are There Other Types of Hair Transplants?
Follicular unit transplantation (FUT) and follicular unit excision (FUE) are the two main types of hair transplantation currently available. (2) However, there are other types of hair transplants, including hair plugs, artificial hair transplants, and hair cloning.
From the 1980s, the original hair transplants, known as hair plugs, were used to treat hair loss. Hair plugs were developed by a scientist called Dr. Orentreich. (4) This procedure used a similar technique to FUE. However, the extraction sites were much larger than those used in FUE, at around 4 milliliters in diameter. FUE, in contrast, usually uses 0.8 to 1.2 millimeter sites. (2,5,6)
The large size of hair plug grafts resulted in a less natural appearance when hair grew out. They also took longer to heal and resulted in larger, more prominent scars. The procedure was also generally more painful than FUE and FUT treatments. (4-6)
Artificial hair transplants use synthetic hair transplanted into balding areas of the scalp. First developed in the 1970s, artificial hair transplants were thought to be a promising treatment for those who didn’t have enough hair for other transplantation methods. However, adverse effects such as infection and scalp irritations caused controversy. (7,8)
As a result of these negative side effects, the FDA banned artificial transplants in 1983. In 1993, a new type of synthetic hair known as Biofibre was developed. Biofibre shows more promise as a hair loss treatment and has fewer potential side effects. However, artificial hair transplants are still not approved in the USA. (8)
Hair cloning has been talked about for years and, more recently, has been researched in detail. Hair cloning works by removing a small sample of healthy hair follicles and cloning them in a lab. The cloned follicles are then implanted in the balding area of the scalp. (9) Hair cloning is not yet available, but research suggests it could be a viable, highly effective hair loss treatment within the next few years. (5)
Getting a Hair Transplant
Do Hair Transplants Work?
Hair transplants are minimally invasive surgeries for hair loss. They work by removing healthy hair from an area of your scalp unaffected by hair loss and implanting the follicles into balding areas. Hair transplants can have impressive results, covering balding areas with new hair growth and achieving the patient’s desired hair density once recovery is complete. (6) Research has shown that the transplanted grafts of hair can have a survival rate of over 90 percent. (10)
Modern-day hair transplants are safe and highly effective. (2) However, a hair transplant will work for thinning hair and early-stage hair loss much better than for later-stage hair loss. The effectiveness of the results will be limited by the number of transplantable hair follicles on the person’s scalp.
How Long Does a Hair Transplant Last?
A hair transplant involves healthy hair follicles being removed from a healthy area of your scalp and implanted into the balding area. Many people wonder, ‘is a hair transplant permanent?’ Although it’s a very effective treatment, it isn’t a permanent cure for hair loss. (11) However, if your question is, ‘will a hair transplant last’, the answer is yes. The transplanted hairs will continue producing hair. Unfortunately, the non-transplanted hairs around them can continue to be affected by hair loss, which is why you may eventually need further procedures.
After a hair transplant, it will typically take 3 to 4 months to see hair growth. In the first 2 to 8 weeks after surgery, you will likely experience shedding at the transplantation site. Initial, temporary shedding is normal, and hair will grow back thicker and healthier. (12) You will likely continue to see growth and an improvement in hair quality for up to 18 months. (3)
How long the hair transplant lasts will depend on the type of hair loss you suffer from, among other factors. Androgenetic alopecia, also known as pattern hair loss or pattern baldness, is the most common form of hair loss. It’s a progressive condition, which means you might continue to lose hair from areas outside of the transplant area even following your transplant. The transplanted hairs will generally not be lost. (11)
Most people will need additional surgeries to touch up any further hair loss they experience and maintain their desired hair density. People often use other hair loss treatments after surgery to help them maintain their growth, such as minoxidil solution. (11)
In general, the transplanted follicles should continue to produce hair as other follicles would. However, they have a similar lifespan to other hair follicles, which means they may gradually stop making as much hair. Some patients may choose to have additional hair transplants over time, while others may be happy with the results they’ve achieved from one. (11)
Should I Get a Real Hair Transplant or a Fake Hair Transplant?
Hair transplants implant hair follicles in balding areas of the head to tackle hair loss. With natural hair transplants, hair is taken from a healthy area of the scalp and transplanted. Fake hair transplants implant synthetic hair into the balding area.
Real hair transplants are approved as safe and typically have positive outcomes, increasing hair growth and hair density for most patients. (2) On the other hand, fake hair transplants are not approved by the FDA. (7) They were banned in the USA due to potential adverse side effects, including recurrent infection, allergic reactions, cyst formations, and more. (7)
Fake hair transplants are more likely to shed and can’t regenerate, so they need frequent replacement. They’re also less likely to look natural. (7) While they could provide a treatment option for those with more significant balding who don’t have enough healthy hair follicles for transplant, a real hair transplant is generally safer and more effective. (7,8)
Maximizing Hair Growth: Ways To Improve Hair Transplant Results
Some patients are advised to use additional medication to maximize hair growth after a hair transplant. Minoxidil is a popular hair loss medication that works by increasing blood flow to the scalp. It widens the blood vessels and allows thicker, healthier hair strands to grow. (13)
Minoxidil is used twice a day topically and has proven results in increasing hair growth. (13) Minoxidil is sometimes used both before and after hair transplantation to maximize results. When used in this way, it helps minimize hair loss and encourages hair growth. (13)
Platelet-Rich Plasma (PRP) is an increasingly popular treatment for hair loss, especially when used with hair transplants. Plasma refers to a non-cellular component of the blood that plays a part in many vital processes, including aiding natural healing. PRP injections use the natural growth factors found within a patient’s own platelets to encourage healing and growth. (4,14)
PRP acts on the hair follicles’ stem cells. It contains growth factors that promote the development of new follicles and encourage hair growth. (14) When used during and after hair transplantation, PRP can increase hair growth and improve hair health. (14)
Hair Transplant Risks and Recovery
What Are The Risks of a Hair Transplant?
As with any medical procedure, there are risks when having a hair transplant. One side effect is swelling (known as edema), which occurs in less than 5 percent of patients and can be treated. (2,15) As with any surgical procedure, bleeding may occur, but this is unlikely with a risk of 0.5 percent. (2)
Pustules (small boils) are a common reaction following a hair transplant but typically resolve on their own. Folliculitis, an infection or inflammation of the hair follicles, is also a post-procedure risk. (2,15) This condition can be treated with antibiotics and topical cleansing. Additionally, scalp numbness, cysts, and ingrown hairs may occur, but these can all be treated. (2)
Infection is a risk with any surgical procedure. Fortunately, it affects less than 1 percent of patients. (2) Finally, some hair shedding (known as telogen effluvium) may occur after transplantation. However, this is normal and healthy hair should regrow within 3 to 4 months. (2)
How Involved Is Hair Transplant Surgery?
Hair transplant surgery typically takes between 4 and 8 hours, depending on how much hair you have transplanted. A local anesthetic is given, which means you’ll be awake during surgery but can’t feel any pain. (12)
The exact procedure will determine the duration of the surgery and your recovery time. In FUT (follicular unit transplantation), hair is extracted by removing a strip of skin, then isolating the hair follicles. In follicular unit excision (FUE), hair follicles are individually taken from the scalp using a small punch tool. (3,12) Healthy hair follicles are then implanted into the balding area of the scalp, known as the recipient site. (2) FUT is generally a shorter procedure than FUE.
In both cases, the recipient site is prepared using very fine blades or needles to create areas where the healthy hair follicles will be placed. These sites will be arranged carefully so that the hair grows in a natural pattern. (2)
How Long Does It Take To Recover From Hair Transplant Surgery?
Depending on the individual, recovering from a hair transplant surgery will typically take between ten days and three weeks. Patients will be given specific aftercare instructions to help them heal as quickly and safely as possible. (1) This will typically involve keeping the area slightly moist to prevent scabbing, avoiding showering for the first couple of days, and avoiding itching the scalp. A follow-up with the doctor will likely occur after 7 days, and any sutures will be removed. You will gradually be able to return to normal activities. (1,2)
Your hair transplant timeline may differ, but in general, you should start to see hair growth between 3 and 4 months after your transplant. Peak growth and hair quality occur after between 9 and 18 months. (3)
Hair Transplant Surgery Costs
How Much Do Hair Transplants Cost?
Hair transplant cost varies greatly depending on many factors. Where you live, the clinic you choose, and the surgeon’s skill all impact price. Some patients may need multiple transplant sessions to cover large areas affected by hair loss. This can also cause the price to increase.
However, the main factor determining the cost is the size of the balding area you want to cover and how many hair transplant grafts are needed. Usually, prices will be quoted per graft. Average prices per graft are:
- UK: Prices range between £3.50-£5
- USA: Prices range from $2-$10.
- Canada: The cost ranges from CA$3-$12
- Australia: Fees range from AU$2-$4.60
- South Asia: Price averages at Indian Rs. 65.
In some cases, additional sessions may be required after a few months to ‘top up’ the hair density and achieve the desired look. Some clinics offer lower prices for the subsequent sessions.
Be aware that some clinics may charge for the initial consultation and aftercare, as well as for the procedure. Other clinics might offer all-inclusive package deals which cover the procedure and all the care you will need.
Hair cloning is the subject of ongoing research when it comes to hair loss. This procedure involves removing a sample of an individual’s hair follicles and cloning them for implantation. (9)
Currently, this treatment isn’t being performed. However, clinics are beginning to offer cryopreservation of hair follicles. Cryopreservation means that your hair follicles are extracted and frozen for use later on in your life. This costs an average of £2,000 plus an annual fee of £100 for 100 hair follicles in the UK. In the USA, follicle cryopreservation currently costs $2,500 plus a yearly storage fee of $125.
How Much Does a FUT Hair Transplant Cost?
Currently, two main hair transplant methods are used: follicular unit transplantation (FUT) and follicular unit excision (FUE). In general, FUT is cheaper because it’s less labor-intensive and time-consuming.
In the UK, FUT hair transplant cost averages £3.50 to £4 per graft. In the USA, FUT can cost anywhere between $2 and $10. In Canada, FUT prices range from CA$2.50 to CA$7.00 per graft. In South Asia, the price averages Indian Rs. 65. In Australia, FUT costs an average of AU$3.
How Much Does a FUE Hair Transplant Cost?
Of the two main hair transplant methods (follicular unit transplantation (FUT) and follicular unit excision (FUE)), FUE is generally more expensive. It takes more time and skill to carry out the procedure. However, it can also have a quicker recovery time, yield smaller hair transplant marks, and generally produce better results. (2)
In the UK, FUE costs average at £5 per graft. In the USA, prices range from $2 to $10, depending on the clinic. In South Asia, the price averages Rs. 65. In Australia, FUE averages AUD$4.60 per graft. In Canada, FUE prices range from CAD$7 to CAD$8 per graft.
Fake Hair Transplants: Are They Worth It?
Artificial hair transplants surgically place synthetic into balding areas of the scalp. The FDA banned them in the USA due to potential adverse effects and safety issues. Possible side effects include infection, allergic reactions, skin irritations, cysts, and more. (7,8) However, synthetic transplants are occasionally used with improved Biofibre material for some types of alopecia. (20)
While fake hair transplants may initially be cheaper, they’re far more likely to need to be replaced regularly, increasing cost over the long term. This is due to damage and shedding. While your hair keeps growing, artificial hair will not. Overall, natural hair transplants are far more cost-efficient and safer. (7,8)
FUE vs. FUT
FUT vs. FUE: Which Is Better?
Follicular unit transplantation (FUT) and follicular unit excision (FUE) are the two primary types of hair transplantation currently used. FUT involves taking a donor strip of healthy hair, while FUE extracts follicles from smaller, round graft areas. Both FUT and FUE have pros and cons, so the question of ‘which is the best hair transplant’ will depend on many factors. (2,4)
FUT is generally cheaper than FUE because it’s less complex, less time-consuming, and requires less skill. (16) However, FUT leaves a more prominent scar and can cause more pain. This procedure is also associated with a longer hair transplant recovery time. (2,12,17)
Some people believe that FUT leads to a higher number of quality grafts and an increased graft survival rate. On the other hand, more recent research suggests that both have a similar survival rate provided FUE is done carefully and with skill. (18)
FUT Pros and Cons
Follicular unit transplantation (FUT) is a hair transplant method. During FUT, the surgeon extracts a strip of skin containing healthy hair follicles from the side or back of the patient’s head. (2)
FUT is generally more cost-effective than other methods as it’s less time-consuming and labor-intensive. This also means that the surgery may take less time. (16) Some people feel that FUT provides a higher quality of grafts and potentially produces a higher quantity of grafts. (18)
FUT does have some cons, including leaving a long linear scar which is more visible than other methods. This procedure may be less suitable if the patient prefers to wear their hair short. (12) FUT also causes more pain and has a longer recovery time than other methods. (2,12,17)
FUE Pros and Cons
Follicular unit excision (FUE) is a hair transplant method using a small, round punch tool to extract individual hair follicle units. (2) FUE produces high-quality grafts and leaves more minor scars that are less noticeable. There is a shorter recovery time and less pain with FUE than with other methods. (2,12,17)
However, FUE requires a lot more skill and takes more time than other procedures. Since mistakes may be more likely, it requires a very skilled, experienced surgeon. (16) FUE also tends to be more expensive than other types of hair follicle surgery, making it less accessible for some patients. (16)
FUE, FUT, or a Fake Hair Transplant?
The choice between follicular unit transplantation (FUT), follicular unit excision (FUE), and a fake hair transplant is personal. Each method has pros and cons, so it’s crucial you do your research to decide what’s best for you.
Overall, FUE produces high-quality grafts and leaves more minor scars, which means a shorter recovery time. It’s also typically less painful than FUT. However, FUE is more expensive than FUT, so for some, FUT may be a more realistic option. (2,12,17)
In general, FUE and FUT are understood to be safer and more effective than a fake hair transplant. This is because fake hair transplants have more serious potential side effects such as recurrent infection, allergies, and cysts. (7,8) Each hair implant is also more likely to degrade, become damaged, and need to be replaced compared to real hair.
Fake hair can be combined with natural hair using FUE or FUT methods to achieve desired hair density. This can be useful for patients who don’t have an appropriate donor area for a full FUE or FUT surgery. (19) However, since artificial hair is more likely to degrade or need to be replaced, this may not be an appropriate method. It’s also important to consider that while the patient’s natural hair will continue to grow, the artificial hair will not, leading to uneven hair. (7,8)
It’s important to mention that the FDA does not approve fake hair transplants. However, they may occasionally be used with an updated Biofibre for some types of alopecia. (20) They’re also used in other countries outside of America, although natural hair transplants are generally considered a safer option.
Artificial transplants have been trialed on patients with alopecia areata, an autoimmune condition that mistakenly attacks the hair follicles, causing hair loss. Initial results show this could be a valid treatment option, but more research is needed. Fake hair transplants have also shown promise for replacing hair in areas affected by burns and post-traumatic scars. (21)
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Last updated July 2021