For most people suffering from hair loss – it’s a major source of anxiety, depression and low self-confidence. With the advancement of hair restoration techniques, a slew of solutions is now readily available to both men and women who are currently facing hair problems.
Throughout the world, over 60% of men and 50% of women are experiencing androgenetic alopecia – otherwise more commonly known as hair loss. Other than popular FDA-approved oral medications such as Finasteride and Minoxidil, which help increase hair density and inhibit hair loss – they come with the downside of not being able to promote new hair growth.
While there are presently many treatments for hair loss, none is more definitive and successful than a hair transplant. Today, the most advanced technique used for hair transplant is known as Follicular Unit Extraction (FUE) – which most doctors and websites talk about as a minimally-invasive, effective solution that results in no trauma for patients looking to restore their crowning glory.
What is FUE?
FUE hair transplants first began appearing in clinics back in 2002, when the minimally-invasive hair transplant surgery was making headway worldwide.
Essentially, FUE involves the extraction of individual hair follicles from the back of your scalp; otherwise known as grafts, and prepares it to be injected into the areas where hair is sparse. Both men and women are eligible for FUE treatment.
Depending on how many grafts need to be implanted, as well as the experience of the team – the entire process can last anywhere from 4 to 8 hours. Because of the intricacy of extracting the individual hair grafts, FUE hair transplants are a manual and labor-intensive process that requires good teamwork in order to be successful.
About 6 months after the surgery, about 70% of the follicles will grow new hairs, and the remaining could take up to a full year to fully appear. Results are very natural-looking and long-lasting.
The key to any hair transplant is the survival of hair grafts. Typically, FUE provides an 85 – 99% graft survival rate – the exact percentage largely dependent on the team performing the surgery.
At The Clifford Clinic, we perform FUE in 4 main steps:
1) Punch incision around hair follicles
2) Extraction of hair grafts
3) Harvesting of hair grafts
4) Implantation of hair grafts
FUE hair transplants are popular due to its minimally-invasive technique – which yields less frequent complications after. Furthermore, FUE allows minimal scarring, which compared to the more noticeable linear scar of the FUT (Follicular Unit Transplantation) technique – is extremely desirable for most patients looking to strut their new hairdo the very next day after treatment.
Is there really NO trauma involved?
Many doctors will NOT want to tell you this – but it is a misconception that FUE is a scarless technique that results in zero trauma done to the hair follicles extracted during the process.
The truth is, even though trauma is hardly visible to the naked eye – patients should be well aware about the possibility of several types of minor trauma that can occur to hair follicles after undergoing an FUE hair transplant.
A common term that you will see in regard to FUE is the transection rate – which measures the hair bulbs that are irrevocably harmed or destroyed during hair follicle extraction and transplantation. In addition, the transection rate has an inverse relationship with the survival of follicular units upon extraction from the scalp, i.e., the higher the transection rate, the lower the survival rates – making the overall treatment less effective.
In general, FUE has a 2 – 5% transection rate, with minimal complications. It is worth taking note that the higher number of grafts harvested, the higher the transection rate.
An enlightening study that revealed the several types of minor trauma done to hair follicles during FUE was done by Jae Hyun Park and Seung Hyun You in 2017.
Studying 100 grafts randomly selected from 42 patients, they were able to assess the trauma done to hair follicles using a ×5.5 magnifying loupe and a ×60 magnifying binocular microscope. The aim of the study was to address the lack of reports and evidence on the nature and extent of injuries done to the hair follicles during FUE surgery.
Identifying 7 types of follicle injury that are likely to occur during FUE surgery, here is what they found:
Using a x5.5 magnifying loupe
- An average transection rate of 7.40% was found.
- 43, 1.52, 1.90 and 4.31 hair follicles per 100 grafts exhibited 4 types of minor trauma. (Hair bulb partial injury, dermal papilla partial injury, fracture and paring respectively)
- An average of 9.21 telogen hairs were observed.
Using a x60 magnifying binocular microscope
- An average transection rate of 6.34% was found.
- 24, 0.79, 1.95 and 9.07 hair follicles per 100 grafts exhibited 4 types of minor trauma. (Hair bulb partial injury, dermal papilla partial injury, fracture and paring respectively)
- An average of 16.62 telogen hairs were observed.
So, to answer the question: does FUE hair transplant truly come with NO trauma?
Important to take note is that trauma is being frequently found in association with all types of damage when examined under the microscope. This is especially in regard to paring and hair bulb injury – both of which provided statistically significant results.
Given that hair bulbs are responsible for generating new hair growth, and that follicles are a finite resource – injuries such as the ones mentioned can profoundly impact survival rates of hair grafts, and lower the success rate of your transplant.
So, while the transection rate is still a very important factor to consider before signing up for FUE surgery – both doctors and patients should also bring minor injuries and trauma into the discussion when deciding on which procedure or treatment is best for them.
The Clifford Clinic difference
There are many other factors that affect the overall follicle survival rate, such as out-of-body time, dryness and physical trauma; however, nothing affects the success rate of FUE surgery more than the skill sets and experience of the operating team.
Backed by highly-experienced doctors and a passionate, competent team – our clinic is able to provide a comprehensive range of hair loss solutions that cater to a variety of patient’s needs, including ARTAS and Regenera Activa.
Each coming with its own set of pros and cons; in many cases, we actually recommend our patients to undergo a combination of these treatments for best results.
While getting a hair transplant in Singapore can cost you roughly $6,000 for a one-time procedure, depending on the extent of work that needs to be done – we aim to make our treatments as affordable as possible for our patients.
When FUE first came out, many doctors were eager to offer this in their clinic, but came to find out that it is much more difficult to perform than they realized. It involves a steep and long learning curve, a strong background of cases, and good endurance from a passionate doctor and team.
Despite the possible types of minor trauma that can happen to hair follicles during an FUE hair transplant, most of them can be minimized with the ideal candidate, proper planning, and perfect execution by an experienced and competent surgery team.
The best way to enter into your treatment is not to have any unrealistic expectations, and to first consult and speak with our doctors – we pride ourselves on being completely transparent with our patients on what they can expect, and recommending the best treatment to fit their needs and goals.