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Pathophysiology of Male Pattern Baldness & FUE Hair Transplant

Pathophysiology of Male Pattern Baldness & FUE Hair Transplant

Pathophysiology of Male Pattern Baldness & FUE Hair Transplant

Hair loss, particularly male pattern baldness, is a prevalent condition that affects a significant number of individuals worldwide. In recent years, Follicular Unit Extraction (FUE) has emerged as a revolutionary technique, offering effective and natural-looking results for those looking for a hair transplant in Singapore. This essay delves into the pathophysiology of male pattern baldness, the procedure of FUE hair transplant, the role of the punch tool, punch sizes used, and the various implantation techniques employed.

1. Pathophysiology of Male Pattern Baldness: Male pattern baldness, also known as androgenetic alopecia, is a progressive condition characterized by a genetically determined sensitivity of hair follicles to dihydrotestosterone (DHT), a hormone derived from testosterone. DHT binds to receptors in susceptible hair follicles, leading to a gradual miniaturization of the hair shaft. This process shortens the anagen (growth) phase and prolongs the telogen (resting) phase, resulting in the thinning and eventual loss of hair.

2. Understanding FUE Hair Transplant Procedure: FUE is a minimally invasive hair transplant procedure that involves the extraction of individual hair follicles from the donor area, typically the back or sides of the head, and their transplantation to the recipient area. The procedure can be summarized in the following steps:

a. Donor Area Preparation: The patient’s scalp is cleaned and the donor area is trimmed to an appropriate length to facilitate follicle extraction.

b. Administration of Local Anesthesia: Local anesthesia is administered to ensure patient comfort during the procedure.

c. Extraction with Punch Tool: The punch tool, a specialized instrument with a circular cutting edge, is used to extract individual hair follicles from the donor area. The punch tool’s size is carefully chosen based on the characteristics of the patient’s hair, typically ranging from 0.7mm to 1.0mm in diameter.

d. Preparation of Follicular Units: The extracted follicular units are meticulously separated and prepared for transplantation. These units consist of one to four hairs, with smaller units often used for the hairline and temples to achieve a natural appearance.

3. Implantation Techniques in FUE Hair Transplant: Implantation is a crucial step in the FUE hair transplant process, ensuring proper placement and natural-looking results. Different techniques can be employed to achieve optimal outcomes:

a. Slit Technique: Small incisions or slits are created in the recipient area, taking into account the direction, angle, and density of the patient’s natural hair. The prepared follicular units are then carefully inserted into these slits using forceps or implanters.

b. Stick and Place Technique: This technique involves creating small holes with a needle or blade in the recipient area. The prepared follicular units are then directly inserted into these pre-made holes using forceps.

c. Choi Implanter Pen Technique: The Choi implanter pen is a specialized device that allows for precise implantation of follicular units. The pen creates a slit and simultaneously inserts the graft, minimizing handling and potential damage to the follicles.

d. Sapphire Blade Technique: In this technique, a sapphire blade is used to create the recipient sites, which are then filled with the prepared follicular units. The use of sapphire blades offers greater precision and reduces trauma to the recipient area.

4. Advancements in Implantation Techniques: Advancements in FUE hair transplant have led to innovative implantation techniques, such as:

a. Direct Hair Implantation (DHI): DHI is a variation of FUE where follicular units are implanted one by one using a specialized implanter tool. This technique eliminates the need for creating recipient sites beforehand, allowing for more precise and efficient transplantation.

b. Robotic Hair Transplantation: Robotic systems, such as the ARTAS system, have been developed to automate the extraction and implantation process. These systems use advanced algorithms and artificial intelligence to select and extract hair follicles, improving accuracy and reducing human error.


FUE hair transplant has revolutionized the field of hair restoration, offering individuals suffering from male pattern baldness a minimally invasive and effective solution. Understanding the pathophysiology of male pattern baldness helps explain the rationale behind FUE hair transplant. The punch tool, with carefully selected sizes, plays a crucial role in the extraction process, while various implantation techniques ensure precise placement of follicular units. As technology continues to advance, further refinements in both extraction and implantation techniques are expected, further enhancing the outcomes and patient satisfaction in FUE hair transplantation.