Bernstein Medical physicians answer the most frequently asked questions on hair transplantation. For additional Q&A on hair transplants visit Answers.
- What is hair transplantation?
- What is Follicular Unit Transplantation (FUT)?
- What is Follicular Unit Extraction (FUE)?
- What is a robotic FUT hair transplant?
- Am I a candidate for a hair restoration procedure?
- Should I choose FUT or FUE?
- Why visit a practice that performs both FUT and FUE?
- ARTAS® System vs. Neograft?
- What does a hair transplant cost?
- How long does a procedure take?
- How long does it take to heal?
- How do I set up a consultation?
- Do I meet with the doctor?
A hair transplant is a surgical procedure in which hair is moved from the back and/or sides of the scalp, where it is permanent (donor area), to areas that are thinning or bald on the front, top, or crown of the scalp (recipient area). Once transplanted, the hair will continue to grow for a person’s lifetime. At Bernstein Medical we perform the two most effective types of hair restoration procedures, Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). For the latter, we use new robotic technology.
Follicular Unit Transplantation (FUT) is a hair restoration procedure in which naturally-occurring groups of one to four hairs, called follicular units, are transplanted from the donor area to the recipient area.
In FUT, after the patient’s scalp is numbed, the doctor removes a thin strip of tissue from the back and/or sides of the scalp. The donor strip is then separated into hundreds to thousands of individual follicular units using precise stereo-microscopic dissection techniques. As the follicular unit grafts are being prepared, the doctor makes tiny slits in the scalp (recipient sites), into which the grafts are placed.
If well executed, the use of follicular units ensures that the transplant results will look completely natural and be undetectable. Follicular Unit Transplantation was conceived by Dr. Bernstein and first described in the medical literature in his landmark 1995 publication.
Follicular Unit Extraction (FUE) is a method of extracting, or “harvesting,” follicular units one-by-one directly from the scalp. In FUE, an instrument is used to make small, circular incisions in the skin around follicular units, separating them from the surrounding tissue. The follicular unit is then extracted (pulled) directly from the scalp, leaving a small open hole that heals with a small white mark.
This method of donor harvesting is what differentiates the FUE procedure from Follicular Unit Transplantation (FUT), in which the donor hair is removed in a long strip that is dissected into individual follicular units under a stereo-microscope. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in FUE and FUT procedures.
The FUE technique was conceived by Dr. Ray Woods in the 1990s in Australia and was introduced into the medical literature by Rassman and Bernstein in 2002. In 2011, Dr. Bernstein began performing FUE using robotic technology, and now all FUE hair transplants at Bernstein Medical use the speed, precision, and consistency of the robotic hair transplant system.
In Robotic FUE hair transplant procedures, follicular units are isolated using the ARTAS robotic system. The ARTAS system is a computerized, image-guided robot that automates the labor-intensive process of extracting hundreds or thousands of grafts in a session. Its advantage over other FUE techniques is due to its precision and consistency in extracting grafts. All FUE procedures at Bernstein Medical are performed using the ARTAS robot. You can also read our FAQ on robotic hair transplants.
The best way to find out is to be evaluated by a board certified dermatologist or plastic surgeon specializing in hair restoration. The answer will depend on the cause of your hair loss, your age, the stability of your donor supply, how extensive your hair loss is, your expectations and a number of other important factors that will be taken into account. Read more about Candidacy for Hair Transplant Surgery.
In general, FUT yields the most donor hair. Therefore, the procedure is best suited for more extensive hair loss and in patients where the main concern is the maximum use of one’s donor supply. The hair is maximized because of the precise nature of stereo-microscopic dissection and the fact that all the hair is harvested from the mid-portion of the permanent zone where the hair is most dense and stable. A limitation of FUT is that it leaves a line scar in the donor area. With normal styling, this is easily covered with hair, but it precludes someone from wearing their hair very short.
FUE is more appropriate for patients who would like to keep their hair very short or who can’t limit strenuous activities in the post-op period. In general, younger patients who need to keep their styling options flexible choose FUE, whereas those who desire the most coverage opt for FUT. Read a detailed comparison of FUT and FUE on our FUE Pros & Cons page.
The answer may be counterintuitive in today’s age of specialization, but the answer is that you should always go to the practice that offers both. To deliver the best care, hair restoration physicians should have expertise in both Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) techniques and should offer both in their practices. There are at least five good reasons why:
- FUT and FUE are both excellent techniques but have different indications for use
- The same patient may benefit from both procedures
- There is a cross-over set of skills from FUT to FUE
- Practices that offer both procedures are usually more experienced
- Better decision making
For a full explanation of each of these reasons, please read our Answers post on the topic.
Neograft is a device that uses a sharp punch to isolate grafts and a suction mechanism to extract them from the scalp. Both the sharp punch and suction are felt by many doctors to cause more injury to the follicles than the blunt dissection technique (used by the ARTAS robotic system for FUE). In addition, the Neograft is a hand-held device that, unlike the ARTAS, is not an image-guided robotic system and, therefore, lacks the precision of the latter technique.
The cost varies depending on the number of grafts transplanted and the type of procedure (FUT or FUE). To get a general sense of the number of grafts that you might need go to the Graft Numbers page. Contact our staff at 212-826-2400 to ask any questions about the cost of a hair transplant procedure or available payment options.
Smaller sessions of FUT (less than 800 grafts) can take about 4 hours, while larger ones (2500 grafts or more) can take all day. Sometimes large sessions of FUE are split over two days. The main determinant of the length of the session depends on the number of grafts being transplanted.
There is some redness and crusting after the procedure. Some patients experience swelling during the first week after surgery. Hair transplants are usually undetectable after 10 days. Follicular unit grafts are permanent in the scalp after 10 days. Read about FUT Post-op Care or FUE Post-op Care.
To schedule a consult, you can call us at 212-826-2400 or submit a consultation inquiry. If you cannot visit our NYC hair restoration facility for a consultation, you are welcome to submit a photo consultation inquiry. In-person consultations are always preferred because an exam allows the doctor to better evaluate your hair loss.
In some practices you will meet with a medical consultant or salesperson. At Bernstein Medical, all appointments are for one-on-one consultations with our board certified physicians. Your physician will be conducting the entire evaluation and making all the recommendations — medical or surgical. Read more about our hair loss consultations or read the Bernstein Medical FAQ page.