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Robotic Hair Transplants & Hair Restoration
Flagship: 110 East 55th Street, New York, NY
212-826-2400 - [email protected]
Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

What is Follicular Unit Extraction and What Other Terms are Associated with the Procedure?

Q: I am considering having an FUE procedure and have heard the phrases topping, capping, and tethering as part of the procedure. What do all these terms mean? — C.C., Hell’s Kitchen, N.Y.

A: These are all terms that refer to the types of injury that can occur to grafts during a follicular unit extraction procedure.

In FUE, a sharp instrument (or sharp instrument followed by a blunt one) is used to separate follicular units from the surrounding donor tissue. Forceps are then used to remove the follicular units from the scalp.

Topping occurs in the first step when the doctor accidentally cuts off the top of the graft so that the remainder of the graft cannot be removed.

Capping occurs when the doctor grabs a graft with forceps and the top of the graft (the epidermis and upper dermis) pulls off, leaving the rest of the graft behind.

Tethering occurs when the bottom of the graft is still attached to the deeper tissues after the first step causing the follicular unit to pull apart during extraction.

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Hair Restoration Answers

What is Graft Compression in a Hair Transplant?

Q: What exactly is compression in a hair transplant? — D.O., Short Hills, N.J.

A: Compression refers to the visible tufting of grafts due to the contraction of the grafts from the normal elasticity of skin around it, after it has been inserted into the recipient site.

Compression is most commonly seen when minigrafts are used in the hair restoration (minigrafts contain more than four hairs each).

Follicular units don’t show visible compression, since they are already naturally compact. However, if more than one follicular unit is placed into the same site, it can exhibit this phenomenon.

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Hair Restoration Answers

After Hair Transplant, Can Donor Hair Become Frizzy and Dry?

Q: Why can donor hair become frizzy and dry once transplanted? — G.F., Stamford, C.T.

A: Frizzing and kinkiness is a temporary phenomenon that is part of the normal healing process after a follicular unit hair transplant.

During the healing process, the new collagen that forms around the grafts can alter their growth. Over time, usually within a year, this collagen matures and the hair quality usually returns to normal.

If grafts have been excessively traumatized or grafts larger than follicular units have been used, these changes are more likely to be permanent.

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