Follicular Unit Hair Transplantation

Question 1

How does FUT (follic unit transplantation) differ from FUE (follicular unit extraction)?

Answer 1

FUHT is the umbrella term.

• FUT is the technique of obtaining follicular units through the microscopic dissection of a donor strop
• FUE is the harvesting of individual units directly from the scalp

Question 2

Candidates for hair transplant age 35 and over

Answer 2

False 25 and over

Question 3

Inadequate response to medication after 3 yr forms part of patient selection for surgery

Answer 3

False 1 y

Question 4

Norwood class IV or greater are good surgical candidates

Answer 4

False III or greater

Question 5

Surgical hair restoration is performed under general anaesthetic

Answer 5

False - local

Question 6

Transplant density is more abundant than non balding density

Answer 6

False, significantly less

Question 7

When hair is blonde or white, it takes less time for thinning to show

Answer 7

False, takes longer. Thinning is most evidence in those with black hair and white skin

Question 8

Limitations of a tight scalp not usually apparent in the initial surgery

Answer 8

True

Question 9

Patients with loose scalp tend to heal with widened scars , due to increased distensibility

Answer 9

True

Question 10

Follicular unit extraction should be considered in cases of very loose but not very tight scalps

Answer 10

False - good for v loose or v tight scalps

Question 11

Donor dimensions - mid portion of harvestable donor zone generally lies over occipital protuberance and extends laterally to within 3 cm of temple hairline on each side

Answer 11

True. 2019 question

Question 12

Distance of the donor dimensions are approx 32-35cm

Answer 12

True

Question 13

Crown coverage should be the goal of the first session

Answer 13

False, should not be . Unless patient has an above-average donor supply, patient’s options will be more limited and chances for aesthetically balanced transplant permanently compromised

Question 14

Takes 6- 12mo to best appreciate cosmetic impact of procedure

Answer 14

False , 12-18 mo

Question 15

Follicular unit transplantation results in linear scars T/F 2019

Answer 15

?True - strip excision . Vs FUE

Question 16

Minoxidil 5% can be resumed 1-2 weeks after procedure

Answer 16

True

Question 17

Finasteride should be stopped one month prior to hair restoration surgery

Answer 17

False - do not stop

Question 18

Hiccups are a possible side effect

Answer 18

True - possible injury to C2-C4 indirectly stimulating vagus or diaphragmatic nerves

Question 19

A tight scalp can be loosened with repeated massage

Answer 19

True

Question 20

A tight scalp can constitute a contraindication to FUT .

Answer 20

True

Question 21

FUE yields many more grafts than FUT

Answer 21

False - in general, it does not

Question 22

FUE causes small pinpoint scars

Answer 22

True

Question 23

Donor area can take on a moth eaten appearance with too many follicular units removed per unit area - either in one session or over repeated procedures

Answer 23

True - this limits ability to wear hair short

Question 24

Hair transplantation creates more hair overall on the scalp

Answer 24

F, hair transplantation moves, rather than creates, hair

Question 25

Back and neck problems , as well as claustrophobia , can sometimes make the hair transplant procedure problematic

Answer 25

T - patients are in a surgical chair for a good part of the day

Question 26

The resulting transplanted density if greater than the person’s non balding density

Answer 26

F, significantly less than

Question 27

Follicular unit extraction is sometimes very difficult in patients with loose scalps as the skin is difficult to stabilise and the follicular units may shred during the extraction process

Answer 27

t

Question 28

Technique is usually aseptic rather than sterile

Answer 28

T

Question 29

Patient must cease finasteride one month prior to transplant

Answer 29

F, common to place patients on finasteride before surgery to minimise post surgical effluvium

Question 30

Main indication for FUE is for patients who want to wear their hair short

Answer 30

T - linear donor scar of FUT may become visible

Question 31

Pros of FUE

Answer 31

No linear scar

• useful hen patient want or needs to wear hair styled back from face and with sides very short
• alternative for when scalp is too tight for primary closure
• ideal for camouflaging donor scars that cannot be excised
• allows pt to resume strenuous physical activities right away
• makes it possible to harvest non scalp hair eg. Beard or body hair

Question 32

Cons of FUE

Answer 32

Graft quality is inferior to FUT
Requires multiple sessions to equal size of a single FUT procedure
Takes longer to perform and is more expensive than FUT
Risks the eventual loss of transplanted grafts by harvesting from outside the ‘sweet spot’ of permanent hair in the donor zone
After large numbers are harvested, fine stipple scars may become visible due to thinning of the donor area or with further balding
Scarring and distortion of follicles may make further harvesting by FUE difficult
Max possible yield is LOWER than with FUT
Entire donor area must be shaved to perform large sessions

Question 33

21G hypodermic needle to create recipient site for one-hair follicular unit graft

Answer 33

T

Question 34

Hair should be placed into the scalp at the angle at which it originally grew, not in the direction that it is to be groomed

Answer 34

T

Question 35

Whorls in the hair should be mimicked by the hair transplant

Answer 35

F, should not be

Question 36

Minoxidil is continued 1-2 wks after procedure, if plan to continue

Answer 36

T