Hair transplantation without shaving
No-shave FUE – Unshaven FUE
FUE (Follicular Unit Extraction) is a hair transplantation technique whereby hairs are taken individually from the donor region and then implanted at the recipient site where the hair is thinning or missing. The procedure is carried out using a special microsurgical device which approaches each hair, makes a small, circular incision around each follicular unit (i.e. graft, or transplant) to a depth of around 2-3mm, so that it can be freed from the surrounding skin. It is very important that the hair is approached at an appropriate angle in order not to damage the root, or other important anatomical structures (the growth centres, muscle or sebaceous gland). In order to carry out successful extraction, the hair in the donor region must be shaved down to 2-3 mm in length. This often means shaving the whole donor region (the back of the head and the sides) very short. It is not unusual for patients to have to wear a completely different hairstyle for a few weeks, until the hair grows back. Women find it particularly hard to opt for a hair transplant for this very reason. So the need arose to offer patients a FUE hair transplant procedure without full shaving of the donor region – a technique called Individual Follicular Trim (IFT).
The donor region prepared for the FUE procedure
The FUE procedure has continually been improved on since its development in the early 2000s. It has been improved on both from the technological aspect – in terms of the devices used to carry out the procedure – and from the medical aspect, and has become more and more tuned to the needs of the patient. One such need is the frequently expressed wish to not have to shave the donor region before the hair transplant procedure. This has resulted in the development of a new FUE technique called Individual Follicular Trim (IFT), which makes it possible for FUE to be performed whilst retaining the existing length of the hair. The technique was developed by Dr James Harris, one of the pioneers and leading world authorities on FUE hair transplantation.
In order to carry out the FUE procedure a smaller region can also be shaved to a length of 2-3 mm, which can be concealed by the surrounding hair. This can be done for smaller hair transplants (up to 1000 grafts), and where the surrounding hair is long enough to cover the shaved zone (minimum length 4-5 cm). It is especially recommended where the patient has very dense hair in the donor region and where use of just a small zone for graft extraction will not visibly thin the hair. However if the donor site is not optimally dense (is less than 60 FU/cm2), this technique is not recommended since it could cause visible thinning of the hair on the back of the head (a “zebra” look). One should also be careful when planning the number of grafts to be taken from a small area in order to avoid over-harvesting and damaging the whole region, slowed healing and scarring.
IFT (Individual Follicular Trim) hair transplantation allows us to carry out the FUE procedure across a large area by shortening each follicular unit (graft, transplant) individually down to 2-3 mm so that it can be extracted with the FUE device. In this way the surrounding hair retains its natural length and does not affect the grafts to be used in the transplantation. Also, the grafts obtained in this way are of excellent quality and do not differ in any way from the grafts that would be obtained if the whole donor region were cut short. The IFT procedure takes longer since additional time is needed to cut the hair to the appropriate length and choose the follicular units for transplantation. It is of particular importance that we ensure an even distribution of the hair to be extracted and that which is not for extraction so that the donor site can be harvested evenly. This is why patients opting for the IFT procedure are sometimes asked to come to the clinic a day before the procedure so that trimming of the hair can be carried out, and then the transplant itself performed the following day. This technique allows for transplantation of up to 1500 grafts. It is generally not recommended for patients who have previously undergone a FUE procedure where there is some scar tissue, usually caused by the use of a large FUE punch (larger than 1 mm). The IFT procedure is particularly useful in hair transplants in women, and in eyebrow transplants. Since it is technically more demanding, requires greater coordination amongst the entire team and precise planning, this procedure should be undertaken by an experienced surgeon. It provides for the same quality of graft as the classic FUE procedure, but also offers the patient convenience since they do not have to alter their hairstyle and after the hair transplant there will be no trace of the procedure itself.
Have a look at a donor region after the IFT method, after harvesting of 1100 grafts.