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What Is A Hair Graft In A Hair Transplant?

    Quick Summary: What is a Hair Graft in a Hair Transplant?

    • What is a Hair Graft? A hair graft is a segment of tissue containing usually 1 to 4 hair follicles. Grafts are the building blocks of hair transplant surgery.
    • Role in Hair Transplantation: Each graft is transplanted from the donor site to the recipient site, in order to treat hair thinning or balding areas. Careful handling of hair grafts during extraction, sorting and implantation is vital for a good result.
    • Graft Calculator: Our clinic’s graft calculator is an interactive tool to estimate the number of grafts needed based on factors such as age, gender, hair type, and hair loss area.
    • Conclusion: Understanding hair grafts and their role in hair transplantation can help patients make informed decisions, leading to natural, long-lasting results.

    What is a Hair Graft in a Hair Transplant?

    Hair loss can be a distressing experience, leading many individuals to seek effective treatments to restore their hair and confidence. One of the most popular and successful treatments for hair loss is hair transplantation. At the heart of this procedure is the concept of the hair graft. In this article, we will delve into what a hair graft is, its role in hair transplantation, and what patients should know in order to make informed decisions.

    What are hair grafts?

    A hair graft is a segment of tissue containing hair follicles. Each graft is transplanted from one area of the scalp (donor site) to another (recipient site) where hair is thinning or balding. A single graft, also known as a “follicular unit”, typically contains 1 to 4 hair follicles.1
    If you take a closer look at the hair on your scalp, arm, or body, you will often see groups of hairs clustered together. Each of these clustered groups is a “graft” or “follicular unit”.
    Other than the hair follicle, a hair graft also includes the first and second layers of your skin (epidermis and dermis). It may sometimes contain the third layer, which is made up of fatty subcutaneous tissue2.

    Multiple hair grafts and multiple hair follicles
    This diagram shows 4 different hair grafts containing different numbers of hair follicles from 1,2,3 and 4 hair follicles (left to right)

    While hair grafts can theoretically be taken from anywhere on your body for a hair transplant, they are usually taken from the back of the head, where the hair more closely resembles those on the rest of the scalp. The size of an extracted hair graft will depend on the surgical technique used, and the tools and technology involved.

    Hair Follicle Vs. Hair Root

    “Hair follicle” and “hair root” are terms often used interchangeably, and lead to common confusion. The hair follicle acts as the anchor for the hair shaft, and contains the root and several other tissue components that play a vital role in hair growth. 

    The hair root is the part of the hair follicle that is actively growing, receiving nutrients and growth signals from the surrounding follicular structures. If you pull out a strand of hair, you might notice the root as a bulb or round ball attached to the end of the hair strand. Understanding this distinction is essential, especially in the context of hair transplantation, where precise knowledge of these structures ensures the proper extraction and implantation of healthy, viable hair grafts.

    The Role of Grafts in Hair Transplantation and Factors Influencing Graft Survival

    Hair grafts are the building blocks of hair transplantation. Their proper extraction, handling, and placement are crucial to the success of the procedure. The goal is to achieve a natural-looking hairline and density that blends seamlessly with the existing hairs.

    FUE Hair Transplant Surgery Diagram

    The main steps of FUE hair transplant surgery are summarised below:

    • Extraction: Grafts are harvested from areas of dense hair growth, which is usually the back or sides of the scalp. The extraction process varies depending on whether Follicular Unit Transplantation (FUT) or Follicular Unit Extraction (FUE) is used.

    FUT involves removing a strip of scalp tissue from the donor area and dissecting the strip into individual follicular units under a microscope with a surgical blade.
    FUE involves extracting individual follicular units directly from the donor area using a small punch tool3.

    If you’re considering a hair transplant and unsure which method to choose, our surgeons at The Treatment Rooms are more than happy to provide expert advice on what would work best for you.
    For a comprehensive read on the differences, our blog post can be found here: FUE vs. FUT. 

    In both methods, the surgeon’s skill in selecting healthy, robust hair follicles from the donor area is paramount to ensure the best possible outcome. A skilled surgeon ensures minimal trauma to the grafts, enhancing their survival rate4.

    • Sorting and counting: Once extracted, the grafts must be handled with care to prevent damage and maintain viability. Grafts can dry out easily if not kept adequately hydrated. They are typically stored in a saline solution, with an optimal storage temperature between 8°-14° C5.

    A high-resolution microscope allows technicians to clearly visualise each graft as it is prepared for implantation. Using forceps and a scalpel, any excess tissue, such as fatty layers, are carefully trimmed away from each follicular unit. The hair follicles are sorted into single, double, triple and quadruple follicular units and meticulously counted.

    • Implantation: The placement of hair grafts is a precise process that requires both training and artistry. During this stage, the surgical team places each graft into tiny incisions made in the recipient area of the scalp. The diameter of the incisions can range from 0.6-0.9 mm. The surgeon must consider the angle, direction, depth, and density of each graft to mimic natural hair growth patterns6. Here at the Treatment Rooms London, we use implanter pens to protect the follicular bulb during implantation. 
    Implanter pens in hair transplant surgery
    • Post-Operative Care: After a hair transplant, the transplanted hair will initially shed within a few weeks. This is a normal part of the process. New hair growth typically begins within 3 to 4 months, with significant improvements visible after 6 to 12 months. Following post-operative care instructions is essential for graft survival. Patients should avoid activities, for a set amount of time, that might dislodge and damage the grafts, such as vigorous washing or combing of the hair, and contact sports.

    Graft calculator for a hair transplant

    For an FUE hair transplant procedure, we understand how difficult it can be to determine the number of grafts required. Our interactive hair graft calculator  provides a personalised solution, taking into account various factors such as your age, gender, hair colour, hair type and hair loss area, to estimate the number of grafts required.

    The number of grafts required will also depend on the total area that needs to be covered and the desired hair density.

    Since each patient is unique, we recommend arranging a consultation with a hair transplant specialist, as it is the best way to find out how many hair grafts you may need to achieve your specific aim.
    To learn more about calculating the number of hair grafts you may require, visit: How Many Hair Grafts Do I Need For My FUE Hair Transplant?

    Conclusion

    Hair grafts are the cornerstone of successful hair transplantation. Understanding the types of grafts, their role in the procedure, and the factors influencing their survival can help prospective patients make informed decisions. With the right approach and expert care, hair transplantation using hair grafts can provide natural, long-lasting results, helping individuals regain their confidence and improve their appearance. While hair loss can be disheartening, we strive to make our patients feel more confident about their locks, and excited for the future. 

    References

    1. Bernstein, R. M., Rassman, W. R. and Seager, D. (1998) ‘Follicular transplantation’, International Journal of Dermatology, 37(11), pp. 841-842. Available at:  https://pubmed.ncbi.nlm.nih.gov/9311372/
    2. Lin, X., Zhu, L. and He, J. (2022) ‘Morphogenesis, growth cycle and molecular regulation of hair follicles’, Frontiers in Cell and Developmental Biology, 10, 899095. Available at:  https://doi.org/10.3389/fcell.2022.899095
    3. Rassman, W. R., Bernstein, R. M., McClellan, R., Jones, R., Worton, E. and Uyttendaele, H. (2002) ‘Follicular unit extraction: minimally invasive surgery for hair transplantation’, Dermatol Surg, 28(8), pp. 720-8. Available at:  https://pubmed.ncbi.nlm.nih.gov/12174065/
    4. Sharma, R., & Ranjan, A. (2019) ‘Follicular Unit Extraction (FUE) hair transplant: curves ahead’, Journal of Maxillofacial and Oral Surgery, 18(4), pp. 509–517. Available at:  https://doi.org/10.1007/s12663-019-01245-6
    5. Cole, J. P. and Reed, W. M. (2012) ‘The optimal holding solution and temperature for hair follicle grafts.’, Hair Transplant Forum International, 22(1), pp. 17-21. Available at:  https://doi.org/10.33589/22.1.0017
    6. Park, J. H., Ho, Y. H., & Manonukul, K. (2023) ‘A practical guide to hair graft placement using the sharp implanter method’, Clinical, Cosmetic and Investigational Dermatology, 16, pp. 1777–1785. Available at:  https://doi.org/10.2147/CCID.S411488
    7. Created with BioRender.com

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