Question/Answer: What is Ultra-Refined Follicular Unit Transplantation (FUT) and how does Recipient Incision Size relate?

[Bill - Seemiller]

Hello everyone.

 

I thought I'd bring this up for general and specific discussion on a new thread instead of continuing it on the thread "Planning to perform HT with Hair Club".

 

As most of you are aware, ultra-refined Follicular Unit Transplantation is the current trend which leads clinics to further refine their techniques, instrumentation, and technology in order to provide the most optimal result.

 

Taking a step back for a minute...I wanted to define "Mini-grafts" for all those who have heard the term and don't know what it is. I want to define it here because I do post some pictures below of mini-grafting. I think you will be able to tell by the pictures why this is outdated:

 

MINI-GRAFTS "CONTAIN" follicular units but are not the same as follicular unit grafting.

 

Simply put, A mini-graft typically contains 5-8 hair bundles (though sometimes combining 2 two hair FUs can be considered a mini-graft. Please don't confuse this with a 4 haired naturally occuring FU).

 

A "follicular unit graft" (sometimes called follicular unit micro-graft) are hair follicles as they occur naturally in 1s, 2s, 3s, and 4s. Since hairs grow in these follicular units naturally, I think you can understand why this would look more natural than using mini-grafts.

 

Let's now discuss the difference between FUT and Ultra-refined FUT?

 

The difference can be answered in two different ways...

 

1. Ultra-refined FUT typically uses skinny grafts as opposed to chubby grafts. This refers to how the FUs are cut from the donor strip - either by leaving a larger or smaller amount of skin around each graft.

 

2. Ultra-refined FUT uses refined instrumententation making smaller incisions whereas clinics that do solid FUT don't necessarily use these refined instruments.

 

Typically, however, those clinics that use instrumentation which makes larger recipient sites are forced to space the grafts further apart to control shock loss and ensure maximum growth potential of the grafts. Using smaller cutting instruments make it possible to dense pack grafts closer together while still maximizing growth potential and minimizing shockloss.

 

One could state, therefore, that the term "ultra-refined" came from the fact that "ultra" skinny grafts are being cut - and "refined" instrumentation is being used by the clinic to cut the ultra skinny grafts and make recipient sites.

 

Now at what point does FUT become Ultra-refined FUT could be debatable. Cleary even amongst the best clinics in the world, there are variations in techniques and instrumentation. But this is not the point of my thread.

 

 

 

My overall feeling is that the smaller the recipient incision and the skinnier the cut of the graft, the better the result. (Maximizing growth potential and dense packing while minimizing shockloss).

 

Of course, please keep in mind that making the recipient sites too small means the FU grafts won't fit into the site. Larger incisions would still be needed for 3 and 4 haired FU grafts.

 

Below this initial post, I will post some Ultra-refined FUT pictures verses some older style pictures. This should hopefully give newbies an understanding why immediately post op pictures are so important when trying to determine the kind of result someone might end up with.

 

Below is the first picture of two ultra-refined FUT immediately post op pictures. Note that the recipient sites are of slightly different sizes, even in these two immediately post op pictures from two different coalition doctors. Though there was some dense packing, please understand that a larger area was being covered in both surgeries, so some density was sacrificed for coverage. More information about sacrificing density for coverage, etc can be found in the following thread:

 

Will I be able to obtain a full head of hair?

 

http://hair-restoration-info.com/eve/forums?a=tpc&s=569...161071123#6161071123

 

 

More will be posted below.

 

Bill

[Bill - Seemiller]

Hello everyone.

 

I thought I'd bring this up for general and specific discussion on a new thread instead of continuing it on the thread "Planning to perform HT with Hair Club".

 

As most of you are aware, ultra-refined Follicular Unit Transplantation is the current trend which leads clinics to further refine their techniques, instrumentation, and technology in order to provide the most optimal result.

 

Taking a step back for a minute...I wanted to define "Mini-grafts" for all those who have heard the term and don't know what it is. I want to define it here because I do post some pictures below of mini-grafting. I think you will be able to tell by the pictures why this is outdated:

 

MINI-GRAFTS "CONTAIN" follicular units but are not the same as follicular unit grafting.

 

Simply put, A mini-graft typically contains 5-8 hair bundles (though sometimes combining 2 two hair FUs can be considered a mini-graft. Please don't confuse this with a 4 haired naturally occuring FU).

 

A "follicular unit graft" (sometimes called follicular unit micro-graft) are hair follicles as they occur naturally in 1s, 2s, 3s, and 4s. Since hairs grow in these follicular units naturally, I think you can understand why this would look more natural than using mini-grafts.

 

Let's now discuss the difference between FUT and Ultra-refined FUT?

 

The difference can be answered in two different ways...

 

1. Ultra-refined FUT typically uses skinny grafts as opposed to chubby grafts. This refers to how the FUs are cut from the donor strip - either by leaving a larger or smaller amount of skin around each graft.

 

2. Ultra-refined FUT uses refined instrumententation making smaller incisions whereas clinics that do solid FUT don't necessarily use these refined instruments.

 

Typically, however, those clinics that use instrumentation which makes larger recipient sites are forced to space the grafts further apart to control shock loss and ensure maximum growth potential of the grafts. Using smaller cutting instruments make it possible to dense pack grafts closer together while still maximizing growth potential and minimizing shockloss.

 

One could state, therefore, that the term "ultra-refined" came from the fact that "ultra" skinny grafts are being cut - and "refined" instrumentation is being used by the clinic to cut the ultra skinny grafts and make recipient sites.

 

Now at what point does FUT become Ultra-refined FUT could be debatable. Cleary even amongst the best clinics in the world, there are variations in techniques and instrumentation. But this is not the point of my thread.

 

 

 

My overall feeling is that the smaller the recipient incision and the skinnier the cut of the graft, the better the result. (Maximizing growth potential and dense packing while minimizing shockloss).

 

Of course, please keep in mind that making the recipient sites too small means the FU grafts won't fit into the site. Larger incisions would still be needed for 3 and 4 haired FU grafts.

 

Below this initial post, I will post some Ultra-refined FUT pictures verses some older style pictures. This should hopefully give newbies an understanding why immediately post op pictures are so important when trying to determine the kind of result someone might end up with.

 

Below is the first picture of two ultra-refined FUT immediately post op pictures. Note that the recipient sites are of slightly different sizes, even in these two immediately post op pictures from two different coalition doctors. Though there was some dense packing, please understand that a larger area was being covered in both surgeries, so some density was sacrificed for coverage. More information about sacrificing density for coverage, etc can be found in the following thread:

 

Will I be able to obtain a full head of hair?

 

http://hair-restoration-info.com/eve/forums?a=tpc&s=569...161071123#6161071123

 

 

More will be posted below.

 

Bill

[Bill - Seemiller]

Below is an example of the use of mini-grafts rather than follicular units. This is older technology and NOT ultra-refined work. This picture is from another member of our community 8 days post op.

 

Take note of how far apart the grafts are spaced apart and how large the grafts look.

 

Bill

[Bill - Seemiller]

Here is a comparison picture I put together of another user's crown work verses my crown work from Dr. Hasson immediately post op.

 

Notice the difference between the two pictures. What do you see?

 

 

On the left side of the picture, the recipient sites are very large and the grafts are spaced far apart. Though I can't be sure, this appears like mini-grafts.

 

On the right side, the recipient sites are small and the grafts are placed much more closely together creating the natural whirl effect. This is an example of Ultra-refined FUT.

 

 

 

Bill

[thanatopsis_awry]

Well done. The differences are really, really striking...!

 

Its a good point that how things look right after the HT are big indicators of the ultimate result.

[Pat - Community Publisher]

Bill,

 

Thanks for taking the time to help people understand the sometimes subtle but important differences between standard follicular unit hair transplantation and ultra refined follicular unit hair transplantation.

 

Since I first became a hair transplant patient and began learning and sharing hair transplant information online over ten years ago, I've seen hair transplantation evolve from small sessions of large grafts and incisions ("mini/micro grafts" containing up to 7 or 8 hairs) to much larger sessions of ultra refined follicular unit grafts that are placed into tiny minimally invasive incisions.

 

This evolution - while improving the naturalness, fullness and healing time for patients - made the procedure more challenging and even less profitable for many clinics. Some clinics embraced these patient friendly evolutions while many resisted them and argued against having to implement these changes.

 

Those physicians who rose to the challenge of successfully providing their patients with true follicular unit hair transplantation came to be recommended on the Hair Transplant Network (to see this list of physicians, click here).

 

Patients have been getting positive life changing follicular hair transplantation from these physicians for several years. When patient results and care have proven to not be top notch these physician/clinics have been promptly removed.

 

Follicular Unit Hair Transplantation 2.0

 

During the past few years follicular unit hair transplantation has once again evolved to an even higher level of refinement that enables patients to achieve greater density, fullness and quicker healing in less sessions. This new evolution has been termed "Ultra Refined Follicular Unit Hair Transplantation". To learn more visit the Ultimate Hair Transplant page of the Hair Transplant Network.com

 

Many of the leading physicians who have been recommended on the Hair Transplant Network for years embraced this new technique, while also expanding their staff and capability to perform large sessions in excess of 3,000 follicular unit grafts. These leading physicians/clinics have been admitted into the Coalition.

 

After ten years of searching there are only just over fifty physicians recommended worldwide on the Hair Transplant Network out of over 1,000 active hair transplant physicians. Of these fifty plus leading physicians/clinics only just over two dozen have met the ultra high requirements for Coalition membership and been admitted. To see the current Coalition members, click here .

 

Are other physicians providing positive life changing hair transplantation? I believe that some are. But in my opinion only the top 5% trier of hair transplant physicians/clinics are really worth recommending or going to since the results are life long.

 

Educated patients who demand only the very best and who are willing to travel to get it are forcing the hair transplant profession to provide optimal results or be left behind.

 

While this patient driven process has caused many if not the majority of hair transplant physicians to be uncomfortable it has resulted in optimal results for thousands of patients online and success for those clinics who have risen to the challenge.

 

Viva La Hair Revolution!

 

Pat

[SinTPA]

Originally posted by Pat - Publisher of this Community:

Bill,

 

Thanks for taking the time to help people understand the sometimes subtle but important differences between standard follicular unit hair transplantation and ultra refined follicular unit hair transplantation.

 

Since I first became a hair transplant patient and began learning and sharing hair transplant information online over ten years ago, I've seen hair transplantation evolve from small sessions of large grafts and incisions ("mini/micro grafts" containing up to 7 or 8 hairs) to much larger sessions of ultra refined follicular unit grafts that are placed into tiny minimally invasive incisions.

 

This evolution - while improving the naturalness, fullness and healing time for patients - made the procedure more challenging and even less profitable for many clinics. Some clinics embraced these patient friendly evolutions while many resisted them and argued against having to implement these changes.

 

Those physicians who rose to the challenge of successfully providing their patients with true follicular unit hair transplantation came to be recommended on the Hair Transplant Network (to see this list of physicians, click here).

 

Patients have been getting positive life changing follicular hair transplantation from these physicians for several years. When patient results and care have proven to not be top notch these physician/clinics have been promptly removed.

 

Follicular Unit Hair Transplantation 2.0

 

During the past few years follicular unit hair transplantation has once again evolved to an even higher level of refinement that enables patients to achieve greater density, fullness and quicker healing in less sessions. This new evolution has been termed "Ultra Refined Follicular Unit Hair Transplantation". To learn more visit the Ultimate Hair Transplant page of the Hair Transplant Network.com

 

Many of the leading physicians who have been recommended on the Hair Transplant Network for years embraced this new technique, while also expanding their staff and capability to perform large sessions in excess of 3,000 follicular unit grafts. These leading physicians/clinics have been admitted into the Coalition.

 

After ten years of searching there are only just over fifty physicians recommended worldwide on the Hair Transplant Network out of over 1,000 active hair transplant physicians. Of these fifty plus leading physicians/clinics only just over two dozen have met the ultra high requirements for Coalition membership and been admitted. To see the current Coalition members, click here .

 

Are other physicians providing positive life changing hair transplantation? I believe that some are. But in my opinion only the top 5% trier of hair transplant physicians/clinics are really worth recommending or going to since the results are life long.

 

Educated patients who demand only the very best and who are willing to travel to get it are forcing the hair transplant profession to provide optimal results or be left behind.

 

While this patient driven process has caused many if not the majority of hair transplant physicians to be uncomfortable it has resulted in optimal results for thousands of patients online and success for those clinics who have risen to the challenge.

 

Viva La Hair Revolution!

 

Pat

 

Thanks much for the pictures! I'm really upset at myself for not getting immediate post-op pictures of my HT w/ Dr. Epstein. I'm 99% sure he only uses ultra-refined but I would prefer to have the pictures to verify. Thanks again,

Sin

[Bill - Seemiller]

Pat,

 

Thanks the for the links back to the site that gives further description and explanation of ultra-refined follicular unit transplantation.

 

It still amazes me to see that many clinics still have not adopted the latest techniques and technologies that optimize the result for the patient.

 

This is why communities such as these are so vital to the selection process of a physician.

 

As I've been a regular member here for many years now, I've been grateful for your hard work and decication to keep this site running. Thanks also to the other decicated members who spend countless hours devoting time to help fellow seeking hair loss sufferers.

 

SinTPA,

 

Dr. Epstein does perform Ultra-refined FUT. Rest easy my friend.

 

Bill

[SinTPA]

Originally posted by Bill:

SinTPA,

 

Dr. Epstein does perform Ultra-refined FUT. Rest easy my friend.

 

Bill

 

Bill,

 

Thanks for the confirmation. I was 90+% sure due to the fact that my graft sites healed very rapidly and I read somewhere in these forums that one of the advantages of Ultra-refined FUT is quicker healing.

 

Cheers,

Sin