I’ve read from many hair restoration experts that hair curliness is an important factor for graft transection. But, now there seems to be a new theory that skin thickness is a more significant variable. Why is this the case?

I’ve read from many hair restoration experts that hair curliness is an important factor for graft transection. But, now there seems to be a new theory that skin thickness is a more significant variable. Why is this the case?

Previously, skin thickness type was completely overlooked in the practice of FUE hairline restoration, as well as in the hair transplant industry as a whole. It has been assumed that hair curvature presents a challenge when attempting to use a straight cylindrical punch to follow the hair shaft down to the follicle. In theory, this may seem to be a logical basis for transected grafts. But direct observations on actual patients do support the concept of skin thickness (either extreme thickness or extreme softness) as a much more significant factor to consider.

Skin Type and Hair Type – Which matters more in FUE hair transplant?

While hair type can also contribute to hair transplant graft transection across patient cases, it plays a much smaller role towards the overall final percentage. Here is the rationale.

Current and older generations of FUE technology fail to serve patients of color. It was simply assumed that the underlying problem was the unpredictable angulation that Afro-textured hair grows in. This makes it difficult for a straight punch to follow the curvature in order to excise around the follicle without transecting it.

Through careful observation in his own clinic in Redondo Beach, Los Angeles, Dr. U noticed comparatively higher transection rates patterns in other ethnic groups, such as those of Asian and Arabic descent, specifically. Although their hair was far from curly and kinky, their skin thickness apparently was the contributor to their graft damage.

Skin Thickness – How does my skin thickness type affect the outcome of my FUE hairline restoration?

All human skin can be categorized within the same spectrum. Those with exceptionally hard and thick skin will find themselves at one extreme end, while those with soft and thin skin will be at the other. However; there are many shades of variance in between, accounting for the wide variety of human phenotypes we see around us in.

Skin thickness will determine a few very important things in FUE hairline restoration. It is the source of tissue resistance the FUE punch will need to cut through in order to retrieve the follicle graft from its origins in the skin. With unusually thick skin, it is more difficult to cleanly and completely excise the follicular unit graft using FUE instrumentation of generic strength and design. Patients with thick skin will need much more powerful tools to see success in their hairline restoration.

Conversely, thin skin can sometimes be too delicate for even the most gentle FUE technology. Using tools that are too fast, rough, or powerful runs the risk of the hair transplant specialist tearing through the skin surrounding the follicle instead of excising it. This leaves the hair graft naked, with no tissue sheath protecting it in the recipient area which will adversely affect their ability to survive in their new location.

Dr.UGraft ™ is engineered to accommodate any type of skin. This all-in-one technology is the first of its kind. Capable not only of FUE hairline restoration in patients of every skin type and thickness, it is also able to extract grafts from the body (where the surrounding tissue is always going to be much softer than the scalp). This unique technology is able to make BHT body hair transplant an option for just about any patient.

Frequently-Asked Questions About Skin Thickness and Hair Restoration for Men

Why has the importance of skin type never been emphasized before in hairline restoration?

As discussed above, most doctors rationalized that the curliness of the hair was the primary cause of transected grafts. Since basic FUE tools, have a cylindrical shape, the practitioner can only rely on the visible hair shaft above the skin as a cue for aligning their punch correctly in order to accurately surround the hair follicle. Trying to trace the curvature of the hair with this configuration would be a futile attempt.

Will skin thickness disqualify me from FUE hairline restoration?

If your hair transplant specialist uses the Dr.UGraft ™ FUE system in his or her practice, the thickness of your skin will be accounted for due to the intuitive and customizable features of this technology.

This technology is built to alert the operator when faced with extreme skin resistance (due to very thick skin) or resistance which is very weak. He or she can then adjust the speed and torque settings, allowing the punch to safely extract your grafts without harming the outer tissue sheath.

Further Reading

An especially comprehensive study on BHT body hair transplant in a large sample of Dr. U’s own patients

Dr. U on hair loss in the New York Times

Does hair loss result from bumps on the back of the head due to Acne Keloidalis Nuchae? If so, what options do patients have for restoring their hair back to a normal looking appearance?

Hair loss can certainly result from Acne Keloidalis Nuchae (AKN), a condition which manifests as varying sizes of bumps on the back of the head. To understand how this form of alopecia occurs, it is important to realize that with this condition, an amplified skin healing response (which is related to a genetic predisposition) is triggered by the presence of the individual’s own hair. 

The hair follicles are no longer able to produce new hair shafts as they once did. Due to the extensive damage inflicted, the skin produces large amounts of thick collagen with the intent of repairing itself. These processes are the basic causes of AKN related hair loss, following the formation of bumps on the back of the head.

It is very important to have this awareness, especially with the widespread misconception that Acne Keloidalis Nuchae is the result of unclean barber clippers and can therefore be treated with DIY (e.g. rubbing alcohol and apple cider vinegar) approaches aimed at addressing bacteria

Is It Possible to Restore Hair In Acne Keloidalis Nuchae Sufferers ?

Understandably, the hair loss which occurs due to AKN can be disheartening for most patients. While it is actually not possible to regrow hair in the areas that have been affected, surgical or laser treatments can be employed to produce more discrete or natural looking outcomes. The exact approach used would determine the type of result which can then be achieved.

An Improved Appearance Through A Raised Posterior Hairline or Sparser Hair Density Following Laser Treatment

New improvements in laser treatment for Acne Keloidalis Nuchae result in better cosmetic outcomes for patients. Depending on the severity of the presentation, they may result in a raised posterior hairline or sparser hair density, coupled with a more natural-looking form of hair coverage. 

To see how these improvements are attained and why they make a positive difference for patients, a good starting point is to first understand the rationale beyond the procedure.

In essence, the aim of a laser treatment would be to epilate (i.e. remove) hair so that it no longer perpetuates and sustains the progression of Acne Keloidalis Nuchae.

Dr.U has outlined specific treatment zones for epilation, based on the spread of the AKN lesions. As one example, if small lesion bumps are concentrated in the lower part of the nape area, the treatment zone would require that all hair is removed within this region, rather than just addressing the individual bumps on the back of the head which would leave a patchy appearance. This would cleanly raise the posterior hairline above an area where hair  has been entirely removed. The end result is far more natural looking in appearance. And many patients would prefer this to having empty regions surrounded by hair.

If the bumps on the back of the head have spread much further up the scalp, Dr.U recommends giving individuals the option to retain some hair, versus completely epilating the entire back of the head. Patients would then be able to retain more styling choices (e.g. short buzz cut).

AKN laser treatment shown before and after procedure with a rather unnoticeable raised posterior hairline and a cohesive region of hair left in tact.

Posterior Hairline In Alignment with Linear Scar

For large-sized lesions, Dr.U has developed a specialized surgical removal technique where the lesion is excised according to a bat-shaped contour. When the wound-edges close together, this results in a linear scar which is then discretely aligned with the posterior hairline and inconspicuous to onlookers.

Large AKN lesion excised with resulting linear scar discretely aligned with posterior hairline

Large AKN lesion excised with resulting linear scar discretely aligned with posterior hairline

Thin Linear Scar Covered By Hair 

Trichophytic closure results in a thin linear scar through which the patient's own hair grows through

Trichophytic closure results in a thin linear scar through which the patient’s own hair grows through

A small sized lesion in the upper part of the nuchal area can be excised. Dr. U has developed The appearance of the wound closure outcome can be improved upon using a method known as Trichophytic closure, an approach used in strip surgery. This is where the upper and lower wound edges are cut at specific angles to produce a more seamless looking end-result when they are closed-together. The lower wound margin would also contain decapitated hair follicles. 

The purpose of this  would be to grow hair through the upper wound margin and resulting linear scar, providing an additional form of camouflage. 

With these surgical methodologies, Acne Keloidalis Nuchae patients are now have new alternatives which are capable of closely approximating the appearance of restored hair. This includes less noticeable scarring and an improved cosmetic appearance through a more normal looking posterior hairline.

Further Reading

Read more about punch size and its relation to pain experienced by the patient 

Did David Beckham have a hair transplant? Find out more here

Does FUE punch size affect how painful a procedure will be?

I’m about to undergo an FUE hair transplant surgery. I’ve heard a lot about how low-risk it is, but I still have my reservations. Will FUE treatment be painful? What are the side effects of hair transplant surgery? What factors determine how painful an FUE transplant will be?

 

Pain is a subjective experience. People of varying personalities, cultural backgrounds, ages, and dispositions will often express wildly differing accounts even when exposed to the exact same set of physically painful stimulation. The amount of pain after FUE hair transplant will depend on a number of factors.

With that being said, it’s natural to assume that if you’re having any type of incising done, you’re likely to experience pain after FUE hair transplant, even if it’s minimal and bearable.

 

Minimizing Pain after FUE Hair Transplant and FUE Hair Transplant Side Effects During Your FUE Treatment

Just like with any type of hair surgery, plenty of measures will be taken against pain after FUE hair transplant by the hair surgeon on behalf of the patient.

Chances are, your hair surgeon will administer local anesthesia wherever you’re having work done to minimize pain during FUE hair transplant. This will greatly diminish the hair grafting side effects that would normally be experienced otherwise.

In order to stave off any psychological effects that may be brought about by the mere thought of having your hair extracted through the means employed by FUE hair surgery, you’ll generally be given the option to watch a movie or television to distract yourself from the FUE procedure itself. This also will have a mitigating effect on any pain during FUE hair transplant you may feel.

FUE punch size may play a role in the amount of pain a patient experiences during FUE hair restoration – the bigger the punch, the larger the wounds inflicted, after all. Do bigger wounds mean more pain?

 

FUE Punch Size and Pain

 

Even as an incredibly low-risk and non-invasive cosmetic procedure, the patient must accept that discomfort and pain after FUE hair transplant is simply something that comes along with an FUE hair transplant. No matter what size FUE punch your hair surgeon decides to use for your procedure, it’s reasonable, as with any type of surgery, to expect some degree of pain after FUE hair transplant and during. It’s fair to say that a wider wound may hurt more than a smaller one. Again, this is subjective. Where FUE punch size becomes much more relevant in the aftermath of your FUE hair replacement (aside from the amount of pain after FUE hair transplant) is FUE scarring.

The size of the punch will be the ultimate determining factor when it comes to the diameter of each puncture wound left behind as your hair surgeon harvests each graft. Dr. U’s Dr.UPunch i ™ is of the highest caliber when it comes to the way it allows your FUE practitioner to excise incredibly hardy grafts while at the same time minimizing the size of the wounds imposed.

The Dr.UPunch i ™ boasts a dual-diameter design. The expanded inner chamber, much wider than the initial diameter of the distal cutting edge, gently expands the incision without tearing into it. More of the tissue surrounding the graft is collected as the follicle is excised, making it much more likely to survive when transplanted to the donor area. Most patients will agree that the results they achieve are well worth any pain after FUE hair transplant.

 

Other Frequently-Asked Questions About the Side Effects of Hair Transplant Surgery, FUE Punch Size, and Pain After FUE Hair Transplant

Is FUE safe?

When performed by a certified professional, without a doubt. FUE hair replacement is a minimally-invasive cosmetic procedure, and as such is far from life-threatening even in the worst possible scenario.

What side effects of hair transplant surgery, such as pain after FUE hair transplant, can I expect after my FUE procedure?

The side effects of hair transplant surgery are generally very mild, especially when compared to those of other types of hair restoration surgery. You can safely assume your chosen donor area will swell and bruise slightly as the FUE wounds scab over immediately after the surgery. These hair grafting side effects will usually subside after a few days. Some pain after FUE hair transplant (or any other type of surgery, for that matter) is to be expected. If you experience significant, unrelenting pain after a week or so and suspect that you may have developed an infection in the area, let your hair surgeon know right away.

Do bigger FUE punches hurt more than smaller ones?

That’s hard to say; the pain after FUE hair transplant one feels will depend greatly on the level of pain tolerance of the individual. Larger wounds may take longer to heal and this may translate into a longer period of pain after FUE hair transplant. With that being said, however, even though a bigger wound may aggravate more nerve endings objectively, it’s safe to say that the actual size of the FUE punch used probably won’t have a significant impact on the amount of pain after FUE hair transplant experienced. 

 

Further Reading

An article on why hair transplant surgery is on the rise

A general overview of the FUE process

Is an FUE hair transplant possible for somebody with Afro-textured hair?

 

My type 4 hair is thick and kinky. Is an FUE hair transplant an option for patients like me?

 

If you would have asked this question even a few years ago, the answer, unfortunately, would have probably been “no”.

 

Due to the lack of properly-advanced hair restoration technology available, patients with Afro-textured hair would sometimes turn to invasive strip surgeries as a solution. This would often leave them with prominent scarring.*

Due to the lack of properly-advanced hair restoration technology available, patients with Afro-textured hair would sometimes turn to invasive strip surgeries as a solution. This would often leave them with prominent scarring.*

 

Thanks to the ingenuity of cosmetic hair surgeon Dr. Sanusi Umar, however, the playing field has been leveled when it comes to Afro-textured hair restoration. The Dr.UGraft™ suite of FUE tools is able to effectively harvest hair of any texture from all areas of the body.

 

Thanks to Dr.UGraft™, this patient was able to hide the strip surgery scar on the back of his head and simultaneously restore his receding hairline.*

Thanks to Dr.UGraft™, this patient was able to hide the strip surgery scar on the back of his head and simultaneously restore his receding hairline.*

 

What allows Dr.UGraft™ to effectively excise curly, Afro-textured hair?

 

The exclusive features Dr. U has imbued the Dr.UGraft™ system with include, but are not limited to:

 

  • A flared, textured distal tip with a cutting edge that faces away from the follicle graft housed within. The dull inner wall protects each specimen from transection, increasing overall yield. This specially-designed FUE punch guides the tool around the C-curve that Afro-textured hair typically grows in, safely and viably harvesting each unit for use elsewhere.

 

  • A graduated, expanding inner chamber to extract bulkier grafts without increasing the size of each punctuation. Wounds created with a punch of this shape are less everted than those incurred by traditional FUE punch tips. As a result, scars from a Dr.UGraft™ procedure tend to heal flatter and more discreetly.

 

  • Foot pedal-operated irrigation that allows your doctor to rescue grafts that become impacted in the lumen during surgery. This feature also hydrates each graft at the point of extraction, preventing each one from becoming dehydrated while waiting to be transplanted.

 

All of these unique innovations and more come together to form a system that can effectively restore the hair of any patient using hair from anywhere on the body. Tightly-curled, Afro-textured hair and a thick outer dermis no longer disqualify you from being a potential candidate. If you’re an individual of African or indigenous descent and you suffer from major hair loss, an FUE hair transplant is now a viable option for permanent relief.

 

One of our most successful examples of Afro-textured FUE hair restoration to date.*

One of our most successful examples of Afro-textured FUE hair restoration to date.*

 

Frequently Asked Questions – Dr.UGraft™ and Afro-textured FUE Hair Restoration

 

What makes extracting Afro-textured hair so challenging in FUE hair transplant surgery?

With straight, Caucasian hair, the path of growth characterizing each follicle is predictable and usually doesn’t deviate from what is seen above the skin. Traditional FUE punches are straight-mouthed, allowing little room for error on the part of the operator. If not carefully navigated, these older generations of tools tend to punch right through the graft, destroying the delicate membrane of the sheath surrounding it and rendering it impotent. This leads to poor graft yield and less hair to populate the recipient area with.

 

How does the Dr.UGraft™ system overcome this limitation?

The Dr.UGraft™’s intelligently-flared tip protects the fragile graft from the sharp blade of the mouth. With this wider window through which to engulf the specimen, combined with Dr.UGraft™’s patented grip, score, and pull functionality, the graft is kept safe within the walls of the lumen while it is separated from the surrounding structures anchoring it in place. 

 

Learn More About FUE Hair Restoration with Dr.UGraft™

 

The Dr. U Hair Clinic in Los Angeles has released this informational video on our revolutionary FUE hair transplant system. It lays out each patented feature out graphically. You can learn more about the Dr.UGraft™ revolution by checking it out below:

 

 

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