The procedure is performed in our office under local anesthesia and usually takes 2-5 hours depending extent of hair loss to be transplanted. There are two techniques used for removing donor tissue – elliptical donor harvesting and follicular unit extraction (FUE). Both result in consistently natural appearing transplanted hair. Elliptical donor harvesting is performed in the majority of patients.  Elliptical donor harvesting is the most efficient method for removing the largest number of grafts for a patient during a procedure.  The donor hair is taken from the back of the scalp under local anesthesia. The donor ellipse is closed with sutures that are removed 7-10 days after surgery. The patient’s existing hair on the back of the scalp will cover the sutures and resulting scarring, so that even the day after surgery no sutures or scarring are evident.

The donor scar will not be visible unless a patient decides to shave or wear their hair very short.  In patients that would like to shave their posterior scalp there is an alternate technique for harvesting  natural 1-4 follicular groupings using 1mm trephines called follicular unit extraction ( FUE).  The primary advantage of FUE is no visible donor scar with closely cropped or shaved hair. The disadvantages of the technique include longer operating time for donor harvesting with less donor hair removed per procedure. A patient undergoing FUE will need 2-4 procedures to obtain an equal number of grafts an ellipse can produce in a procedure .

In a donor ellipse hair follicles are separated into its natural follicular hair groupings, or grafts. A staff of 3-5 highly skilled surgical assistants with thousands of hours of hair transplant experience typically creates 400-1800 grafts in 30-60 minutes.

While the 1-4 hair grafts are being created, the patient’s recipient sites (balding skin) is anesthetized under local anesthesia, and hundreds or thousands of recipient sites are created using a needle so small no scars or textural changes occur in the frontal scalp. They are created in a dense but random manner throughout the balding scalp to produce the maximum density possible with each surgery, while appearing completely natural one and even thirty years after surgery.

During the procedure the patient can watch a movie, listen to music, take breaks to go to the restroom or simply talk with the hair transplant team.

Once all the grafts have been created they are placed into the pinpoint incisions using fine microvascular forceps where they heal overnight by natural clotting factors.

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