Hair Restoration (FUE vs FUT) - Visage Cosmetic Plastic Surgery

What Causes Hair Loss?

For many years, the preferred clinical treatment for hair loss was an invasive technique known as “strip” hair restoration, aka FUT (follicular unit transplantation). Although effective, the strip method leaves behind a scar and involves significant discomfort and recuperation time. As a leading hair transplant/restoration specialist in Toronto, Dr. Marc DuPéré prefers follicular unit extraction (FUE) for most patients —the technique and technology featured by brands such as NeoGraft®, ARTAS® and SmartGraft™. In the skilled hands of an expert, this innovative approach creates natural-looking results with minimal downtime and no visible scarring.

Hair loss can affect both men and women, although it can differ quite a bit between the sexes. The distinctions between male and female hair loss shape the way the condition is treated.

In both men and women, hair grows in 3 stages: anagen, or the active growing phase, catagen, the brief transitional period, and telogen, the “resting” period during which the hair is inactive. It’s normal to shed a few dozen hairs each day. However, when the growth cycle is disrupted, more rapid hair loss occurs and thinning begins to become more noticeable.

In addition to normal male- and female-pattern baldness, hair loss can occur due to long-term nutritional deficiencies, stress, physical trauma such as a burn, scar, or a surgical incision. This type of hair loss can occur anywhere on the body where hair grows, including the eyebrows, eyelashes, beard area, arms, pubis, and legs. Dr. DuPéré can restore hair to these areas as well as the scalp.

Hair Loss in Men and Women

Men

Men are more prone to hair loss than women, and male patients make up a large portion of our hair restoration clientele. Typically, male hair loss, androgenetic alopecia (commonly called “male-pattern baldness”), first appears as a receding hairline. For some men, hair loss can progress quite slowly. For others, the transformation is faster. Hair may also begin to thin around the crown. Male hair loss can be categorized using the Norwood Scale, a tool for measuring the severity of male baldness.

Because the back of the head tends to be less affected by male-pattern baldness, this area is typically the preferred site for harvesting donor follicles.

Women

Although a very small number of women experience androgenetic alopecia, women typically experience hair loss in a different way. Both male and female hair loss often has a genetic component and a hormonal component. Women may be more affected by hormonal fluctuations. Unlike men, women tend to experience hair loss primarily at the crown, with the hairline being less affected. While thinning can extend beyond the crown, complete baldness in otherwise healthy women is uncommon. Female hair loss is classified using the Ludwig Scale.

Learn more about hair restoration for women.

Things Top Hair Restoration Surgeons Consider

One reason plastic surgeons are the best choice for hair restoration is their extensive training and comprehensive understanding of both aesthetics and scalp/hair anatomy. Unlike some providers, Dr. DuPéré takes into account numerous considerations when planning hair restoration.

The facial rules of thirds and fifths: That a well-proportioned face can be divided horizontally into thirds and vertically into fifths, with each eye taking up a single fifth.
Strategies for creating a natural-looking hairline that is not perfectly symmetrical
The PASSO algorithm, which stands for position of the hairline, angle of transplanted hair, shape of the hairline, and softness of the hairline
Lowering the hairline for transgender women
Long-term planning for maintaining good results, especially for patients in the early stages of hair loss
Techniques to increase the visual perception of hair, such as scalp micropigmentation
Potentially harvesting hair from non-scalp donor sites
Improving the appearance of a previous strip scar

FUT vs. FUE

Most experienced hair restoration surgeons, including Dr. DuPéré, are able to offer both FUT and FUE methods in Toronto. Although there are numerous differences between them, the key variations are as follows:

FUT, or follicular unit transplantation, is more commonly known as the “strip” method. This older form of hair restoration uses a strip of donor follicles, removed from the back of the head, and grafted to the scalp. It provides a large volume of high-quality hair, but leaves a long, linear scar and is associated with a longer recovery and more post-procedure discomfort.
FUE, or follicular unit extraction, can be achieved with systems such as SmartGraft® and NeoGraft®. FUE uses gentle pneumatic suction to harvest each follicle individually, usually from the back of the head, before grafting them to areas of thinning hair. This is a meticulous technique that requires an area of hair shaving but leaves no visible scars.

Why Do We Prefer FUE?

Superior, natural-looking results
FUE offers a shorter, simpler recovery than previous methods
No obvious scarring anywhere
Reduced discomfort after the procedure

Are You a Candidate?

Dr. DuPéré is highly experienced in the nuances of hair restoration, and recognizes that each unique patient requires a different, customized approach. Although FUE is the newer and more preferred method for many, some patients remain better candidates for FUT. Depending on the density of hair in donor areas and the estimated number of procedures one may need over time, several FUT or FUE procedures may be performed on a single patient over a lifetime. If you’re experiencing hair loss or hair thinning, you are likely a candidate for some form of clinical hair restoration. During your initial visit with Dr. DuPéré, you will explore the options available to you.

Your Hair Restoration Consultation

Your initial consultation with Dr. DuPéré is quite thorough. After a physical examination of your hair and a discussion of your hair loss history and relevant medical conditions, you can expect to review various hair restoration techniques, including the pros and cons of each technique. The two of you will also plan your procedure, including the number of grafts expected to be harvested and transplanted, the amount of time your procedure will take, and the number of procedures you may require in the future. Finally, Dr. DuPéré will work with you to ensure you have clear, realistic expectations about your results.

Dr. DuPéré encourages patients to bring along photos of parents and grandparents, both paternal and maternal sides. Becase hair loss typically has a genetic component, these photos can help Dr. DuPéré anticipate your needs.

Preparing for Your FUE Procedure

There are a number of steps you can take to ensure your hair restoration procedure is as safe, effective, and comfortable as possible.

Whether you have FUE or FUT, you and Dr. DuPéré will discuss and potentially adjust your use of over-the-counter products such as minoxidil (Rogaine®) or prescription finasteride (Propecia®) for some weeks before your treatment. For at least 1 week before your procedure, you should discontinue the use of the following:

Anti-inflammatories including aspirin, naproxen, and ibuprofen (Advil)
ADHD medications including Adderal, Ritalin, Concerta, and Vyvanse
Herbal supplements including vitamins and naturopathic medicines, omega-3, fish oils, vitamin E, etc.

If you use nicotine products or recreational drugs, please plan to stop for at least 3 weeks before your procedure and 3 weeks after. This minimizes the risk of potential complications and maximize hair survival. If you are taking prescribed blood thinners (eg. Coumadin, Plavix, Xarelto, Pradaxa, Eliquis, Heparin, etc.), please let Dr. DuPéré know during your consultation. You may need to adjust your dose before your procedure. You’ll also have a prescription for a post-op medication faxed to you several days before your procedure. We recommend filling this as soon as possible so you have it on hand after your appointment.

The night before your procedure, wash your hair with an antimicrobial shampoo such as DIAL soap/shampoo or Anti B antibacterial shampoo. Please do your best to get a good night’s sleep beforehand, and eat a hearty, nutritious breakfast before you come to the office UNLESS you are having an intravenous sedation. Patient undergoing intravenous sedation will not be allowed to have anything to drink or eat 8 hours before the procedure.

Plan to wear comfortable clothes that can be soiled. Shirts and tops that button or zipper are preferable to styles that must be pulled over the head, since you can remove them without disturbing your treated area.

Please feel free to bring along a device on which you can listen to music, as well as earbuds (not headphones). Leave your jewelry and valuables at home. Although you can drive to your appointment, you’ll need a trustworthy adult to come pick you up and drive you home.

Pack a high-top, loose-fitting, adjustable baseball cap to wear after your procedure. Baseball caps are preferable because they can be adjusted to accommodate dressings and bandages.

Your Procedure Experience

We begin your appointment by taking a series of photos of your treatment area to be used as “before” pictures. We typically administer a light oral sedative, although intravenous or gaseous sedation is also available. We use a nerve blocker with local anesthetic to keep you comfortable, repeating as needed throughout your treatment.
We shave your donor site, which makes it easier to harvest the follicles.

You’ll be lying on your back for the latter portion of the procedure. We have a TV with Netflix, so you’ll be able to watch what you’d like. Depending on the number of grafts required, you should plan to be at the clinic for most of the day.

We will provide you with a light lunch, so there’s no need to bring your own or go out. Please let our staff know if you have any allergies or intolerances.

After your treatment is complete, Dr. DuPéré bandages and dresses your head.

Recovery & Results

Once you return home after your treatment, you can manage your discomfort with mild narcotics. Most patients require prescription medication for about 48 hours after treatment before transitioning to over-the-counter anti-inflammatories.

Dr. DuPéré recommends spending the first 2 days resting at home. This will minimize unnecessary swelling over the forehead and around the eyes (with hairline procedure) and discomfort. Most patients return to their normal routines after the initial 48-hour resting period. Refrain from working out or engaging in strenuous activities for 10 days.

We recommend wearing a clean, high-top adjustable hat (one that does not touch the treated areas) for several days after your treatment. A loose bandanna or scarf is also a suitable option.

Your transplanted hair will always behave like the hair from where it came. It is likely to survive for quite a long time, although hair loss can progress. This is why photos of your relatives are helpful during the consultation and planning process.

With our comprehensive approach, there is a good chance that hair restoration is right for you. Learn more. Request your consultation online or call Visage Clinic at (416) 929-9800 to begin planning your process.

Hair restoration is generally safe, although localized symptoms and discomfort after treatment are common and transient.
When you need to lie down, keep your head angled upward, either in a reclining chair or with the aid of pillows.

Cosmetic Surgery / Hair Restoration (FUE vs FUT)

FUE Hair Restoration