Rafael Nadal, world tennis champion, is reported to have undergone a 4,500 unit follicular unit graft transplant in 2016. He opted for donor site extraction using the follicular unit extraction (FUE) technique. While the report from the UK Mirror newspaper did not show before and after photos, it did indicate that Nadal was seen sporting a short haircut. The paper also reported the transplant procedure took more than 10 hours. These few facts suggest that he did have a a follicular unit graft (FUE) procedure as opposed to a strip harvest. It also demonstrates some of the drawbacks of FUE.
The state of the art in hair transplant is follicular unit grafting (FUG) or sometimes called follicular unit transplant (FUT). The idea is to take small follicular units – 1-5 hairs – and transplant them into the scalp. The hairs are harvested from areas that are not susceptible to androgenic alopecia. These areas include the sides and the back of the scalp. The harvest can take place either by removing a strip of hair which leaves a linear scar or through follicular unit extraction (FUE). FUE removes individual hairs using a special motorized punch. The hairs are then automatically 1-4 hairs. The down side of the follicular unit extraction technique is that the hair has to be shaved and the procedure can take much longer than strip harvesting. FUE also runs a greater risk of damaging hair follicles making them unusable for transplant.
Hairline Design with Hair Transplant Surgery
Regardless of how the hairs are harvested, they are all placed the same way. Small follicular units of 1-5 hairs are placed with a random but patterned approach. The pattern and direction of hair placement will depend on the area of transplant. The number of follicles per graft will also depend on the location where the hair is placed. Final results are seen in 6-12 months as the hair has to have time to grow.