Today, there are two fundamental approaches to hair transplantation.

The first—which seems to be the most popular among Quebeckers—consists of grafting follicular family units. In the vast majority of cases, two sessions are required at a one-month interval.

The second approach consists of grafting pure follicular units. The transplantation can be done during a single session and, on average, it is possible to transplant 40 to 45 follicular units per square centimetre. With this option, very high numbers of grafts are transplanted, in the order of 3,000 to 4,000 in the case of a large surface (≥ 100 cm²).

An infrared diode laser technology has been in use for the past 8 to 10 years in the United States and Europe. When the laser is applied to the scalp, it produces a biostimulatory effect with anti-inflammatory properties, thereby stopping post-treatment hair loss. (The laser is manufactured by MedPro.) People with hair loss develop a perifollicular inflammation that decreases cell metabolism and “strangles” the follicles. The follicles begin regressing and hair becomes increasingly fine and no longer grows as fully as it once did. This phenomenon is known as miniaturized hair follicle regression. Obviously, the hair will eventually fall out and new hair growth will cease. This loss of hair is what is referred to as baldness.

Since hundreds of years, men have used countless ways to hide their baldness. Wigs and hairpieces are good examples. In modern-day times, traditional methods still exist, but they are described in confusing terms: non-surgical micrografting, weaving, “folligraph”, etc.

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Hair loss, which affects a significant percentage of men and a minority number of women, is largely due to a genetic factor. Other factors, such as disease or side effects of medication, may also be responsible for hair loss.

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This is a technique of harvesting that doesn’t affect the way the hairs are implanted which involves removing the follicular units one at a time at the back of the head with a manual or motorized circular scalpel. This technique is recommended if one wishes to avoid a linear scar at the back of the head. But it’s important to note that it often leaves circular or patterned scars which are undesirable if someone wishes to save their hair.

In recent years it’s become possible to use a robot to collect the follicular units by FUE method. The software is apparently able to determine the approximate angle of the follicular units in order to allow their extraction with the greatest possible success. Despite what the manufacturer and some physicians-users claim, the level of transections – damaged follicular units – can be as important, if not more important, than with manual FUE if the patient selection is not perfect. This means that the percentage of potential patients for this approach may be very small. Its biggest disadvantage is its cost, which is considerably more for the patient.

The selection of follicular units by robots is always done at random. The doctor doesn’t have control over the total number of hairs that will be implanted, which can reduce the appearance of volume. The technology is developing rapidly, however, and perhaps we will see robots becoming more efficient than the human hand in the future. This remains to be seen.

This is an approach that, at first glance, seems quite new and innovative, but that ultimately involves using a surgical technique that has existed for twenty years. In contrast to the FUE where we have an average of 2.1 hairs per graft, it offers the possibility of grafting up to 4 to 5 hairs per graft, sometimes more, by judiciously grouping follicular units together during the preparation under the microscope (Multiple Follicular Unit Graft). The technique requires strip sampling and dissection under microscope.

Getting through the maze.

Several tools and techniques are now at our disposal to permanently treat baldness. However, it’s difficult to determine which approach works best due to variables such as degrees of baldness, hair types, budget, etc., and also to clearly understand all these technologies.

Yes, it is possible to use the hair transplant procedure to correct the appearance of eyebrows! Using powerful microscopes, the pure follicular unit transplant approach enables us to retrieve from the donor area single strands of hair that we then transplant to the bald sparse areas of the eyebrows. The results are very impressive.

Dr Alain Sabourin pure follicular unit transplant approach can also be used to transplant hair to the temples. The hair on the temples, located on either side of the front of the head where the hair points down, may gradually recede with baldness and create the impression of a wide forehead. Follicular units with 1 or 2 hair strands can be transplanted on the temples to give the face back its structure and greatly rejuvenate appearance. Here, our success resides in the ingenious and delicate use of a specific type of incision ( coronal incision) to ensure the perfect exit angle of each hair from this area of the scalp. This creates an extremely natural and undetectable appearance.