Grafts or follicular units are the basic building blocks of hair transplant. Earlier it was thought that hair grows as a single strand throughout the scalp. But then it was observed that human hair actually grows in bunches of 1-5 bundled together to form a single anatomic and physiologic unit. This was named the follicular unit and when it comes to hair transplant it is called a graft.
To the naked ye, it may appear that hair grows individually. However, if one trims the hair short and then looks at the scalp under magnification, the groups become readily visible. These hairs are grouped on the surface of the scalp because they represent the tops of the naturally occurring follicular units that lie below. It is the transplantation of these follicular units, rather than the larger mini-micro grafts or plugs that has revolutionized modern hair transplantation and the surgeons world wide, are able to achieve great looking results.
The follicular unit not only consists of a small group of hair follicles (three units are shown in the above photo on the left), but it also contains nerves, blood vessels and a tiny muscle called the erector pilorum.
A major advantage of using follicular units in hair transplant surgery is to be able to keep the recipient sites as small as possible.
The smaller the recipient sites, the closer together they can safely be placed in the scalp. Small recipient sites also allow larger numbers of grafts to be safely transplanted in one hair restoration session without injuring the scalp or compromising its blood supply. Therefore, using follicular units maximizes the density of grafts that can be transplanted in one session and the number than can safely be used at any one time.
The look of fullness in a follicular unit transplant is not only dependent on the number of hair grafts but on the number of hairs each graft contains. Since the hairs in the follicular unit are very close together, transplanting follicular units allows the most hair to be placed into the smallest possible recipient sites, giving maximum fullness to the hair transplantation procedure. This guarantees that these grafts will not appear pluggy, because follicular units represent the way hair grows in nature. Although using follicular units prevents a pluggy look, they must be placed in the proper direction and distribution to ensure a totally natural appearance to the hair restoration.
Using hair grafts larger than follicular units will always compromise naturalness in the hair transplant and using grafts smaller than follicular units will always result in less fullness.
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