What is a true follicular unit graft?
When viewed with a microscope or high powered glasses, one can see that scalp hair grows from the scalp in unique bundles or units, consisting of 1-4 hairs, (on average 1.8 hairs per follicular unit). True follicular unit microscopic dissection is when follicular units are dissected with microscopes into these 1-4 haired naturally occurring units, keeping the hair bundles intact as they naturally grow. There is a small fibrous band around each unit that keeps it together. When a follicular unit of, for example, 3 hairs is further dissected into 3 1-haired grafts, that graft is no longer a true follicular unit but a graft cut down to size. The graft’s integrity is now compromised and there is the concern of graft damage. Follicular unit extraction, where grafts are cut out at the source at the scalp 1 at a time, does not always yield a true follicular unit. This is because the .6 mm to 1 mm rotating drill used to cut out the graft may cut into a follicular unit and only extract a portion of the hairs in that unit.
Exclusive follicular unit transplantation can be used to treat a bald frontal scalp with 1 session to give a natural feathered hair line appearance. Only 1-haired follicular units would be used to reconstitute a hair line, then adding 2- and 3-haired single follicular units as one goes further behind the hair line. In some instances, to give added fullness behind the hair line, 2 individual follicular units, very close together, otherwise called a follicular unit families, may be employed. The decision to use all single follicular units or a mix of single follicular units and follicular unit families is made at consultation with our doctor and the patient.