Follicular unit transplantation for male pattern baldness: evaluation of first 250 cases

Muhammad Ahmad, Nabila Ahmad


Objective To restore hair, making the scalp look natural, by using follicular unit transplantation technique.


Patients and methods Hair transplantation surgeries were performed on consecutive 250 patients between the ages of 24-69 years by ‘follicular unit transplantation (FUT)’ method from January, 2006. Patterns were classified according to the age group. All the procedures were done under local anesthesia as an outpatient procedure. A small strip of scalp containing hair with dimensions of 15-20cm x 1.5-2.1cm was excised from the occipital regions with the patient in prone position. The donor area was closed primarily using a non-absorbable 3-0 material with lower edge trichophytic closure technique. The hair-bearing strip was dissected into units containing clusters of one, two, three, and four follicles, under magnification. The anterior hairline was drawn preoperatively on each patient. Implantation of the follicular units was initiated immediately after the slits formation. A minimum of 1500 and maximum of 3235 follicular units were placed in one session. Transplanted areas were left open without any dressing. The donor area was covered with a small dressing which was removed the next morning. The first washing was started after 48 hours. The donor area stitches were removed after 10-12 days.


Results The mean age of the patients was 36.6 years. Majority of the patients (65.2%) were in 21-35 years age group. 28% of the patients belonged to type V of Norwood classification. The transplanted hair entered into the ‘telogen’ phase and were lost within 2-4 weeks. The regrowth started in the third month, but it varied from patient to patient. The results were achieved in 8-9 months. No hematoma, infection or necrosis was observed in the early postoperative period. Mild periorbital edema was observed in 9 patients only, however, it disappeared in the first week. Two patients displayed the inclusion cysts which were managed by drainage and, topical and oral antibiotics.


Conclusion Good planning, carefully prepared follicular units, and careful placement provide results that was satisfying for both the surgeon and the patient.



Follicular unit, hair transplantation, male-pattern baldness, androgenetic alopecia, follicular unit transplantation

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