Types of Hair Transplantation

All surgeries at Dr. Sparano’s New Jersey Institute for Robotic Hair Surgery are performed using either follicular unit transplant (FUT) or follicular unit extraction (FUE) techniques. These differ primarily by the way the hair is selected from the donor site at the back and sides of the scalp. Our FUT technique is performed by classic “strip procedure” or “strip surgery” methodology. Our FUE technique at this time is nearly always performed with use of the Artas® robotic system (occasionally referred to as RFUE). At times we use a purely manual FUE technique with use of the S.A.F.E. system.

Strip Surgery

Simply speaking, strip surgery involves two long, linear, adjoining incisions across the back of the scalp of varying width ranging from 0.9 – 1.2 cm, and of varying length. A strip of skin with associated hair follicles intact is excised without trauma to the deeper tissue planes. The tissue is closed using careful plastic surgical techniques, including when indicated, a trichophytic closure. The strip is carefully and microscopically dissected among a team of experienced hair technicians into naturally-occurring individual follicular units of 1-, 2-, 3-, 4-, or 5+ hairs. Once thorough dissection is complete, the team begins the transplantation process. The individual follicles with associated hairs are placed into the pre-planned surgical design delineated by Dr. Sparano.

Depending on the size of the surgery, the procedure takes most or all of a clinical day. Dr. Sparano and his team perform only one dedicated surgery each day. The sutures across the back of the scalp remain in for 10-14 days. There is no use of bandages, only carefully studied medicated gauze, ointments, and shampoos.

Robotic FUE

The vast majority of Dr. Sparano’s surgical cases are performed with use of the Artas® robot. This system utilizes follicular unit extractraction (FUE) technique, in which individual follicles are harvested from the back or sides of the scalp “one-by-one.” There is thus no need for long, linear incisions for follicular unit harvest. While this technique has traditionally been a tedious, long, and difficult one, the technologic advances available by use of the Artas® robot has changed the threshold for patient candidacy considerably.

In short, hair along the back and sides of the scalp are shaved to about 1mm in length. The robot is programmed to select the best hairs as per Dr. Sparano’s preferences, and to execute follicular unit extraction along parameters designed to optimize the outcome. Every follicular unit harvested is then studied and potentially trimmed by the technician team. As in strip surgery, the individual follicular units are then manually placed in accord with the pre-planned surgical design created by Dr. Sparano. While the robot is capable of incision-site making and (in forthcoming fashion) placement of follicular units, we believe a surgical team’s manipulation during the final stage of surgery provides the most aesthetically-pleasing results.

For more information about the Artas® robot technique, please follow this link.