Hair loss affects up to 85 percent of men and 40 percent of women. Follicular unit transplantation (FUT) and other hair transplants are minimally invasive surgeries to help cover bald spots caused by hair loss.

Hair transplants date back to at least 1939 in Japan. In the early days, the results usually looked unnatural and gave a plug-like appearance. It wasn’t until surgeons first started transplanting individual hair follicles (also known as follicular units) in 1995 that hair transplants started giving natural-looking results.

There are two predominant types of hair transplantation currently in use:

  • Follicular Unit Extraction (FUE)
  • Follicular Unit Transplantation (FUT)

In FUT surgery, a surgeon cuts a strip of skin from the back or side of your head and extracts individual hair follicles. These follicles are then inserted into the balding parts of your scalp. The surgery works best at covering a receding hairline caused by male pattern baldness.

Keep reading to find out what you can expect during FUT surgery, who the best candidates are, and how FUT differs from FUE.

During FUT, a surgeon cuts a strip of skin from your scalp, usually from the back of your head. The exact size of the strip depends on the number of follicles needed to cover bald spots. The strip usually doesn’t exceed 1 to 1.5 centimeters (0.4 to 0.6 inches) wide. Once the individual follicles are removed from the strip, they’re re-inserted into your scalp.

Hair transplant surgeries take between 4 and 8 hours. FUT surgery is generally quicker than FUE surgery. Most people stay awake during the surgery with a local anesthesia that numbs their scalp.

Here’s what your procedure will likely look like:

  1. The surgeon will re-draw your hairline, mark the area of hair extraction, and take photographs for your medical record. You may have the option of taking a sedative before surgery. Local anaesthesia will be applied to your scalp to numb it.
  2. The hair at the donor site, where your hair is removed from, will be trimmed to about two millimeters.
  3. The surgeon will cut out the strip of skin with the hair follicles that will be used as a graft. You’ll stay awake during the surgery.
  4. A technician will remove individual hair follicles from the strip and prepare them for transplantation.
  5. The surgeon will close your scalp with sutures.
  6. The hair follicles will then be inserted into the balding parts of your scalp in a pattern that looks natural.
  7. An antibiotic and bandages will be applied to your scalp.

Most people see results from the surgery in 6 to 9 months. Some people have to wait a year to see results.

Microscopic follicular unit transplantation is a term that refers to either FUT or FUE hair transplantation. FUT surgery is also called Follicular Unit Strip Surgery (FUSS).

Both FUT and FUE transplants require you to have enough hair on your head to use as a graft.

Men with androgenic alopecia (commonly called male pattern baldness) make the best candidates for FUT. In men, this condition commonly appears in the Norwood pattern or an M-shaped hairline with hair loss at the temples. Women with this condition usually experience the Ludwig pattern, which causes hair loss along the hair part or thinning at the top of the head.

If a medical condition like a thyroid disorder or alopecia areata is causing your hair loss, FUT surgery likely won’t be an option.

The following conditions also make you a good candidate for FUT surgery:

  • Age. FUT is generally performed on people over the age of 25. Hair loss patterns are less predictable in younger people.
  • Diagnosis. Men with the Norwood pattern of hair loss tend to respond best to hair transplantation.
  • Hair thickness. People with a high hair follicle density generally receive better coverage.
  • Area of balding. FUT is most useful for treating hair loss at the front of the head.
  • Hair color. People with a hair color similar to their skin color generally make better candidates since they have less color contrast.

FUT and FUE both involve transplanting individual hair follicles. During FUT surgery, a surgeon cuts a strip of skin from the back or side of your scalp and then extracts the hair follicles. In FUE surgery, your surgeon will remove individual hair follicles directly from your scalp, rather than first taking a strip of scalp skin.

FUE is currently the more common surgery. Some of the advantages of FUE include:

  • quicker healing time
  • less pain after surgery
  • doesn’t cause a significant scar
  • hair from other body parts can be used
  • can be used even if you have poor hair density

Some advantages of FUT include:

  • may be a better option if you need a large number of hair follicles grafted
  • shorter operation time
  • cheaper surgery

Complications after FUT are rare. A large supply of blood to the head allows it to heal quickly and helps prevent infections. Less than one percent of people develop an infection from the surgery.

Some potential complications include:

  • unnatural looking hair
  • bumps or scarring
  • inflammation of hair follicles (folliculitis)
  • bleeding
  • swelling
  • pain
  • numbness
  • cysts

FUT scarring

FUT surgery leaves a scar at the site of hair removal. The scar will fade over time but is permanent. The size of the scar depends on how many hair follicles were used during surgery. The scar is generally hidden by your hair, but it may be visible if you keep your hair short.

Shock hair loss

Donor hair effluvium is commonly referred to as shock hair loss. It’s a common occurrence where transplanted hair falls out within two months after surgery. The hair almost always grows back within four months.

The average cost of FUT hair transplant may be between $4,000 and $10,000. The price may be even higher at some clinics.

Some factors that can determine the cost include:

  • Amount of hair being transplanted. Most clinics charge by the number of hair follicles being transplanted, but some clinics offer a fixed price.
  • The surgeon. The price of surgery varies between clinics and the experience of the surgeon.
  • Location. Clinics in some cities may charge more for FUT surgery.
  • Travel costs. If you have to travel for your surgery, you should also budget for travel expenses.

It’s unlikely that your insurance will cover FUT since it’s usually considered a cosmetic surgery. It may be covered in some instances if you’ve lost your hair from burns or trauma.

Some clinics offer payment plans to pay for the surgery over several installments

FUT surgery is a method of extracting hair follicles from the back or side of your scalp and using it to cover bald spots. The surgery is considered generally safe and can create a natural-looking result if done properly by a trained surgeon. The surgery leaves a scar at the site of hair extraction, so if you usually wear your hair short, FUE surgery might be a better option.