Follicular Evolution - from big grafts to micro grafts to ultra refined grafts.

Surgical hair restoration has dramatically evolved from the big round “plug” grafts of the 1960’s and 70’s, to the “mini micrografts” of the 80’s and early 90’s, to modern hair transplant procedures using entirely follicular unit grafts.

More recently, hair restoration surgery has gone through another important evolution that is improving both the naturalness and fullness that can be achieved from any one surgical hair transplant session.

Ultra Refined Grafting - Smaller Blades, Incisions and Grafts.

Today’s micro surgical blades, like the size of hair grafts, have become ever smaller and now enable hair transplant surgeons to safely make more tiny graft incisions in a given area than ever before. Surgeons are then able to “dense pack” select areas with as many as 40 to 60 follicular unit grafts per square centimeter. This graft density is as much as twice that of the standard follicular unit hair transplant procedure.

Such high densities of transplanted hair typically produce the appearance of fullness even after only one surgical session. Patients also experience rapid healing and no visible skin distortions due to the tiny size of these incisions.

Ultra Refined Follicular Unit Grafting - Hard on the clinic but easy on the patient.

Ultra refined follicular unit grafting raises the bar for physicians and their staff. This delicate and demanding hair transplant procedure requires more skill and careful attention to be performed properly. The smaller and more tightly packed incisions require more closely dissected follicular unit grafts that are carefully trimmed under microscopes or excised under nominal duress via Follicular Unit Excision (FUE). These small and densely packed incisions are also more difficult to place the grafts into.

This procedure also requires more careful patient selection, as “dense packing” of grafts is not appropriate for all patients.

Ultra Refined Follicular Unit Transplantation – the new “Gold Standard”.

In the hands of a highly skilled hair restoration surgeon and staff the Ultra refined follicular unit hair transplant procedure can achieve excellent new hair growth that is so natural that it is undetectable even under close scrutiny.

While the standard micro “follicular unit” hair transplant does produce natural looking results, its ability to achieve high density in only one surgical session is limited. Thus patients may have to do subsequent surgical sessions in a transplanted area to achieve a full look.

The many patient benefits of this new procedure are significant and include:

• The ability to get excellent hair density in only one surgical session.
• Minimal trauma in the graft recipient area with rapid post surgical healing.
• Little or no visible pitting or distortions in the transplanted areas.
• More natural direction and angulation of the transplanted hair.
• Today hair transplant surgeons can control and vary the angle and direction of tiny graft incisions to a high degree. This enables the transplanted hairs to grow out at natural angles and directions.

The Lateral Slit Technique.

Many of the physicians recommended on this site use this lateral slit technique (also known as “coronal” or “perpendicular” grafting) exclusively or in combination with other techniques.

The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

Ultra Refined FUSS and FUE Hair Transplants

Ultra refined follicular unit grafting can be accomplished via strip surgery (FUSS) or follicular unit excision (FUE) formerly Follicular Unit Extraction. 

These two distinct techniques have to do harvesting follicular units from the donor area while ultra refined follicular unit grafting has to do with creating tiny grafts and dense packing them into minimally invasive recipient sites. 

Thus, as long as a hair transplant surgeon can harvest tiny follicular units via FUSS using microscopic dissection or via FUE using an appropriate device and can densely pack them into small, minimally invasive incisions with maximum growth and results, then the physician is performing ultra refined follicular unit grafting.

Surgeons who perform Ultra Refined Follicular Unit Hair Transplantation.

While all the physicians recommended on this website perform quality follicular unit hair transplants, only some of them are capable of performing large sessions of ultra refined follicular hair transplantation.

However, all members of the Coalition of Independent Hair Restoration Physicians perform ultra refined grafting with excellent results.

Learn more about the Coalition and its outstanding member physicians.