The grafts are extracted as follows : the surgeon takes hair follicles from the back of the head using a very small punch. The punch is a circular bit the diameter of which varies between 0.7 and 1 millimeter, each follicular unit (FU) varying in size depending on the number of hairs it comprises.
The transplant procedure comprises 2 steps : first, all FUs required for the procedure are extracted and sorted by size (1, 2, 3 or more hairs). The sorting process allows for a more natural-looking recipient area as larger follicles give a more dense look. A larger follicular unit will typically be implanted at the top or back of the scalp whereas a small one will be used along the hairline at the front where hair is thinner.
FU extraction takes longer than the implantation process because it is a meticulous job : transection or follicle trauma must be avoided. The quality of the extraction process plays a large role in the overall success of the transplant. Transection rates usually vary between 20 and 50%, which means that up to half of the extracted hair will be lost in the process.
The FUs therefore have to be extracted in sufficient numbers to account for this unavoidable loss.
The second step of the procedure is the implantation of the follicles using a Choï implanter pen or a forceps.
Forceps implantation requires prior micro-incisions in the scalp to receive the extracted FUs.
At The Clinic, we prefer by far the Choï implanter pen method, which entails much less scalp trauma and allows for more precise implantation. After a local anaesthesia is administered, the surgeon implants the follicles within the scalp using a pen consisting of a beveled needle and a piston. Once the follicle is inserted inside the pen, the right implantation angle is calculated and the hair is injected with a press of the piston. This technique allows for much more precision and a denser implantation (70 FU/cm2) than the forceps-based method.
At The Clinic, we only use this manual technique for light baldness cases, i.e. involving the graft of less than 1000 FUs. Beyond that figure, the ARTAS robotic procedure is preferred.
The Clinic owns the only ARTAS robot in Paris. This machine allows for an automated implantation of FUs.
The robot, which is monitored and guided by our specialist, selects and extracts follicular units (FUs) following a random pattern generated by an algorythm ; this allows for the preservation of a natural look of the donor area. The ARTAS robotic arm is fully articulated can extract FUs at all angles. The extracted FUs are then collected and stored in platelet-rich plasma for future implantation.
Only 3 practices in France are equipped with the ARTAS robot ; this is the only technique that can guarantee a very low transection rate (3 to 5%) and that can be applied to patients with fuzzy or Afro hair.
In addition to this performance, the ARTAS procedure is cheaper as the quote is based on the number of implanted FUs and not on the number of extracted ones. You therefore only pay for the FUs that have actually been successfully transplanted.