About FUT

Transplanting began in 1939, when Dr. Shoji Okada established the process of punch grafting. In 1959, Dr. Orentreich applied that treatment to thinning hair and so becoming widely used. Since the latter half of the 1980's, in order to improve the more unnatural aspects of punch grafting, mini-grafting and micro-grafting was developed with the graft becoming smaller. Also, Professors Sasakawa, Tamura and Fujita attempted to develop a method by using smaller grafts. Unfortunately this did not develop much further. In 1992, using the 'Choi Method', transplanting was done with needles and has since become quite common in Japan and Korea.

FUT Operation f low

  • Counselling
  • Donor collection
  • Graft division
  • Transplant


General and detailed observations are made. In the general diagnosis, age (when hair thinning started etc.,), health condition, motivation for consultation, level of expectation (whether patient understands the results of the operation or they are holding too many expectations), psychological and emotional factors with attention paid to hereditary background etc.,

In the detailed observation, the following 1) to 6) are checked.

1. Discriminatory diagnosis of hair loss. 2. Hair Loss Progress is examined For the purposes of classification, the area of hair loss is measured as precisely as possible, with determination of the number of necessary hair strands to be transplanted.
3. Density of donor In order to determine the number of necessary hair strands to be transplanted, the necessary measurements of the donor area must be calculated. The density of the donor varies from person to person and also according to the back or the side of the head areas. 4. Measuring the diameter of the hair Hair diameter is measured by a digital-micrometer. If the hair diameter decreases by 50%, the same density of hair realized only increases 25%. Actually, hair density is measured as thin (1 point), middle (2.5 points) and thick (4 points). 5. The degree of straight or curly hair Curly hair (2.5~4 points) is easier to gain volume than straight hair (1 point). 6. Hair Color Results of hair transplant are more successful when the hair color resembles the skin color. Compared with light color skin and blond hair with white people or the dark color skin and black hair of black people, Japanese with their lighter skin and black hair have a stronger contrast with the handicap that their skin is more visible. Hair color is classified into the following: Black (1 point) and white to blond hair (2 points).

Even with a transplant of the same density, the results will differ by the above factors 4)~6). With each factor divided into 3 levels, the evaluation results will be assessed on the basis of these points. A total of 3~10 points would indicate a high degree of satisfaction on the customer side.

Stages and progression of hair loss in men


4.Donor collection

First, depending on the number of strands to be transplanted, the donor (hair to be transplanted) is removed from the back of the head.
At that time,we do not use a multi-bladed knife as it could damage the region.
Firstly, the hair around the donor is trimmed and the donor collection area is prepared.

For example, 1 cm2 requires 160 strands of hair. Therefore, when transplanting 2,000 strands of hair, 12.5 cm2 need to be taken from the scalp.
Following on, the donor is cut away with the help of a magnifying glass.

The techniques used here is the 'Open Technique'.
With this a simple blade knife is used along with a magnifying glass. The hair root can be seen up close and is cut away for an area of several cm2. The main advantage of using the 'Open Technique' is that there is no loss in cutting the hair root.
A multi-blade knife will cause 8~20% damage to the donor but the 'Open Technique' will only damage 2~3%. Our clinic uses the 'Open Technique' method to stitch up the donor wound properly and the 'Invisible Scar' technique to ensure as little damage to the wound as possible.
The 'Trichophytic donor closure' was released by a Dr. Frechet from France in 2005. Currently, using this method and the 'open technique' is the best way to guarantee the least possible damage from the donor scar.

So the hair can be collected again and taken from the same donor location.

Trichophytic donor closure
When the donor wound incision of about 1mm is stitched up, the wound is left clean without being seen easily through the transplanted hair.


3.Graft division

Next, the grafts are separated.
The extracted donors are separated into units.
One unit consists of 1~4 strands of hair, fuzzy hair, the sebaceous gland and the erector.
Hair will be transplanted relative to the unit size. One hair strand will be transplanted as one. Two hair strands will be transplanted as two. etc.,
When the grafts are separated, a microscope and a back-light are used to prevent damage to the hair.
Using the microscope is a special characteristic of FUT.

As can be seen in the photo, the grafts are color coded based on their size and kept in pallets. This is to prevent the grafts from drying as they can become unusable if left unprotected and dry for 5 minutes.
Therefore, at this time it is very important to monitor the humidity while the process is being carried out.

A 'unit' includes hair that is being transplanted but also the sebaceous gland, erector and soft downy hair. This unit will be transplanted in total as it is.
The area circled in the right photo shows such units.
From “THE LOGIC OF Follicular Unit Transplantation” by Robert M. Bernstein (MD) and William R. Rassman (MD)



Finally the transplant is done. When the transplant is done a magnifying glass is used and the transplant is done as a suitable depth. First, a slit is made in the scalp to match the appropriate number of grafts to be transplanted. There, the
grafts are planted using a special set of pincers. The number of grafts and strands of hair are again confirmed and all are transplanted.

The day after the operation, the bandages can be removed. Swelling is expected to develop around the eyes for about 1 week. This is thought to be because the anesthesia applied to the scalp during the transplant operation starts to affect lower areas of the face over time.
In order to prevent swelling, it is advised to wear a headband whilst sleeping.

This is Yokobi style FUT that we operate, Follicular Unit Transplantation (Unit transplant).
As time passes, day by day the technology is making great advances.
Medical Corporation Yokobikai 
Yokobi Clinic Kenichiro Imagawa