The next major breakthrough came with the introduction of Follicular Unit Transplantation (FUT) in 1995. In this procedure, the entire hair restoration is carried out using the naturally occurring follicular units of the patient's scalp, which each usually contain between one and four hairs. The donor tissue is obtained via single, rather than multiple, strips from the back of the scalp, and the individual follicular units are then dissected from this strip. When performed skillfully, FUT enables the surgeon to produce cosmetically acceptable results.
In the past year or so, a new technique called Follicular Unit Extraction—again performed with a punch—was proposed as an alternative method to remove the donor tissue for transplantation. This procedure was initially dismissed by most hair transplant surgeons as inefficient and labor intensive. It also left some potential transplant patients wondering why leaders in the field of transplantation had returned to the much-maligned punch and for whom this approach is preferable.
It turns out that a punch, albeit one that is only 1 mm in size, can be used to harvest individual follicular units in some patients. One of the pioneers of follicular unit extraction, Dr. William Rassman, president and founder of the New Hair Institute in Los Angeles, explains that a 1 mm punch is just the right size to grab the follicular unit and remove it intact from the donor area.
