From The Desk Of Dr. John Cole

Hello everyone,

Its been slightly more than one year since we began transitioning from a predominantly strip- based hair restoration practice to one that predominately performs follicular extraction.  We must say that the results are nothing short of amazing thus far. 

The FIT procedure provides much more donor area so we can help a greater number of patients. As a result we are making FIT more convenient for our valued European and Middle Eastern patients by training physicians and surgery staff through our offices in London and Cyprus. Other changes at IHTI include a new technique called BHT or body hair transplant.

The Advantage of FIT

One thing we’ve been able to achieve is to eliminate visible donor scarring.  This has tremendous impact on the hair restoration process, especially with younger patients.  One thing that always bothered me was beginning hair restoration on a young patient in his early 20s.  These are the individuals most prone to develop greater degrees of hair loss and to re-consider their decision to have surgical restoration.  The problem with a strip harvest is that it leaves a permanent scar on the back of the scalp in the donor region.  This is does not pose a problem for those who desire long hair, but individuals with extreme hair loss often times choose a short hair style.  This short hair style may expose the donor scar.  This is especially true for individuals who desire a shaved head.  Our method of follicular extraction, called FIT or follicular isolation technique, allows the individual to shave his head later in life without visible scarring to the naked eye.  This option solves the visible linear donor scar that we were concerned about in the young patient.  In fact we have already seen the advantages in at least one patient whom we delayed for several years prior to his first hair restoration surgery, which was FIT.  He was showing signs of becoming a class 6 at 24 years of age.  We performed over 2000 grafts on him using FIT.  All the years of explaining the difficulties in achieving the desired level of coverage did not convince him that the hair restoration surgery process would be a long, expensive, time consuming process that would have limitations in terms of coverage based on the degree of hair loss we anticipated he would experience.  Once he saw that 2000 grafts did very little to achieve full coverage in a class 6 pattern, he became convinced that he was not the ideal candidate for hair restoration surgery.  He finally realized that he may require well over 7000 to 10,000 total grafts to achieve a fuller look.  His final assessment of the situation was that at least he could shave his head. 

This brings us to one of the other great advantages of FIT:  with a shorter hair style, FIT can be used to create an apparent fuller degree of coverage with fewer grafts than it would take with the hair long.  We call this the “less is more” phenomenon.  You could not wear the hair short with a strip harvest unless you are willing to risk exposing the linear scar.  With FIT you do not have the visible scar, so you can wear the hair as short as you like.  With a very short hair style, you expect to see some scalp.  Think of a Marine recruit.  You expect to see his scalp.  You see a contrast between the hair and the scalp though.  One might call it a 5 o’clock shadow on top of the head.  In other words, you see two colors –- the color of the head and the color of the scalp.  FIT can help you create this illusion.  You can create a thin coverage on top of the scalp using natural follicular groupings (units) and at the same time thin the donor region so that its density begins to match that of the top of the scalp.  This gives you the appearance of the same hair-to- skin contrast on both the top of the scalp and the donor region.  In other words, less hair grafting can make you appear to have fuller hair coverage.

The problem with shaving your head without any hair coverage in the balding areas is that you do not have the illusion of coverage.  Why?  Because there is no 5 o’clock shadow appearance on the top of the scalp.  Instead, the balding or thinning areas look bald.  You have a contrast between the hairy scalp and the bald scalp.  You can shave your head, but there is an obvious difference between the bald areas and the hairy areas.  FIT can eliminate this contrast so that you appear to have hair in multiple regions.  The good news is that you can create this "less is more" phenomenon with fewer grafts than it would take to achieve the full look with longer hair.  It is an optical illusion, but it is one that works.