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Scarless 4th Generation FUT (Strip) Hair Transplant with Trichophytic Closure Technique

In the present scenario there are number of hair transplant techniques known that can put a patient in dilemma while selecting the technique but the demand and dominancy of follicular unit transplantation (FUT) is increasing day by day.This technique is not only helping in getting vast density and fine quality of hair but also give immediate and long lasting  result  where as other hair restoration therapy like follicular unit extraction (FUE)  take considerable time and generally gives low yield of follicular units.

Follicular unit transplant surgery is extremely successful and safe, but only significant disadvantage of this method is resultant linear donor scar from extraction of strip after surgery that put off a person in keeping short hair since one can notice it easily, but fourth generation hair transplantation lend a hand to overcome problem linked to linear scar develop during the FUT method. The scar can be minimizing by using a technique called “Trichophytic closure”. Trichophytic closure is opening door for the patients who want to get high quality hair line in single session and relief from scar that arises after surgery.


FUT Hair Transplant Surgery

Follicular unit transplant (FUT) is the conventional hair transplantation method which involves extracting a linear strip usually between 0.8mm to 1.2mm wide and between 20cm to 26cm in length of hair bearing skin from the back or the side of the scalp. In the latest 4th generation FUT, for getting dense follicle units, the lower part of the occipital area and the temporal area is used since this area is highly capable of creating a new hairline and for obtaining high-quality grafts. After the harvesting of the grafts by expert technicians, the gap is closed by trichophytic closure leaving no visible scar after surgery. The strip is dissected into ultra refined follicular units by using video assisted microscope and then the grafting process is done.

The methods of extracting strip in 4th generation FUT is more prevalent over any other hair transplantation methods as the strip contain follicular unit which is more viable and having maximum probability of flourishing  new hair line because the follicular unit contain a sac-like structure beneath the scalp which produces and nourishes new hair growth whereas in case of FUE, the  follicular units are removed directly from the donor site one by one which could  increase the chances of follicular unit damaged, i.e. higher transection rate and ultimately affect the growth of FUs. During an FUE treatment, the surgeon can harvest around 2,000 follicle units on the other hand, 4th generation FUT may involve the harvestion 4,000 to 5,000 follicle units in a single session with minimal pain and assurity of maximum growth.

The only inadequacy of conventional FUT can be corrected by the advanced trichophytic closure technique used in 4th generation FUT to reduce the linear scar develop after the hair restoration surgery by concealing under the patient’s own hair in the immediate post surgery period.  Though there are several different variations of the trichophytic closure technique, this technique can be described as one where the edge of the incision is trimmed and closed in such a way that hair can grow through it. A new hairline grows on the scar can provide camouflage and help the patient to wear short hair.


During the process when a strip of hair is taken from a donor area and transplanted in recipient area may result in visible scar but, now thanks to the latest and most advanced 4th generation FUT hair transplant with the aid of trichophytic closure technique promises scar free and natural look. The area from where a strip is harvested is sutured or stapled in a way that the edge of one flap immediately overlaps on another flap reducing the visibility of the scar. The procedure can be initiated by removing the epidermal edge to create a sloping or ledge type edge. The opposing side is then brought to the trimmed epidermal side to allow for a slight overlap. The epidermal edge is trimmed till the level that does not affect hair growth, so that hair can grow easily through the scar to assist in concealing the donor scar. Once the flaps are closed, the two sides bind together with surgical staples/suture for about two weeks whilst the scalp repairs itself and hair growth occurs in the sutured area of donor site. Afterwards, a very fine thin line is appeared which is hard to see, extremely difficult to find, allowing the patient to wear his or her hair very short in the donor region. This advanced 4th generation technique is even working with smaller grafts; a greater amount of hair units can now be extracted and transplanted by the strip extracted containing the follicular unit with a low transected rate of graft.

Any hair transplantation can only be successful when it helps in achieving a natural-looking hairline, high quality follicular unit, hair density as well as without any visible mark or scar of treatment being noticeable. The synergism of Trichophytic closure and follicular unit transplantation, termed as 4th generation FUT is serving as a stepping stone for restoring hair immediately and result oriented with less visibility of scar.

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