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FUE Transplant: Step by Step

*This blog is a transcription of a video covering a Modena Hair Institute patient who saw Dr. Yazdan for a FUE hair transplant procedure, also known as follicular unit extraction. We’ve included the video itself here as well*

Mark, an international business entrepreneur from Scottsdale, Arizona, has arrived in Modena Hair Transplant Center in Las Vegas for his first hair transplant surgery. As he tells it, over a year beforehand, his brother came to this same office to have his own FUE transplant surgery done, and he wants to find out what Dr. Yazdan can do with his own receding hairline, which has been steadily getting worse over the past 5-10 years.

In his office, Dr. Yazdan examines Mark’s hair to determine factors such as the condition of his follicles, the density of his hair, and viability; it’s necessary to plan the transplant in extensive detail to ensure the best possible results.

As Dr. Yazdan explains, “In aging patients with typical male pattern baldness & a receding hairline, it’s necessary to restore the hairline in the angles. I think it’ll be sufficient to fill the temporal area & lower the hairline.” Speaking to Mark, he says, “Your hair looks healthy, and your donor zone is perfect. It will take approximately 1,500 grafts to lower your hairline and fill in the sides & temporal area. We’ll use the FUE method, we’ll begin at 8:00 AM, and by 5:00 PM we’ll be finished.” From there, Dr. Yazdan carefully measures & reconstructs the patient’s ideal hairline; it is of the utmost importance to make this hairline natural & optimally dense. 

It is not necessary to cut the patient’s hair before hair transplant surgery using the strip (FUT, or follicular unit transplantation) method, but with Mark it was decided there would be follicular unit extraction, which requires the donor area to be shaved before the procedure begins.

After the patient has undergone anesthesia, the doctor extracts the grafts from the patient’s existing hair. Dr. Yazdan has also developed a unique process for anesthesia. The patient feels no pain during the course of the surgery or after, and the area is also not subject to the post-procedure swelling typical at outside clinics. 

Mark’s procedure in progress.

Now we see how the extraction of hair takes place. Separate grafts are extracted from the donor zone, one at a time, and accuracy is essential, as is the experience of the surgeon & the tools available. It is crucial to ensure that the grafts are not damaged in the process of extraction. The surgeon’s technique & use of a tiny plug (measuring 0.7mm in diameter), ensure virtually no visible scarring. There are no stitches, and the wound heals within 3-4 days after the procedure.

It’s not only the quality of graft extraction that is essential for a successful hair transplant, but also the quality of their processing. The longer a hair remains out of the human body, it experiences increasingly greater stress, and the likelihood of successful settling goes down. At Modena, to ensure the grafts are processed quickly & professionally, between 3-5 assistants work on graft processing for each surgery. This is a substantially large number of support staff compared to the majority of other clinics, and it enables large procedures to be carried out in a very short period of time, guaranteeing an almost 100% graft survival rate in turn. Grafts are processed by highly skilled personnel with the use of state-of-the-art microscopes. While the surgeon extracts the follicles, the rest of the team works to process the grafts. It’s an extremely laborious task, requiring attention to detail and modern magnifying equipment. 

As that happens, Mark takes a break & prepares for the next stage: implantation of the hair. Once the extraction process is completed, the area already looks presentable. The donor zone shows little to no sign of bleeding & is covered by the surrounding hair. In the meantime, the surgeon starts to prepare apertures for the grafts in the recipient zone. At this stage, it’s also important for the surgeon to take the direction of hair growth into account. At Modena, we use the latest precision tools which enable the transplant of grafts in the minimal possible time & the preservation of the direction of hair growth set by the surgeon during aperture creation. Furthermore, their small diameter ensure the natural density of hair in the transplant zone. The hairline, the direction of growth, and the hair density are all carefully calibrated to ensure an authentic, natural look. 

Each aperture is counted by a special device, which displays the figures on a monitor & enables the surgeon to check on the accuracy of the apertures in real time. As the procedure is actively carried out, Mark is able to speak clearly to the camera & discuss what’s happening, showing no signs of discomfort or pain. It’s well worth noting that in the course of the procedure, lasting many hours, there is virtually no blood. 4-5 people work to transplant the grafts, as it is of significant importance to keep operating time to a minimum. 

On the day after the surgery, during a follow-up appointment, it’s impossible to tell that he had undergone hair transplant surgery the day before. Modena’s techniques also virtually eliminate the risk for an allergic reaction. On the second day, mark comes to the clinic again. Our personnel wash his head, the doctor offers post-care recommendations, and Mark says goodbye to the team.

Mark, immediately after his FUE procedure.

Mark’s story is just one of many in the history of Modena, and you can be the next to reclaim your hairline. We have locations in Las Vegas, Beverly Hills & Newport, and we’re willing to help you make the journey to gain back your confidence. Visit our website to schedule a free consultation, learn about the different services we offer, & feel free to call us at any time during our business hours.

What is Causing My Hair Loss?

causes of hair loss
Hair loss can happen at any age. At Modena Hair Institute we’ve designed topical and medical hair loss programs for patients in their early 20s, as well as those in their late 50s. While hair loss is universal, its causes and origins may be summarized into three general categories.

Very few lay people understand that hair loss is not a single, simple diagnosis, but that it is actually a common symptom that can be caused by a variety of different conditions. This is one of the reasons why finding the correct diagnosis and treatment for hair loss can be difficult, and why Dr. Amir Yazdan at Modena Hair Institute continue to study every possible underlying cause and treatment option.

By far the most common cause of hair loss in both men and women is Androgenic Alopecia (AGA). Otherwise known as genetic pattern baldness, AGA occurs when the hair follicles have inherited an increased sensitivity to dihydrotestosterone (or DHT). This hormone is a natural by-product of the breakdown of testosterone in the body and is present, in varying degrees, in both men and women. When sensitive hair follicles are exposed to DHT they begin to shrink and their growth cycle shortens. Over time, they produce gradually thinner and thinner hair strands until, eventually, they stop producing hair altogether.

FUE gratfs
A second general type of cause behind hair loss may be termed external influence. While genetic pattern baldness is an internal and physiological concern, things like stress, menopause, environmental disturbances and diet may cause hair loss through external disturbance.

Individual hair follicles on the scalp do not continuously produce hair, but instead go through distinct cycles of growth and shedding. However, a variety of external factors can potentially disrupt these cycles, causing a condition called telogen effluvium where large amounts of hair are shed at once. Anything that causes a physiological shock to the body can potentially cause telogen effluvium, including physical trauma, major surgery, or even crash dieting that starves the body of necessary proteins. In some cases, emotional trauma and stress can prompt changes in eating or sleep patterns that can also result in similar symptoms.

A third general type of cause behind hair loss is auto-immune disease. There are several different auto-immune symptoms that can potentially result in hair loss, but the most common is alopecia areata, a condition similar to rheumatoid arthritis where the body’s immune system attacks the rapidly growing cells at the base of the hair follicles. The inflammation that results interrupts the natural cycle of hair growth and causes hair to shed in small, round, smooth patches on the scalp. In some rare and extreme cases, alopecia areata (AA) may progress to the point that all of the scalp hair is lost, a condition called alopecia totalis, or even to alopecia universalis, the complete loss of all body hair.

As is apparent, diagnosing hair loss can be complicated and there is really no such thing as a ‘one-size-fits-all’ treatment. That’s why, at Modena Hair Institute in California and Nevada, we spend so much time and effort determining the specific underlying cause of a patient’s hair loss. That is the only way we can formulate a personalized hair restoration treatment program that addresses patient’s individual needs.

Dr. Amir Yazdan, MD, is an internationally renowned hair transplant surgeon, expert guest on Dr. Phil and The Doctors, creator of the GroMD hair restoration product line, ISHRS member, accredited member of the IAHRS and a visceral advocate for patient care. Learn more about Dr. Yazdan or read rave reviews from his patients.

What Makes African-American & Asian Hair Transplants Different

The art and science of hair transplantation continues to progress after nearly a century of practice. African and Asian hair transplants continue to prove more difficult than those of a Caucasian heritage.

Hair transplants have become an increasingly valid option in restoring one’s hair, and it’s safe to say that there are quite a few people who are keen to figure out how well the procedure will work for them. For Caucasian patients, including those of other ethnicities with similar hair, this has rarely been an issue as far as hair type is concerned. They’ve had the FUT procedure (also known as the “strip” procedure), along with the newer FUE method, open to them for as long as those options have been around. Rather, their eligibility has always been an issue of specifics.

African American & Asian patients, however, were in a different situation for a long time. Their hair follicle & skin types, for reasons we’ll dive into soon, once made them virtually ineligible for either type of hair transplant procedure. Now, however, as the technology has developed & hair restoration surgeons have gained further experience with those procedures, the door has begun to open up for them as well.

These advancements have been astounding, to say the least. To help you understand why, let’s go through some of the particular factors a surgeon must navigate in performing a procedure on a African American or Asian hair transplant patient.

An Asian patient at Modena Hair Institute before & after their transplant.

Hair Density

For Asian patients, the issue boils down to them having generally lower hair density across their scalp, meaning that there are less options for follicles in the donor area. This decreased margin for error means that a trained eye is especially vital in carrying out the procedure, lest the results end up looking thin & unnatural. 

With African American patients, the density factor comes into play a different way. Specifically, it’s a combination of their hair density being higher than average, along with the fact that their follicles are curled (more on that later). As a result of this, the challenge comes with placing the non-linear follicles in close, natural groupings. This isn’t an issue at Modena, however; we have the experience to know what a natural hairline looks like, and we have unique tools that allow us to bring that ideal, natural hairline into reality.


African American patients are at special risk of a particular healing issue known as keloid scarring. People of any skin color can get it, but it’s been noted as affected darker skin patients the most often. Essentially, it refers to growth of extra scar tissue upon post-injury healing, and the issue is even believed to be passed on across one’s family.

To avoid any suffering from this issue, when patients visit Modena Hair Institute, those with a known history of keloid scarring in their family will go through a very minor test session to determine whether they’ve got it as well. Thankfully, however, even if you see that type of scarring happening on other parts of your body, the vascularity of the scalp means it’s generally less likely in that area. Furthermore, even if it does happen, Modena’s Dr. Amir Yazdan offers his Newport, Beverly Hills & Las Vegas hair transplant patients a special medication to combat it during the procedure, dramatically minimizing it as a result.

For Asian hair transplant recipients, It’s less an issue of specific potential issues (although keloid scarring is still possible), and more an overall increased risk of scarring. If there are genetic issues that might affect this, patients receive the same sort of minor tests mentioned earlier to determine how they’ll react to the full transplant.

Hair Follicle Shape

Lastly, as mentioned in the first point, the hair follicles of African American people are curled in the scalp, leading to the typically very curly nature of their hair. The extraction process changes accordingly, and a punch with a slightly larger diameter than normal has to be used to fully capture the curled follicle, without damaging the surroundings of course. Dr. Yazdan, for example, uses a 0.8-1mm punch to fully capture each follicle while avoiding the surrounding area in turn.

Overall Eligibility 

Given the different factors we’ve discussed here, especially with scarring in mind, we at Modena Hair Institute generally perform FUE transplants on African American patients, especially males, since FUT (“strip”) procedures leave minor scarring as a result. Asian patients, however, are eligible to receive either depending on the doctor’s analysis of each particular case.

Why Modena?

Yes, it’s more than possible for African American & Asian patients to get the hairline of their dreams, but as we’ve suggested, it’s only possible if the procedure is being done by someone with years of experience & knowledge on their belt. That’s exactly what we provide here at Modena Hair Institute.

Our practice has had years of experience handling these specific types of transplants, and that’s exactly what it takes to do it right the first time. Sure, other clinics offer these transplants, but many of them have rarely performed procedures on non-white patients, especially Asians & African Americans. Because there are many different nuances in how their procedures are done, this simply won’t do; you’ll be far better off with a clinic like ours that’s spent quality time working with cases like yours.

It’s not just down to procedure experience, either; without the right tools, the best possible results are that much further out of reach, and risk comes creeping that much closer. That’s why, instead of the tools used for the majority of our patients, Dr. Yazdan has highly specialized tools at his disposal for his African American patients. By taking this vital step, he’s able to offer them a full, natural head of hair, an even hairline, and properly-healing donor & transplant areas in turn. Other clinics simply don’t offer this level of specialization, and it’s for that reason why their attempts at performing the procedures are loaded with risks that no patient should ever have to face.

Dr. Yazdan examining Countess Vaughn on The Doctors.

Lastly, at Modena, Dr. Amir Yazdan, a board-certified physician, personally performs every transplant at our clinics, with no assistants handling the procedure itself. The time he’s spent perfecting his craft & practicing case-specific methods makes him more than qualified to handle patients of all backgrounds, and the results he’s achieved speak for themselves.

Learn more about African American hair transplants here, check out more info on Asian hair transplants here, schedule your consultation, and be sure to visit our website to learn more.