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NHT's Surgical Process: What Happens During Surgery

Hair transplant surgery at NHT follows a carefully structured process designed for precision and optimal graft survival. Whether you're undergoing our FUE 2.0 or FUT 2.0 procedure, the surgical day follows similar phases: Donor Harvesting, Graft Preparation, Recipient Site Creation, and Implantation.

The procedure typically takes 4-6 hours depending on the size of your procedure.

1

Donor Harvesting

The primary difference in hair transplantation techniques is the manner in which donor is extracted from the donor area.

Follicular Unit Extraction (FUE 2.0)

During FUE 2.0, follicular units are extracted individually using a 0.9mm circular punch. The donor area has been shaved to 1 cm and anesthetized prior to extraction.

Positioning

You'll be positioned in lateral (side-lying) and prone (face-down) positions during extraction to provide optimal access to different areas of the donor zone.

The Extraction Process

The 0.9mm punch size allows us to extract the entire follicular unit precisely to the depth of the hair follicle while preserving protective surrounding tissue. This size represents an optimal balance—smaller punches risk transecting follicles, while larger punches remove excess tissue and create more visible scarring.

Follicular Unit Transplantation (FUT 2.0)

During FUT 2.0, a horizontal strip of scalp tissue is removed from the donor area in a single excision. The donor area has been shaved to a minimum of 2cm and anesthetized prior to extraction.

Positioning

You'll be seated upright during the harvesting phase.

Donor Site Selection

The strip is taken from the occipital scalp superior to the occipital protuberance. This location experiences minimal movement during healing, which reduces scar widening over time.

Strip Removal & Closure

After the strip is excised, the wound is closed using a bilateral trichophytic approach with multi-layer suturing. This closure technique allows hair to grow through the scar line for improved concealment.

Mid-Procedure Break

After donor harvesting is complete, you'll have time for a restroom break and lunch. During this time, our surgical technicians begin preparing your harvested grafts under stereoscopic magnification.

2

Graft Preparation

While you're resting, our team of four specialized technicians dissects the donor tissue into individual grafts using state-of-the-art MANTIS stereoscopes.

Why Microscopic Dissection Matters

Hair grows in natural groupings called follicular units (1-4 hairs per unit). The stereoscopes provide magnification that reveals not only visible hairs but also resting follicles that aren't currently growing. These represent 10-15% of the total hair in your donor tissue.

Grafts Cut and Sorted by Size

Three graft sizes allow for natural hairline design while maximizing density and hair yield.

  • ​1-2 hair follicular units: Used for creating a soft, natural hairline

  • 2-3 hair follicular units: Placed behind the hairline for gradual density increase

  • 3-4 hair bi-follicular units: Used for maximum density in areas requiring fullness

3

Recipient Site Creation

Once graft preparation is underway and you're repositioned comfortably in a reclining chair, your surgeon creates the recipient sites where each graft will be placed.

The Process

Using ultra-fine 19-gauge needles, your surgeon makes thousands of precisely angled micro-incisions in your scalp. Each incision is oriented to match your natural hair growth pattern.

Site Design Considerations

Hairline and frontal area:

  • ​Horizontal incisions for 1-2 hair grafts at the hairline edge.
    Three rows of vertical incisions for 2-3 hair grafts.
    Vertical incisions for 3-4 hair grafts behind the hairline for density.

Crown/vertex area:​​

  • ​Circular/spiral incision pattern radiating from the natural whorl.

  • Primarily 3-4 hair grafts to achieve adequate density under light.

4

Graft Implantation

The final phase involves placing each prepared graft into its designated recipient site.

Precision Placement

Two to three of our surgical technicians work simultaneously using specialized micro-forceps to pick up individual grafts and carefully inserts them into the pre-created sites. They ensure that each graft is:

  • Oriented correctly (following the natural growth direction).

  • Seated at proper depth.

  • Handled with minimal trauma to preserve follicle integrity.

  • Matched to site size (smaller grafts at hairline, larger grafts for density).

Procedure Completion

Once all grafts are implanted:

Follicular Unit Extraction (FUE 2.0)

No bandage is required. You may wear a loose-fitting hat if desired. 

Follicular Unit Transplantation (FUT 2.0)

A bandage is placed around your head to provide gentle pressure on the donor incision site. You can wear a hat over the bandage and remove it yourself after 24 hours.

All patients receive:

  • Post-operative care instructions.

  • Prescription medications (pain reliever, antibiotic, anti-inflammatory as needed).

  • Follow-up appointment scheduling.
     

Most patients report feeling alert and comfortable at this point—the local anesthesia continues to provide numbness for several hours after the procedure.

​

Patients that opted for Twilight IV sedation cannot drive a vehicle after the procedure and must arrange for alternative transportation. ​

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