The Value of Double vs Single Follicular Unit Technique
I have seen on the internet, the promotion of a double FU technique. Can you explain it to me and tell me about the value of a double follicular unit technique.
Follicular units (FUs) have one, two, three or four hairs each. When they are placed in the recipient area, they are graded in the frontal hairline (FUs with one hair each up front). There are times when the doctor wants to have more two or three hair grafts and the donor area yielded too many one hair grafts (common in Asian patients). In this situation, two single hair grafts (or one single and one double hair graft) are placed into a single recipient site and that is what is referred to as a ‘double FU technique’.
A bald man may get between 250-500 single haired FUs at the leading edge to create a soft, transitional hairline zone. All other FUs should contain more than one hair each to produce value. As each person has a different distribution of single hair FUs out of a harvested strip, the number of single hair FUs are determined by the anatomy of the patient (not the surgeon). So to get more than a single hair FU to place behind the leading edge transition zone, one might have to double up the single hair FUs to get reasonable bulk. More bulk can be obtained by putting a single hair FU with a two-hair FU to create a three-hair FU so that there is a way for the surgeon to determine and control the bulk of the hair that is transplanted.
I understand your answer but think you’ve completely misunderstood this person’s question. Double-follicular units (or DFUs as they’ve been termed) have been talked about on some of the transplant forums for the last few months, and are associated especially with the Shapiro brothers in Minnesota (and most especially with the technique of Paul Shapiro). DFUs are follicular units cut to contain 5 to 6 hairs, and the Shapiros contend that they offer enhanced density, primarily when used in the mid-scalp, and should be considered “true” follicular units just like 1-, 2-, 3-, and 4-hair grafts. Certain forum posters have worried that DFUs might too closely resemble the old minigrafts and have wondered if there is any dfference. You may want to search for Dr. Shapiro’s explanations of DFUs on the hairtransplantnetwork.com forum. The technique you describe of placing more than one FU into a single recipient site is not what’s being addressed by the question.