hair follicle follicular unit grafts

Difference between Hair, Follicle, Follicular Unit and Graft

Arogyam Hair Transplant Clinic is into its seventh year of operation from 2012 and 700+ patients have been operated upon and more than 5000 treated with other means effectively till date from all over Assam and the North-East including Meghalaya, Nagaland, Arunachal, Manipur, Mizoram and Tripura. Patients have also been treated from other states of India like Jharkhand, Bihar, West Bengal, Tamil Nadu, etc along with NRIs from UK, USA, New Zealand, Canada, Nepal, Bangladesh and Bhutan.
Dr. P. J. Mazumdar introduces in Guwahati, Assam and the North East the most advanced technique for hair transplantation – the Blunt Motorized FUE method – which is extremely effective, painfree and highly comfortable for the patient.

Anyone who has read up on hair transplant will come up against these four terms – hair, follicle, follicular unit and graft, and it may seem a bit confusing at first. What do these terms mean?

These terms are often used wrongly and interchangeably, but actually they all mean different things. This is what they actually mean:

Hair – hair is simply the outer shaft of keratin material, the part that we all identify as hair conventionally. No problems in understanding this.

Follicle – Follicle means the root of the hair, the part which is buried under the skin. It is the follicle which produces the hair shaft. The follicle consists of the bulb, which are the stem cells which produce the hair, the layer of skin cells, sebaceous cyst and other supporting cells.

Follicular unit – a follicular unit is a collection of hairs which are grouped together in the skin. The great importance of this structure was discovered by Bernstein and Rassman in 2002 and this can be considered the starting point of modern hair transplant surgery. Hairs are not arranged singly in the scalp but are grouped into units which can consist of one, two, three, four or even more hairs. An average Indian will have 2.2 hairs in one follicular unit.

The hairs in a follicular unit are not simply hairs which accidentally happen to be close together- a follicular unit has a distinct anatomical structure. The hairs in a follicular unit are surrounded by a distinct collagenous sheath which groups them together, they have a common blood supply, a common nerve supply and most importantly, a common tiny muscle, the erector pilae. This is the muscle which makes our hair stand on end when we are cold or anxious. The hairs in one follicular unit have one common erector pilae muscle instead of each hair having one muscle.

Modern hair transplant began when this structure of a follicular unit was recognized and transplant of intact follicular units was started.


Graft – a graft is a medical term which means a tissue or organ which is taken from one part of the body and placed in another. A graft can be a skin graft, bone graft, cornea graft, a kidney graft, etc. In the context of hair transplant, graft means the plugs of hair which were transplanted. Hair grafts have come a long way from the initial punch grafts and strip grafts to mini and micro grafts, becoming progressively smaller. Today a hair graft universally means a follicular unit. So graft in today's hair transplant language almost always means a follicular unit and the two can be considered synonymous. When the hairs are in the skin, we call the group of hairs a follicular unit but when we cut them out to transplant them, this becomes a graft.

Takeaway point – The final point of difference is that a graft can consist of one, two, three or more hairs. So when discussing points like cost, etc or analyzing the claims of slick websites, always note carefully whether they are talking of grafts/follicular units or hairs.

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Quality assuarance

Arogyam Hair Transplant Clinic takes several steps to ensure that quality is maintained for each and every patient. The key to quality maintenance is to implement quantizable quality standards and maintain proper documentation and review of processes. Downtown Hospital is an ISO 9001:2008 and NABH accredited hospital which demands strict adherence to quality control.Steps taken are:

100% safety assurance: all procedures are done in the main OT of Downtown Hospital with its full complement of anesthesiologists and critical care specialists. Hence patients are assured of full safety standards at the same level as that of major surgeries including transplant surgeries.

100% sterilization assurance: since procedures are done in the major OT full sterilization is maintained. Fumigation is done every week and swab tests are done to check for contamination.

Best instrumentation: Arogyam Hair Transplant Clinic uses the best available instruments like 6X Heine Loupe for precision and accuracy, Blunt Titanium punches which avoids damage and transection of the grafts, Choi implanters to standardise the process of planting and prevent damage during planting, Major OT level sterilization, fumigation and autoclaving of all instruments, etc.

Efficiency count: Efficiency counts for FUE like transection rates and speed of transplant are noted and documented for each case and reviewed every 10 cases. Arogyam Hair Transplant achieves international standards of transection and speed consistently.

Correct recepient density: To ensure correct recepient density, 'density stamps' are used to ensure proper density is achieved. Angle and direction of hair is meticulously maintained.

Out of body time: The out of body time, the time for which the graft is outside the body, is the most critical factor for success in hair transplant. Aroyam Hair Transplant follows a special procedure to ensure that this time is the minimum. This is done by doing only 500-600grafts at a time and then replanting them. This ensures that time out of body is less than or equal to1 hour only. This is the shortest period acheivable. Many centers do upto 2000-2500 grafts at a time so that time out of body goes upto 4-5 hours. We are proud of our time out of body quantum. Though this may cause some sacrifice of time but results are more important.

Follow up: follow up period is critical for the patient when there are many doubts and anxieties in his mind. In our clinic, Dr. P. J. Mazumdar will remain always accessible to the patient directly on his personal cell for any questions the patient may have during this period.

List of articles

The academic certificates of Dr. P. J. Mazumdar may be examined here: Academic Certificates. His resume can be perused here: Resume. To find the contact address and other details, go to Contact. The blog contains various blog posts mainly on Hair Transplant.  To see photos of hair transplant cases done in Downtown Hair transplant clinic, go to Photos>Results from the Navigation menu. To see videos related to Hair Transplant Procedure, go to Photos>Videos from the Navigation menu.