FUE Hair Transplant – Follicular Unit Extraction

In recent years a new technique known as an FUE hair transplant has become increasingly popular. The acronym FUE stands for Follicular Unit Extraction.

Sure Hair International’s own proprietary Uni-Strand™ technique and the FUE technique are similar in that the doctor and his technicians take the hair from the donor area by extracting individual follicular units one at a time.

Each follicular unit is extracted with a micro punch. The advantage of the FUE technique is that the removal or extraction of grafts from the donor area does not require a linear incision, and therefore the surgery does not leave a linear scar in the donor area as most conventional hair transplant procedures do, also recovery from the procedure is much faster and stitches are not required. When an FUE hair transplant procedure is done properly there is very little evidence of any surgical procedure.

The FUE hair transplant technique has been a welcome addition to hair transplantation technology. It does, however, have its limitations.

Most importantly, FUE does leave very tiny scars in the donor area at the graft extraction sites. When the extraction is properly performed by an experienced doctor or medical technician these graft extraction sites are usually so small that they can’t be detected even with a very short haircut.

Secondly, there is potential for a high graft transection rate. In the hands of an under-experienced doctor or technician many potentially healthy grafts can be lost this way.

Also, the technique is very labour-intensive, and it can take many hours to remove the thousands of grafts that most surgeries require.

But, for the right patient, with the right needs, in experienced hands, it can be a very valuable technique.

How it works

In the FUE hair transplant procedure, a 0.7 – 0.95 mm surgical punch is used to make a small incision in around the top part of the follicular unit. The unit is then carefully extracted directly from the skin on the scalp.

Because a manual FUE Hair Transplant procedure will not leave a linear scar it is often recommended for patients who would like to wear their hair quite short, less than number “1” on most regular clippers.

FUE’s biggest limitation, when compared to the “Uni-Strand ®” FUT or strip procedure offered at Surehair International, is that it’s much more labour-intensive, and therefore more costly.

We find that our patients are best served if the FUE procedure is reserved for patients that do not need large areas to be transplanted or who have suffered minimal hair loss.

FUE, is in fact a type of the “Uni-Strand ®” set of procedures, where the follicular units are extracted directly from the skin on the scalp, rather than being dissected from a strip of hair baring skin that has already been removed.

To say it another way, with “Uni-Strand ®”, individual follicular units can be obtained in one of two ways; either through single strip harvesting and stereo microscopic dissection, or through FUE. The finished result, once the hair is transplanted will appear identical.

The table below summarizes the pros and cons of Follicular Unit Extraction. Vs. the FUT or Follicular Unit Transplantation method.

Advantages of a FUE Hair Transplant

• No linear scar. For patients who wear their hair very short, or who are intending to shave their head from time to time no linear scar is very important.
• Also can be important for patients who are at greater risk of scaring.
• Perfect for repairing previous donor scars that can not be excised.
• Also a good alternative when the scalp is too tight for a strip incision.
• Gives doctors the ability to harvest finer donor hair from the nape of the neck to be used along the hairline or the eyebrows.
• The FUE method makes it possible to harvest body hair from the chest or beard.
• Is Most appropriate in cases when a limited number of grafts are required.
• There are instances when a FUE hair transplant may be less expensive then FUT hair transplant.

Disadvantages of a FUE Hair Transplant

• Follicular unit grafts yielded is less in FUE than with FUT strip method. This is due to the limits of harvesting all the hair from the permanent zone.
• The irregular scarring of the donor area from FUE makes subsequent FUE sessions more challenging.
• Higher follicular transection rates when compared to “Uni-Strand® FUT”
• Higher patient variability to determine good candidates compared to the Strip method
• Increased difficulty excising the entire follicular unit.
• Increased difficulty in obtaining a natural-looking distribution of follicular units.
• For the sake of efficiency larger follicular units are usually targeted, but often those units are not ideal for the hairline.
• Grafts are more delicate and can be subjected to increased trauma during placement in the scalp since they often lack the protective dermis and fat of grafts microscopically dissected from a strip.
• Microscopic dissection can still be needed if the number of single hair follicular graft units is inadequate.
• Possibility that problems could occur with buried grafts. This happens during the blunt phase of the three-step technique. When the graft is pushed into fat and must be removed through a small incision
• After many FUE grafts are harvested, previously fine stippled FUT linear scars may become visible due to thinning of donor area.
• Can Require multiple sessions to equal the size of a single “Uni-Strand ®” FUT session.
• FUE is manually more intensive so it takes longer to complete a session.
• More time usually equats to more expensive than a “Uni-Strand ®” FUT session