Follicular Unit Extraction
Follicular Unit Extraction (FUE) is a hair transplant method that individually harvests hair grafts from the donor area of the scalp. This method of harvesting hair follicles allows the grafts to be removed without leaving a linear scalp scar.
FUE Decision Making Process
The FUE method used depends on the individual goals and needs of each patient. There are manual and automated methods of performing FUE which allows for an adjustment in the depth and size of the FUE punches employed by the surgeon. The selection of the punch depth and size is determined by the patient’s scalp. It also can be influenced by the characteristics of their hair. The decision making process of which FUE method to use is also based on how best to minimize trauma to the grafts, assessing the quality of the donor hair if it is coming from areas other than the scalp and, most importantly, which method will yield the best final results. When it comes to FUE, besides the advantages and disadvantages listed below, there are a number of steps you need to follow before having a FUE transplant.
- No linear scar following the surgery
- Reduced overall recovery time
- Minimal post-op pain
- Increased regions from which to harvest as surgeons can now use areas of the “safe zone” that used to be off limits such as areas of the permanent zone where hair grows at a very steep angle
- The ability to use hair from other parts of the body for transplant including the beard and body hair
- The creation of a more balanced final result by reducing donor area density and minimizing the contrast between the donor zone on the scalp sides and the back and the transplant area
Disadvantages of FUE:
- There is a limited number of grafts available to be transplanted in each session
- This is a operator dependent procedure requiring superb hand and eye coordination
- More expensive as the hair is harvested individually and thus more labor intensive
- More time consuming due to the limited number of grafts which can be obtained per session
- People with a higher hair demand usually need more than one hair transplant session to achieve the coverage they desire
How FUE is Performed
Our practice harvests FUE grafts with the help of a variety of tools including robotic, motorized and manual devices. The decision of how to harvest and extract the grafts is made on a case by case basis. Each of the methods described below is aimed at the ultimate goal of reducing total out of body graft time thereby improving the overall survival rate of the individual grafts.
- Chasing method: This method enables the technician to quickly extract from the donor area very soon after the physician scores the grafts. This extraction occurs almost immediately after the grafts are scored as the technician remains in close proximity to the scoring surgeon. This method serves to lessen the out of body time of the grafts as well as increases their overall viability.
- Premade incisions: Designing and making the target sites before beginning the graft extraction is another technique utilized to facilitate implantation of the grafts post-extraction.
- Serial extraction and placement: This method was developed by Dr. Mohebi himself as a way to implant FUE grafts as soon as they are removed. This is achieved by having his surgical team work in sequence to minimize the out-of-body time of the grafts and improve follicular graft survival.
- FUE simultaneous extraction and placement: Simultaneous FUE extraction and placement is a hair restoration method designed to improve the growth of the transplanted hair follicles. The extracted grafts are implanted immediately after they are extracted from the donor area. In less than an hour, the grafts are scored, removed, counted by the surgical team and sorted under a microscope before being implanted. This method minimizes the time grafts stay out of body and can improve the overall quality of the transplanted hair.
FUE Hair Transplant Cost
- The extent of baldness and number of grafts a patient needs
- The fee per graft charged by the surgeon
- The type of FUE procedure like: regular, celebrity or non-shaven or body hair transplant
More information about procedure pricing, as well as options for financing, can be found on this hair transplant cost page. Please contact our office to schedule a physician consultation to determine the number of grafts necessary to give you the results you desire by undergoing hair restoration.
Why FUE is the Ideal Hair Transplant Choice
When it comes to hair transplant methods, FUE is one of the two main techniques utilized by surgeons to extract follicular grafts from the donor area. FUE has increased in popularity because it involves minimal pain for the patient. In addition, there are fewer complications and no visible linear scar at the conclusion of the procedure. Some limitations of the procedure include a smaller number of grafts being harvested during any one session and a higher overall procedure cost.
Before and after FUE transplant with 3546 grafts – 12 months elapsed
Shaving Your Head is not Always Necessary During FUE
The process of shaving the head of a patient is made on a case-by-case basis. There is no set answer as a hair transplant can be performed without shaving, with minimal shaving or using layer shaving that allows for hiding of the donor sites by longer neighboring hair. Here is an easy way to think about whether shaving will be necessary or not:
- Layer shaving for smaller FUE procedures – Patients with longer hair requiring 2000 grafts or less for their transplant normally do not require complete shaving of their donor area. These patients could have a linear shaving in which neighboring hair can cover the shaved layer and minimize the visibility of shaved donor areas.
- No shaving at all with Celebrity Hair Transplant – In some cases, individual hair can be cut before they are extracted. In this procedure, there is no shaving of the donor area. Due to the labor intensity of the procedure, the number of grafts will be much smaller as discussed earlier in this article.
- Full shaving for larger FUE – If the planned hair transplant procedure calls for a large number of grafts (over 2000) or the patient requires more than a one day FUE procedure to maximize the number of grafts, the surgeon will likely need unrestricted access to a large area of scalp. In this case, layer shaving might not be possible and the entire donor area will be shaved.
FUE and Hair Follicle Damage
FUE should not cause any damage to the existing hair if it is performed correctly. There are a variety of punch sizes and shapes available for scoring or microscopically cutting the grafts as well as the different instruments available to extract the grafts. The punches and instruments used, as well as the method of extraction, may change based on the type of donor hair you have in order to avoid damaging the existing hair.
FUE After a Previous Strip Transplant
Even if a patient previously had a strip procedure, they may still safely choose to undergo an FUE transplant for a variety of reasons:
- No pain – One of the most common reasons to have FUE is that it virtually has no pain and this is even true during the first night. If they do experience mild discomfort, taking over the counter pain killers is typically sufficient to control the pain.
- Smoother recovery – The recovery period after FUE is much smoother with regard to the donor area. There is no excessive scalp tightness and minimal to no donor wound complications.
- Inability to harvest the strip – Patients who have very tight scalps run a risk of stretching the scar. In this case, the scalp may not allow for additional strips to be harvested. It can also severely limit the number of available grafts that could be harvested along with the previous scars.
- Less aggressive – Many people just do not want to undergo an aggressive procedure that involves any cutting, suturing or stapling of the scalp.
- Lack of hair – Some patients do not have enough usable scalp hair that is suitable for harvesting through a strip method. They may need to choose hair from other parts of the body such as the beard or chest which is only possible with FUE method.
FUE and Exercise
You can start non-strenuous exercises immediately after an FUE procedure. Any activities that involve rubbing or scrubbing of the recipient area should be avoided until the fifth day after the procedure. In general, most patients can resume all activities one week after surgery.
Curly Hair Does Not Impact FUE Candidacy
Curly hair does not impact your candidacy for hair transplant. In the past, there were limited methods of extracting and transplanting curly hair as curly hair added a greater level of complexity to the procedure. Modern technology and the diversity of the tools available to us allows for the harvesting of every type of hair including wavy or very curly hair such as typical African hair for African-American hair transplantation.
Hair for FUE is not Limited to the Scalp
The simple answer to this question is “Yes!” FUE allows for hair to be harvested from other parts of the body including the beard, chest, extremities and even pubic area.
FUE and Your Job
When you can go back to work depends on what you do for a living as well as whether or not you can wear a hat. You can expect some redness and minimal scabbing in the transplanted area for the first few days after the FUE procedure. The scabs are usually easily removed by proper washing during the first 4 days. Some swelling on the forehead and even around the eyes might be apparent for 3-4 days after your hair transplant. The swelling will subside after day four.
Once you undergo a FUE hair transplant, here is the timeline of what to expect after a FUE transplant, and what you need to do to maintain your results, following the surgery.
Further FUE Questions
Have more questions about FUE transplant? Please visit our FUE FAQ page.