Follicular Unit Extraction

Follicular Unit Extraction (FUE) is a method of hair transplantation where hair grafts are individually harvested from the scalp donor area. This method allows the grafts to be removed without the need to create a linear scalp scar.

Why Choose FUE?

The decision to have FUE depends on the goals of each individual patient.

FUE offers automated and manual techniques that allow the surgeon to adjust the size and depth of the FUE punches. The punch depth and size depends on the patient’s scalp and the characteristics of their hair. In addition, the use of FUE is also based on the quality of the donor hair (if it comes from body areas other than the scalp) and if FUE will provide the desired results.

When deciding whether or not to undergo FUE, it is important to consider the advantages and disadvantages of the procedure:

FUE Advantages

  • No linear scar after surgery
  • Minimal post-op pain and reduced overall recovery time
  • Hair can be used, for transplant, from other areas of the body, including beard and body hair
  • The final results include reduced donor area density
  • A minimized contrast between the transplant area and the donor zone on the back and sides of the scalp

FUE Disadvantages

  • Limited number of grafts can be transplanted per session which makes it more time consuming
  • The surgical team must have excellent hand and eye coordination to achieve the best results
  • Since the hair is harvested individually, it requires more labor and can cost more than other methods
  • People who need a high number of grafts usually need more than one hair transplant to achieve the desired coverage

How is FUE Performed?

FUE grafts can be harvested using robotic, motorized and manual devices. The method used by the surgeon depends on the goals of the individual patient. Each method below is designed to reduce the total out of body graft time while also improving the overall survival rate of the grafts.

  • Chasing method: A method that lets a technician extract from the donor area soon after the physician scores the grafts. The extraction occurs almost immediately after the grafts are scored to lessen the out of body time of the grafts. This method also increases their overall viability.
  • Premade incisions: The practice of designing and making the target sites, prior to graft extraction facilitates the implantation of the grafts post-extraction.
  • Serial extraction and placement: Dr. Mohebi developed this method so the FUE grafts can be implanted as soon as they are removed. The surgical team works in sequence to minimize the out of body time of the grafts which also improves follicular graft survival.
  • FUE simultaneous extraction and placement: This method improves transplanted hair follicle growth. The extracted grafts are implanted right after being extracted from the donor area.  It takes less than an hour for the grafts to be scored, removed, counted by the surgical team and sorted under a microscope before they are implanted. This method lessens the out of body time of the grafts and improves the transplanted hair quality.

How Much Does FUE Cost?

The total cost of a hair transplant depends on a number of factors:

  • The number of grafts needed by a patient
  • The per graft fee
  • The type of FUE procedure performed by the surgeon

Want to know more about procedure pricing? Contact our office to schedule a consultation to determine the number of grafts necessary needed to produce your desired results.

Will You Need to Shave Your Head Before FUE?

Here are some tips to help you determine if shaving will be necessary:

  • Layer shaving for smaller FUE procedures – Patients with longer hair that requires 2000 grafts, or less, for a transplant normally do not need a complete shaving of the donor area. These patients could benefit from linear shaving where the neighboring hair can cover the shaved layer while minimizing the visibility of the shaved donor areas.
  • Celebrity Hair Transplant – With some patients, the individual hairs can be cut before they are extracted. With Celebrity Hair Transplant, there is no shaving of the donor area. However, due to its labor intensive nature, the number of grafts will be much smaller.
  • Full shaving for larger FUE – If the hair transplant requires over 2000 grafts, or the patient requires multiple days of FUE to maximize the number of grafts, the surgeon will likely need unrestricted access to a large area of the scalp. In cases like this, layer shaving might not be possible and the entire donor area will need to be shaved.

Does FUE Damage the Hair Follicles?

When performed correctly, FUE should not cause damage to any existing hair. There are a wide assortment of punch sizes and shapes available for scoring or microscopically cutting the grafts along with different instruments to extract the grafts.

FUE Following a Previous Strip Transplant

Patients who previously had a strip procedure can still undergo FUE transplant. Some of the reasons for FUE after a previous strip procedure include:

  • Free of pain– FUE involves virtually no pain during, and after, the procedure. If patients do experience mild discomfort, over the counter pain killers can control the pain.
  • Smoother recovery– The recovery after FUE is much smoother, in regard to the donor area, with no excessive scalp tightness and minimal complications.
  • Risk of scar stretching– Patients with very tight scalps run a scar stretching risk and the scalp may not allow additional strips to be harvested. The number of available grafts to harvest might also be limited.
  • Less aggressive method– Many people do not want a procedure that involves cutting, suturing or stapling the scalp.
  • Lack of hair– Some patients simply lack enough scalp hair that can be harvested via a strip method. In these cases, they might need to choose hair from the beard or chest or other parts of the body. This option is only possible with the FUE method.

FUE and Exercise

Non-strenuous exercise can be resumed immediately after FUE. Activities that involve rubbing, or scrubbing, the recipient area need to be avoided for 5 days. Most patients resume all activities a week after their surgery.

Curly Hair

Do not worry if you have curly hair. It does not impact your candidacy for FUE. Modern technology, as well as the diverse tools available to surgeons, allows for wavy or very curly hair to be harvested. This includes typical African hair for African-American hair transplantation.

When Can You Go Back to Work?

Returning to work depends on your daily job duties as well as whether or not you can wear a hat. There will be some redness and minimal scabbing for the first few days in the transplanted area. Forehead swelling, as well as around the eyes, can be seen for 3-4 days post-transplant. The swelling will subside after the fourth day.

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