Follicular Unit Extraction - A guide to Hair Transplant Surgery

This is the name given to a new method of hair transplantation in which individual follicular units are removed from the donor site. This means that these follicles will remain in the same state and will grow as normal in the recipient site.

Note: the donor site is the name given to the band of hair around the head which lies just above the ears. This is a common feature of male pattern baldness.

Basically, FUE is part of the Follicular Unit Transplantation (FUT) method in which hair is harvested in small groups (units) and inserted into the bald area of the scalp (the recipient area).

The advantage of this method is that there is no need for the surgeon to make a long incision in the donor area. He or she uses a small micro needle which ‘punches’ a tiny incision around the hair follicle before extraction.

This is an ideal method of surgery for patients who like to have short hair. So if you have a short, cropped hair style then this surgery is for you.

It is also recommended for patients who have a tight scalp or have previously undergone the ‘strip’ method but with little success.

It sounds very similar to follicular unit transplant (FUT) surgery but the main difference between the two is in the way the donor hair is obtained.

FUT involves removing the follicular units in strips which are then dissected under a microscope. These units are then inserted into the recipient area.

But with FUE, the follicular units are taken directly from the donor area and then inserted into the recipient area.

You can find out more in our comparison FUT with FUE section.

Things to consider with FUE

There are a few things to think about in regard to the way the follicular units are obtained or ‘harvested’ as this does impact upon the procedure. These include:

  • The number of grafts in a session
  • The damage (transaction) rate to the follicular units
  • How the follicular units are distributed
  • The total number of follicular units
  • The aftercare

You may undergo a ‘FOX test’ during the initial stage of surgery in order to assess the level of potential damage to the hair follicles.

FOX stands for ‘ease of extraction’.

There are patients who respond better than others to unit extraction and it is important to check to see if you are likely to be one of them. If this is the case then you need to consider whether to stick with the FUT procedure which will not damage the hair follicles or to go with FUE but risk follicle damage.

Remember: damaged hair follicles will affect the growth of new hair. This can reduce the amount (density) of new hair and the coverage of your bald area.

If you have chosen FUT then you can still undergo the FOX test in case you require further surgery and/or may need FUE some time in the future.

What this procedure can do is to hide the signs of a previous hair transplant surgery. So if you have undergone a hair transplant before but via an older method such as a micro/mini graft then this tends to leave a long, linear scar on the back of your head.

FUE can disguise this scar.

The Follicular Unit Extraction (FUE) procedure

The process is very much the same in that you will be given an injection of a local anaesthetic into the donor area which then freezes that area. You may be also be given a sedative as well.

Find out more about this in the day of your hair transplant section.

We also discuss in general what happens before and after surgery. This can be found in our preparing for your hair transplant and after your hair transplant surgery sections.

The surgeon will use a microscope and a slender instrument (micro-needle) which makes a small circular incision around the follicular unit. He or she is then able to remove or extract the unit. This means no long, linear scar or stitches.

The follicular units are removed, one by one in a time consuming procedure.

This also makes it rather expensive as well.

The recipient area (bald area of the scalp) is injected with a local anaesthetic in order to be ready for the follicular units. These units are then inserted into the recipient area. A maximum of 800 follicular units are transplanted in a single session. This means that it cannot be completed in the one session and you will have to undergo three or four sessions to achieve the result you want.

Another difference between this and FUT is that body hair can be sued for transplantation. But these are not of the same quality as the donor hair and don’t always work as well.

FUE does result in great looking hair although there is no difference in the end result between this and FUT.

The advantages of FUE

The advantages of this procedure include:

  • No linear scar
  • Don’t need staples or stitches
  • Good choice of procedure for patients with short hair
  • Good option for patients with previous scarring or a tight scalp
  • Can use body hair
  • Good choice if a limited number of grafts are required
  • Quick healing time
  • Minimal discomfort after surgery
  • Less downtime/able to resume normal activities and exercise quickly

The disadvantages of FUE

Every procedure has its advantages and disadvantages and hair transplantation is no different.

The disadvantages of this procedure include:

  • Time consuming procedure
  • Costs more than FUT
  • Risk of damage to the follicular units
  • Limited supply of donor hair as some hair must be left to cover the rest of that area
  • Small scars may obstruct nearby follicular units which can be problematic if further sessions are required
  • Less hair density than with FUT
  • Not enough suitable candidates for unit extraction than with FUT
  • May be difficult to achieve an ‘even spread’ of units
  • More than session is needed
  • If body hair is used then this is unlikely to be permanent
  • Risk of the hair graft being pulled off when extracted

After FUE you may experience soreness, swelling and some discomfort around your scalp but this ease within a week.

No surgery is 100% risk free but the chances of this happening with FUE are extremely rare. Any complications which do occur will include infection, bleeding, poor wound healing or a poor results but this tends to be rare.

Recovery from FUE is quick, in fact, quicker than with any other procedure so you can expect your scalp to be fully healed within a week after surgery.

It usually takes around a year for a full head of hair to have grown.

Hair Transplant Surgery Methods Guide Index:

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