Follicular Unit Extraction (FUE) is a method of extracting, or “harvesting,” donor hair in a follicular unit hair transplant procedure. In FUE hair transplant surgery, an instrument is used to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue. The unit is then extracted (pulled) directly from the scalp, leaving a small open hole.
This process is repeated until the hair transplant surgeon has harvested enough follicular units for the planned hair restoration. This process can take one or more hours and in large sessions, may be accomplished over two consecutive days. The donor wounds, approximately 1-mm in size, completely heal over the course of seven to ten days, leaving tiny white scars buried in the hair in the back and sides of the scalp.
This method of donor harvesting, removing follicular units one-by-one directly from the scalp, is what differentiates the FUE hair transplant from a traditional Follicular Unit Transplant (FUT), where the donor hair is removed from the scalp in one thin, long strip and then subsequently dissected into individual follicular units using a stereo-microscope.
Before the grafts are harvested, tiny “recipient sites” are made in the balding area of the scalp using a fine needle-point instrument. The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the appearance of the donor area and in the quality and quantity of grafts obtained with each technique.
Indications for FUE Hair Transplants
Because FUE does not leave a linear scar, it may be appropriate for patients who want to wear their hair very short. It is also an advantage for those involved in very strenuous activities, such as professional athletes, who must resume these activities very soon after their procedure.
The technique is also useful for those who have healed poorly from traditional strip harvesting or who have a very tight scalp. FUE transplants also allow the surgeon to potentially remove hair from parts of the body other than the donor scalp, such as the beard or trunk, although there are many limitations with this process.
Possibly the most straight-forward application of this technique is to camouflage a linear donor scar from a prior hair transplant procedure. In this technique, a small amount of hair is extracted from the area around a linear donor scar and then placed directly into it.
Some patients desire Follicular Unit Extraction simply because they heard that it is less invasive than FUT or is non-surgical. The reality is that both procedures involve surgery and in both cases the depth of the incisions (i.e. into the fat layer right below the hair follicles) is the same. The difference is in the type of incision made. In FUE there are multiple round incisions scattered diffusely through the donor area and in FUT there is one single, long incision in the middle of the donor area. FUE should be chosen if the multiple round incisions are preferred and not because the technique is “non-surgical.”
Post operative care
Since FUE harvesting requires a much larger area compared to strip harvesting (approximately 5x the area for the same number of grafts) in order to perform large sessions of FUE, the entire donor area must be shaved. This can present a significant short-term cosmetic problem for many patients. In contrast, with FUT using strip harvesting, the donor incision can be covered with hair – even with very large sessions.
On the other hand, because there is no linear incision with FUE, patients can resume strenuous activities and contact sports much sooner after the procedure.
BEFORE & AFTER GALLERY
- England cricket legend Chris Tremlett - hairline restoration: 5 months post procedure hairline thicker and restored
- Blackburn footballer Jason Steele: Significant hair-loss restored. 12 months post procedure.
- Female hair restoration side: 6 months later hair loss on the side has been restored
This depends on the number of hair required. On average, the treatment takes no more than a day to complete. However, when large numbers of hairs are required the patient can split the procedure across two days.
The new outline of the hair will be visible immediately, but it is normal for the transplanted hair to shed a few weeks after the procedure. New transplanted hair begins to grow at around 10 weeks.
After around 6 months, the results will be full and can be groomed, and in most cases, it can take a year to be fully grown.
In the few months following hair surgery, before the new hair starts to row, there may be some shedding of the original hair so that the transplanted area may temporarily appear slightly thinner.
The Norwood Scale determines different stages of male balding. It is also an indicator of how hair loss will progress over time.
- Minimal hair loss/normal head of hair
- Insignificant hair loss at the temples
- The first stage that requires treatment
- Receding hairline and thinning hair on the vertex
- Bigger pattern on the vertex and hairline
- Patters at both sites are bigger but a thin division line is still present
- The bridge is gone but several strands of short fine hair may remain
- The most severe form of hair loss – little hair on the front or top of head
There are three main causes:
- Hormones: Dihydrotestosterone (DHT) makes the length of the growing cycle decrease and as this progresses, with each new cycle the hair shaft becomes smaller.
- Genes: Hereditary hair loss can be passed on by either parent. If a parent is severely bald, it doesn’t mean this will be hereditary, there will just be a higher chance.
- Age: Follicles when exposed to DHT over a long time will increase hair loss. The age at which this process starts differs between everyone.
Follicular unit extraction offers permanent results.
The cause and nature of hair loss will dictate whether the client is suitable for a procedure. It is quite possible that a person with extensive hair loss can achieve extremely good results after restoring hair. Clients can also go onto a hair loss prevention program.
Our surgeons will be able to measure hair loss to identify the best course of action.
Follicular unit transplantation (FUT) yields the most donor hair, and is best suited for more extensive hair loss and in patients where the main concern is maximising the use of a donor supply.
The hair is efficiently used because of the precise nature of the procedure – and the fact that the extraction is from the area that is densest and most stable.
A limitation of FUT is that it leaves a line scar in the donor area. With normal styling, this is easily covered with hair, but it precludes someone from wearing their hair very short.
The FUE method is better suited for individuals who don’t have extensive hair loss. In the case of a candidate having extensive hair loss, multiple procedures may be required.
In certain cases, where the hair loss is only minimal, we will also recommend a hair loss prevention program, with recommended lotions and medications.
The technique is not painful; local anaesthetic will numb the area before treatment starts, and the patient will not be able to feel anything during their treatment other than a small rubbing sensation.
FUE is a minimally procedure, carried out under local anaesthetic. Many of our patients even fall asleep during their procedure.
Compared to FUT, no stitches are required after treatment and recovery time is minimal – being able to leave the clinic immediately following treatment, and healing within 5 to 7 days.
Precise and fine instruments are used to minimise trauma, with results often being entirely undetectable. As the strongest and healthiest hair follicles are selected for the procedure, the results are natural-looking and densely packed.
There is a decrease in the volume of hair that can be transplanted due to the limited donor area. However, in most cases there is sufficient donor area to restore the hair as desired.