FUE and How Its Done & How It Works

Follicular unit extraction is known as FUE. 

 

This is one of two surgical methods of taking hair follicles from the donor region around the back and sides of the head. These are naturally occurring groups of one to four hairs, used for hair transplantation. 

 

The other surgical method is called Follicular unit transplant (FUT). The BAHRS has pushed for a change to the name from 'Extraction' to Follicular Unit Excision. 

 

The name change came about to accurately describe the procedure which involves surgically cutting or incising a full-thickness hair follicle skin graft with a circular punch or motorized drill and subsequently carefully extracting it from the scalp to be placed into the balding donor scalp. 

 

Due to the new developments of incision punches (which used to be handheld) and devices and a variety of different extraction techniques, it was necessary to define the procedure. Additionally, many places were incorrectly marketing the extraction procedure as a simple plucking of hairs and deceiving the public. The hairs are in no way 'plucked' but they are surgically cut out of the scalp with a small hollow cylindrical punch. This results in very small scars, that fade to a small dot which is easy to hide with a short hair style. 

 

The follicular units obtained from both FUT & FUE are the basic building blocks of follicular unit hair transplant surgery. 

 

Follicular unit extraction was first described in 1988 by Masumi Inaba in Japan, who introduced the use of a 1 mm needle for extracting follicular units. 

 

Follicular unit etraction takes considerable time and expense to learn and to develop skills to a high standard. 

 

The first initial part of the procedure involves making a small incision with a circular cutting punch around the hair follicle through the epidermis into the subcutaneous tissue in order to release the follicle from the underlying tissue. 

 

The graft is then extracted using very fine FUE extracting forceps, they are then carefully preserved until it is time to reinsert into the recipient area, be that the hairline, temples, mid-scalp or crown. 

 

Each follicular unit is excised one at a time over 2-4 hours. This is carefully handles as to not damage the root of the follicle, this is called 'transection'. 

 

Additional care must also be taken by our team of highly trained hair restoration technicians when extracting the grafts with forceps to insure the hair follicles are not crushed or manipulated too aggressively which could also affect the re-growth over the coming months post-surgery. 

 

Hence FUE requires a great deal of skill, time, focus, and experience to achieve good results long term. 

 

Still to this day, most larger hair transplant surgeries use FUT as opposed to FUE to excise as many grafts as possible in one day. The yield is still considered a slightly higher % of success. 

 

The survival of follicular units upon cutting around the hair follicle and then extracting from the scalp is one of the main reasons for successful hair transplantation. If a follicular unit is transected during the incision process, there is a high likelihood that it will not survive the hair transplant surgery, and the hair transplant is more likely to fail. 

 

While FUT procedures using strip-harvesting of follicular units typically guarantee a large number of non-transected follicular units, hence the noted success rate of FUE is around 85-90%, and FUT remains 93-95%. 

 

FUE surgery may cause "pit" scarring in the donor region, These are small, round, and typically white scars in the patient's donor area where the grafts have been removed. 

 

Follicular unit extraction generally has a quicker patient recovery time and significantly lower post-operative discomfort than follicular unit transplantation (FUT). Normally recovery from FUE is shorter, around 5-7 days, whereas FUT requires 10-14 days. 

 

However on the flip side, there is a risk of nerve damage within the donor region post-surgery having removed a long linear strip of skin, this can result in numbness and/or pain in the donor area. 

 

This risk is not the same using the FUE procedure. 

 

FUE provides an alternative to FUT in both scarring, price, and recovery. All these things need to be considered when selecting what method is best for you. 

 

Although patients selecting FUT are advised to perform Scalp Massage prior to undergoing FUT, sometimes when the scalp is too tight for a strip surgery, the FUE is the best and safest method of hair transplant. 

 

Before the surgeon removes the follicles using FUE, the team will shave the back and sides of the donor region, another consideration for recovery and returning back to work. 

 

With all hair transplant surgery, the surgeon needs to ensure extracting hairs from the Safe Zone, as hairs extracted close to areas of hair thinning may well not be permanent and suffer from hair thinning and DHT. 

 

When considering severe hair loss and the potential for multiple procedures, FUT is often the better method if the plan is to perform 1-2-3 operations, as subsequent sessions of FUE are more difficult. 

 

If considering FUE or FUT Surgery, Elite Hair Restoration perform FREE Video Consultations daily, MOonday through Sunday 8am to 8pm.