Follicular unit extraction (FUE) is a surgical hair restoration procedure involving individual removal and reimplanting healthy hair follicles. This treatment can address many types of hair loss, including thinning and baldness due to genetics or aging.
FUE requires a unique punch tool to be successful, and it takes time to develop the skill to extract follicles without damaging them. This comprehensive guide to FUE will explore what it is, how it works, and the benefits of this minimally invasive hair transplant technique.
- 1 What Is FUE?
- 2 How Does FUE Work?
- 3 What Is the Donor Site?
- 4 What Is the Recipient Site?
- 5 What Are the Advantages and Disadvantages of FUE?
- 6 What Are the Alternatives to FUE?
- 7 What Are the Contraindications to FUE?
- 8 What Is the Recovery Period Like for FUE?
- 9 What Are the Side Effects of FUE?
- 10 What Is the Cost of FUE?
What Is FUE?
FUE is a surgical hair restoration technique that harvests follicular units one at a time. The patient’s hair must be trimmed short so the surgeon can easily view the follicles and avoid cutting them with the punch.
The newer instruments used in follicular unit extraction have made this procedure much more viable. This unique technique is also less likely to give the “plug” look that older methods could create. However, sound surgical skill and armamentarium are essential for desired results.
How Does FUE Work?
Follicular unit extraction (FUE) involves extracting individual hair follicles from a safe donor site on the scalp or body. This is ideal for people with a limited number of grafts needed.
It also works well for patients with Ehlers-Danlos syndrome who are prone to widened scars from traditional strip excision. FUE can leave tiny circular spots virtually impossible to see with a short haircut.
This method of harvesting requires a lot of skill to avoid injury to the surrounding tissue. It should only be performed by physicians, Physician Assistants (PA), and Nurse Practitioners.
What Is the Donor Site?
Many hair restoration procedures require a significant amount of healthy scalp tissue. This tissue is known as the donor site.
This is the region of the scalp that contains hair and hair roots that can be transplanted into bald or thinning areas of the scalp.
The most common method of harvesting these follicles is strip harvesting, which involves cutting a thin strip of tissue from the scalp with a single or double-bladed scalpel. Your physician hair restoration specialist may also offer elliptical-style donor harvesting, which uses elongated oval incisions instead of a strip.
What Is the Recipient Site?
The surgeon makes hundreds to thousands of tiny incisions called recipient sites on the balding areas of the scalp where harvested follicular unit grafts will be placed. The pattern of these incisions and their angle are critical.
Hair grows in natural groupings of 1 to 4 inches. Modern techniques harvest these in their biological collections and transplant them for a more natural hairline.
After thorough surface asepsis and tumescent anesthesia of the donor area, your surgeon uses tiny circular punch tools that are 0.6-1 mm in diameter to extract the follicular units (FU). The FUs are temporarily stored and processed/arranged for implantation.
What Are the Advantages and Disadvantages of FUE?
FUE allows for a scar-free procedure when it comes to hair transplantation. However, it does require that your hair be trimmed short for the surgeon to harvest the follicular units.
It is a time-consuming technique and requires high skill levels to perform successfully. The surgeon must align the punch correctly, find the correct depth, and avoid cutting into arteries, veins, or nerves.
Inexperienced surgeons can also cause physical injury to follicular units during the extraction process. This can lead to transactions detrimental to the grafts’ growth rate.
What Are the Alternatives to FUE?
Many over-the-counter remedies, topical treatments, and hairstyles are available to treat thinning or receding hair. However, surgical procedures are often the best option for more significant hair loss.
One such method is strip surgery. However, this technique leaves a linear scar that can be seen even with short haircuts.
Conversely, FUE produces tiny, circular scars that are only a few millimeters in size. These scars are easily concealed with surrounding hair and should be undetectable once they have grown. The recovery period is also shorter with FUE.
What Are the Contraindications to FUE?
FUE is a simple office procedure that requires minimal recovery. However, it may not be suitable for all patients. For example, extracting intact follicular units in patients with dense hair can be difficult.
This is because the follicles are closer and may be more challenging to dissect with a sharp punch. For this reason, we use a dull point to avoid follicle trauma and increase graft yield. This also helps prevent scarring in the donor area.
What Is the Recovery Period Like for FUE?
Unlike the older strip method, FUE does not leave a linear scar on the scalp. Instead, FUE leaves scattered, circular scars almost undetectable with a short haircut or a completely shaved head.
In the first week following your FUE hair transplant, you may experience soreness and swelling. But this will fade quickly. Most patients return to work and their routine in a matter of days. New growth usually takes a few months, though every patient is different. During this time, you should avoid hair products and treatments.
What Are the Side Effects of FUE?
FUE does not leave a linear scar in the donor area but can produce many small (less than one millimeter in diameter) white dots. However, these dots are easily hidden with longer hair and will likely fade with time.
During a FUE procedure, Bosley physicians will place the follicular units into your thinning areas with great artistry. These placements will match your natural growth pattern for the most natural-looking results. You may experience mild pain and swelling for three days. Other side effects include numbness, bloating, and itching.
What Is the Cost of FUE?
Unlike FUT, which involves the removal of a strip of hair-bearing skin, FUE uses individual healthy follicles directly from your scalp. Although this method may leave tiny white dots where the strands were extracted, your new hair will fade or cover these scars.
FUE is a versatile technique that can address a variety of dermatological indications like androgenetic alopecia, facial hair restoration, tractional alopecia, alopecia areata, stable vitiligo, and hirsutism.
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