Follicular Unit Extraction (FUE) is the most advanced, minimally invasive technique for hair transplantation available today. It provides the most natural-looking results with no linear scars. Recovery time is faster, virtually painless, and risks have been significantly reduced with this technique. It also works for people who like to wear their hair short.
For many physicians, FUE has replaced Follicular Unit Transplantation (FUT), which is less desirable because it leaves linear scars. While FUT involved removed strips, FUE extracts very small units of hair – only 1-4 hairs each – with a specialized 0.9mm or 1mm punch. It is very precise. To be successful, the method requires considerable special training and is very labor-intensive for the surgeon and staff, but the rewards are well worth the effort.
Unfortunately, in the early days of the procedure, there were many failures because some doctors began to offer it before they had the proper training. When done incorrectly, portions of the root of the hairs are damaged, and the growth is then impaired. At our practice, we believe in the utmost integrity to ensure that all of our patients are happy with their results.
Currently, we use the NeoGraft® device, which is a state-of-the-art technology for FUE that allows us to provide a fast, efficient, and precise procedure.
The FUE Procedure
Follicular Unit Extraction can be a lengthy procedure, but the NeoGraft® system has significantly reduced the time required. In any event, a local anesthetic and light sedation will make you drowsy enough that it won’t feel like a long time.
You will be seated in a comfortable reclining seat. If you like, you can watch movies or television during the procedure. Most of our patients say the time seems to go fast, as they spend some of it sleeping and some of it watching entertainment or listening to music, similar to what they do when on an airplane flight.
Just like on an airplane, you can take breaks to stretch, eat, and use the restroom. However, the portion of the procedure in which the donor hair is extracted must be done without interruption.
Some shaving of the hair is required in the donor area. Depending on the amount of hair required and the length of your existing hair, this can sometime be covered with hair that remains on your scalp.
A team will assist the surgeon during your procedure. The anesthetic will be administered in a ring around the scalp so that the entire scalp will be numb. All you feel is light pressure as the procedure continues. If, at any point, you feel the need for additional anesthesia, it can be immediately provided.
No scalpel, stitches, or staples are required at the donor sites after the follicular units have been removed. The incisions are tiny and circular, and they heal on their own within days. A total of up to 3,000 grafts can be harvested in a single session. You may require more than one session in order to receive optimal results.
After the donor units are extracted, they are placed in a solution that is similar to your body’s natural fluids, and they are kept at a particular temperature in order to preserve them. They must also be specially prepared in order to be transplanted to the new area. In part, this involves removing excess fatty tissue from the units. Often, some of the follicular units that contain three or four hairs are dissected down to single hair grafts to assist in creating a very natural hair line. Extra care must be taken not to damage the tissue so that optimal growth can be achieved when transplantation occurs. The NeoGraft® has significantly reduced the time in between extraction and transplantation.
We take great care in determining the best recipient sites for your hair transplants. These sites are very important for you to receive an excellent result, as the distribution of hair and the angle that it grows will make all the difference in how you look. For this reason, FUE is both a science and an art.
The placement part of the procedure takes the longest, and you must keep your head still. You can take breaks during this portion, however. Advanced grafting techniques are used, and small incisions are made in the recipient areas that coincide with your natural pattern of hair growth. Absorbable sutures are usually used so that they don’t have to be removed.
Recovering from FUE
You will be fitted with a tennis bandage around your head, and you will wear a baseball cap home. Although most people will want a couple days off work, many patients can return to work the next day and can resume some athletic activities such as swimming, tennis, or golf within three days.
We will ask you to elevate your head on pillows for the first few nights. If this makes it difficult for you to sleep, we can provide sleep medication, as well as pain medication for any post-operative soreness. You may also feel a bit numb in the areas that were treated.
You can shower the next morning with a special shampoo, and we will provide you with specific instructions so that you do not disturb the grafts. If you come into our office the next morning, we will show you how to shampoo your hair properly. Your next follow-up appointment will be in approximately two weeks, but you can call us at any time with questions as you heal.
A great deal of healing takes place within a week. Some patients experience minor forehead swelling for a few days, but redness and swelling should be nearly, if not completely, gone by one week. Some scabbing may occur, but these can be covered with your hair style, and they will wash away within a few days. The new grafts should not be visible with the use of hair spray to keep hair in place.
You may start gentle washing of your hair two days after the procedure, and after about a week, you may wash your hair normally.
After about two weeks and for a couple of months, the transplanted hair will be shed because the hair follicles will have entered a dormant phase.
In the third month through the sixth month, the transplanted hair will begin to grow again. It will be very fine at first, and in the 5-10-month period, more hair growth continues. At about eight months, the hair growth will thicken. It takes a year or more for the final appearance from the procedure to show, so this procedure requires patience. But the new hair growth will be worth the wait.
The transplanted hair is permanent, but hair loss can continue. For this reason, some patients may require maintenance procedures, but most do not.
Are You a Good Candidate for FUE?
Not everyone is a good candidate for FUE, and we have been trained to determine whether this procedure will be successful for you. If not, we will be honest with you and offer alternatives.
People with unusually tightly curled hair are not usually good candidates, and you must have enough donor hair to be transplanted.
The procedure may be advantageous for those who have had previous hair transplants that left scars. FUE can be used to cover the scars with new grafts.