Follicular Unit Extraction

What is the Follicular Unit Extraction Method?

Follicular Unit Extraction (FUE) represents a modern iteration of the conventional Follicular Unit Transplantation (FUT) technique, wherein the implantation of follicular units into the recipient area remains consistent, ensuring a natural transplant growth without the appearance of “plugginess.”

The differentiating factor lies in the method of harvesting hair from the donor area. In contrast to FUT, which involves excising a strip of hair, suturing the area, and then dissecting follicular units under a microscope, FUE individually removes follicular units one by one. Consequently, no wounds require suturing, and microscopic dissection is unnecessary.

The FUE procedure entails using a 0.8mm – 1 mm punch around a single follicular unit to create a small circular incision through the skin. The follicular unit is gently extracted from the loose connective tissue underneath the skin. Once removed, no additional preparation is needed, and the small hole naturally heals over one to two weeks. This process is repeated numerous times until the desired number of follicular units are obtained, leaving the patient with multiple 0.8mm – 1 mm round white scars, as opposed to a linear scar associated with FUT.

Advocates of FUE emphasize less noticeable scarring and the absence of scalp tightness, a common issue in FUT due to tissue suturing. However, FUE has notable drawbacks, including the challenge of performing large sessions efficiently. The slow and tedious nature of extractions may necessitate multiple-day sessions for patients seeking significant coverage.

Advocates of FUE emphasize less noticeable scarring and the absence of scalp tightness, a common issue in FUT due to tissue suturing. However, FUE has notable drawbacks, including the challenge of performing large sessions efficiently. The slow and tedious nature of extractions may necessitate multiple-day sessions for patients seeking significant coverage.

A theoretical concern with FUE is the potential impact on long-term growth. During extractions, follicular units are gently torn from underlying tissues, and the absence of the deepest component of connective tissue beneath the follicles may lead to weakening over time. The novelty of this technique makes long-term outcomes uncertain.

Patients must also be aware that scarring is inevitable in the donor area, albeit in a different form. FUE results in numerous tiny round scars, which may be preferable or not, depending on specific patient characteristics, such as scalp tightness, scarring tendencies, and hair loss patterns.

In conclusion, while FUT has historically served its purpose, both the Direct Hair Implantation (DHI) technique and FUE offer superior results at a similar cost. Therefore, patients can receive more effective treatment and better outcomes with these advanced techniques.

The Four Stages of a FUE Hair transplant

Before an FUE hair transplantation, local anaesthetic is administered, so you won’t feel more than a slight pressure during the procedure

1. A Micro Punch tool is used to cut a small circle of skin around the individual follicular unit
2. The follicular unit (or graft) is gently prised away from the surrounding loose connective tissue under the skin
3. The harvested grafts are sorted according to how many individual hairs in each follicle
4. The grafts are then implanted into the balding area of the scalp

What is the difference between FUE and FUT?

There are a number of key differences between the FUT and FUE hair transplant methods.

Often called the ‘strip method’ or ‘strip surgery’, FUT hair transplants take large strips of donor hairs from the patient’s scalp. These strips of hair are then dissected under a microscope before being implanted into the balding area. In comparison, follicular unit excision (FUE) takes much smaller hair grafts from the donor area, not only making it quicker, but leaving most patients with much less scarring than those who have undergone FUT.

Why choose FUE over FUT?

• During procedure, there is less pain involved in FUE than FUT. This is because no major, or large, incisions are required.
• FUE is also a quicker than FUT. This is because no separations need to be made under a microscope as is needed with FUT. This means you can tailor your hair transplant around your busy schedule!
• After the procedure, FUE typically has a much quicker recovery time when compared to FUT. This is because of the reduced scarring made by the 1mm punches. Patients are left with tiny scabs that quickly heal as opposed to large incisions made in the scalp.