Follicular Unit Extraction

What Is FUE?

FUE (follicular unit extraction) is a new technique for harvesting follicular unit grafts from the scalp or other body areas for use in hair transplantation. It has been performed in hair transplantation for more than five years. Recent improvements in instrumentation have enabled an improvement in the quality of the grafts produced to the extent that they are now comparable with microscopically dissected follicular unit grafts.

What Makes FUE Different From Other Hair Transplant Techniques?

The difference lies in the matter of graft harvesting. In FUE, there is no linear excision of the skin. No scalpel is used and there are no stitches. The follicles are “extracted”, rather than cut, from the skin. The skin heals quickly in the space where the follicles were, without visible scarring, and the grafts are transplanted in the usual manner to the thinning areas on top.

What Are the Advantages of FUE?

Some patients prefer not to choose strip excision, out of concerns of discomfort, the appearance of the linear scar, the desire to avoid stitches, or the desire to wear a very short hairstyle in the future (where a linear donor scar could potentially be visible). Some patients just don’t like the idea of an incision in their skin and opt for FUE instead. In addition, there are some patients with quite tight scalps, in who strip excision possibilities are limited due to the scalp’s remaining ability to stretch. FUE is not dependant on scalp stretch, and so is just as feasible in those with tight scalps.

Patients who have had this done report no pain in the donor area and quicker healing.

What New Possibilities Does This Technique Offer?

Any hair on the body can be transplanted to the scalp to thicken what is already there. With strip harvesting, there is always a linear scar remaining to make most non-scalp donor areas impossible to conceal. Harvesting hair with a strip from the center of the chest, as an example, leaves a scar similar to that of coronary bypass surgery. FUT leaves small micro-dot scars, rather than a visible linear scar, and has become the preferred technique for body hair transplants.

Some situations require only a very small number of grafts and again, FUE is often preferred, rather than a strip.

Is FUT “no-Scar” Hair Transplant Surgery?

No, it isn’t. Any time the skin is cut, it’s the only way to heal is through the formation of a scar. FUT leaves individual “micro-dot” scars that are undetectable in the vast majority of patients, but they are still scars. It’s just that they are less noticeable to the eye than a scar that is a line. FUE scars in most patients are tough to even find.

What Is the Scarring Like From Strip Harvesting?

This has recently gone through an evolution with the development of the Trichophytic closure technique. In the hands of an experienced hair surgeon, traditional strip harvesting will leave a 1-2mm wide scar in 90-95% of patients. Trichophytic closure produces an even narrower scar with hairs that actually grow through the scar, further hiding it. In practical terms, this means that in Dr. Elliott’s experience, 95% of patients will never be bothered by the appearance of their donor scar, and need not choose FUE based on donor scar appearance. These patients would tell you that their hairstylist has trouble finding it.

What Is the Disadvantage of FUE?

This procedure has been in use in hair transplantation for several years now. When first conceived, the rate of damage to the follicles during the extraction process was unacceptably high, in Dr. Elliott’s opinion. Further development in technique and instrumentation followed and the quality of the grafts improved to become comparable to what can be achieved through modern microscopic methods.

Once this evolution occurred, Dr. Elliott was confident in offering this method to his patients. Currently, the disadvantages of FUE are time and cost. This process is 3 or 4 times more time-consuming than FUT (follicular unit transplantation) with strip harvesting. In FUT, the strip is dissected into grafts by skilled technicians under the microscope. In FUE each graft is extracted by Dr. Elliott one at a time, but this is preferred by some patients. This means that moving the same number of grafts takes much longer. This raises the costs involved when compared to strip harvesting.

Dr. Elliott will explain the advantages and disadvantages of FUT, combination grafting with MUGs and FUs, and FUE relative to your situation, goals, and concerns. You can choose the method that you prefer.

Why Did Dr. Elliott Decide to Offer This Procedure in His Practice if It Is So Time-Consuming?

Dr. Elliott is committed to excellence in all aspects of hair loss treatment. He is an invited speaker at international hair surgery conferences and a world-recognized master of Multi-Unit Grafting. He believes that there is a solution to any hair loss problem and saw the advantages of FUE for some problems and some patients. When he was satisfied that the technique had evolved to be able to provide these advantages without sacrificing graft quality, it had passed his personal test.

Dr. Elliott knows that for some patients, strip harvesting is not technically feasible, or unappealing. FUE offers these patients the opportunity to deal with their hair loss through transplantation and enhance their personal appearance and confidence.

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