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Improvements in instrument technology and technique have now made follicular unit extraction (FUE) a procedure competitive with strip harvesting for obtaining donor hair for transplantation.

In FUE, a physician removes one FU – or follicular unit, at a time, targeting those that appear most likely to thrive and produce hair in a recipient site. It requires more skill from the physician and more cost from the patient than does strip harvesting, which is the removal of a strip of scalp tissue bearing hundreds of follicular units.

FUE is a newer technique than strip harvesting. As FUE evolved, so did the development of instruments for harvesting follicular units.

Here is a history the instruments used for FUE.

The Manual Punch: The manual punch is a circular hollow scalpel with a diameter of 0.7 to 1.0 millimeter. It is the original FUE instrument. The punch is placed over the visible portion of a follicular unit’s hairs, and pressed downward with manual rotation to incise the skin around the FU and free it from surrounding tissue. The FU is then extracted by traction with forceps.

The SAFE System: A three-step manual process called The SAFE System uses a sharp circular punch to incise skin around the FU, then a blunt circular punch to loosen the FU from surrounding tissue. The third step is extraction.

Powered SafeScribe®: The Powered SafeScribe® is a hand-held motorized device to extract follicular units with minimal potential for damage, and deliver them for transplantation. A range of punch sizes and types is available. In skilled hands, the Powered SafeScribe® can reduce the time of FU extraction sessions, reduce potential for scarring, and deliver a high rate of undamaged FUs.

RotoCore: This automatically rotates the sharp FUE punch as it incises skin around the FU. The device allows the physician to pre-set the punch to cut to a selected depth.

The Feller Instrument: The Feller FUE instrument combines FUE procedures into a single instrument to help the physician work faster and more efficiently.

Cole Isolation Technique: The Cole Isolation Technique, also called Follicular Isolation Technique, uses instruments designed especially for this technique. The rationale for CIT is to selectively isolate and extract intact a single FU at a time, along with elements of its environment.

NeoGraft: This is a mechanical device that provides a rotating sharp punch to incise the FU, and a suction instrument that extracts the FU and moves it to a collection tray that can hold up to 50 FUs awaiting transplantation.

ARTAS® SystemThe ARTAS® System is the most mechanized FUE device. It is a completely robotic device. The system has been given clearance by the U.S. Food and Drug Administration for use in harvesting FUs from brown-haired and black-haired men who have been diagnosed as having male-pattern balding. The system is operated by a physician who uses a computer-assisted, image-guided robotic arm equipped with Powered SafeScribe® small punches to incise and an air-suction unit to extract individual FUs.

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