FUE or Follicular Unit Extraction is a method of harvesting hair follicles from the donor area (the back and side of scalp where hairs won’t fall out during the patient’s lifetime).
In FUE hair transplant, the surgeon extracts each follicular unit one by one using a micro punch that varies in diameter from 0,7mm to 1,1mm. There are many types of punches and ways to use them (manual punches, motorized punches, sharp, blunt, among others) and all of them can offer good hair transplant results in experienced hands. What makes a big difference is the surgeon’s ability and experience. There is even a robot which helps the surgeon in the extraction process of the FUE.
A FUE hair transplant is different from the Classic Technique, also known as Strip procedure or FUT (Follicular Unit Transplantation) because in FUT a strip of scalp is surgically removed from the donor area and the follicular units are prepared outside the body by technicians using microscopy. After the closure of the scalp, a linear scar will be present in the donor area. With FUE the follicular units are removed one by one, so, there isn’t an incision and a linear scar, instead there are many punctiform scars. It’s important to say that FUE isn’t a scar free technique, only there isn’t the linear scar.
The follicular units can be one, two, three of four hairs clustered in each unit. This is very important for the success of the transplant because this is the natural way that hair grows. These follicular units are very similar in FUE and FUT.
To achieve a natural look from your transplant depends on many factors such as anterior hairline desing, good density, direction of implantation, use of appropriate follicular units in each location, etc. This can be achieved both by FUE and FUT procedures.
In regards to scarring in the donor area, FUE leaves many (hundreds, or even thousands) of punctiform scars usually less than one milimeter in diamater. When properly done, one can hardly see them even with a short haircut, but if you shave your head completely you will see many white dots.
The old “plug” look is long gone due to newer instruments used. The old punches had 0,5cm in diameter or more where in FUE the punches are usually of less than 1mm in diameter. Just enough to incise the skin around the follicular unit. This way, the transplant done by FUE has the same natural results of the Follicular unit transplantation done by strip. With the old punches technique, each punch could remove 15 to 20 hairs together giving the “dolls hair” aspect that is definitely in the past.
The FUE procedure is usually more time consuming than FUT. An FUE surgery time varies according to the surgeons experience, speed in harvesting and patient characteristics. The procedue can take anywhere from a couple hours to extract 200 grafts for a scar correction to a surgery over two consecutive days for a megasession of 2,500 to 3,000 grafts.
The donor area recovery is vary fast. In two or three days all the incisions are healed as there are no stitches to be removed. The recovery of the implant itself is similar to the FUT technique: the hair starts to grow in around 3 to 4 months following surgery and grows 1cm per month.