Follicular Unit Extraction

What is the Follicular Unit Extraction Method?

Follicular Unit Extraction (FUE) represents a modern advancement in the traditional Follicular Unit Transplantation (FUT) technique, maintaining consistent follicular unit implantation into the recipient area to ensure a natural transplant growth without the appearance of “plugginess.”

The key distinction lies in the method of harvesting hair from the donor area. Unlike FUT, which involves excising a strip of hair, suturing the area, and dissecting follicular units under a microscope, FUE individually removes follicular units one by one. As a result, no suturing of wounds is required, and microscopic dissection becomes unnecessary.

The FUE procedure involves 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 beneath the skin. Once removed, no additional preparation is needed, and the small hole naturally heals over one to two weeks. This process is repeated multiple times until the desired number of follicular units are obtained, leaving the patient with numerous 0.8mm – 1 mm round white scars, rather than the linear scar associated with FUT.

Supporters of FUE highlight less noticeable scarring and the absence of scalp tightness, a common issue in FUT due to tissue suturing. However, FUE comes with notable drawbacks, including the challenge of efficiently performing large sessions. The slow and meticulous nature of extractions may require multiple-day sessions for patients seeking significant coverage.

A theoretical concern with FUE is its 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 acknowledge 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.