FUE (Follicular Unit Extraction)


natural hairline hair transplant photoHair transplant patients are attracted to today’s surgical hair restoration because not only is it proven to grow hair in completely bald areas, but in the right surgical hands it can be so natural that even hairstylists can’t detect the result. Hair transplantation has come a long way since the days of old plugs, but just how natural are they? Can today’s hair transplants be spotted or do they blend naturally with the rest of a patient’s remaining hair?

In this hair loss discussion thread, members of our community share their own personal hair loss stories and how surgical hair restoration has changed their lives. You are encouraged to read others and share your own experience with hair replacement surgery.

Bill - aka Falceros
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Can I get body hair transplanted to my scalp?  How effective is this solution?

This hair loss question was answered by Dr. Cam Simmons of Toronto, Canada, who is one of our recommended hair restoration physicians.

There are other hair transplant doctors who have done a lot more body hair transplants than me. I have performed body to body hair transplantation in rare situations but do not usually recommend transplanting body hair to the scalp for the following reasons:

  • Body hair is not the same quality of hair as scalp hair and does not look as good or as natural.
  • The life cycle of body hair is different than for scalp hair so it takes longer for the transplanted hair to grow.  Also transplanted body hair will spend less time in the hair growth phase and more time in the resting phase than transplanted scalp hair.  See the normal scalp hair growth cycle for more information.
  • Body hair transplantation is still quite new in medical terms, so there is not a lot of data about results or survival of the transplanted hair.  FUE for body hair is usually technically more difficult than for scalp hair.
  • So far, I have been disappointed by the few results that I have seen of other surgeon’s body hair transplants.
  • Most men still have scalp hair available for transplantation.

Hundreds of hair loss questions are answered on our discussion forum and received in our inbox on a weekly basis. Below, we’ve collected some of these hot topic questions of the week and posted responses by veteran hair transplant patients and leading hair restoration physicians.

You can also ask your own questions and get answers on our hair restoration forum or privately by using the contact form.

Is Finpecia (Generic Finasteride) as Effective as Propecia?

Can Doctors Predict Future Hair Loss?

Dealing with Hair Restoration Complications (Dr. James Vogel)

What is the Difference between Rogaine and Minoxidil?

How Many Grafts are Needed to Restore a Balding Crown?

Bill - aka Falceros
Associate Publisher/Editor

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When is it safe to color or dye my hair after a hair transplant?  Can I do this as early as 10 days post-op?

This question was posed by a hair loss sufferer seeking hair loss help on our hair restoration forum and answered by Dr. Steven Gabel of Hillsboro, OR who is an elite member of the Coalition of Independent Hair Restoration Physicians.  His professional answer is below.

There is no magical answer to when hair transplant patients can start dying their hair. The reason for this is that each patient heals at a different rate. I have some patients who come back 10 days after their hair replacement procedure and their incision and recipient sites look like they have healed.  I have others that need a little more time to heal.

The postoperative instructions I give patients are to wait until the transplanted hairs have gone through their initial shock period – usually four to six weeks.  By that time, I know that the grafts are firmly in place and exchanging their blood supply. The problem with hair coloring and the dying process is that different hair stylists will use several chemical compounds to dye the hair and I don’t want any risk of injury to the hair follicles with outside chemicals. My advice is always: be patient!

This hair loss article was written by Dr. Ron Shapiro of Bloomington, MN who is a member of the Coalition of Independent Hair Restoration Physicians

What is Follicular Unit Extraction (FUE)?

Hair Transplant Pysician Dr. Ron ShapiroFollicular Unit Extraction (FUE) is a method of obtaining donor hair for Follicular Unit Transplantation (FUT), where individual follicular units are harvested directly from the donor area, without the need for a linear incision. With the FUE technique, a .8mm to 1 mm punch is used to make a small circular incision in the skin around the upper part of the follicular unit, which is then extracted directly from the scalp.

Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) are sometimes mistakenly viewed as being two totally different hair transplant procedures. FUE, in fact, is a sub-type FUT where the follicular units are extracted directly from the scalp, rather than being microscopically dissected from a strip that has already been removed. To say it another way, in Follicular Unit Transplantation, individual follicular units can be obtained in one of two ways; either through single strip harvesting and stereomicroscopic dissection, or through FUE. Therefore, when comparisons are made between FUT and FUE, what is really being compared is the way the follicular grafts are obtained (i.e. strip harvesting and dissection vs. direct extraction). The process in the recipient area is the same.

The main advantage of FUE is that it does not cause a linear scar. Therefore it is useful in patients who for one reason or another may in the future want to have their donor area very short. (<1cm in length). This advantage was the main reason for the development of the technique.

Most hair loss sufferers who undergo hair transplant surgery are careful to keep a certain level of discretion about their procedure to prevent drawing attention to themselves. However, there may come a time and a place where you decide to share your experience with members of your family, friends, or other loved ones.

If you’re like most hair transplant patients, you fear how other people are going to react when you tell them you’ve had hair restoration surgery.  In this hair loss forum discussion thread, members of our community explain how others reacted when they shared their hair restoration experiences with people in their lives.  This is a must read for those concerned about how people in their lives will react to their hair transplant.

Bill Seemiller - aka Falceros
Associate Publisher/Editor

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Men and women with hair loss are rightfully excited by the prospect of being able to restore a natural looking head of hair with surgical hair restoration. However, understanding the limitations and risks of hair transplant surgery is just as important as counting its benefits. One important but controversial topic worth discussing is hair transplant dense packing, which enables the appearance of a thicker, fuller head of hair.

Though most surgeons agree that a certain level of dense packing is appropriate in some patients, not everyone requires large quantities of hair packed in a single area. Whether or not a balding man or woman is eligible for and how much dense packing is appropriate largely depends on the patient’s current and risk of future hair loss, donor hair availability, long term hair restoration goals, and what can realistically be accomplished.

A few hair replacement clinics have made claims that they can pack up to 70, 80, and even 100 follicular unit grafts (hairs as they occur naturally in the scalp) per square centimeter (FU/cm2). And though men and women  suffering from baldness are often intrigued by a physician’s ability to pack hair closely together due to dreams of recovering a full head of hair, too much dense packing might inhibit healthy hair regrowth.

This insightful hair transplant article was written by Dr. Bernardino Arocha of Houston, TX - an elite member of the Coalition of Independent Hair Restoration Physicians.

Hair characteristics, caliber, presence of curl, color, angle of emergence, and sheen play a pivotal role in the outcome of hair restoration surgeries. If your hair genie offered one of two wishes:

1) To double the amount of your hair;
2) To increase the diameter of your hair from thin to coarse.

Which of the wishes would be your choice? Well wish number one is quite simple by doubling the amount of hair you increase the volume by two, but what about the other option? If we go from fine hair with a diameter of 40 microns to coarse hair with a diameter of 80 microns, the area covered increases TWELVE fold since hair shaft is a circle the area is ∏r2 hence  (3.14)(2)2= 3.14x 4≥12. 

Hair transplant preop

hairtransplant11

The other characteristics have a significant influence on the cosmetic impact of the hair transplant result, but to a lesser degree. The presence of curl can have a great impact on the volume; hence very curly. African-American hair covers a greater volume and more than compensates for the lower hair density in this race. The color or rather the amount of contrast between the color of the hair and the complexion is also important. Black hair looks thinner on the fair skinned individuals, while fuller on a tanned or darker individual. Similarly, a fair skinned individual with black hair who is transplanted will appear to get thicker hair as he ages and his hair turns grey. It is all attributed to the decrease in contrast.

Given the state of today’s current economy, a few members of our hair loss forum have asked if the apparent economic recession is preventing people from proceeding with hair transplant surgery. While a few patients have expressed concern over their own finances and are reluctant to spend any money, others are taking the plunge and restoring their hair with surgical hair restoration.

Overall, those considering hair restoration surgery need to develop realistic expectations and a long term hair restoration plan with a leading hair loss surgeon. This should include sound financial planning and an assurance you can commit to the plan.

You are encouraged to share your input on how financial planning is an important part of surgical hair replacement on this thread.

Bill - aka Falceros
Associate Publisher/Editor

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This insightful information was posted on our hair restoration forum by Dr. Alan Feller of Great Neck, NY who is a member of the Coalition of Independent Hair Restoration Physicians.

Hair Transplant Pysician Dr Alan FellerI would like to announce the unveiling of a new tool designed specifically for the performance of Follicular Unit Extraction (FUE) surgery. It is my hope that every hair transplant doctor already performing FUE surgery, or those who would simply like to start offering this wonderful procedure to their patients, will explore this new tool and perhaps add it to their own clinical practice.

Incorporated into its design are practical solutions to problems that have plagued the follicular unit extraction industry since it’s introduction to the Western Hemisphere in 2001. Deleterious forces resulting in graft damage during FUE procedures such as: Torsion, Traction, Compression, Overheating, and Desiccation are addressed and minimized using this new instrument like none other.

newtool

This tool also offers the unique combination of lowering operator skill level requirements while actually raising the quality of each and every extraction. This translates to faster “ramp-up” times for new hair restoration doctors interested in adding FUE Hair Transplant surgery to their practices; as well as making for easy and near seamless integration into clinics that already offer FUE to their patients.

This device allows not only for greater quality of extraction, but greater speed as well. Much greater. And all without any extra risk to the grafts themselves. The same cannot be said of other FUE tools on the market.

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