Follicular Unit Extraction (FUE) Hair Transplantation

FUE Hair Transplant – Austin, TX

Follicular Unit Extraction, also known as FUE Hair Transplantation, involves the individual extraction of follicular units from the sides and back of the scalp.

FUE has become the most popular harvest method over the past 10 years. It is more comfortable post-operatively than donor strip harvest and does not require sutures. The incisions are usually 1mm or smaller and when they heal it is very difficult to see that any surgery was done to the back of the scalp. This allows the patient to wear their hair very short in the back of their scalp.

With follicular unit hair transplantation (FUT), there is always a narrow linear scar where the strip of hair was removed, which is covered by the surrounding hair. If the patient later shaves their head or crops it very short, the linear scar may be visible. This is not the case with FUE’s since every follicular unit is individually extracted, leaving the donor area virtually scarless.

FUE Hair Transplant FAQs

Follicular Unit Extraction, commonly called FUE, is a modern hair transplant technique in which individual follicular units are removed from a donor area and transplanted into areas affected by thinning or hair loss. The following answers address some of the most common questions patients ask about FUE hair restoration.

What is a FUE Hair Transplant?

How is FUE different from a FUT Hair Transplant?

The primary difference is how donor hair is collected.

With FUE, individual follicular units are removed one at a time. With FUT, a narrow strip of tissue is removed from the donor area and then divided into individual follicular units under magnification.

FUE leaves many small, circular extraction sites that generally become difficult to see after healing. FUT leaves a linear scar in the donor area. The most appropriate method depends on the patient’s goals, hair characteristics, donor supply, prior procedures and preferred hairstyle.

Who is a Good Candidate for FUE Hair Transplant?

Does an FUE Hair Transplant Look Natural?

A natural result depends on careful planning, appropriate hairline design, proper graft placement and an understanding of how hair grows in different areas of the scalp.

The direction, angle, distribution and density of transplanted follicles must be customized to the patient. Results can vary based on donor supply, hair caliber, curl, color contrast, scalp characteristics and the extent of hair loss.

Is an FUE Hair Transplant Permanent?

Hair follicles taken from the permanent donor area are generally resistant to the hormonal effects that cause common pattern hair loss. Once successfully transplanted, these follicles are expected to continue growing in their new location.

However, a hair transplant does not stop the patient’s existing non-transplanted hair from thinning. Medical treatment may be recommended to help preserve surrounding hair when appropriate.

Do I need to Shave My Head for FUE Hair Surgery?

Some FUE procedures require shaving of all or part of the donor area so the follicles can be removed efficiently. In selected cases, a limited or concealed shave may be possible.

In our practice our highly trained medical technicians can work withing you exising hair to avoind shaving the top of your in some cases.

The shaving requirements depend on the number of grafts, the patient’s hairstyle, donor density and the surgical plan.

Is FUE Hair Transplant Painful?

Local anesthesia is used to numb the donor and recipient areas. Patients may feel pressure, movement or mild discomfort during portions of the procedure, but significant pain is not typically expected once the area is numb.

Tenderness, tightness, itching or soreness may occur during the early recovery period. Postoperative discomfort is usually managed with the instructions and medications provided by the surgical team.

How Long does an FUE Procedure take?

The procedure may take several hours and, in some cases, may be divided over more than one day. The length of the surgery depends primarily on the number of grafts and the complexity of the treatment plan.

Patients should expect to spend much of the procedure day in the OR reading, listening to music, or watching TV while the surgeon and techs work. We also provide a nice lunch of your choice during a break.

What is the recovery like for FUE?

Small scabs usually form around the transplanted grafts and extraction sites. Temporary redness, swelling, itching and tenderness may also occur.

Many patients return to desk-based work within several days, although visible redness or scabbing may remain longer. Strenuous activity, swimming, direct sun exposure and certain hair-care practices may need to be restricted during the initial healing period.

Patients should follow all postoperative instructions carefully.

When will the transplanted hairs begin to grow?

How many hair grafts will I need?

Are there risks associated with FUE?

Can I have additional FUE Procedures in the future?

How do I find out whether FUE is right for me?

Placing of Grafts

When manual placement of grafts is utilized there is no difference in regard to the technique of placement of strip harvested or FUE harvested grafts. There may be some concern about the fragility of the FUE grafts and the fact that they may be more susceptible to drying and over manipulation.

Technical Expertise

A somewhat different skill set is required for FUE harvesting. The surgeon must be able to align the small punch correctly, find the right depth and adjust the punch to account for changes in direction of the hair. The primary concern with FUE is the rate of transection. That is, if the hairs in a follicular unit are transected, they are less likely to grow. This is in part dependent on the level of transectionand the surgical expertise of the hair surgeon.

As noted above, the physician must be able to adjust the punch to accommodate changes in hair direction. Patients with curly or very wavy hair may be difficult to treat when FUE is used. In comparison, strip harvesting is suitable for all types of hair. The use of the blunt punch can be helpful in harvesting curly or wavy hair with the FUE technique.

FUE surgery can be demanding, and expertise is required. Our surgeons have performed both FUT and FUE surgery and are comfortable with both techniques. Our surgeons use high-power loupes (4x-6x) to easily see and follow the angle of the hair follicles in the scalp, allowing them to safely extract individual hair follicles.

An important issue associated with some mechanized FUE devices is the marketing to physicians that unlicensed personnel may be able to perform the harvesting. This raises significant legal issues in many countries, including the U.S. There are states where it is clearly illegal to have a non-physician, non-physician Assistant (PA) or Nurse Practitioner (NP) perform such surgery. In the US, entrepreneurial nurses and medical assistants are setting up hair transplant clinics and hiring physicians as medical directors who may have limited or no hair transplant experience, but who “supervise” the procedure. Many U.S. states allow the physician to delegate responsibilities to staff under supervision, but both the degree of supervision and the extent of staff responsibilities are not clearly defined.

You should always ask, "Who will be performing my hair transplant surgery?"

Dr. Michael Hughes performing FUE harvesting.

The donor are immediately after surgery and 8 months later. Within days, there was virtually no evidence of surgery in the donor.

FUE into scars

FUE can be used to try to camouflage linear donor scars. This is considered by many hair restoration surgeons to be another excellent use of the technique. Some surgeons have suggested that a combination of strip harvesting and FUE is the optimal use of the techniques.

Instrumentation

The cost of instrumentation for strip harvesting and non-mechanized FUE is modest. With the advent of mechanization, the cost for machines that can be used for FUE can be expensive. Robotic or motorized devices can cost thousands of dollars, and one system currently sells for over $350,000 (USD).