Follicular Unit Extraction (FUE) - An Overview

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Follicular Unit Extraction (FUE) is a form of hair transplantation, in which individual follicular units are taken directly from the donor area. A very small circular incision in the skin is made around the follicular unit, which is then removed from the scalp. This avoids the necessity of a linear incision, which takes place in more traditional forms of hair transplantation such as Follicular Unit Transplantation (FUT), which uses a strip harvesting method. FUE was developed in order to avoid the linear scar that results from hair transplantation using the strip harvesting method. FUE is thought to be most suitable for patients who like their hair worn very short or, ironically, for those who like to shave their heads or have a fashionable buzz cut! It does make you wonder why such individuals require hair transplantation in the first place!

Implementing FUE hair transplantation is a highly skilled procedure. Prior to the operation, the surgeon clips a large section of the hair in the donor area. It is possible to perform the procedure in someone with long hair, with the sides shaved in strips so that it can be covered by the surrounding hair, but this causes a visibility problem, because the open area is not removed. As the surface hair is at a different angle to the follicle below the skin, correct alignment can be difficult and keeping the tool exactly parallel with the follicles can be a challenge. Individual scars produced using the FUE method are numerous but are extremely small. The open wounds can weep and crust for some days after hair transplantation, but healing is generally very good. The procedure is particularly useful for those patients with an increased risk of donor scarring, such as non-Caucasians. However, any hair transplantation procedure should be undertaken with caution, if it all, in patients with known healing and scarring problems, for example in people who have a history of Keloid scarring. It should be noted that FUE does produce scarring, despite a common misconception that this is not the case. However, the individual scars are extremely small and so healing is normally very quick. The procedure also causes minimal disruption to those active patients who take part in contact sports, as healing is very fast. Moreover, there is minimal discomfort in the donor area and no post-operative pain in the recipient area.

With FUE, it is possible to use non-scalp hair, such as beard or other body hair, to complement the scalp hair transplantation procedure. Unfortunately, such hair is often a poor match with scalp hair and is therefore only of minimal benefit. Resultant scarring on the donor areas of the body could also present a cosmetic issue. FUE is particularly recommended for patients who have a tight scalp and for which more conventional hair transplant procedures might be difficult. The small incisions also make it easier to extract donor tissue from previously inaccessible areas, such as low on the back of the scalp or very close to the ears or temples.