How Follicular Unit Extraction (FUE) Works
The FUE method of harvesting donor grafts is a popular method of hair transplant for patients employed by Zack N. Charkawi, MD, at Men’s Health Atlanta. Follicular Unit Extraction, or FUE, is a method of extracting, or “harvesting,” donor hair in a follicular unit hair-transplant procedure.
- In FUE hair transplant surgery, an instrument is used to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue.
- The unit is then extracted (pulled) directly from the scalp, leaving a small open hole. This process is repeated until enough follicular units for the planned hair restoration have been harvested. This process can take one or more hours and in large sessions, may be accomplished over two consecutive days.
- The donor wounds, approximately 1-mm in size, completely heal over the course of 7-10 days, leaving tiny white scars buried in the hair in the back and sides of the scalp.
This method of donor harvesting, removing follicular units one-by-one directly from the scalp, is what differentiates the FUE hair transplant from a traditional Follicular Unit Transplant (FUT), where the donor hair is removed from the scalp in one thin, long strip and then subsequently dissected into individual follicular units using a stereo-microscope.
Before the grafts are harvested, tiny “recipient sites” are made in the balding area of the scalp using a fine needle-point instrument.
The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles.
The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the appearance of the donor area and in the quality and quantity of grafts obtained with each technique.
Candidates for Follicular Unit Extraction
Hair transplantation is an elective procedure. However, patients should meet a number of basic criteria that will determine if they are candidates for the follicular unit extraction surgery:
- A diagnosis of androgenetic alopecia (common genetic hair loss) or another condition that is amenable to hair transplantation
- Previous medical therapy is studied and evaluated
- Sufficient hair loss that it affects a person’s aesthetic appearance
- Adequate donor hair to satisfy current and future needs
- Realistic expectations on what surgical hair restoration can accomplish
For most patients, these basic guidelines determine their candidacy. However, for female and young male patients, determining candidacy is more complicated.
About the Procedure
- Follicular Unit Extraction hair transplantation is a minor procedure carried out under local anesthetic. You will be awake while Dr. Charkawi works on the grafts.
- Local anesthetic is injected into the donor area of the scalp. The anesthetic does sting a little but is quite bearable and goes numb quickly.
- Next, the hairs are extracted one by one. They are carefully harvested in a spread pattern to minimize the visual decreasing of density in the donor area.
- Then, the balding area is also anesthetized and numerous micro-incisions are made using a specially shaped micro-needle. The grafts are then placed into these incisions.
After the Procedure
- After the anesthetic wears off in 3-4 hours, the scalp feels a bit tight and sore but this eases and returns to normal in a few hours. Simple paracetamol or co-codamol will help. Minimal swelling is sometimes observed and is completely normal. The affected area of the scalp will appear slightly pinker than usual for a few days but this soon passes.
- The tiny transplant normally falls out within a couple of weeks. This is normal and due to “thermal shock.” The hair then grows normally from the hair root and will be noticeable in approximately 3 months and will continu growing as fast and as long as your normal hair.
- If the transplanting is into a thinning area, this can occasionally cause temporary shedding of some existing nearby hair shafts which regrow.
FUE is a minimally-invasive hair restoration technique, but you still have to expect a bit of redness which will occur both in the recipient area and the donor area. It will disappear in a couple of days, depending on the individual’s skin tone and healing process.
There is usually no pain after the procedure but patients should take it easy for the first couple of days. It is recommended they avoid touching the area and keep from sweating excessively on the recipient site. Dr. Charkawi will provide special hair washing instructions and advice on shampoos to use for the first 2 weeks after the procedure to help speed up the healing process.
Since FUE harvesting requires a much larger area compared to strip harvesting (approximately 5x the area for the same number of grafts) in order to perform large sessions of FUE, the entire donor area must be shaved. This can present a significant short-term cosmetic problem for many patients. In contrast, with FUT using strip harvesting, the donor incision can be covered with hair – even with very large sessions. However, because there is no linear incision with FUE, patients can resume strenuous activities and contact sports much sooner after the procedure.
Each patient is unique; therefore, results may vary.
Dr. Charkawi performs follicular unit extraction (FUE) at his office located in Johns Creek, Georgia. The procedure is considered minimally invasive because only the most superficial layer of the skin is cut and holes are tiny. Dr. Charkawi has treated hundreds of patient in the Atlanta, GA, area including Alpharetta, Marietta, Milton, Cumming, Athens, and Lawrenceville. Schedule an appointment to see if hair transplant surgery could be right for you.