A notable development in the science behind hair replacement surgery is Follicular Unit Extraction (FUE). This is the method of obtaining donor where the individual hair units are harvested directly from the donor area using a 0.8mm to 1.0 mm punch. A circular incision is made in the skin around the upper part of the follicular unit which is then extracted (pulled) directly from the scalp leaving a small open hole.

Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) are sometimes mistakenly viewed as being two different procedures but in fact they are two different ways of extracting the donor hair.

The main advantage of FUE in hair transplant surgery is that it leaves no linear scar. Therefore it is useful in patients who may in the future want to wear their hair in the donor area very short (less than 1cm in length). This advantage was the main reason for the development of the technique.

With FUE from very large areas or over multiple sessions, small white dots in the donor area at the sites of each extraction may become visible. It is therefore essential that a highly skilled and experienced surgeon is selected to ensure virtually scarless hair transplant surgery.

The instrumentation used and the techniques employed in FUE have improved dramatically over the last few years with significant benefits for clients. In summary:

1. There is a much better understanding of the number of extractions able to be taken from each donor area before scarring occurs
2. Sessions of up to 1500 FUE grafts can safely be carried out in one day
3. Two sessions of 2000+ FUE grafts can be undertaken over consecutive days without compromising either the cosmetic result or the donor area
4. A larger area of the head is able be used as the ‘donor’ area for harvesting follicular units
5. FUE is labour intensive and to ensure minimal damage to the extracted follicular units and produce the best results in the transplanted area it does require a highly skilled, focussed and experienced hair transplant surgeon.
6. FUE is less invasive and almost pain free with a very rapid recovery
7. FUE allows professionals, sports men or women and patients with strenuous physical work to return to their work or training regimes very soon after the procedure

ADVANTAGES

The main advantage of FUE is that it does not cause a linear scar and is therefore particularly useful for the following types of patients:

1. Patients who want the option of wearing their hair very short (<1cm) or shaved and not want any evidence of having had a hair replacement procedure
2. Young patients who currently need smaller numbers of grafts and where the likely future degree of hair loss is not yet known.
3. Patients who have already had strip harvesting and may have a tight scalp, making strip extraction difficult. In this instance, FUE can be used to obtain more grafts.
4. Patients who need to camouflage a widened linear donor scar from a prior hair transplant procedure.

DISADVANTAGES

1. FUE is more labour intensive and time consuming; therefore relatively expensive when compared to traditional strip harvesting.
2. FUE requires a much larger area from which to extract the grafts and the entire donor area must be shaved. This can be a problem short term for those who prefer to style the rest of their hair longer