FUE Hair Transplant Surgery

 

FUE is a term used to describe a surgical hair transplant procedure, Follicular Unit Extraction; the method of extraction makes the major difference between the other recognised hair transplant technique; FUT. On the right candidate the FUE technique can be an excellent option and can open the safe donor zone outside the traditional strip or FUT zone for harvesting; expanding the donor area has a number of advantages

Follicular Unit Extraction Punch Tool

Follicular Unit Extraction Punch Tool

Candidates that have undergone previous surgery and then donor has been impaired with scarring FUE can extract around the scarring and over a wider surface area to increase the total number of grafts available. If scarring is too wide or an irregular shape to excise via FUT then grafts can be removed randomly from other areas of the donor and then placed into the scar tissue; not removing the scar but helping to camouflage the area

FUE can expand the donor zone because of the method each follicular unit is removed or extracted; a cylindrical instrument around 1mm in diameter surrounds the hair shaft and then makes a punch into the scalp

Understanding the direction of the hair as it exits the skin is vital, as is depth control of the punch; as it is impossible to see with the eye FUE is a blind extraction technique; a great understanding of anatomy is required. The direction of the hair as it exits the scalp can differ from how the follicle is directed under the skin; if this is not understood it can lead transecting the follicular unit, best case scenario is the FU is split and the healthy hair count reduced, worst case scenario the FU is worthless due to being divided

The angle of the hair will alter dependent on the area of the scalp it is position in, the sides and back of the head; when punching the FU´s the positioning of the hand needs to change to compensate for the change in direction

The depth the FU sits in the scalp can also alter, some more shallow or deeper than other; in general most individuals there is a small variant in depth around the head but in some cases the depth can alter dramatically, even in the same areas, making depth control of the punch harder to be consistent

Regardless of manual or motorised punch tools these are basic fundamentals that have to be taken into account; with due care any damage caused during the extraction process can be kept to a minimum, with around a 5% transection rate; if the transection rate gets too high then a decision has to be made whether the process should be continued

To extract the FU´s it is considered better that the hair in the donor area is shaved to make it easier to detect the hair shaft direction and encompass the punch around the graft; on very small procedures it may be possible to partial shave an area that can be hidden by the surrounding hair, but any procedure requiring a decent graft count requires shaving

Although FUE grafts are removed individually they still a need for the FU´s to be cleaned and sometimes trimmed and this should be performed under magnification. This is to ensure the quality of the follicular units and that all are fit to be used

Due to the punch size being small the grafts generally will be leaner than FUT grafts, less fatty tissue surrounding the FU. Any graft requires care when being handled but FUE grafts a little more; to not hold the bulb as it is easily crushed

FUE surgery will leave small cylindrical scarring around the donor, some hardly visible even under close inspection; other can be more visible, looking a little chicken-pox scarring. An educated harvesting pattern must be adhered to and not remove adjacent FU´s or create a man-mad pattern of extraction as this can highlight the scarring with shorter hair, long hair it cannot be seen

When researching hair transplant it is important the technique utilised is best suited to your hair loss pattern now and in the future as the 2 different techniques have advantages and disadvantages to them

 

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