Follicular Unit Extraction is a popular surgical hair restoration technique. Commonly and better known as FUE. For some people. The idea of having a linear scar, however narrow, is unacceptable. FUE provides another option for harvesting from the donor hair. With Follicular Unit Extraction, Doctors are able to extract follicular units. Hair groupings of 1, 2, 3 and 4 hairs individually from the donor area. In the best hands the FUE hair transplants can leave little obvious change to the donor area. Doctor performed FUE hair transplants can deliver natural results.
With the advent of the FUE technique few doctors wished to perform the procedure. With some procedures taking the day to perform 500-1000 grafts. To put into perspective. On a good candidate a good FUT Doctor could perform a 4000 plus graft procedure in the same time frame. While the benefits of Follicular Unit Extraction are quite appealing to many. It is a tedious process for the surgeon and the surgical team. Mainly because it requires much more time to harvest the grafts. Unable to see below the skin surface. As a result, the grafts are harvested ‘blind’. Overtime understanding of FUE improved. As did the size of the sessions that could safely be performed.
Evolution of FUE Hair Transplants
With time and improvement in surgical instruments and techniques the graft numbers improved. With an experienced FUE Doctor being able to safely extract and place around 1500 grafts per day on a good candidate. Possibly rising to around 2000 grafts. On a very good candidate with good conditions. If the procedure requires more grafts. The FUE procedure will be performed over two days. With a cap on the graft numbers at 3000.
A manual punch instrument was always the preferred method. This also evolved over time with the use of a motorised punch. Later still the use of a computerised robot arm. Programmed by technicians to extract the hairs. The latter greatly increased productivity. Allowing sessions to be completed in a shorter time frame. As well as larger procedures in a single day. As a result, more FUE procedures could be performed daily. This is also the case with non-robotic FUE. Often with hair technicians replacing the Doctor punching the hairs from the donor area.
Common FUE Donor Hair Concerns
With FUE being a blind extraction technique there is the chance of graft transection being high. Studies suggest that graft mortality could be as high as 35%. Transection is the splitting or cutting that damages the hair unit. Transection can occur when punching the hair units. As a result, the correct depth control is essential. As well as understanding the hair exit point from the scalp and natural hair characteristics are vital.
Over-harvesting can occur over one or multiple FUE hair transplants. As a result of too many hair follicles being extracted. Either overall or from an isolated area. As a result patchy areas of low hair density. The donor area is a finite resource. The hairs do not grow back when removed or damaged. A shot-gun or moth eaten look can be the result. With obvious visible scarring. That cannot easily be concealed. Due to the lack of surrounding hairs.
Splitting hair follicles into smaller hair units. This can be similar to transection. Although splitting is often a deliberate act. After extracted to increase the number of grafts. Multi-hair units are divided. To create smaller hair units. To increase the number of grafts. Although this can decrease the number of hairs due to damage when splitting.
Doctor Performed FUE Hair Transplants
A FUE hair transplant is a medical procedure. Performed under local anaesthetic and mild sedative. The Doctor needs to sit with their patient to discuss the planning,donor and recipient areas, including hairline design, medical care and answer questions from the patient. The Doctor should be taking the lead in key areas of the hair transplant procedure. Medical, planning, artistically designing and leading the team.
- Consultation & Planning – Doctor Performed
- Donor Management – Doctor Performed
- FUE Donor Harvesting – Doctor Performed
- Custom-Made Recipient Sites – Doctor Performed
To perform FUE to the highest standard the donor area requires total shaving, except possibly for very small procedures. Shaving allows the harvesting pattern to be spread. Over the widest, safest surface area possible. The hair density can be correctly measured around the safe zone. from each side and back of the head. To calculate the average hair density over the donor area. Also calculating the average hair count in the area. The Doctor can then map out the safe zone and areas of high density and hair count. To ensure an educated extraction pattern can be performed. As a result over harvesting can be avoided.
FUE DONOR HARVESTING
When punching and extracting the hair follicles. The Doctor needs to understand skin anatomy and hair characteristics. Shaving also allows the Doctor to precisely measure the angle the hair exits the scalp. The punch size may vary dependending on the area of the scalp due to hair follicle size changing. There can also be slight variation sin the hair characteristics and depth of the hair follicles under the skin. Without correct professional understanding of these and more aspects transection and damage will occur.
CUSTOM-MADE RECIPIENT SITES
The slit making in the recipient area should be the domain of the Doctor. This is an area that can make or break a hair transplant result. The Doctor is careful to assure that the grafts will grow out in a natural direction, angle, orientation and pattern. Always needing to be aware to avoid damage to surrounding hair. At the same time, needing surgical skills to place a high hair density. As a result, when grown out will look natural and blend with the surrounding hair.