Follicular Unit Extraction - "FUE"

fue-hair-transplant
“FUE”  is short for Follicular Unit Extraction. The hair units or follicular units are removed individually. One by one using a cylindrical surgical punch. This instrument surrounds the hair units. The technique requires skill and precise measurement under magnification. As each hair is carefully removed from the donor area.

PROS
  • FUE hair extraction is randomly spread and leaves no linear scar
  • Post-operative recovery is fast and less restrictive
  • Able to “cherry pick” the hairs to suit the area of placement
  • Widens the donor area to expand the number of FU available in conjunction with Strip
  • Gives a new alternative to repair patients to widen the harvesting potential, especially with the advent of BH

Follicular Unit Extraction leaves no linear scar in the donor. There is no need for stitches and downtime post op is reduced compared to the FUT technique. Instead, the extraction points/scars are spread randomly around the back and sides the head.

FUE can be slow to perform. This is due to the nature each hair is removed one by one. The manual nature of the technique allows the Doctor to feel the depth and angle of the follicular unit.  Make adjustments to the punching as and when required. In some cases, the depth or direction can alter almost constantly.  As a result, it is important the seating position and hand orientation changes to match the changes in the hairs.


The FUE technique has proven to be a superior option for those with minimal thinning. The Norwood 2, 3 and possibly 4 hair loss stages.
The Finer Points To The FUE Technique

There are key elements to an FUE hair transplant. Read more on the roles of the Doctor and their technical team performing your hair transplant. FUE is the in-demand hair transplant technique but is the information true or false. Does the size of the FUE punch tool important to your result.

FUE – The Importance Of The Doctor´s Role

A hair transplant Doctor should have a major role in your hair transplant. From the moment of your consultation to the final graft being placed. They should be personally involved in specific aspects of the medical procedure. Their medical understanding of the skin and hair will ensure the careful extraction and placement of the grafts. Understanding the exit point of the hair shaft, understanding the direction under the skin, and understanding the skin characteristics and how they change. Gone unnoticed and without an understanding of the importance of these and many other factors will result in a high % of damage or transection to the hair units and donor area. The graft placement and hairline design are crucial for the look and planning of the hair transplant.

FUE –  The Desired Hair Transplant Technique

The FUE technique has grown to be the most desired technique. This is partly due to some dubious marketing. As a result, it has become known as non-scarring, which is untrue. That said, in the correct hands, it is an excellent surgical procedure.

FUE has helped those who have undergone multiple “older” procedures. Especially when their donor is impaired. In these cases, FUE widens the donor area allowing more hair to be made available.

Larger areas of hair loss such as NW4 and higher can be treated with FUE.  These cases require a higher than average donor hair density. Also, good hair characteristics to ensure sufficient grafts can be safely removed.


Performing a hair transplant to the highest standard takes an experienced FUE doctor. Dedicated to taking the time to master the technique and understand the anatomy of the skin. It enables the doctor to provide the patient with better results short and long-term. Being able to leave a more pristine donor. Especially over multiple procedures when harvesting the maximum number of follicular units safely.


Larger punches can be faster and easier to use. Generally, they require less precision and can take more hair in one punch. But this is not Pure FUE.

We are dealing with micro numbers with variants in mm´s. With differences when comparing the use of a smaller .75 mm FUE punch to that of a 1.0 mm. But, the area of extraction is 85% smaller. With a .8 mm punch, the area of extraction is 60% smaller. with around a 0.85mm punch diameter being able to remove the majority of follicular units.

A number of punch sizes are used with FUE. Some doctors preferring a larger punch diameter. Others prefer to refine the punch size and use a 0.75-0.8mm diameter punch size.  The smaller punch can remove or at least minimise skin trauma. As well as peripheral damage to surrounding FU and reduce visible scarring. Whilst being able to encompass an intact follicular unit without damage or transection.

By splitting the safe zone into areas it is possible to calculate the safe number of grafts available. Whether the donor is viable for FUE and how many grafts can be extracted now and in the future. Splitting the donor area into sections allows for a precise calculation. This will calculate the average density of follicular units and the ratio of single to four hair units.

The extracted hairs do not regrow once removed. But the number of hairs remaining and the hair density reduces.  If the amount of hair is reduced too much the area will become patchy. Often anymore than 4500 – 5000 taken over multiple procedures will start to be a problem.

In percentage terms, how much can be removed. 20, 30, 50, 60%. Safely the figure is around 35% over multiple procedures. Under good conditions with an average to higher starting donor density. Hair characteristics will also play a role in how much can be safely removed. Some characteristics hide better the loss of the hair. If too much is removed it leaves obvious “hairless” areas. Possibly more visible scarring. As a result, it will impair the donor for future hair transplants.

More can obviously be removed. The hair in the area generally grows in a downwards direction. Because of this, with a little hair length, the loss is less obvious. Even so, there will still be visibly thin patchy areas.


Shaving allows the Doctor to precisely measure the hair angles. Especially the follicular unit (FU ) angle as it exits the scalp. The hair density changes around the head.

To perform FUE to the highest standard the donor area requires total shaving. With the exception of small procedures such as 100-500 grafts. Smaller areas can be shaved and hidden by surrounding hair. Shaving will allow for a better harvesting pattern. With the FU spread easier over a wider surface area. This will reduce the change in hair density over the donor. Also, avoid over-harvesting leaving patchy low-density areas. The extraction % changes dependent on hair density. As a result, without shaving this is almost impossible to calculate. This is especially true with larger hair transplant procedures. FU angulations, skin variations, healing can all be helped.

FUE being a blind extraction method. Meaning it is not possible to see below the skin surface. This is the difficulty when the punch enters the skin. As to what damage can be done. Each extraction may need to vary slightly. This can be dependent on the area and the angle of the hairs. The need to change position is not something that can be avoided regardless of the instruments used. Pressure control is also important to achieve minimum transaction. Considering the effects to the surrounding hair units.

There are various punch methods employed to perform the FUE hair transplant technique. Hand controlled manual punch instruments to motorised punch tools can be used. Dependent on the hand control of the user the pressure, friction on the skin can be minimal to high. The finger to the punch pressure helps gauge the skin characteristics. It is possible to minimise transaction to as little as 1-2% in some cases. Even in demanding cases rarely increases to above 5%. This is made possible by the minimal transference of resistance.



Learn more about hairline design, graft placement, and shock loss, also Follicular Unit Transplant (FUT) hair transplant technique.


Free, No-obligation Consultation

The next step is having answers to your questions. With an online consultation, we want to make that as easy as possible for you. Not to mention, free and without obligation.

Your personal assessment is designed to answer your questions. Are you a good hair transplant candidate. What is your hair loss stage? Are your goals and expectations realistic? How many grafts, which technique and the cost.

For an online consultation and request a quote use the consultation form and complete the details. Alternatively, request more information on a hair restoration treatment by sending your contact details to us.

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