Hair transplant has come a long way from the days of Punch Hair Transplant to FUT (Follicular Unit Hair Transplant), and the very recent FUE (Follicular Unit Extraction) technique. With the advent of FUE hair transplant, the dream of ‘no visible scarring’ on the donor area now seems possible.
In FUE, grafts are extracted like individual follicular units in a two or three step technique, while the method of implantation still remains the same as in traditional FUT. The addition of the automated FUE method seeks to overcome some of the limitations in this rather new technique and it’s now possible to achieve over a thousand grafts in a single day.
PRINCIPAL OF FUE
In FUE hair transplant, extraction of intact follicular units depends upon the principle that the area of attachment of the arrector muscle to a follicular unit is the tightest zone. After this is loosened and separated from the surrounding dermis, inferior segments can be easily extracted. Since the follicular unit is narrowest at the surface, small micro-punches of size 0.6 to 0.8 mm need to be used. Consequently, the resulting scar is too tiny to be recognized.
- Patients who have very short hair.
- When a patient specifically requests for FUE and enough grafts can be harvested to meet his/her needs.
- Patients with limited hair loss or patients who require small sessions.
- Treatment of widened scars caused due to traditional strip excisions.
- Patients who have inadequate laxity for strip excision.
- Scarring from dermatologic conditions, neurosurgical procedures or trauma.
- When previous scars from strip surgeries make further strips impossible.
- Patients who heal with wide or thickened linear scars.
- Athletes who need to resume full activity immediately after the procedure.
- Patients with an inordinate fear of scars or pain.
- Unrealistic patient expectations
- Not enough donor supply
- Scarring that makes the two and three step procedure problematic
- Patients who are not willing to undergo long sessions or multiple sessions required due to the slowness of the procedure.
- Patients who are not willing to cut their hair short. For this reason, women are mostly not good candidates for FUE.
- Large bald areas requiring more than 2500 grafts
FUE is a type of hair transplant procedure wherein the method of extraction is different, but the implantation is similar to FUT. It’s a suture-less method of hair restoration wherein hair follicles are extracted from the back of the head using special micropunches and implanted in the balding area. The procedure is performed under local anesthesia.
- On the day of treatment, the entire donor area is trimmed to a length of 1–2 mm.
- The grafts are extracted from the donor area using special micropunches of 0.8 and 1 mm.
- The extracted graft can consist of 1to 4 or rarely even 5 to 6 hairs. This is the most tedious and time consuming part of the entire procedure. Following extraction, the grafts are implanted in the same way as FUT.
- Minimal post-operative down time
- Can sport short hair
- Microscopic scars are almost invisible
- No need to visit the surgeon again for stitch removal
- Can cover preexisting scars caused due to strip surgery
- Can utilize body hair for added density
- Needs less manpower as compared to FUT
- The procedure is less traumatic and no surgical experience is required
- Less equipment is needed
- Minimal graft preparation
FUE is a brilliant advancement in hair loss treatments. It pushes the field of hair transplant surgery a step closer to the ultimate minimally invasive status. This treatment can serve as an important alternative to traditional hair transplant. However, more research is required to render the procedure faster, cut down treatment time and improve treatment costs, so that the technique can be used by more patients.