Follicular Unit Extraction Creates a New Hairline

[Posted on April 9th, 2014 by Dr. Carlos Puig]

Follicular unit extraction (FUE) is a type of hair replacement surgery that avoids scars on the scalp by removing small amounts of hair in one session. It is similar to follicular unit transplantation (FUT), but is much less invasive. It uses much less hair than other forms of transplantation, and leaves the donor area on the scalp intact. The creation of new types of tools for FUE has made the process more efficient than it ever was in the past.

Modern hair restoration has been in existence since the 1950s and has evolved throughout the decades. The most common form of hair transplantation is the strip harvesting method. The surgeon removes a strip of healthy hair from a donor site on the scalp and sews the harvested area back together. This results in a scar, however small, that is visible when the patient decides to wear their hair very short or shaved. The hair from the graft is removed in small sections, then inserted into the scalp in the area to be restored.

For those who want to avoid scarring, they can have the follicles removed in small groups and inserted into the scalp at the restoration site. The process is straightforward, heals more quickly than strip harvesting and readily fills in the hairline in the front.

The process of follicular unit extraction starts by shaving the donor area down to a short length. This is typically done at the back of the scalp where the hair is most resistant to the effects of balding. The surgeon uses a punch tool that draws out one to two hair follicles at a time from the scalp. It is important to draw out the follicle with the root intact which means that the punch cuts through some of the layers of skin. After removal, the back of the scalp heals up with minimal scarring. The scars themselves are small and round, and easily covered up when the surrounding hair follicles grow back.

After harvesting, the surgeon begins the medical hair restoration process. Before inserting the new hair, the surgeon determines how the hair will be inserted in order to recreate the hairline. This is done by puncturing the area in a pattern with needles or blades. The blades or needles used are very fine in order to create enough of an opening with which to place the follicles into. Once the recipient site is prepared, the surgeon inserts one to four follicles in the opening. Upon completion, the patient can go home to let the scalp heal.

It is important to follow the surgeon’s instructions for post-operative care after follicular unit extraction. The scalp heals quickly, but scabbing around the new grafts can put them at risk. Medication may be prescribed to prevent the follicles from dying off after surgery. Over time, the follicles take root and the hair starts growing normally with the existing hair, creating a full and natural hairline.