Written by: Dr. Carlos Puig
Follicular unit extraction involves removing or harvesting small groupings of hairs for use in a transplant to another part of the body. The intent is to restore growing hair to a portion of the body devoid of hair currently. The follicular unit extraction differs from strip harvests, another commonly used donor hair gathering method, in the size and shape of the extracted area.
The follicular unit extraction method is growing in popularity among the surgeons who practice hair transplants. The procedure has a long history of achieving good results. The surgeon uses a hollow 1-millimeter needle to create a shallow incision around a single hair or grouping of up to four hairs. Think of this as a plug of skin with attached hair. The surgeon then gently removes or extracts the plug from the patient and sets the donor tissue aside for transplant. A skilled surgeon, with the proper instruments, can extract nearly 1,000 plugs per hour. The extraction sites commonly include the back of the neck or regions of the body with hair. However, body hair does not grow as long as hair from the head when transplanted.
The extraction sites of the follicular unit extraction method are commonly only small pits in the skin and limited in size. The strip extraction method results in larger scars from the larger segments of skin that are harvested which may be more noticeable.
Other advantages include the survivability of the harvested donor hair. Skin segments harvested using the strip method are dissected into smaller segments for transplanting. This added process of cutting the tissue produces some skin segments that are not viable or useful during the transplant procedure. The follicular unit extraction limits the tissue harvested to only viable plugs of hair. This increases the chances of the hair successfully transplanting to its new location.
In addition, the follicular unit extraction method of harvesting hair allows the surgeon to select healthy air from a larger segment of the body. This also increases the possibility of transplant success over strip extraction which gathers donor material from smaller areas.
The Final Steps
Whether the strip method or follicular unit extraction is used, the harvested hair and skin is then transplanted into the scalp utilizing identical procedures. The patient often makes the decision of the extraction method based on consultations with the physician. In many cases, the physician bases his recommendation on the instruments he has available and has a high level of comfort utilizing.
Patients considering a hair transplant procedure may wish to discuss the process with a couple of physicians and find one that has a history of success utilizing the methods they prefer.