What to Know About Follicular Unit Extraction

[Posted on October 16th, 2013 by Dr. Carlos Puig]

Follicular Unit Extraction (FUE) is the process of extracting follicular units directly from donor sites of the patient to be used in hair transplants. The process that uses a 1 mm needle has been growing in popularity since it was first tested and shown to be effective in 1998. After the hair is extracted one follicle at a time, it can be successfully transplanted onto the scalp. The growing demand for FUE stems from the increasing number of well-trained hair restoration experts who are continually perfecting the procedure as well as the new and innovative precision tools that increase its success.

How it Works

The process begins by extracting follicular unit grafts, which are natural hair groupings, with either one, two, three or four hairs. Each group is harvested using a tiny punch. After carefully scoring the skin surrounding a follicular unit, a small punch goes into the soft tissues around the unit. By gripping the hair above its surface, the follicular unit can be separated and extracted. Although a small hole remains where the extraction takes place, it is invisible to the eye after a few days.  With the follicular unit extraction completed, the physician can immediately transplant it into a recipient site that was prepared before the extraction. Using the “stick and place” technique, the grafts are placed in the recipient site one by one as they are extracted. The grafts can also be stored in a special solution for transplantation onto the scalp at a later time.

Advantages of Follicular Unit Extraction

Compared with Follicular Unit Transplantation (FUT), or strip harvesting, FUE is less invasive because it does not remove an entire strip of skin. With the small punches used, there are small punctures with no need to close the wound after extraction is completed. There are no sutures or staples so there is decreased stress on the donor area that results in less pain and discomfort. Since it is less invasive, there is no linear scarring left behind. As a result of the shorter healing time, patients are able to sleep more comfortably after the surgery with fewer days off work or upset in their daily routines. Although patients undergoing FUT are advised to avoid strenuous exercise as well as weightlifting for three months, FUE patients can return to their regular activities more quickly. In addition, follicular unit extraction can be performed in more varied areas of the body and scalp, such as:

  • Nape
  • Chest
  • Arms
  • Beard
  • Legs

Using FUE, doctors can select only the optimal follicular units that are best suited for hairline surgery. They are able to identify, isolate and choose the fine, single haired units for hairline regions and thicker or coarser follicular units for other areas of the scalp. Because of its less invasive nature, it is also ideal for smaller and more specialized areas, such as eyebrow reconstruction or on younger patients.