Techniques FUE
Thursday, 15 November 2012 19:19

Follicular Unit Extraction (FUE) is a method of extracting, or “harvesting,” donor hair for transplantation in a follicular unit hair transplant. In an FUE procedure, an instrument is used to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue. The unit is then extracted (pulled) directly from the scalp, leaving a small open hole.

This process is repeated until the hair transplant surgeon has harvested enough follicular units for the planned hair restoration. This process can take one or more hours and, in large sessions, may be accomplished over two consecutive days. The donor wounds, approximately 1-mm in size, completely heal over the course of seven to ten days, leaving tiny white scars buried in the hair in the back and sides of the scalp.

This method of donor harvesting, removing follicular units one-by-one directly from the scalp, is what differentiates the FUE procedure from a traditional Follicular Unit Transplant (FUT), where the donor hair is removed from the scalp in one thin, long strip and then subsequently dissected into individual follicular units using a stereo-microscope.

After the grafts are harvested, tiny “recipient sites” are made in the balding area of the scalp using a fine needle-point instrument. The follicular units are then placed into the recipient sites where they will grow into healthy hair-producing follicles. The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures. The difference lies in the quality and quantity of grafts obtained with each technique.

Robotics & Other Instrumentation for FUE

Follicular Unit Extraction is an instrument-dependent procedure; therefore, the type of tool used for this procedure significantly affects its outcome. In fact, the development of increasingly better extraction instruments has closely paralleled advances in the procedure.

Indications for FUE

Because FUE does not leave a linear scar, it may be appropriate for patients who want to wear their hair very short. It is also an advantage for those involved in very strenuous activities, such as professional athletes, who must resume these activities very soon after their procedure.

The technique is also useful for those who have healed poorly from traditional strip harvesting or who have a very tight scalp. FUE also allows the surgeon to potentially remove hair from parts of the body other than the donor scalp, such as the beard or trunk, although there are many limitations with this process.

Possibly the most straight-forward application of this technique is to camouflage a linear donor scar from a prior hair transplant procedure. In this technique, a small amount of hair is extracted from the area around a linear donor scar and then placed directly into it.

Some patients desire FUE simply because they heard that FUE is less invasive than FUT or is non-surgical. The reality is that both procedures involve surgery and in both cases the depth of the incisions (i.e. into the fat layer right below the hair follicles) is the same. The difference is in the type of incision made. In FUE there are multiple round incisions scattered diffusely through the donor area and in FUT there is one single, long incision in the middle of the donor area. FUE should be chosen if the multiple round incisions are preferred and not because the technique is “non-surgical.”
Comparing FUE & FUT

Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT) are frequently compared as if they are two totally different, even competing, hair transplant procedures. Despite this common misconception, the difference between FUE and FUT is the method by which follicular units are removed from the donor area in the back and sides of the scalp. The remainder of the procedure is essentially the same.

However, the harvesting method does have important implications for the hair restoration procedure as it will affect the total number of high quality grafts that can be harvested from the donor area and, ultimately, the fullness achieved from the hair transplant. In general, the harvesting method of FUT via strip is superior to that of FUE for two main reasons. The first reason is that the FUT procedure allows the surgeon to produce the highest quality grafts by isolating the follicle units with minimal trauma (this disadvantage is minimized with Robotic FUE). The second is that FUT enables the surgeon to best utilize the most permanent part of the donor area. Because the differences between FUE and FUT are significant, the pros and cons of FUE should be considered when deciding which procedure is best for you.

 

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