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Timothy Carman, MD

Follicular Unit Extraction (FUE) - San Diego, CA

Follicular Unit Extraction (FUE) is a hair transplant surgical technique that was developed as an alternative to the traditional FUT or strip surgery. Like any surgical procedure there is not one solution for all patients and during your consultation Dr. Carman will review your options and suggest the best surgical path to achieving your goals.

FUE can be described as extracting individual follicular units one at a time. In a traditional hair transplant surgery utilizing FUT donor harvest, an incision is made to remove a linear strip of tissue from the scalp. The harvested tissue is then dissected under a microscope to create the individual follicular units. The differences between the two procedures related to the donor area is the manner in which they potentially scar. In a tradition strip procedure a person will have a linear scar line across the donor area. In an FUE procedure there will be small circular dotting from the extraction sites, which may or may not be apparent, as this varies from patient to patient.

Both of these procedures have been proven effective to treat hair loss, when used in the appropriate clinical setting.

The advantages of an FUE are as follows:

  • No linear incision and no linear scar.
  • In some cases, patients are able to wear shorter hair styles.
  • Most useful for patients who have had multiple procedures and who cannot be harvested with traditional strip surgery methods.
  • Patients who need repair work, for example, to cover wide scars by adding hair into the scars.

Disadvantages of an FUE are as follows:

  • A FUE procedure usually takes longer than a traditional strip method.
  • FUE procedures limit the amount of grafts that can be harvested at one time.
  • There is small white dotting in the areas of extraction, with a loss of follicular units per square area.
  • The hair mass in the donor becomes less dense as a result of extraction, which may be cosmetically significant.
  • The cost of a FUE is usually higher than a traditional strip surgery
  • Recovery time is actually longer, as the large shaved area in the donor is apparent for up to two weeks.

The FUE Hair Transplant Procedure

FUE can be broken down into 3 distinct sub-procedures.

  1. Extraction Phase:
    During the extraction phase, the follicular units are harvested from the donor region, which traditionally is located on the back and the sides of the scalp. That area is first shaved very close to the scalp in order to accommodate the actual extraction process. Next, fine punches are used to superficially incise a circular cut around each follicular unit to be harvested. Following that, the follicular units are gently pulled out from the surrounding tissue using fine forceps. The extraction process does take significant time and should be performed only by the surgeon in order to achieve high quality graft harvest results. The extraction phase is the only difference from traditional FUT hair transplantation.
  2. Site Creation phase:
    The second part of an FUE procedure, which is similar to strip excision, is creating the places to insert the follicular units for transplant. The follicular units must be set into the scalp at exactly the right depth, angle, location and density in order to achieve a completely natural and aesthetically satisfying appearance. In addition, this needs to be done without damaging the patient’s pre-existing hair.
  3. Graft Placement Phase:
    This part of the procedure may last for 3 to 4 hours or more, dependent on the number of follicular units that are extracted for your individual procedure.

Recovery After An FUE Procedure

The recovery time for FUE vs FUT is really is related more so to the appearance of the back of the patients head, as it is shaved very close. It will usually take most patients at least ten days for the hair to grow in a fashion that cosmetically covers the extraction sites. After an FUE procedure, you may have pain or discomfort for a day or two, however this is well addressed by post op medications.

There may be residual numbness on the scalp that could last for a few months during the healing process.