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FUE HAIR TRANSPLANT

A FUE procedure harvests individual hair follicles from an area like the back of the head, and transplants them to a balding crown or receding hairline.

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Follicular unit excision (FUE) is a donor hair harvesting technique used by hair transplant surgeons to harvest individual follicular units (tiny bundles of hair follicles) from the sides and back of the head, so they can be transplanted into areas with hair loss.

“FUE used to be known as follicular unit extraction,” explains Dr. Jae Pak, a hair restoration surgeon in Los Angeles, “but the International Society of Hair Restoration Surgery (ISHRS) substituted ‘excision’ for ‘extraction’ to make it clear that FUE is a surgery that requires a cut in the skin with a scalpel-like tool. This subtle change was made because FUE had been marketed as a ‘scarless surgery,’ which it is not: it does involve the cutting, or excision, of the skin.”

During this procedure, a surgeon uses a small, sharp, cylindrical instrument (about 0.9 mm) to meticulously harvest or excise each follicular unit of one to three hair follicles. These tiny hair grafts are then implanted into thinning or bald areas.

Before the hair follicles are implanted, the surgeon makes a microscopic incision in a precise angle to match the natural growth direction of your hair. “The surgeon has control of how each and every hair follicle will eventually be placed,” explains Dr. Pak. With an artistic surgeon, this hair transplant method can re-create a natural-looking hairline and crown, with life-long results. 

However, it cannot achieve your original hair density because the hair follicles that are being transplanted are taken from another part of your scalp, usually the back of the head. “The more hairs you transplant, the less hair you will have in the donor area,” Dr. Pak cautions. 

The tiny scars left by FUE are circular and random, which makes them less obvious than the linear incision left by follicular unit transplantation (FUT), or strip harvest technique. For this reason, FUE harvesting is ideal for men who want to keep their hair trimmed very short post-surgery.  

“However, the less obvious scar of the FUE is a paradox when the hair is kept very short and you exceed 3,000 to 4,000 round scars on the back of your head,” Dr. Pak explains. “The patchy dots can be noticed, and it may defeat the purpose of being able to wear your hair very short.” Scalp micropigmentation can make the scars less obvious, but the hair on the back of your head may feel thin, he notes. 

“This goes to show there is no perfect solution,” says Dr. Pak. “In the grand scheme of things, you are accepting one thing to improve another,” so realistic expectations are key.

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