Question 1

What is an FUE hair transplant?

Accepted Answer

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.

Question 2

What are the pros and cons of FUE hair transplant surgery?

Accepted Answer

Pros

Unlike the FUT harvesting technique, which leaves a linear scar at the back of the head, FUE harvesting leaves thousands of less obvious dot scars.
In the hands of a skilled, meticulous, and artistic surgeon, the results can also be very natural looking—not the dreaded “hair plugs” look.
Recovery time is relatively short. You should be able to return to work within a day or two of the procedure, resume light exercise within four to seven days, and get back to strenuous exercise after 10 days.
A majority of RealSelf members rated their procedure as Worth It, with many calling the results “life-changing” and citing a boost in confidence following their surgery.

Cons

There’s a limit to how many follicular units can be harvested—it’s generally capped at 2,500, to minimize scarring.
FUE leaves visible scars that can be very noticeable if you keep your hair buzzed extremely short, especially if you have 3,000 or more scars.
If you have all-over hair thinning, you may not have enough healthy follicles to harvest (unless you find a hair transplant surgeon who specializes in body hair grafting).
Because FUE is a painstaking hair restoration procedure, a transfer can take hours—sometimes up to six hours for 1,000 follicles. Some transplant procedures involving more than 2,000 grafts are broken up into two sessions on different days, to make it easier on the surgeon and patient. However, the time involved depends largely on the skill and expertise of your provider and their staff, which can “vary vastly,” according to Dr. Pak. “Some doctors who are technically proficient with a great surgical team can easily harvest 2,000 to 2,500 grafts in under one hour and finish the entire surgery before noon.”
FUE can also be more time-consuming and less efficient than FUT harvesting in terms of hair yield, the quality of the hair follicle anatomy, and growth potential, according to Dr. Pak.
Some clinics allow technicians to perform FUE procedures, depending on the regulations of the state or country. In California, it is illegal for technicians to perform FUE, but “unfortunately this is not closely regulated, and patients are not usually aware of who is doing what part of the surgery,” Dr. Pak cautions.

RealSelf Tip: Usually, the entire donor area is shaved before an FUE procedure—not an appealing prospect for women and other people with long hair. But there are no-shave versions of FUE, in which only the hairs in the area slated for transplantation are trimmed, leaving the rest of the hairs alone.

Question 3

How much does FUE hair transplant surgery cost?

Accepted Answer

Your FUE surgical hair restoration cost will depend on your surgeon’s credentials, level of experience, their practice location, the volume of grafts you’ll need, and a few other key factors. You can finance your treatment with CareCredit.

See our complete guide to FUE hair transplant costs

Question 4

FUE hair transplant before and after pictures

Accepted Answer

The FUE hair transplant photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

Who makes a good candidate?

Accepted Answer

FUE hair transplant procedures can be a good choice for any healthy adult with hair loss—and enough donor hair to treat it.

This technique can be especially effective at treating thinning hair caused by male-pattern baldness (androgenetic alopecia). This genetically caused condition is characterized by a receding hairline or baldness at the crown or temple. Male pattern baldness usually begins with a receding front hairline that progresses until it creates a bald patch on top of the head.

Half of all men have some degree of hair loss by age 35, so this hair replacement procedure is a popular one.

Question 6

FUE hair transplant vs. FUT: What’s the difference?

Accepted Answer

According to the International Society of Hair Restoration, there are two harvesting methods for hair restoration surgery: follicular unit transplantation (FUT) and follicular unit excision (FUE).

During a FUE procedure, thousands of individual follicular units are harvested from a wide donor area (back and sides of your scalp).

Follicular unit transplantation (FUT) involves the surgeon making an incision to remove a strip of hair from the back of your head, and then dissecting individual hair follicles from the strip under a high power stereo microscope. This technique is also known as strip harvesting or the strip method.

If you're comparing FUE hair transplant vs. FUT, keep in mind that the FUE technique for harvesting is a more popular choice for men with very short hairstyles, because the circular scarring is less noticeable than the linear scarring left by FUT.

“FUT harvesting is a popular choice for men and women with longer hair styles, since it does not require shaving,” notes Dr. Pak.

Question 7

What happens during FUE hair transplant surgery?

Accepted Answer

The procedure involves harvesting individual healthy hairs from donor sites where you have good hair density. Dr. Scott Sattler, a Seattle-based plastic surgeon, says that density is usually quite good in the back of the head, so a substantial number of hair follicles can be removed without it being noticeable.

However, this depends on the total number of grafts excised and how short you keep your hair. For example, 2,000 FUE grafts harvested can be noticeable with a very short hairstyle.

Here’s what happens during the procedure:

To start, your provider will shave or trim the hair in the donor region to a length of 1/16 of an inch. The hair on the top of the head may be left slightly longer, but it’s easier to harvest a larger number of follicles when hair is cut short. This improves the efficiency of the small cylindrical punch used to remove the hairs and surrounding tissue from the scalp: if the punch isn’t aligned perfectly, it can cut off the bottom of the hair follicle as it punches the area out.
Your surgeon will inject local anesthetic into the treatment area to make the procedure as painless as possible.
They will then extract the follicular unit grafts, using a 0.8 mm to 1 mm punch and fine forceps, to remove small bundles of hair-bearing scalp.
Immediately after the extraction, your surgeon will place the follicular units in a special preservative solution.
In the areas getting donor hair, your surgeon will make microscopic slits—angled in the direction of your natural hair growth—and place the individual hair follicle grafts into these recipient areas.
The entire process can take many hours. You may need additional anesthetic every few hours to keep you comfortable, so be sure to let your surgeon know when you start to feel discomfort.

Although the procedure creates up to 2,500 tiny dot-like scars (1 mm in diameter), scattered over a large area, they are less detectable as the new hair grows out.

Question 8

What can you expect during FUE hair transplant recovery?

Accepted Answer

Most people take three days off work after an FUE procedure.

The transplanted area will have crusting or scabbing and may look pink (like a sunburn) for about a week, so you may want to take more time or plan to wear a hat while you heal.

Irvine, California, hair restoration surgeon Dr. Amir Yazdan says, “Recovery is fast, but it takes about 10 days for the donor zone to look fully healed.”

Your doctor will give you specific instructions for washing and caring for your hair during recovery. Follow those instructions closely, to ensure the best result.

Most doctors recommend waiting 48 hours before washing your hair, then being very gentle as you cleanse (no scrubbing). Instead of positioning your scalp directly under the shower head, try for less pressure, even using a cup to pour water over your head for the first week of showers.

Here’s a guide to how quickly you can return to regular activities (for best results, heed your surgeon’s advice).

After 3 days: Return to normal activities and light exercise, such as walking and light yoga.
After 7 days: Resume moderate exercise, but avoid anything that greatly elevates your heartbeat or causes you to really perspire. The scalp can be very sensitive after a transplant, and excessive sweating may irritate it and damage new hair grafts.
After 10 days: Get back to swimming, cardio, running, weight lifting, and other strenuous activities.

Question 9

When will you see results from an FUE hair transplant?

Accepted Answer

You should see about 50% of the transplanted hairs grow in within five months, 80% growing in at eight months, and a final result in 12 to 24 months, according to doctors on RealSelf.

Most of the newly transplanted hairs will fall out within the first three to eight weeks, a process known as anagen effluvium. Often, this happens in a wave, around weeks three and four.

New hair growth begins about two to four months post-op, initially emerging as finer hairs and gaining length and diameter as the growth continues. It doesn’t all grow in at once, since each hair has three growth cycles and runs on its own clock.

Eventually, your new hair will grow at the same rate as nontransplanted hair: approximately one-half inch per month.

Question 10

Are results permanent?

Accepted Answer

Your new hairs should be as robust as your natural hairs by the end of the first year, so results are considered permanent. In other words, the transplanted hairs take on the same characteristics as the hairs in the donor area (from where it was taken).

That said, a hair transplant doesn't prevent new hair loss. Your natural hair may continue to thin. To prevent this, your doctor may recommend other hair loss treatments, such as medications like minoxidil or finasteride.

Question 11

What are the risks and potential side effects of FUE hair transplant surgery?

Accepted Answer

Common side effects include swelling, pain, itching, scalp numbness, ingrown hairs, and a scab that forms on the areas of the scalp where hair was removed or implanted.

According to Dr. Jayanthy Ravidran, a plastic surgeon in Chennai, India, the biggest risks associated with FUE hair transplant surgery are excessive bleeding and infection.

Before surgery and during the first few days afterward, avoid drinking alcohol and taking any medications that thin the blood, to avoid excessive bleeding on the scalp.

It's also a good idea to avoid smoking or any form of nicotine, which compromises your body's natural healing process.

Question 12

Is it safe to get an FUE hair transplant in Turkey?

Accepted Answer

The safety of FUE hair transplants in Turkey and other locations where the procedure costs significantly less than in the U.S. is up for debate. A 2017 report found that approximately 60,000 people come to Turkey for hair transplants every year.

Despite legal requirements that all hair transplant operations in Turkey be performed by doctors, most clinics disregard the rule, according to the report.

The U.S. Department of State has also issued a level 2 travel advisory, recommending that travelers "exercise increased caution when traveling to Turkey due to terrorism and arbitrary detentions.” Do careful research if traveling for surgery is something you’re considering.

Related: 6 Key Things to Do If You’re Traveling Outside the U.S. for Surgery

Question 13

What should you know about FUE harvesting with Neograft and other robotic devices?

Accepted Answer

Some physicians use robotic hair transplant devices, such as ARTAS, for harvesting FUE grafts. This type of automation is considered to be an advancement in harvesting hair because it lessens the workload for some doctors.

“It is important to understand that a publicly traded company named Venus Concepts acquired NeoGraft and Artas Robot, so their marketing and public awareness campaign exceed the individual doctors who offer FUE or FUT,” Dr. Pak explains. “Neograft and Artas are merely one of many medical devices that doctors may use in performing FUE harvesting.”

Also be aware that the NeoGraft and ARTAS companies provide technicians who can be hired by the day, so this device is sometimes marketed to doctors as a way to delegate FUE transplant surgery. Experts say you’ll get the best results with a licensed physician who has extensive training in hair restoration surgery.

“Keep in mind that FUE is merely a method of harvesting the donor hair,” says Dr. Pak. “Many people seem to forget the most important part: the implantation of those hairs gives you the end result. FUE and FUT are just harvesting methods.”

Question 14

Sources & studies

Accepted Answer

“Surgical Treatments.” ISHRS, 29 Jan. 2020.

“Turkey Travel Advisory.” U.S. Department of State, 5 Sept. 2019.

Magid, Pesha. “In Turkey's Cutthroat Hair-Transplant Industry, the Losers Are Patients and Syrian Refugees.” Quartz, Quartz, 12 Apr. 2017.

Zarei, Mina, et al. “Low Level Laser Therapy and Hair Regrowth: an Evidence-Based Review.” Lasers in Medical Science, U.S. National Library of Medicine, Feb. 2016.

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FUE HAIR TRANSPLANT QUESTIONS

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