|Follicular Unit Extraction
aka FUE, FIT, FUSE, DHI, Woods, FOX technique.
This page explains the theory and practice of FUE. For more information on the science of hair loss and hair transplantation, please click here.
FUE is a recently developed technique for removing individual hairs in skin. The concept is simple: one uses a circular punch to score around the hair, thereby releasing it. It is a bit like using an apple corer.
This produces follicular hair grafts of 1, 2 or 3 hairs which are sorted, trimmed if necessary and then replaced, using the current accepted techniques. It is only in the method of extracting the hair that differs from the Strip technique, not the method of re-implantation.
The advantages of FUE include the reduced visibility of the donor area scarring. This enables short hair styles to be retained. In some patients, the straight line scar may show if the hair is cut very short or shaven. In FUE, the small circular scars which occur, are hidden in the gaps between existing hairs, in a diffuse manner.
Another advantage of FUE is the ability to use hair unobtainable by the strip method, thereby releasing more of the potential donor area. Even after 2,3 or even 4 strip method procedures, there is still abundant hair left in the donor area, either low down, high up or very far forward. Body hair can even be used . A scar may show through in those areas and therefore we cannot take a strip of skin from there. FUE though, gets around that problem.
Disadvantages of FUE however, include the slowness of the technique. Currently, it takes much longer to remove hair in this way. This means that it works out much more expensive than the strip method and achieves less in each session of transplants. This is improving and new technologies and equipment will speed this up in the future.
One converse disadvantage to FUE against the strip method, is that although it releases more grafts from the donor area unobtainable by strip, it isn’t as efficient at obtaining grafts as the strip method. The reason is because you have to leave hair behind with FUE. Or to put it another way, if there are four potential, adjacent hair grafts to take, you can only take one of those. You must leave the other three behind. If you took them all, the area would be bald! With strip, you remove every single hair but then stitch the sides together so that there isn’t a gap, just a fine scar. This means you have taken a large number of grafts in one go, without leaving any gaps.
Theoretically therefore, the maximum amount of donor hair obtainable would be by a combination of these techniques. A patient would have three strip procedures, extracting the maximum number of grafts each time and reusing the same scar again (i.e. there would still only be one scar after the three procedures. This is usually quite fine and easily hidden). The patient would then use FUE to release further grafts in the hard to get to areas – in front of the ears, lower hair line, even body hair.