- Best Results10-12 months+
- Treatment Recovery3-8 days
- Procedure Time4-8 hours
- Skin SpecialistDermatologist
- Duration of ResultsYears+
- AnaestheticBlocks, sedation
- Back to Work3-7 days
FUE Hair Transplantation
FUE or follicular unit extraction hair transplantation is a procedure that transfers hair follicles to thin or bald areas. A local anaesthetic is injected into the donor area of the scalp and then the desired number of hairs are extracted one by one from it. They are carefully harvested in a pattern to minimize the visual decrease of density in the donor area. These follicles are then transferred to the target sites of lower hair density. This new form of hair transplantation gives a natural appearance, indistinguishable from normal hair.
FactsFacts on FUE Hair Transplantation
- This procedure is a low downtime method of effectively treating hair loss
- Tiny 0.8 to 1.1 mm harvests are removed from the donor area
- These follicles are then transferred to thinning & bald areas
- Ideally you should be on medical therapy to slow down hair loss
- Scarring is minimal compared to older ‘strips’ & hair plugs
- In most cases we can expect significant improvement within a few months
- By extracting one follicular unit at a time, hair transplantations can achieve a natural outcome
Where are hair follicles taken from?
The majority of men will have a good source of hair follicles in the occipital region of the scalp (back of scalp). This area is resistant to hair loss & acts as a good source of hair follicles.
FUE can also harvest hair from the beard & body areas. The majority of hair surgeons would prefer the scalp before other areas as there are more terminal hair follicles.
What are the differences between FUE & FUT hair transplantation?
Both FUE & FUT (Follicular unit transplantation) procedures yield similar results, however the difference is how the hairs are extracted from the donor site.
With FUE, each hair follicle is harvested & placed individually. FUT involves the removal of a strip of scalp from the donor area. This section of scalp is then dissected, & individual hairs are harvested. FUT used to be the transplantation procedure of choice from the 1990 to early 2000’s however the vast majority of hair transplants in the current climate are FUE. With FUT transplantation, the donor area takes much longer to heal & results in a linear (line scar). Put simply, FUE leaves less scar tissue & enables a more homogenous growth in the donor area.
How many sessions will I require?
1-3. It depends on many factors including your age, degree of thinning, progression of hair loss & expectations. Some patients receive a hair transplant in the late 20s, then revisit their surgeon a decade later for a second procedure.
Your dermatologist will give you a guide as to the projected number of follicular grafts as well as guide you as to the obtainable coverage.
How are donor follicles harvested?
Donor follicles are harvested by hand, under local anaesthesia. We use specialised instruments measuring 0.8 to 1.2 mm in diameter to meticulously remove individual hair follicles. These follicles are then grouped into one, two, or three hair units.
Careful dissection of hair follicles keeps our transaction rates below 3.8%.
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How are the follicles placed into the thinning areas?
The recipient site (balding area) is anaesthetised and numerous micro-incisions are made using a specially shaped micro-needle. The grafts are then placed into these incisions. Another method that I use is a hair follicle implanter.
The hairline is constructed with one terminal hair unit follicles as this gives a natural wavy contour. Two & three unit follicles are placed further into the hairline. This gives hair density. Each and every follicular unit is meticulously transferred by hand.
How successful is this procedure & does it cure baldness?
FUE (& FUT) are the most successful hair transplant techniques available today. The hair survival rate is typically between 95 to 98% at one year with a very slow decline thereafter. FUE yields a natural outcome with minimal, if any, scarring.
FUE does not cure baldness, it repurposes hair follicles that are more resistant to baldness / hair fall & transfers them to sites of low hair density. Ideally your dermatologist will discuss the need for medical therapy as this ensures long term-lifetime results post-transplant.
What is the recovery like?
After the anaesthetic wears off at 4 to 6 hours the scalp will feel a bit tight & sore but this soon eases and returns to normal in a few hours. Simple paracetamol or co-codamol will help. Swelling is normal & subsides in a few days. If a dense low hairline is constructed, you will have some swelling of the forehead & upper eyelids.
The tiny one millimetre holes in the donor site will seal within 2 to 3 days. The recipient site (area of thinning) will be red for a few days. Bleeding stops within 12 hours of the procedure.
When will hair grow?
The transplanted hair falls out within a couple of weeks. This is absolutely normal and due to transient shock. Hair will then grow normally from the hair root and will be noticeable by approximately 3 months and carry on growing as fast and as long as your normal hair. Full density is reached at the 8 to 10 month mark.
If hair is transplanted into a thinning area, then this can occasionally cause temporary shedding of some existing nearby hair shafts. They then regrow, so don’t stress.
Is it possible to get my old hairline back?
It depends on your age, the progression of hair loss & the density of your donor site.
In most cases we can recreate your old hair line, however in younger patients it is prudent to be more conservative.
Why does FUE look more natural compared to FUT or strip harvesting?
With strip harvesting a section of the donor site is cut out. This means that hair density in the occipital areas (back of the head) is higher compared to the FUE technique. The latter reduces density globally in the occipital area, & repurposes hair to the bald / less dense areas. The overall look of FUE is more natural.
How long does the procedure take?
An FUE hair transplant can be undergone in either one long session (known as a giga session) or several smaller sessions. The length of time for an FUE procedure can vary, & is dependent on the number of grafts. A typical session takes 3-5 hours.
A larger procedure of around 2,600 to 3200 grafts will require a session that stretches over two days. Other factors that extend the length of the procedure include-
- Wavy hair
- Unshaven FUE
- Blonde or lighter coloured hair
- Sebaceous or oily skin, thick dermal scalp layer
- Excess bleeding
What is the recovery time of FUE?
Unlike traditional strip surgery, FUE hair transplantation does not require large areas of the scalp to be harvested. There is also no linear incision on the back of the head, nor does it leave a linear scar, hence recovery is super fast.
The donor site typically closes off within 2-3 days without the need for sutures. The recipient site takes around a week to settle down. Scabs fall off around day 8 to 10. You may experience swelling at day 2-4 if your frontal hairline is recreated. Your dermatologist will give you an accurate indication of recovery.
Will I require medical treatment after hair transplantation?
Yes. Much akin to transferring a patch of lawn/grass to another area, you do need to water & fertilize it.
Dermatologists encourage the use of simple topicals including minoxidil & or topical finasteride to preserve your remaining follicles. Your physician will also discuss the benefits of minoxidil taken orally.
When will I grow new hair?
3-6 months, with best results in 9 to 12 months. Be patient as it take time for the repurposed hair follicles to adapt to their new home.
Is the procedure painful?
FUE is a minimally invasive surgical procedure that is administered under local anaesthetic. You will be conscious for the entire time however we do give you a mild sedative on the day of the procedure. Post-surgery there may be mild discomfort & swelling.
How to stop your medical treatments prior to FUE?
If you are on oral tablets such as minoxidil, finasteride or dutasteride you can continue on your current dose.
Stop all topicals 48 hours prior to FUE, & recommence 10 days after your procedure. This will reduce scalp irritation. Do not just stop your minoxidil without first consulting your dermatologist as rebound telogen (hair fall can occur). If you have just started minoxidil, you may get a temporary telogen 2-4 months after commencement of this medication. Discuss this with your treating dermatologist.
What are the side effects of FUE?
Side effects are rare. It is important to differentiate the expected outcomes from events that are unexpected.
Common events include: scalp redness, itchiness, transient pimples in both transplanted & harvested areas. Transient hair loss is also common, mild & self- limiting.
Rare side effects include infection, scarring in donor & recipient areas, & cysts.
How would you know if FUE is the right procedure for your hair loss?
The only sure way to tell if you are a good candidate for FUE hair transplant is to schedule a consultation with a dermatologist. A clinical examination will give an accurate diagnosis. Most cases of hair loss is due to male pattern baldness or androgenetic alopecia, however skin specialists can differentiate other rare hair loss disorders.
The next step is to optimise your medical therapy before the transplantation. This prevents further hair loss & maximises growth post transplant.
If the cause of your hair loss is compatible with a hair transplant & you have adequate hair density in the donor areas, your surgeon is likely to deem the FUE procedure suitable for you.
Davin’s Viewpoint on FUE Hair Transplants
The follicular unit extraction procedure accounts for the vast majority of hair transplant procedures. There are many FUE variations including full shave FUE, partial shave, strip shaven donor sites as well as minimal cut & no cut procedures. Shaving with a blade 0 allows for fast extractions of large areas, whilst no-shave techniques add 10-40% more time. Recipient or replanting of hair can be done via microslits or a Choi implanter.
I will discuss two important points in the context of FUE, firstly the need for a conservative hairline in younger patients & secondly the importance of medical therapy before, & after FUE.
The hairline defines hair transplantation. There are many variations as to how to reconstruct this area. We consider age, donor density, current state of the recipient site, racial & ethnicity of the patient as well as facial shape. It is also important to listen to the patient’s expectations. Our team of dermatologists will guide you as to the most suitable design, based on the above factors.
It is important to stabilize the hair loss with medical therapy. The two most powerful drugs are minoxidil & finasteride. This combination can stabilize hair loss in over 90% of cases, especially important in the younger age group. Be guided by your dermatologists as there are pros & cons of oral versus topical therapy.
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