- Best Results10+ months
- Treatment Recovery1-4 days
- Procedure Time3-8 hours
- Skin SpecialistDermatologist
- Duration of ResultsPermanent
- AnaestheticBlocks, sedation
- Back to Work1-2 days
FUE Unshaven Hair Transplantation
Unshaven FUE (follicular unit transplantation) as the name suggests, means that the donor site is kept long. This enables the patient to hide the donor site, providing a more discrete healing time. This procedure involves pre-trimming selected hairs on the day of hair transfer, followed by follicular unit extraction & then implantation.
FactsFacts on Unshaven FUE
- This procedure is the most discrete form of hair transplantation
- The donor & recipient sites are NOT shaved, hence the name Unshaven
- Individual hairs or a very narrow strip are snipped on the day of the surgery
- These individual units are harvested using specialized punches
- Longer hair covers up the donor areas
- Unshaven FUE is useful for transplantation of between 800 to 1600 follicular units
- The donor site is indistinguishable from the surrounding hair offering the ultimate in discretion
What is the difference between unshaven vs shaven FUE?
The extra ‘U’ in U- FUE stands for unshaven. FUE is a surgical hair transplantation method, favoured over the more invasive strip harvesting method known as follicular unit transplantation (FUT).
FUE accounts for 98% of hair restoration treatments. While most hair transplants require at least shaving the donor area (typically the back and sides of the scalp), U-FUE procedures are performed without any shaving of the donor area for ultimate discretion. This is popular with people who like to keep long hair and do not wish to shave part of or all of their head for a hair transplant.
Where are new hair follicles taken from?
Transplanted hair follicles are sourced from the donor site, predominantly the back of your scalp, known as the occipital area. This area is resistant to male pattern hair loss & provides a good amount of donor follicular units.
The occipital area is the common ground for all forms of hair transplantation including follicular unit transplants (FUT) as well as FUE procedures.
For patients with low hair density, dermatologists also use body hair from the beard, & chest area as possible donor sites. We prefer scalp hair as they contain more terminal hairs compared to body hair.
How do we remove hair follicles without totally shaving the donor area?
Compared to normal FUE, unshaven transplants do not totally shave the donor area. We employ one of three methods-
- Strip shaving: means we only shave a strip of donor area (4 to 8 mm long). These strips are hidden by longer hairs above & below the strip area. Conservative numbers of donor follicles can be harvested with this method.
- Snip & harvest. This method involves cutting every third or fourth hair shaft from the donor site the day of the procedure. We then go in and harvest the selected snipped hairs. This leaves uncut hair to hide the donor site.
- Total harvest without shaving or cutting: This method harvests the entire hair unit without shaving or cutting. This is the most complex & time-consuming way of harvesting for the dermatologist. Uncut harvesting blunts our instruments faster than cut harvesting method. Can be done, but adds 70-90% more time compared to other methods.
How do we extract hairs from the donor site?
Precise extraction of the hair follicles is paramount for a successful procedure. This is the most demanding stage of any hair transplant surgery as we want viable follicles.
We use special tools known as serrated punches. These measure between 0.8 to 1.1 mm. Under magnification, we extract each and every chosen follicle by hand. These follicles are then checked under a microscope to ensure quality control & follicle viability. These are then stored in petri dishes, awaiting transfer to the bald areas.
With unshaven FUE, the extraction process is significantly longer compared to shaven FUE. Even with taping, lighting & magnification, finding follicles in uncut hair is like finding a needle in a haystack. It can be done, but adds time. In some cases, we schedule this procedure over two days.
View our Treatment Gallery
How do we implant the hairs in the new site?
Dermatologists employ one of two methods to implant extracted hair follicles into the areas of baldness & thinning.
- Slit incisions with microblades. We use specialised blades 0.1 mm in thickness including sapphire glass to make very tiny incisions under local anesthesia. Each incision is followed by manual implantation of the follicular unit. Each follicular unit will contain between 1 to 3 terminal hairs (up to 4).
- Specialised hair implanters are used in some cases. These measure 0.7 to 1.2 mm in diameter. This allows the dermatologist to implant at the same time as incision. Both slit incision & implanters yield the same results. The implantation process takes between 90 to 180 minutes to perform, depending on the extent of hair loss & amount of follicular units transferred.
What is the recovery time with unshaven FUE?
This procedure has the fastest heal times as the donor site is well hidden. In fact viewing from behind, no one can tell you had anything done, even an hour after the procedure. The recovery is focussed on the recipient site & there is no way to hide this (unless you wear a cap).
The donor site holes (0.8 to 1.1 mm) heal up within 2-3 days. Recipient site will have redness & swelling for 2-5 days. Scabs will form & fall out within 8 to 12 days.
Transplanted hair will fall out within 2-3 weeks. This is absolutely normal. New hair will start to grow at the 3-month mark.
When will I see the results?
3 to 6 months with full growth at 9-12 months. PRP & microneedling can potentially accelerate hair growth. Dermatologists recommend concurrent medical management to prevent further hair loss in other sites.
How many sessions are required?
1-2 depending on your desired outcome. Unshaven FUE is limited by the amount of donor follicles you have. Careful consideration should be given to younger patients or those whose hair loss have not stabilized.
For giga-session of FUE, 2 sessions are planned. For a conservative approach, a subsequent session may be required many years after the first session.
Are the results permanent?
Yes. FUE hair transplantation is the most permanent way to address balding. We transfer hair follicles from areas of the scalp (& body) that are resistant to the effects of hair loss.
The caveat is that the balding process is still active in the context of the remaining hair follicles in the recipient sites. This is why it is essential to be on medial therapy to prevent further hair loss.
What are the disadvantages of unshaven FUE?
It takes a lot more time to perform this procedure. This adds significant costs. As hair follicles are not clearly visible your dermatologist will slow down the extraction process.
Follicular implantation is the same process across all forms of hair transplantation, including unshaven, shaved FUE & follicular unit transplantation.
What are accelerated growth hair treatments after FUE?
PRP or platelet rich plasma injections after FUE hair transplants can give an accelerated result. It works by providing hair with nourishment & growth factors.
A series of 3 sessions every month is recommended. Thereafter one treatment every 3 to 4 months for the first-year post FUE.
What do dermatologists prescribe to slow down hair loss?
Dermatologists prescribe two scientifically proven, high value drugs to slow down hair loss. This combination will slow down hair loss in over 90% of patients.
Minoxidil is a drug that increases the lifespan of the hair follicle, extending the growth or anagen phase. Typically, 5% minoxidil lotion or foam should be applied daily. Studies have shown that twice a day application is ideal. This drug can be taken orally in a 1 to 2.5 mg pill.
Finasteride is a drug that inhibits the enzyme that produces DHT (dihydrotesterone). DHT induces follicular miniaturization, leading to permanent hair loss. This drug can be prescribed orally, or as a lotion, often in combination with minoxidil.
In some cases, your dermatologist may elect to use another enzyme blocker called dutasteride. Most will pulse this medication once or twice a week. Other proven ways to treat balding include PRP & microneedling. More on these topics in other pages.
Why are the costs for unshaven FUE higher than normal hair transplantation?
Hair transplantation without shaving adds significant time to the procedure & subsequently higher costs.
Many clinics often do not offer unshaven treatments, as this form of hair transplantation adds many more hours to the procedure. If you could imagine the process of snipping one hair at a time, then manually extracting the hair follicle without damaging the underlying tissue. Do this for 1500 to 2500 hair follicles, then implanting the follicle one at a time.
Regardless, if all important factors are sufficiently taken into account, then an unshaven FUE transplant can be an excellent option and opportunity for certain patients – especially if it is essential professionally or even privately to be able to be socially discrete following the treatment.
Davin’s Viewpoint on FUE unshaven hair transplantation
This procedure gives the best discretion- result ratio as the donor site is undetectable even one day after the surgery. The downside is the enormous amounts of resources added to the procedure, namely the extra time allowed to snip individual hairs. Unlike shaved FUE, only select hairs are trimmed, usually one in every four to five hairs in the donor area (back of head).
Remember, Unshaven FUE only hides the donor site. The recipient or bald/balding site still requires grafts to be implanted. Hence the true value of discretion is lost in this area.
Ideal candidates for unshaven FUE include patients with long hair, limited downtime, hair loss primarily high up (temples) & with a relatively low graft number; 800 to 1500 follicular units. Discuss this with your dermatologist to see if this method is suitable for you.
Join the conversation
Join Dr Davin Lim on Instagram to stay up to date