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Follicular Unit Extraction or FUE is the procedure where individual follicular units are extracted by a fine punch either manually or by using a motorized machine.
Extraction of the follicle involves a small circular incision on the scalp skin and to justify this(extraction and incision both are involved in the process) now FUE is called as “Follicular Unit Excision”. This is the latest change in terminology by the ISHRS.
Punch size is usually 0.9 to 1 mm for scalp and 0.75mm to 0.8 mm for a beard. These tiny holes heal by themselves within a day or so. Fast healing and rapid recovery in 1-2 day is the biggest advantage of FUE. Good quality of punches leaves practically no visible scar in the donor area either beard or scalp.
Normally No one can detect that grafts had been taken from the beard. No stitches are required and hence no linear scar on the occipital area of the scalp. These benefits of FUE Hair Transplant make it very popular. A person can keep his hair short as he doesn’t require hiding linear scar on the back of the scalp.
There is a lot of improvement in the technique of FUE and quality of punches in the last 20 years. Initially, FUE was done for a small number of grafts only and it was used as an adjuvant to FUT.
It was said that it is impossible to do mega sessions with the FUE and hence grade VII baldness cannot be covered with FUE because of the limited donor availability and long learning curve.
Also, this procedure is very much time consuming so extracting 3000 grafts was very difficult. But now in the modern era FUE is gaining its popularity because we can extract grafts‘N’ number of grafts.
The donor area is extended to areas other than scalp and thus an unlimited number of grafts can be taken from scalp, beard, chest, abdomen, and extremities. We can extract as many as 8000-9000 grafts from different donor area in 2 to 3 sessions of hair transplant. This much grafts can cover full head even in grade VII.
About FUE Procedure
FUE involves following steps-Planning of the hairline, Anesthesia, Punching, Extraction of Grafts, and Implantation of Grafts. Each and every step is important, trauma or insult of grafts at any of the step will result into a poor growth of grafts and poor result
Planning
Analysis of the donor and recipient area with emphasis on the future requirement is required. Use of body hair along with the scalp hair preserves the scalp hair for future also.
Planning of hairline should be done keeping in mind that face will mature with the age and too low hairline will look abnormal.
In males frontotemporal angle should be designed properly to show normal recession in this area, this will enhance the natural look of the person.
Temporal peak point should be reconstructed with very fine single hair roots otherwise it gives artificial look.
Crown should be avoided before the age of 28-30 years unless very much indicated.
Anesthesia
A procedure is same as in FUT. We use a vibrator and cold sponging along with the injections to reduce pain.
Punching of grafts done by the surgeons only. It is a blind procedure and technically most demanding. Even a minor change of the angle during punching may cause transection of hair follicle – complete or partial transection. The success of hair transplant depends on the ability of the surgeon to punch grafts with minimum transection rate. All over world Transection rate of 5-10% is acceptable but at Rejuvenate Hair Transplant Centre, one of the best centre for hair transplant India Transection rate is usually 2-3 %.
Extraction of grafts
It is done simultaneously by the assistants with the help of forceps. The main thing to remember here is drying of grafts should be avoided.
Implantation of grafts in FUE is critical as grafts are not as chubby as of FUT and prone to get injured. Monitoring is required at this step to prevent even microtrauma. We use ‘No Touch to Root Technique’. This improves the result of FUE very much.
Why Choose FUE Procedure
Previously it was thought that if laxity of the scalp is less or a person wants to keep his hair short than only he should choose FUE. But with the advancement in the technique and punches, anybody can go for FUE. Results are excellent with the FUE hair transplant in India in the hand of best hair transplant surgeon.
– FUE Results
Here we are presenting some of the results of FUE. Results usually start coming within 4-5 months and the complete result may need a year. You can see the naturalness of the direction of hair and hairline.
– FUE Benefits
1. The main advantage of FUE is – It is like minimally invasive surgery. No linear cut for the strip, no suturing and so stretching sensation after the procedure. Pain is also negligible, healing is faster so post-operative comfort is much more than in FUT.
2. No linear scar on the back of scalp so the person can keep his hair short, no need to hide scar with long hairs.
3. FUE hair grafts can be taken from the areas like beard, chest, abdomen, and extremities. Even in scalp grafts from the periauricular area and neck can be taken by FUE which is not possible with FUT.
4. Mega sessions and coverage of grade VII baldness are better with the FUE due to body hair transplant(BHT) where other parts of the body are used as a donor and thus we can extract as many as 8000-9000 grafts in multiple sessions.
5. Normally Graft to hair ratio is taken as 2:1 for scalp hair. In FUE we can pick up grafts with multiple follicles, so the ratio is much more (2.3:1) and this will give better density than FUT.
