What Is FUE Surgery?
FUE (follicular unit extraction) hair transplant surgery is far less invasive than traditional strip surgery. There is no use of scalpel or staples or sutures. FUE is far better described as a “procedure” than as a “surgery.” With this technique the donor area is shaved down to the skin so the individual follicular units (FU’s) are exposed. Once the individual follicular units are visible, we can cherry-pick the most ideal FU’s to be extracted. Usually the units with the most follicles are chosen for removal. This allows us to maximize the number of follicles per graft excised. The average number of follicles per graft is considerably greater with this technique than with traditional strip harvesting and microscopic dissection.
Once each follicular unit is extracted it is passed on to technicians so that each graft is then trimmed of excess tissue and rendered to be the perfect size for our custom recipient sites. There are multiple modifications possible with the FUE technique such as unshaven FUE, where only the follicular units to be extracted are shaven and the surrounding hair is left longer. In this way the entire donor site appears unchanged with no evidence of a procedure apparent. This technique takes longer but offers the advantage of complete undetectability and is suitable for individuals requiring zero postoperative downtime.
While the term FUE seems quite specific – in fact it has been used to describe any extraction technique that does not involve a scalpel. Any size punch will qualify, be it sharp, dull, manual or motorized.
The longer the punch, the greater the trauma to the scalp and the increased likelihood of donor scarring. Since the whole concept of FUE is to reduce the amount of visible scarring, the use of large punches may actually increase the amount of scarring in the harvest area. As a general rule small, sharp manual punches are able to produce graphs with the least possible trauma to both the graft and the donor area.
How Are FUE Grafts Harvested?
The harvesting of FUE grafts is a very specific skill requiring very good fine motor coordination and patience. At our Clinic we currently employ a team of 24 technicians who have been working with microscopic dissection for many years. Only four of these technicians with the very highest level of skills have been trained to perform FUE extractions. This training has taken place at the two best clinics in the world performing the best FUE technique at the very highest skill level. We believe that our technicians can match and most likely exceed the skill of the very best physician extraction available anywhere in the world. In addition to our technicians work without any time constraints whatsoever. This contrasts with the physician who is skilled to the level of providing the very best work will likely have a busy practice and simply not be able to spend the whole day doing extractions.
Currently Dr. Wong is using a highly refined motorized punch felt by many physicians to be the best motorized punch in the world. Dr. Hasson is using a modified manual punch. He believes the tactile feedback provided by the manual punch results in the production of the very finest and least traumatized graphs. The added speed of a motorized punch is unnecessary as time to perform extractions is a complete non-issue. Quality is the only issue.
It is now possible to produce graphs very very close in quality to that produced by strip excision and some microscopic dissection. The only difference is the amount of perifollicular fat surrounding the follicles. This means that the follicles are more exposed and require a modification of the insertion technique. This is accomplished by the use of inserter pens or distention of the recipient sites immediately prior the graph insertion.
At Hasson and Wong we have spent years perfecting the FUE technique to the level that it compares favorably to our strip technique. We feel that without doubt our reputation for strip technique will be equalled to providing the very best FUE available in the world today.