FUE is the abbreviation of English words Follicular Unit Extraction. Fue hair transplant method has gained its popularity compared to the FUT due to many advantages. Moreover, the ability to transplant hair from the areas despite the back of the head, such as beard, chest made FUE demand to grow rapidly.
What is FUE Hair Transplant?
FUE Hair Transplant is hair grafts transplantation between two ears or other body parts hair that are genetically resistant to shedding. The follicles are extracted one by one and transferred to the hairless area. This method was invented by Dr. Rassman back in 2002, it got very popular together with micro motor technique replacing from the sector the remaining FUT method. FUE is considered as the newest hair transplant method.
FUE is the abbreviation of English words Follicular Unit Extraction. Fue hair transplant method has gained its popularity compared to the FUT due to many advantages. Also, the ability to transplant hair from the areas despite the back of the head, such as beard, chest made FUE method demand to grow rapidly.
We practiced cases when 10.000 grafts were transplanted by the FUE. This, of course, depends on the donor area capacity. The FUT method allows transplant a maximum of 3000-4000 grafts. Very rarely both the FUT and the FUE are applied in combination. For example, when the FUE hair transplant is made, the FUT operation follows in 1-2 days. 10.000 grafts can be implanted to those who have Norwood 6-7.
General Information About FUE and Its Advantages
In the FUT method, 1.5-2 cm X 20-30 cm scalp skin is cut out from the donor area, then it is merged to the skin of the target area. In the FUE, the hair roots are extracted one by one, there are no cuts and suture. People quickly switched to the FUE escaping from cutting their scalp hair and its suture. As a consequence, the FUE completely replaced FUT method from the sector.
In the FUT method only the hair area on the back of the head can serve as a donor, while in the FUE, all hair on a body can be used. Particularly, transplantation from chest and beard hair made the FUE method advancing. As a result the number of grafts for transplantation significantly grew. Additionally, compared to the FUT method the absence of the suture and linear scars related to the pleb part made the FUE one of the best hair transplants. When the hair is short scars of the FUT are recognizable. In opposite, the FUE leaves point traces that can be easily camouflaged.
Another advantage of the FUE method is post-operation pain. After the FUT surgery pain continues 3-4 days. This is because the head skin is cut and sutured, it is considered as small invasive surgery. Moreover, there is hypokinesis at topagnosis of the back of the neck area 3-4 months after the operation. In some cases, this lack of sensitivity lasts from 6 months to one year. As for the FUE, the skin state turns to normal in 48 hours. The topagnosis (lack of sensitivity) is much higher in the FUT compared to the FUE. We will describe more differences in these procedures in our other article.
What are the FUE Stages?
The only difference between the FUE hair transplant and the FUT is graft extraction.
Information about the period before and after hair transplantation is explained in this article. We can summarize the stages of an FUE Hair Transplant as follows.
- Local Anesthesia. Local Anesthesia is not a special application for the FUE as it is also implemented at the FUT. We describe anesthesia detailly on another page.
- Hair Roots Extraction. This is our major topic on this page.
- Hair Transplant (Transplanting the Grafts to Hairless Area). Grafts implant has no connection to the FUE, we already explained it in our article about hair transplant methods. Hair Transplant via the FUE and FUT techniques is similar.
Let us examine the FUE method specifications.
How is the FUE Hair Transplant Made?
FUE is graft extraction. The hair on the back of the neck or other body parts can be used for the FUE hair transplant. More information about implanting hair from the beard or hair from other body parts is described in related articles. Let us study the transplantation of the hair from the back of the neck. The patient must be positioned face-down or serjeant.
The face-down position helps to take the grafts easily from the occipital and back of the head areas. Once the grafts are taken from the sides the patient is placed in a lateral decubitus position (in other words, tilted position). Graft extraction is much easier in this pose. Extracting the grafts from a lay-down position is faster but it causes intense bleeding. Thus sitting position makes less bleeding.
First of all, the recipient area should be marked with a regular pen. This pre-planned approach helps to divide the area equally. The divided sections are inflated with saline which is also called an isotonic solution. Skin swelling simplifies hair extraction and prevents roots from damage. Once the local anesthesia is applied to the area, extraction of the hair grafts can begin.
Punches are used during graft extraction. 2,5x – 4x loupe ratio is enough. If the loupes are not used, the grafts can be damaged significantly. Thin punches cut the roots of the hair without the need to suture, and the grafts are extracted one by one. These extracted hair follicles are placed individually in pine containers called Petri dishes and kept in the cooling containers until the transplantation. The follicles should be preserved until implanting in cold temperature at 0,4 degrees Celsius.
FUE Donor Area
It is necessary to have the hair shaved for the FUE hair transplant. The hair length on the donor area should be 1mm at the regular FUE operation; it is called Zero shaving. Normally, around 5000-7000 grafts are extracted from the shaved zone depending on the need and capacity of the donor area.
It is better to extract grafts from a safe area. The safe area has strong roots and they are very rich with anagen. It is also possible to take out the follicles from above ear and occiput (back occipital bone). The hair in this area is thinner and better suits the front head. Roots from the under vertex area have a high possibility of hair loss risk, which is why it is not an appropriate place. There is also a risk of hair loss with the parietal ear hair in the future. Even if grafts are taken from this zone, the small amount must be extracted. This is more important for young people.
Moreover, fewer grafts should be extracted from the marked (with pen) lines. The pen line creates a smooth transition. To obtain a more natural look the hair roots in near the line should be thinner.
The diameter of the FUE punch plays an important role in the graft number that can be extracted. Thick punch results in more limited graft extraction and transection rate is considerably high. Moreover, it leaves bigger cuts on the skin. We prefer punch 0.7, 0.8, and 0.9 mm in diameter. In most cases, patients are not pleased with shaving. Sometimes, it is possible to do transplantation without cutting the hair. We describe the unshaven hair transplant method in another article which excludes hair incision.
3 Important Rules in the FUE Hair Transplant
- FUE Punch Size and Depth Control
- Fue Punch Entry Angle
- Grafts Number and Donor Capacity
1- FUE Punch Size and Depth Control
The most important point in graft extraction that should be paid attention to is the entry depth of the punch. It does not matter if it is manual or has a micro motor. When the punch is too long hair roots can be damaged during extraction, it is called dissection. It causes unnecessary graft loss. Patients have different graft sizes; the ideal punch length can be determined and fixed after a few tries. In opposite, if the punch is short, it is difficult to pull out the hair, and this causes destruction too.
2- Fue Punch Entry Angle
The other important point is a proper entry angle of the punch. It is easy to find the right angle after a first try. A wrong entry angle causes transection, which is the destruction of grafts. There is a difference between the hair growing angle inside and outside of the skin on the back neck area. A well-qualified FUE hair transplant doctor can easily identify proper angles and continue the surgery accordingly. Transection scale (destruction volume) is a percentage relation of defected hair roots to healthy grafts. A 2-10% transaction scale is acceptable according to the general international standards. In this method, our transaction rate is 1-2%. This is a result of our experience in FUE and technique skills.
Tools for the FUE Hair Transplant
FUE has two hair extraction techniques. Both techniques include extraction by various diameter tools called the punch. These punches vary as sharp, round, fish- mouth, serrated, and Dr. Umar’ the U shaped. The diameter of a punch depends on the thickness of the graft. There are many producers of the punches in the market, their diameter ranges from 0,6 to 1,5 mm. We do not find the operation with wide tipped punches appropriate. In most cases, 0,7, 0,75, 0,8 and 0,9 mm diameter is suitable for graft extraction. Additionally, a punch length is as important as the diameter. The length is selected according to the hair size, this is 3 mm, 3,5 mm, or 4 mm.
a) The Manual FUE
Hair roots are extracted manually with a thin and sharp punch. There are many different manual punch types in the FUE transplant. The extraction by a manual punch is much slower than by micro motor. Round and fish mouth punches are more favorable for manual operation. The hair roots are easily released from a round punch, while fish-mouth requires a back and force movement.
b) FUE Micro Motor Method
The micromotor is located inside of the punch. The tool with adjustable speed works on electricity. Circling the punch extracts hair grafts faster than the manual. However, if the speed is too high, grafts can be damaged. There is a false belief that the micromotor punch destructs grafts. Yet, if the tool implemented correctly in the FUE hair transplant, the outcome is excellent. Nowadays, micro motor FUE is used more often compared to manual.
c) Robotic Hair Transplant
The USA has been developing a modern computerized hair transplant device. It is manufactured by Artas company. It is not a complete hair transplant machine. The device marks the grafts and only cuts them via rotation. Than these grafts are gathered manually like in the classic approach. Automated hair transplant increases a damage risk of the grafts significantly. Moreover, the diameter of their punch is generally 1,2 mm, which also reduces the number of healthy grafts. Additionally, the thick punch can touch and hurt other grafts nearby. Ultimately, it leaves notable scars on the skin. In our opinion, this system is regressive in the FUE, thus we do not practice it. We would like to emphasize that the robotic system contributes no advantages to a hair transplant.
After The FUE Hair Transplant (Donor Area)
The donor area starts recovery very fast after the FUE hair transplant. If adequate grafts number is smoothly taken, the donor area recures itself in 10 days and hair extraction is not recognizable at all. On the picture below you can see the condition of the skin before and after hair extract.
Before the transplant / 1st day after the transplant
What are the Advantages and Disadvantages of the FUE Hair Transplant?
- According to our experience, it is not healthy to transplant more than 2000-2500 grafts at the FUE transplant during one session. If it is necessary to extract a big volume of grafts, an operation can be divided into 2-3 consecutive days.
- One session approximately lasts 5-6 hours. As already mentioned, big volume hair transplant should be split to several days otherwise the risk of damaging grafts increases.
- Women completely switched from the FUT to the FUE. The benefit of the FUE to operate without shaving makes it a fist choice.
- Additionally to that, the best suitable eyebrow transplant method is FUE too.
- The FUE technique for a beard transplant became irreplaceable. This is because the hair in the anagen phase (hair in the development) transplanted one by one selecting only strong grafts.
- The claim that there are no scars after the FUE hair transplant is incorrect. It is important to remember that any surgical interference leaves traces. However, when hair grows in the transplanted area, it covers all operation traces. If the big and atypical volume of grafts are extracted and the hair is short in the donor zone, scars can be recognizable, which causes discomfort to a patient. The scars/traces increase due to the number of extracted grafts and the diameter of punches.
- There is no connection between the FUE and pen implanter hair transplant methods. Fue is the type of hair roots extraction, while the pen implanter is the hair implantation method. The pen implanter has been in practice together with the FUT since 1990. Due to the pen implanter is a new approach in our country, there is a misunderstanding that it is operated only with the FUE.
FUE Hair Transplant Results
Patients are interested to know the outcomes of the FUE transplant in advance. You can check the results of our work in the section Before and After hair transplant on YouTube, Facebook, and Instagram. You should take into account the natural look and density of implanted hair as the main criteria. You can also refer to diverse forums for more information about the FUE. To get more details about Dr. Hakan Doganay’s operation outcomes please contact us directly.
The FUE Hair Transplant Price
Due to legal restrictions, we can not publish our rates on the website. To get the FUE hair transplant quote please mail us or contact via phone 0090 533 247 1990 (available on WhatsApp). We will provide you more information about the FUE hair transplant and its price for you based on the photos that you will share with us.
Frequently Asked Questions
What is FUE?
In the past, the skin of the head was cut and transplanted by the FUT method. Today almost nobody is operated by the FUT approach. The FUE technique means extracting grafts one by one without any need for cut or suture which is very beneficial compared to the FUT.
They Say they can Take Limitless Number of Grafts, is it Possible?
This is a piece of completely unprofessional information. Every person has his/her individual donor capacity. If your donor capacity is 3000 grafts and you transplant 6000 grafts, you can destroy the hair roots and will also need additional assistance from a better doctor to correct the donor area
Is it True that the Record for Hair Transplant is 10.000 Grafts?
The statement is encouraging but none of the Professional doctors in the World agrees to make it. If the FUE hair transplant procedure lasts more 5-6 hours, than it is better to divide it into several days. Transplanting of 5000-6000 grafts at once may sound exciting, yet this will not lead to any positive result.
Which One Should I Chose: Sapphire, Gold or Ice FUE?
In the last couple of years, advertisements offer microfue, icefue, goldfue, or similar kind of modern varieties of the FUE hair transplant, they try to draw attention by offering a fake new product. There are no such techniques as microfue, nanofue, fueplus, etc. This is just a word game in promotion, which is aimed to get as much attention as possible. You are better to focus on the specialist who will operate you. It should be a very experienced and trustable doctor.
- Does the use of implanters affect the quality of FUE grafts? Hair Transplant Forum International May 2017, 27 (3) 96-99; DOI: https://doi.org/10.33589/27.3.0096 https://www.ishrs-htforum.org/content/27/3/96
- Haartransplantation: Welche Technik für welche Patienten? Journal für Ästhetische Chirurgie volume 12, pages135–141(2019) https://www.researchgate.net/publication/332133456_Haartransplantation_Welche_Technik_fur_welche_PatientenHair_transplantation_which_technique_for_which_patient
- Hair Transplantation: Current Concepts and Techniques https://www.sciencedirect.com/science/article/pii/S0022202X15525943