1. What is FUE?
FUE stands for Follicular Unit Extraction. This is a hair transplant technique in which the hair roots (follicular unit or graft) are extracted individually from the rear or side of the scalp (the donor area) by means of a hollow drill known as a punch and then implanted one by one into the bald or thinning areas of the scalp (the recipient area).
At this centre we use the ‘FUE Plus’ technique with two types of punch instead of one so as to reduce damage to the hair roots to less than 5%.
2. How does FUE differ from the hair transplant technique most commonly used today, known as the strip method or FUT (Follicular Unit Transplantation)?
In the FUT or strip method, a strip of skin is excised from the back of the head (the donor area) using a scalpel or surgical knife. The donor area is then sutured together with thread or staples, and heals leaving a thin linear or occasionally band-like scar. Under the microscope the hair roots are extracted from the strip of skin and then implanted into the bald or thinning areas of the head (the recipient area). The FUE technique requires no scalpel or surgical knife, no strip of skin is removed and no line or band-shaped scar is left behind. As a result the patient loses none of his scalp.
3. Are there no scars at all with FUE?
The hair root (follicular unit or graft) is extracted with a punch or hollow drill which leaves a small hole about 0.6 to 1 mm in size. These tiny wounds heal in the form of a scar. Since scar tissue always contracts, the tiny wounds heal much smaller than the original holes, but extremely small white scars are left behind. The hair can be cut to as short as 0.5 cm without these tiny scars showing.
4. Does a graft or follicular unit (FU) always contain a single hair root? Is a hair root the same as a hair?
A graft or follicular unit (FU) usually consists of 1 to 2 hair roots, but some grafts can contain 3 or more hair roots. It depends to a large extent on the area from which the grafts are taken (the donor area).
As a general rule we can say that a transplantation of 500 FU’s is equivalent to transplanting 750 hairs.
5. In most cases hair loss is due to DHT or dihydrotestosterone which attacks the hair roots. Is there a risk of DHT attacking the transplanted hair roots as well?
The donor area is resistant to DHT. In people with extreme hair loss we actually find that the areas of hair at the rear or sides of the scalp are unaffected, which is precisely why these areas are used as the donor zone.
6. Are hair transplants suitable for anyone suffering from baldness?
A lot depends on the reason for the hair loss. Certain types of hair loss are temporary, for example, so there is no point in a transplant. Certain conditions such as alopecia areata and trichotillomania form a contra-indication for a hair transplant.
The size of the recipient area is another important factor, and the patient’s own expectations can also play a significant part.
Only a doctor has the skill and experience to assess all of these different aspects. The ultimate decision of course rests with the patient, but the doctor will advise against a transplant if the patient’s expectations are unrealistic.
7. Is a microscope needed to split the grafts with FUE?
The grafts that contain more than one hair root are split under the microscope for implantation in certain areas like the hairline. In some areas it is not cosmetically necessary to split grafts with multiple hair roots.
8. How are the grafts implanted?
The graft is implanted using the slit method. An extremely fine knife is used to make small (1 mm maximum) slits in the skin so that the grafts can be inserted into the skin tightly packed together. The size of the graft (one hair root or more) determines the size of the knife. Slits of different sizes are made in the course of a transplant procedure. What is important is that only grafts that are intact, i.e. that have a hair root, are implanted.
9. How are the grafts extracted?
The grafts are extracted from the scalp with a small drill or punch. It is essential that the grafts are extracted intact, which means that the hair root and its hair must be removed together as a unit. If the root is left behind in the scalp after extraction, this is known as transsection, and hairs removed in this way cannot be implanted. There is to date not a single scientific reason for assuming that these non-intact hairs grow, so it is essential that intact hair roots alone are extracted.
At our centre, grafts are extracted in two stages with two different punches (known as the FUE Plus technique). This reduces the number of transsections to less than 5%.
10. What anaesthetic is used with FUE?
FUE is carried out under local anaesthetic. The patient is therefore fully conscious throughout the procedure.
11. What happens to the implanted hairs?
Immediately after the procedure little scabs form where the grafts were implanted. This is part of the healing process. The newly implanted hairs fall out in the weeks following the procedure. This is a normal reaction to the implantation. The hair root remains in the scalp however and produces new hair growth.
12. How many grafts are implanted per square centimetre?
30 to 50 grafts per square centimetre will usually be implanted during an initial procedure (70 to 100 in exceptional circumstances).
The desired density will depend on the wishes of the patient, the natural density, the position of the recipient area, the colour and the quality of the hair.
13. When do the implanted grafts begin to grow?
Grafts start growing 6 to 12 months after surgery.
14. Why does Hairtransplant & Cosmetics only offer FUE?
Hairtransplant & Cosmetics has decided to specialise in FUE as a successful and minimally invasive hair transplantation technique. This has led our doctors to acquire unusual knowledge and experience and to further refining their techniques. Our doctors believe that FUE can stand as a fully fledged hair transplantation technique alongside the FUT or strip method, even for major sessions. FUE may not be suitable for certain patients, however, and they will be referred to colleagues who specialise in other hair transplantation procedures.
15. How soon can I return to work following an FUE procedure?
You can return to work the next day (if the donor and recipient areas can be concealed by the other hair), but most people find that it takes 10 to 14 days for signs of the procedure to begin to fade (the donor area heals, scabs in the recipient area disappear and hair in the shaven areas has grown back sufficiently).