FUE Hair Transplant FAQ

If you are considering surgical hair transplant as solution to your hair loss problems, the very first thing you must do is to research the difference between FUE and STRIP hair transplant techniques. There are vast differences between the two techniques, both in terms of price as well as methodologies.

The following is a FAQ section for FUE hair transplant put together by Poet, one of the hair transplant veterans in the hair loss community.

Follicular Unit Extraction. It is the individual removal of hair follicles in their naturally occurring groupings of 1-4 hairs. A special tool is used to create about a 1mm incision and the hairs are removed with forceps

There is currently a large debate between these two and this FAQ is not meant to foster this debate, only to present the facts. I see the following as risks of Strip Excision and benefits of FUE. With strip excision a strip of flesh is removed from the permanent ring of hair around the occipital lobe and sides of the head. The most serious problem that occurs is excessive scarring, because the remaining tissue cannot accommodate the tissue that has now been depleted, and over time stretches. To demonstrate. Lean your head forward until your chin is touching your chest. Place your hand firmly on your occipital lobe near the base of your head. Pinch this area of skin. Any where from a few millimeters to an entire inch of skin may be removed from this pliant skin. This loose skin gives us what is known as laxity. Which allows you to comfortably move your head and sleep. Do not trust anyone's opinion other than your own if you have enough laxity to spare for this surgery. Perform the same exercise on the sides of your head, pinching the skin to determine how much "extra" skin you have. Realize a portion of this hair bearing skin will be permanently removed. Another risk is this strip of skin must then be dissected by techs under stereo-microscopes. There is a risk the follicles may be accidentally transected or transection at the donor site may occur. Finally nerve damage may occur as a scalpel is used and a sub dermal excision must be made. This nerve damage can range from hyper-sensitivity to numbness. Not all patients have these complications and many have enjoyed success with strip excision. Just be aware of their potential. An emerging trend is to have one strip, and add successive density with FUE.

With FUE there is a minimal reduction of laxity because as little extra skin is removed as possible. Only the hair and surrounding tissue is removed. If done properly there is no need for further dissection. There is no donor scar, and no area to stitch up post operatively. Repeat procedures can be performed as soon as the next day. Also hair can be taken from a much wider range than the occipital lobe and sides of the head. Hair can be taken from anywhere on the body. Though I highly recommend only having hair removed in areas that can be concealed by clothing or other hair, as a precaution.

Transection is when the lower portion of the hair, the hair bulb which generates new hairs is cut off or damaged during the removal of the follicle. Your transection rate will vary depending on the skill of your doctor and the precision of their tool. An expert physician will have a transection rate around 5%. Other physicians may have anywhere from 20-60%. Sometimes higher. Because donor hair is limited. Transection is a serious issue.

Yes immediately following the procedure you will have a small 1mm scab where the hairs were removed. Once this scab sheds in about a week to two weeks. A small red dot is likely to remain. Depending on your healing characteristics this dot may perfectly match your skin, turn white, or remain somewhat red. Often hairs removed from the head are completely undetectable due to the remaining hair. Some scarring is likely to remain anywhere from 6 months to permanently. Consider this when you are having hair removed and from where it is removed. I strongly suggest not having facial hair removed. Remember FUE is not magic, and some marking, though minimal is likely to remain.

Depending on your pre-existing density in the donor area of the head. There may be a thinning effect. If too much hair is removed from a single area a patchy look will result. The amount of hair that would have to be removed before this occurs depends on individual characteristics. In the typical FUE procedure this is not a concern. However I suggest having hair removed from as wide an area as possible. You must realize any area that hair is removed from will have to be shaved. Infection and or ingrown hairs, occurring from hairs that are transected and continue to grow is another concern. Finally peripheral hairs may be transected and permanently damaged, resulting in loss of more hairs than actually harvested. I strongly suggest using Monoxidil 5% with Retin-A-a one month post operatively to aid in the recovery of any transected or damaged hairs in the area of extraction.

In my opinion no. Even though using very small gauge needles hair can be densely packed. I believe the hairs of someone with a true full head of hair is closer together than even this can be provide. However with FUE you can come closer than ever to this goal, due to the wider range of available donor hairs. The entire body.

Of course what is good, will vary from person to person. But in my opinion for the person with average density. 1800 grafts will be needed to avoid a look that is too thin or spread out from the hairline just before the crown. For the crown another 800 for a dusting effect. The crown takes more grafts to achieve coverage due to it's curved shape. If you have hair loss behind the crown about the same amount per inch will be needed to achieve coverage as on the top of the head. Some individuals chose to first get a strip excision to build density and fill-in with FUE, also covering their donor scar with FUE. covering donor scars with FUE is not always successful and it should not be assumed this can absolutely be done.

I have diffuse hair, can I just touch up the area's where I have lost hair and not lose my existing hair?

This will depend on the skill of your doctor. The use of high magnification and high gauge needles will help. Also individual placement of recipient grafts will also aid diffuse thinners. With any hair transplant future hair loss should always be considered. I recommend placing at least some hair in areas that are diffuse but at some time are likely to shed. And placing more hair in areas where there is complete loss. This way in the event you lose all your hair, you won't have patches of hair where you were once bald, and no hair, where you once had hair. Shock loss is always a risk, but tends to be minimized with FUE due to it's less invasive nature.

My chest hair is darker, shorter and curlier than the hair on my scalp, will this look right on my head?

According to studies by Dr.Ray Woods, the pioneer of FUE, over time, hair from the donor area tends to take on the characteristics of the recipient area, including length.

FUE is very labor intensive and highly specialized. Any doctor offering a mega-session in FUE should be approached with caution. Each hair must be individually removed. With strip, all that is needed is an excision of anywhere from 500-3000 grafts and dissection by techs. A typical strip surgery takes about 3-4 hours. A typical FUE procedure takes from 8-12. The doctor must be compensated for their extra labor. Also though you may save money with other methods, you run the risk of paying with your health. Money tends to regenerate, one's health does not. That said what are the costs? Dr.Woods currently is the best and original FUE provider, however his rates have changed since I went to him, so you will have to contact him for rates. As FUE gains popularity I'm sure rates will begin to vary. However I'd expect to pay at least twice as much as you would for a typical strip surgery.

I hate to say this but the anesthetic was worse for FUE. The reason for this is, for me personally I had hair taken from all over my body. Well that's great, but the price I had to pay was injections all over the place.. So it can be painful and takes at least two weeks for the soreness to go away. Why am I willing to put up with this? Because once that pain is over, I'm done, no lasting tightness or increased nerve damaged from scarring.

After the FUE procedure patients tend to be alert and not in pain. Some mild pain killers will be prescribed in the event there is any pain. Typically one can return to work the very next day. The scabs and redness however will persist as long as two weeks. Anywhere from 1 week to a month the majority of hairs will first grow rapidly but then shed, as is common with all transplants. Around 2-4 months the hair will again grow. Also around this time some hair lost from shock will again grow.

Sleeping the first few nights will probably be uncomfortable due to swelling and injection sites for anesthesia. When multiple FUE procedures are performed in a row swelling can get quite intense in the face, as saline from the anesthetic is not rapidly absorbed in the body. This swelling subsides 1-2 days after the last FUE procedure is finished, and primarily occurs from frontal work. The first few nights after your FUE procedures you must likely will want to take pain killers to help sleeping. Within 3 days I didn't need them to sleep comfortably.

As far as your head starting to look normal again about 2 weeks. Weight lifting sports etc. I would suggest waiting 3 weeks, but ask your doctor. Showering with direct contact 2 weeks. Hair dying 1 month. Over the course of the next month, the donor sites will get smaller and smaller

Please verify everything stated here with your personal physician. I am not a doctor.

Do not apply direct shower pressure for 2 full weeks. Use only a cup of warm soapy water to clean the head for this time.

Until scabs are healed use only Peroxide, Alcohol, Witch Hazel or Tea Tree oil sparingly to clean blood and/or infected areas

Do this for the four months following your hair transplant. This will help your new grafts to grow, and your donor hair the best chance to recover in the event of transection.

The above is provided by courtesy of one of our
forum members to facilitate discussions.
Please do not take this as medical advice.

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