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Follicular Unit Extraction (FUE) Hair Transplant

Author: Kanika Gupta
by Kanika Gupta
Posted: Feb 12, 2016

Hair transplantation is a surgical technique that moves individual hair follicles from a part of the body called the 'donor site' to a bald or balding part of the body known as the 'recipient site'. It is primarily used to treat male pattern baldness. In this minimally invasive procedure, grafts containing hair follicles that are genetically resistant to balding, (like the back of the head) are transplanted to the bald scalp. Hair Transplantation can also be used to restore eyelashes, eyebrows, beard hair, chest hair, pubic hair and to fill in scars caused by accidents or surgery such as face-lifts and previous hair transplants.

Hair transplantation originated in Japan in the early 1900s and has evolved greatly over the past century. In the 1980s, as part of this evolution, came the advent of follicular unit extraction (FUE). FUE, wherein the practitioner extracts follicular units (natural groupings of 1 to 4 hairs) one at a time, is now the ideal method of extraction for hair transplantation.

FUE method of transplantation is a no-stitch procedure that involves implanting the grafted follicular units into the balding recipient area. While FUE hair transplantation requires the practitioner to possess a higher skill set in order to perform the procedure successfully, this technique continually yields the most successful outcomes in hair density, natural-looking hairlines, and minimized scarring. FUE hair transplantation is generally pursued for the treatment of androgenic alopecia, also known as pattern baldness. This genetic hair loss condition results in balding of the crown, front, hairline, and temple points. But with the innovations of the Follicular Unit Extraction, it is nearly impossible to tell a natural head of hair from one that has undergone hair transplantation.


Once you’ve had a one on one consultation with your physician and decided to proceed, you will be given the necessary instructions to prepare yourself for your day of surgery. Some of these instructions may be tailored to your particular needs. Put the instructions into place whenever specified and follow them carefully. On the morning of your surgery, you should have a bountiful breakfast and arrive with a thoroughly shampooed scalp. Upon arrival at the clinic, "before" photographs will be taken of you. The donor area, being the back of the head in most cases, will then be shaved and prepared for surgery.


There are different options for treating hair loss, not all surgical:

  1. Minoxidil, commonly known as Rogaine, and finasteride, commonly known as Propecia.
  2. Surgery is the most popular means of permanent hair restoration with three main techniques at the forefront:

scalp reduction

temporoparieto-occipital (TPO) flaps and other variations of flaps

Punch graft, minigrafts, and micrografts

Hair transplantation, including follicular unit strip surgery and FUE hair transplant

Rogaine and Propecia are the two FDA approved, prescription-based hair restoration drugs on the market. These drugs must be used continuously in order to stop hair loss, unlike FUE hair transplantation, which is a permanent procedure.

Scalp reduction and temporoparieto-occipital flaps, or TPO flaps, have become obsolete due to consistently botched results, a high probability of permanent scarring, and the potential for nerve damage. Also, they are considered hair restoration surgeries, unlike the FUE hair transplant, which is transplantation surgery.

The FUE hair transplant is an improvement of the punch graft technique. Punch grafts are 4mm grafts which result in what we call "doll’s hair." Another unsightly outcome of punch graft surgery is the 4mm round bald marks left permanently on the back of the head. Minigrafts and micrografts were developed as an improvement of this method, but still yield unnatural, pluggy-looking results as compared to FUE hair transplant.


Potential candidates for FUE hair transplant using head hair only are those who do not suffer a total depletion of scalp donor hair. An FUE clinic that does not practice BHT would be unable to service a patient without sufficient head hair remaining intact.

A clinic that does put body hair transplantation into practice, such as the DermHair Clinic of Los Angeles, would be equipped to service patients whose scalp hair loss is so severe that their head donor hair is not sufficient for transplantation. This includes FUE hair transplant patients who:

Suffer from severe pattern baldness

Have excessive scarring from previous surgery

Have endured some sort of accident or burn that has left them bald


While follicular unit extraction using body hair transplantation has changed the face of hair loss, there remain some people who still will not qualify for this type of surgery.

  1. People who lack the supply of good quality head, body, or beard hair will not be candidates for any type of FUE hair transplant, even with the use of BHT.
  2. There is a relative contraindication for hair transplant generally in patients who are too young, i.e., below the age of 24. This is due to the fact that a person under the age of 24 who suffers from androgenic alopecia has likely not finished balding. Also, this age group may be psychologically and financially unprepared to grasp the long term implications of hair transplant. That said, after careful counseling, even young patients can undergo an FUE hair transplant. Counseling must fully take into account: future hair loss, total available donor pool, and the patient’s ability to countenance future follow-up transplantation (which could create an unnatural look if not done).
  3. Some people with extremely curly or kinked follicles, such as most of African descent. These patients should ideally undergo a test procedure to determine their transection rates and consequently their suitability for FUE hair transplant.
  4. People with an abnormal tendency to scar, as in scar hypertrophy, or keloids.
  5. People with bleeding or clotting abnormalities.
  6. People with allergies to local anesthesia.


Follicular unit extraction is a safe and minimally invasive method of hair transplantation. Patients can minimize their risk by following all pre- and post-procedural instructions and by selecting an experienced surgeon. However complications may yet arise even in the best of circumstances. Factors that increase the chance of complications of FUE hair transplant could include:

Physiology of the patient

An inexperienced practitioner

A practitioner who values quantity over quality

A practitioner who abdicates his skills to unlicensed personnel or flawed machines ( eg vacuum based technologies or robots that lack the human touch)

Unknown and unforeseen complication factors may arise on rare occasion

The FUE hair transplant is, hands down, today’s leading surgical technique for hair restoration. While it does require practitioners to take their time implementing the utmost skill, the life-changing results patients enjoy makes it a highly rewarding process overall. FUE hair transplant using body hair transplantation has also become much more widely used and accepted because of its undeniable success rates in the hands of experienced practitioners.

More specialized branches of Follicular Unit Extraction have developed. This includes an area known as facial hair to head transplant. Follicles from the beard region are extracted and inserted into areas of hair loss. This course of action is used in cases where head hair is not enough to create sufficient coverage.

About the Author

Kanika Gupta is Ceo ofa href = ""Hair Transplant Abroad and author of the articles written on websites, e-zine sites, including,,

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Author: Kanika Gupta

Kanika Gupta

Member since: Feb 11, 2016
Published articles: 3

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