FUE (FOLLICULAR UNIT EXTRACTION)

Follicular Unit Extraction, or FUE, is the most popular and commonly used transplant option. This procedure involves taking individual hair follicles directly from the skin on your scalp in high-density hair growth parts and transplanting them to an area of low-density.

FUE is generally suited to treat:

  • Patients who present dense hair growth areas, where hairs can be taken for transplant without leaving thinning or bald patches.
  • Patients of “older age” with a stable balding pattern.
  • Patients with less balding/thinning areas as each hair are individually grafted.
  • Patients with naturally shorter hair. This characteristic entails less scarring, with only minimal signs visible once the hair regrows.

THE PROCEDURE

  • The surgeon will examine the scalp for parts of suitable hair growth to identify the donor area, usually located at the back or sides of the head.
  • A local anaesthetic will be applied to the neck and scalp.
  • Both the donor area and the transplant area will be shaved down completely.
  • The surgeon will remove hair follicles individually from the skin (grafts) using an automated tool.
  • Using a needle or sharp tool, the surgeon will make the same number of small incisions to hair follicles.
  • Each hair follicle removed will be transplanted into one of the small incisions until all grafts have been transplanted.
  • The area will be cleaned, and the surgeon will discuss post-operative aftercare with you.
  • This procedure takes a considerable amount of time due to individual grafting, and its length may vary slightly depending on how many grafts are required.

PREPARING FOR THE PROCEDURE

Before the procedure, you will have a consultation to decide the number of grafts you must have, followed by a screening of multiple images and a review with the surgeon. They will then discuss the number and placement of grafts to ensure you are comfortable and happy with the upcoming procedure.

Your surgeon will discuss with you what to do before your surgery; commonly, it is advised that you:

  • Cease to smoke at least 24 hours before the surgery.
  • Abstain from alcohol from 3 days before surgery. If possible, try to reduce alcohol intake longer than this as it may lead to better results.
  • Avoid certain medications as these may affect the procedure or aftercare process. Such medications include:
    • anti-inflammatories (at least two weeks before surgery)
    • blood thinners
    • Beta-blockers

Discuss the cessation of prescribed medications with your doctor and surgeon before surgery to receive specific advice.

  • Do not get a haircut. Having your hair at a natural length will enable the surgeon to harvest them more efficiently at donor sites, assess areas that can be used, and trim them as needed to carry out the procedure. Also, it is advantageous as having longer hair may cover up sutures.
  • Massage the scalp 10 minutes per day. This practical step will soften the skin and improve blood flow to the scalp, aiding healing time following the surgery.

POST-OPERATIVE CARE

  • Due to multiple individual grafts, the patient is advised how to wash the hair correctly as there will be bleeding post-op and scabs forming, which will have to be removed daily. After 7-10 days, the scabs should be mostly gone.
  • Advice on which shampoo to use for this washing is given as they must be silicone and perfume free.
  • The first week following surgery, patients are advised to sleep on their backs with their heads slightly raised on some pillows to avoid much of the transplanted areas being touched.
  • A spray bottle containing a water solution is provided upon discharge which must be applied every 20 minutes for the first 12 hours. For the first three days of post-op spray half-hourly during the waking hours. Ensure every transplanted or donor area is sprayed. This solution should be kept refrigerated.
  • Avoid touching the newly grafted hair follicles as this may damage them.
  • Do not drink alcohol or smoke for 48 hours following surgery, as this will interfere with the healing of the grafts.
  • You can return to work the next day.

RISKS OF FUE

While steps are always taken to minimise risks, there is still a small chance that some side effects may occur, such as:

  • Swelling
  • Bleeding
  • Infection
  • Donor site depletion
  • Pinpoint scarring
  • Buried grafts
  • Epithelial cyst
  • Necrosis
  • Overharvesting
  • Numbness and persistent pain

BENEFITS OF FUE

  • Very minimal scarring, virtually undetectable
  • The advanced technology utilised allows for the least invasive, most precise procedure
  • Minor discomfort post-op
  • Complications are infrequent
  • Faster recovery – Due to the procedure being less invasive, you can resume daily activities within 48 hours
  • A higher graft survival rate
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