The follicular unit extraction technique (FUE) is similar to follicular unit grafting (FUG) in that both techniques utilize the concept of transplanting individual micrografts to the recipient site. The main difference between FUE and FUG is that FUE avoids a linear scar at the donor site incision. This is because in FUE, the grafts are harvested one at a time with precise 0.8 and 1mm punch blades. The result is a scattered array of essentially undetectable pinpoint scars across the back of the scalp. Thus, approximately 70% of patients can shave their heads without any visible scars, while the rest are able to cut their hair quite short.
In order to perform FUE, the back and sides of the head are first shaved, and the grafts are subsequently harvested with the patient lying face down. The procedure is labour-intensive and can last several hours, depending on the number of grafts required. With smaller procedures of 500 or fewer grafts, oftentimes rather than shaving the entire head one can shave narrow “bands” of hair which can be concealed by the overlying longer hair. Even in those instances where shaving the head for a large FUE session is required, the hair tends to grow back quickly and looks nearly normal by 2 weeks.
While FUG is still the mainstay technique for hair transplantation, FUE is clearly the way forward for many patients. It is usually the best procedure for the younger male patient; the African-American patient; and/or the patient desiring reparative work who has a limited supply of donor hair. FUE is also a great technique for obtaining grafts that are to be placed into a donor site scar from a prior procedure to help reduce its visibility. In addition to their application in the scalp, FUE grafts can be used in certain cases of beard and eyebrow restoration.