FUE follicles containing 1-4 hairs are removed individually from the donor site (usually on the sides and back of the head,) and artfully transplanted into thinning or balding areas on the head. The individual extraction of the donor hair ensures minimal risk of skin scarring as compared to the old strip-surgery method.
The major difference between the 2 treatments is the way in which the hair is extracted from the back of the scalp. The implantation process is the same. Strip procedure requires the harvesting of a strip of scalp from the donor area. The strip is only millimetres in diameter and is removed using a small scalpel. The strip is placed under a microscope and divided into grafts containing 1 or 2 hairs. The strip method usually leaves visible scarring and requires stitching to close the scar. Follicular unit extraction (FUE) is a process that utilises a small punch tool that removes hairs from the donor sites. The tool removes grafts that contain either 1 or 2 hairs. FUE procedures use a much larger donor area than strip procedures. The punch tool will likely be used across a large area of the scalp to extract healthy hairs. Both procedures insert 1 or 2 hairs at a time into tiny incisions. Some patients find that the incision sites for strip procedures are somewhat larger and more noticeable than that of FUE procedures. Both procedures require incisions that are less than 1 millimetre in diameter.
In the absence of obvious contra-indications such as certain medical conditions or poor donor area, most adult patients are suitable for FUE hair transplantation. In cases of poor donor area, a strip procedure (FUT) may be more appropriate. Some surgeons however may try to push the strip procedure (FUT) suggesting that the patient is not suitable for FUE. This can often reflect the surgeon’s lack of interest and experience with FUE.
Transplanted hairs behave in a similar way to the hair from where they were taken from. They usually last a lifetime for most people or at least into old age when the procedure is done correctly.
Male pattern baldness, the most common cause of hair loss in men, is caused by a hormone called DHT (dihydrotestosterone), which shrinks the hair follicles located on the top of the head and leads to the common hair loss patterns. There are however other causes for hair loss, which our medical team can discuss with you.
The majority of the patients are comfortable both during and after hair transplant surgery done by the Follicular Unit Extraction-method. When administering the local anaesthetic patients will experience some discomfort or pain. Once the medicine starts to work the patient should not feel any pain. Post-operative pain is less and the recovery much faster than strip-surgery. Pain medications to use at home are prescribed by the surgeon.
The art of a hair transplant is to conceal the scars. When performed by skilled surgeons, FUE hair transplants are only detectable by thorough examination. The donor site however will have very fine scars or areas of hair loss completely hidden by your existing hair. Patients should refrain from shaving the back of the head because healing and scarring can vary from person to person.
This depends on your type of work. If you don’t have a physical or strenuous job, medically you can go back to work after just a couple of days, otherwise return after 7 days. The other consideration is from a cosmetic point of view. If you do not have sufficient hair to cover the donor site or if you are very concerned about anyone knowing, then it is probably best to take a couple of weeks off work. You will not be able to wear a hat immediately after surgery, although a modified cap may be possible depending upon the surgeon’s opinion. The sun will not damage your grafts, but as your scalp may still be numb you will need to wear a hat to avoid sunburn to your scalp.
Any recently performed hair transplant should give a natural and in most cases an undetectable look from the front. The lateral slit technique plays an important part in creating a natural result. However, it may be mentioned that even if the surgeon is experienced, a limited number of patients may experience poor hair growth due to inherent medical conditions, circulation problems, diet and lifestyle factors can negatively affect the growth of hair and overall outcome. These are not necessarily due to the transplantation techniques. From the back a strip-transplant will leave a linear scar, which in some cases can be rather visible and disturbing. FUE procedures significantly reduce the risk of visible scarring.
With any breach of the skin the risk of an infection does exist, however small it may be. Post-operative infection is very rare. In the rare event of an infection, it is usually treatable with antibiotics.
This can differ from patient to patient but it is common for the ‘bulb’ of each transplanted follicle to go into a dormant phase for around 12 weeks before it starts to grow. Within 5-6 months you should see approximately 50% of growth. Full growth can take 12-18 months. It can take longer in the crown area.
Although a very good result is expected, the results can never be guaranteed as it depends on many factors; hair loss area size, donor area quality (volume and density), size of the procedure, lifestyle and diet, medication, underlying medical conditions, unrealistic expectations and the quality of the hair transplantation procedure.
During hair transplantation we are only redistributing your existing hair to your thin or bald areas. The transplanted hair usually behaves like the donor hair. We are not creating new hair. Having said that, in expert hands, the limited donor hair available can be used to create the illusion of a lot more hair in people with significant hair loss. In extensive baldness it may be difficult to get extensive coverage with high density. Your surgeon will be able to determine that on examination.
Technically hair transplantation can be performed at any age. The patient’s age is a vital factor to be considered, though. Preferably the patient should be at least 30 years of age. Under certain circumstances younger patients may be considered.
Yes. With FUE there is no linear scaring and the donor-area is essentially left intact. The procedure can be repeated and a large number of hairs can be removed without noticeable thinning in the donor-area. As hair loss is progressive, a patient may need between 1-3 hair transplants throughout their adult life.
FUE hair restoration minimises the trauma to the scalp and thereby reduces the risk of any serious complications or side effects, including scarring, prolonged pain or numbness, to a minimum. However, medicine is not a precise science with a 100% predictable outcome. The following problems have been brought to our attention.
- – As with all surgical procedures requiring anaesthetic, there is some pain during the procedure and in the healing stage immediately after the procedure.
- – Swelling – mostly mild to moderate. This usually disappears in a few days
- – Scarring – Is usually hidden from the naked eye and should only be visible by close inspection when the hair is cut short
- – Growth issues. A very small percentage may experience unsatisfactory growth. Again, this can be due to a number of reasons. Patients are advised to speak to their surgeons if this is the case.