FUE (Follicular Unit Excision)
Previously known as Follicular Unit Extraction
The FUE procedure: the principle involves harvesting follicular units with a punch whose diameter measures between 0,7 and 1 mm.
Punch of 1 mm on the scalp
What is a follicular unit? It is a couple of hairs (between 1 and 4, rarely more) that exits from the same pore. The follicular unit is also known as grafts.
Microscopically view of Caucasian grafts
The FUE harvesting is a very delicate process for several reasons:
- It is blind under the skin;
- Hairs do not always follow the same direction under the skin;
- The punch is narrow;
- The angle of the shaft change under the skin because of the arrector pili muscle;
- The hair follicle can be curbed and very difficult to harvest.
Microscopically view of curly grafts
Nevertheless, even in the most difficult conditions due to the graft’s characteristic (extreme curl in hair shaft for example), we can perform hair transplant with great results.
The goal is to obtain the best quality grafts in order to have an optimal new hair growth. To achieve the finest result, grafts must present the protective dermis and fat that include stem cells reservoir responsible for hair growth cycles (chubby graft).
It is very important to avoid causing injury to the adjacent grafts; those we don’t harvest in order not to damage the donor area and also to avoid the FUE white dot scars and a “moth-eaten appearance“. This is why we do not perform a procedure called Maxi 3D, which consists of harvesting with very large punch (2 mm diameter or more)
The FUE challenge nowadays is using narrowest punch that allows to collect graft of excellent quality and minimizes the risk of lesion of adjacent follicular units.
Most operators puncture the skin to a depth of 2 or 3 mm as to avoid any transection.
In our hair transplant centre, we can puncture the skin and harvest with manual punch, motorized punch or with the ARTAS robot.
Manual FUE extraction
Unlike many things we might read on internet, we manage to harvest grafts of excellent quality and there is no lesion of the tissue surrounding; the pressure on the skin is light and the transection rate is the lowest. Our cadence harvesting assures 500 grafts per hour. Besides, only with the manual FUE we can perform a long hair transplant, the latest technique in hair transplant.
Motorized FUE extraction
The punch is still guided by the operator but the harvesting is faster than the manual harvesting or the robotic harvesting. With the motorized FUE procedure, we can harvest between 1500 and 2500 grafts per session.
Several motors are available, some of them reproduce the work of the human hand by creating oscillations.
In our team, the transection rate is very low: 1 or 2% in “easy patients” and up to 5 or 6% in difficult patients.
With those technologies, the quality of the grafts is similar to the one obtained with the manual FUE procedure. A lot of different punches models can be found: sharp punch, dull punch or hybrid punch (see picture below).