- Anesthesia

Follicular Unit Extraction: Questions and Answers

When dealing with hair loss and the bounty of potential restoration options, it is encouraged that people ask questions and do as much research as possible. Many answers can come from a certified hair restoration physician, articles in medical journals, and credible Internet sources. The following is a series of common questions and answers regarding follicular unit extraction:

What is follicular unit extraction?

Follicular unit extraction, or FUE, is a micro-surgical hair transplantation method wherein the surgeon harvests hairs from the donor area one follicular unit (natural groups of between one and four hairs) at a time. The donor area is generally anywhere among the back and sides of the head, to include finer hairs from the nape of the neck or behind the ears. This harvested hair is then implanted into the balding recipient area.

What are the procedural steps taken?

  1. The patient lies face down on the operating table.
  2. Local anesthesia and intramuscular hypnotics are administered.
  3. A pen-like handheld micro-punching tool and needle device are used, under magnification, to extract each follicular unit from the donor area.
  4. Follicular units are preserved in a holding solution until the extraction portion of surgery is complete.
  5. Patient turns to sit face up for local anesthesia to be administered to the recipient area.
  6. Customary blades are used to make microscopic slits in the recipient area.
  7. Surgeon implants follicular units into slits.
  8. Medical assistant will provide detailed care instructions.
  9. The patient receives a prescription for antibiotics, topical medication, and mild pain killers.

What is the healing rate?

Being that FUE is a minimally invasive surgery, requiring no staples, stitches, or bandaging, the recovery time is typically quick. The donor site should heal within one week, with hair growing back by the second week post-op. The recipient site should flake of all scabs within two weeks, however it is normal for a shedding phase to continue in this area for eight weeks.

When will I see growth in the recipient area?

New hair will begin to grow at approximately four months and continue until eighteen months, at which point new hair growth should be mature, healthy, and thick, and blend in with surrounding hair.

Who is a candidate for this procedure?

A good candidate for FUE hair transplant is generally any patient over the age of 24 who still has sufficient donor hair in tact. Usually, such patients do not suffer severe baldness or excessive scarring of the scalp. If they do, body hair transplantation (BHT) would be a possible solution. Regardless, for any successful FUE or BHT surgery, a patient must not have extremely curly hair, no history of blood clotting abnormalities, and no allergies to anesthesia.

What are the potential complications of this procedure?

Though follicular unit extraction is a safe, effective, and minimally invasive surgery, complications may still arise as with any medical procedure. An inexperienced practitioner, or one who values quantity of surgeries over quality, could add to the risk of complication. The use of un-perfected vacuum-based devices might also be risky. Other potential complications could stem from unforeseen physiological hazards, such as blood clotting abnormalities or an allergic reaction to anesthesia.