FUE Hair Transplant in Pompano Beach FL

What is FUE?

FUE is Follicular Unit Excision/Extraction, one of two widely used follicular graft harvesting methods. The other is FUT or the strip method. For the FUE procedure, after the skin is prepped and numbed with medication, a small dermal punch device is used to extract each follicular unit. FUE may be a better option for those who are not candidates for the more reliable FUT procedure or for those who require only a small number of grafts to achieve their hair restoration goals. FUE is not ideal for individuals who need a lot of grafts to treat large areas of advanced balding or thinning.

How is an FUE performed?

The donor area is shaved and prepped. The physician then numbs the area with local anesthesia. He then uses a small dermal punch device to core around the follicles. Next, the follicles are then delivered from the underlying tissue. Every follicle is inspected under microscopes to ensure they are of good quality for transplantation. The tiny holes from the dermal punch device are left to heal on their own.

After selecting a follicular unit, the physician must estimate the angle and depth of the follicle to be excised, and this process is repeated hundreds to thousands of times. To have optimal results, FUE requires a particular set of skills and experience because it is a “blind procedure,” meaning the physician can only estimate the direction of the hair root below the skin within the scalp when applying the punch tool used to cut around the follicular unit before its extraction. And because the physician cannot directly visualize the course of the hair within the scalp this leads to an increased risk of transecting or cutting the follicle and its supporting structures. As a result, every follicular extraction attempt may not yield viable hair to be transplanted.

Graft quality with FUE

During an FUE procedure, there is much more mechanical handling of the hair follicles. Even in the best hands, the major drawback with the FUE is that the follicles themselves are more susceptible to trauma during the many stages of the extraction process. As a result, FUE grafts do not grow as robustly compared to FUT grafts. Only those grafts judged to be of good quality are transplanted. But, even after a diligent quality inspection of the graft, the delicate structures of the hair follicles may have sustained undetectable damage, resulting in poor or no growth. The strip method tends to give much higher quality grafts because using microscopes during harvesting avoids injury to the follicles. For this reason, the strip method has higher graft survival rates, leading to better growth and aesthetic appearance.

The FUE procedure is very time intensive because of the longer surgical time required to extract the follicular units. The time-intensive nature of FUE limits the size of the procedure in each session because larger volume procedures will require the hairs to be out of the scalp for more extended periods of time and, therefore, adversely affect the viability and survival rate of the grafts. As a result, there is a much lower number of grafts that can be harvested during an FUE session compared to FUT, and the overall downtime can be greater with an FUE, especially if looking to transplant large numbers of hairs since this would typically need to be performed over two or more sessions. In addition, FUE has a much higher cost than FUT due to the time-intensive nature of the extraction process.

To be able to harvest a sufficient number of grafts and avoid over-harvesting in any area, the hair follicles are taken from a much larger region, and this creates the risk of including hair that is outside the safe zone. Therefore, the transplanted follicles may not be permanent and may contribute to thinning of the transplanted area over time.

How does FUE impact future procedures?

This diffuse scarring in FUE harms the donor area not only because the area has been thinned by this method but also because all of these small scars distort the remaining follicular units and surrounding tissue making future extractions in a following procedure more challenging, and thereby, limiting the total available donor hair.

Who are the best candidates for FUE?

The best FUE candidates have straight or slightly wavy hair, unlike those with very curly or kinky hair. Skin thickness and texture also affect the success rate of follicular extraction in FUE. Hair follicles in thicker skin are more anchored to surrounding structures making it more difficult to free the follicle with the FUE device. Thin mushy skin has its own set of challenges as well. The strip method would give high-quality yields for all hair and skin types.

Aside from hair and skin type, the number one characteristic of a good FUE candidate are those individuals who only need a small number of follicular transplants to achieve their desired results. FUE can also be considered for those who plan to have short hairstyles or those who need to resume regular activity relatively quickly. Some individuals have limited scalp laxity or glide and because of this, they may not be ideal candidates for the strip procedure.

Beware of FUE false advertising.

FUE is often disingenuously promoted as being scarless. However, despite the advertising claims and the heavy marketing, FUE is not a scarless procedure because the use of the dermal punch device leaves small round holes that are left to scab, creating small round scars. FUE is more likely to cause significant damage to the donor region than FUT, especially when many extraction attempts are made. It should also be noted that not every extraction attempt yields a viable follicle to be transplanted. Each extraction attempt leaves small dot scars, and over-harvesting may lead to a thinned swiss cheese or moth-eaten appearance of the donor area. This graft harvesting method decreases the density of the donor region, which often compromises future hair restoration procedures if they are needed.

Conclusion

Not everyone is a candidate for a successful FUE procedure and despite the potential downsides, FUE has a role in hair restoration. Before you decide to have hair transplant surgery you must think carefully about your expectations and discuss them with your surgeon. Each graft harvesting procedure has its role in hair transplantation, so looking for physicians who can offer both services is essential.