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Hair transplants: the follicular unit extraction (FUE) technique

The follicular unit extraction method of hair transplantation involves isolating single hair follicles or very small groups of two to three hair follicles from areas of healthy hair and transplanting them into thinning or bald areas of the scalp.

The small puncture incisions used to harvest the micrografts for FUE hair transplants measure no more than a millimetre so do not leave any significant scarring. This gives the FUE hair transplant a distinct advantage over the strip incision method or FUT method, which can leave tramline scars at the back of the head.

The second advantage of a FUE hair transplant is that it can use hair from anywhere on the body. This is particularly useful in cases of male pattern baldness, as the hormone testosterone, which when converted into dihydrotestosterone (DHT) causes male pattern baldness, conversely causes hair elsewhere on the body to grow more thickly. The FUE hair transplant technique uses hair from the chest, back, and legs to provide micrografts for hair transplantation surgery.


Preparing for a follicular unit extraction hair transplant

The exact preparations for a FUE hair transplant will depend on the donor area being used. If the micrografts are to be sourced from the head itself, your surgeon may recommend the application of minoxidil to the scalp to promote strong hair growth prior to your hair transplant. However, if the hair is to be sourced from elsewhere on the body, minoxidil is best avoided even as a scalp treatment as this may inhibit hair growth in the donor area.

It is advisable to avoid smoking for several weeks before surgery and cut out drinking alcohol for a few days before the transplant. This will help you avoid any potential complications with the local anaesthetic and with wound healing. Other things to bear in mind include:

  • Since FUE hair transplantation is a lengthy process, you are also advised to eat a good breakfast to sustain you for several hours

  • You should arrive with clean hair but do not use conditioners or any other products that may leave a residue on the individual strands of hair

  • You should also dress in something (like a button-up shirt) that can be removed without pulling it over your head, so that you do not disturb your new hair transplant sites

Since FUE hair transplants create fewer micrografts than the strip harvesting method, your surgery may take several hours. You should prepare for this by bringing something to occupy you while the treatment takes place. It can often help to bring along a friend for conversation and moral support. If you are having a large area of transplantation, you may require two to three sessions to achieve the result you want.


The FUE hair transplant procedure in detail

The donor areas for FUE hair transplant grafts are shaved before the treatment begins. You will then be given injections of local anaesthetic to numb your scalp skin.

Once this takes effect, the FUE micrografts are then harvested using a small punch tool that pierces the skin to the depth of the hair follicle. These punches range from around 0.9 mm to just 1.2 mm in diameter, which means that the donor site heals very quickly, leaving no scar.

The FUE micrograft is then transferred to the area of scalp being treated and is carefully positioned to mimic the growth patterns of normal hair. Great care is taken in the selection of recipient sites so that you gain a wholly natural and authentic look that can be styled in many different ways. If your FUE hair transplant involves using hair from the body rather than the head, these may need to be placed closer together because body hair is noticeably thinner than head hair.


After your FUE hair transplant

You will need to arrange transport home after your FUE hair transplant surgery as you will probably feel tired from the long procedure. However, you should not experience much pain, and what discomfort there is can easily be dealt with using over-the-counter painkillers. You may be given antibiotics to reduce the risk of infection, and if so you should take these regardless of whether you experience any symptoms or not.

You should be able to resume normal activities a couple of days after your FUE hair transplant but it is sensible to take precautions that will help you to avoid damaging the new grafts. Loose fitting clothing, or preferably clothing that does not need taking off over your head, should be worn for a few days and suitable care should be taken with personal hygiene, not only around the new grafts, but also around the donor sites.

Unlike strip incision techniques, FUE hair transplants will leave no visible scars either at the donor site or around the transplant. In some cases, you may experience some hair loss from the transplant areas in the first few weeks, but this is just a natural part of the growth and rest cycles of the hair. Normal growth will begin after three months, blending in naturally with the hair around it.


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