Follicular Unit Extraction
vs. Older Methods of Hair Transplantation
by: Dr. Robert Jones
Punch grafts, scalp reductions, scalp extensions…
In the past, as the names of these earlier procedures indicate, undergoing
a hair transplant was a painfully unpleasant process. Men with receding
hairlines and balding scalps often resorted to the unnatural-looking,
and often ridiculed, toupee to avoid the pain, slow healing, and scarring
of a transplant.
Because of this, the hair transplant business was staggering in the late
twentieth century. Surgeons knew that hair restoration techniques needed
Fast forward into the beginning of the twenty-first century…
Thousands of bad comb-overs and strip incision scars later, the new technique
that hair restoration surgeons were waiting for was finally perfected.
The hair transplant community eventually embraced follicular unit extraction
(FUE). Surgeons praised the method and potential patients were curious
But what exactly is follicular unit extraction? And is it really more
effective and beneficial than older methods of hair transplantation?
Follicular unit extraction involves the removal of small groups of hair
follicles (usually between one and four) from the donor site and their
reinsertion into the receptor site. These small grafts allow for equal
distribution of hair in the balding area of the scalp and produce more
natural-looking results. In fact, once the receptor site has completely
healed, it is virtually impossible to detect that any sort of hair transplant
procedure has taken place.
The differences between FUE and the older methods of transplantation
Firstly, the FUE procedure is quicker and less painful than any other
hair restoration technique. FUE is performed with a punch-like scalpel
that cuts the skin around the follicle. This facilitates the removal of
about one to four follicles from the donor area at the same time. Also,
the advanced method of follicular perforation™ allows the surgeon
to make a shallow punch on the surrounding tissue, ensuring that the graft
be released from the tissue with minimum traction and with better ease.
The extracted follicles (called grafts) are then inserted into small slits
that have been cut in the recipient area. These slits do not need suturing,
heal quickly, and are completely undetectable once the new hair begins
to grow in about seven to ten days.
Secondly, FUE is beneficial because the recovery process is much faster
and less painful. In most patients, the grafts become fully secure in
about eight days after surgery and the surgical wound in the donor area
usually heals within one to two weeks. Some discomfort may be present,
but usually analgesics like Tylenol or codeine will help. Generally, normal
activity may be resumed one to two weeks after the procedure. In older
methods of hair restoration, bleeding, suturing, and bandaging were parts
of the long and painful recovery process.
Thirdly, 100% of hair loss sufferers are candidates for FUE. In the past,
hair restoration was not as widely available to every hair loss sufferer
as it is today. There were various criteria that each candidate had to
meet to be eligible for a hair transplant. Such criteria included the
patient’s age, color and texture of hair, skin complexion, amount
of donor hair available, and future hair loss projections. However, because
the methods involved with follicular unit extraction are so advanced,
such criteria are not much of a concern. For example, the amount of donor
hair on the head is not an issue when determining candidacy because the
procedure allows for the extraction of hair from other parts of the body.
Fourthly, the incidence of complication during the FUE procedure is lower
than with other transplantation methods. In a study, published by Dr.
Masumi Inaba, of over 150 patients treated with FUE, researchers found
that patients suffered only from mild discomfort from sitting still for
several hours at a time. Furthermore, only four out of the 150 patients
experienced donor area shock, while two more patients experienced a more
limited variety of patchy circular alopecia (hair loss). Nevertheless,
all patients made full recoveries within five weeks.
Lastly, FUE patients recover without visible scars in the donor or recipient
area. Unlike previous methods, like strip incision, where an unattractive
linear scar was exposed in the donor area, FUE does not leave ugly, unbearable
scars on the head. Instead, the tiny slits that are cut in the recipient
area are conveniently hidden by new hair. The final result of FUE in all
patients is that of a seamless, natural, healthy-looking head of hair.
For all those who are suffering from hair loss and are searching for
the best method of restoring their youth, follicular unit extraction should
be considered. It is a hair restoration method that discards the use of
the painful linear donor incision and regards 100% of hair loss patients
as proper candidates for the procedure. It is widely predicted that within
the coming years, follicular unit extraction will make further advancements
and become the method of choice for every hair restoration surgeon and
About the Author
Dr. Robert Jones has been practicing medicine since 1979. He is active
in the field of hair restoration. An advocate of providing his patients
with the best quality, Dr. Jones is among the first doctors in North America
to use follicular unit extraction—a procedure he praises for its
great value and efficiency. Dr. Jones is a member of the International
Alliance of Hair Restoration Surgeons, the International Society of Hair
Restoration Surgery, the International Society of Cosmetic Laser Surgery,
and the American Society for Laser Medicine and Surgery. He is also the
president of the International Society of Follicular Unit Surgeons. For
more information on Dr. Jones or follicular unit extraction visit www.drrobertjones.com