Typically FUE has been performed by shaving the entire back and sides of the scalp as the hairs harvested via FUE need to be very short. Recently I have been performing no shave FUE or long hair FUE. This technique involves cutting short the hairs to be harvested from the donor region individually while leaving the hair around it long. This allows us to perform FUE without shaving the entire back and sides of the scalp and makes the entire process much less visually invasive. This process requires very specific expertise but for many people that want FUE but don’t want to shave their heads this is a great option. I recently posted a video of the process on my youtube channel which shows the entire process.
In the past we needed to shave the back and sides of the scalp to perform FUE because the follicles can only be extracted as short hairs.
Noe we have a new technique called long hair FUE. With this technique we go through the donor region and individually cut short the follicles we will extract while leaving the hair around it ling. This allows the patient to keep their hair long for the procedure and creates no significant change to the patients visual appearance.
This technique is a but more expensive than short hair FUE but for those that don’t want to shave their head it can be the difference between doing the procedure and not doing it.
The photo below shows a long hair FUE patient of mine’s donor region one week post procedure.
For a long time the only way to perform FUE was to shave the entire back and sides of the scalp as the hair needs to be a few millimeters long in order to extract. That has now changed.
Now we can perform long hair FUE which allows the patient to keep their hair long and completely conceal any evidence that FUE was performed in the donor region.
The patient leaves their hair at least 1.5 inches long and we go through the donor hair individually and randomly cut short the follicles we plan to extract. This allows us to completely conceal the donor region. It also allows up to choose the follicles with the most hairs per follicle which gives the patient the best ultimate result.
Since I have had multiple strip harvest hair transplant procedures in the past, I wanted to have this technique performed on myself to better understand what it felt like, which would in turn give me greater insight into the process. I can wholeheartedly state that this process was so much easier than my previous strip harvest procedures. I had virtually no pain the next day and was back to work a day later.
The photo below shows my donor zone the day after over 2000 follicles were harvested via long hair FUE.
I believe that this process will revolutionize FUE and open it up to so many more people that were hesitant, like myself, because they did not want to shave their head for the procedure.
Here is a patient of mine who had hair loss classified as norwood 6 on the norwood hair loss scale. This essentially means that most of the hair on top of his head had been lost secondary to genetic hair loss.
I performed a follicular unit extraction (FUE) hair transplant using a 0.85mm punch tip. I personally extracted each and every follicle. Many other physicians delegate the extraction component of the procedure to technicians but I prefer to perform the extractions myself.
The patient is thrilled with his results and plans to return for another procedure to create even more cosmetic density.
Here is a male patient of mine who has a case of LPP which is a form of scarring alopecia. He has lost small patches of scalp hair in no specific distribution secondary to the disease process and he los all his eyebrow hair as well. He previously had an eyebrow tattoo and was disappointed with the look and presented to me for eyebrow transplants.
I explained to the patient that scarring alopecia is a very unpredictable process and that no guarantees could be made as to the success of the eyebrow transplant. Due to the fact that he had scattered patched affected in the scalp I felt our greatest chance of success was to perform the procedure with an FUE harvest and to find unaffected areas of the scalp to harvest the donor hair from.
I personally harvested every follicle using a 0.8mm motorized punch. We only placed single hair grafts into the eyebrows. We placed approximately 270 hairs per eyebrow.
The results here are shown after only 6 months. The patient should see some increased growth over the next 2-3 months.
The patient is beyond thrilled. The lack of eyebrow hair previously was a constant reminder of his disease process and the new eyebrows have given him a new self confidence.
This is a patient who previously underwent an FUE procedure performed by another physician with unnatural results secondary to the placement of large grafts in the hairline. I created more density and placed single hair grafts into the hairline to create a more natural look. The grafts were harvested via FUE using a 0.8mm motorized punch tip. Approximately 400 single hair grafts were placed into the hairline to create a much more natural look.
Unfortunately there are many physicians offering hair transplants that are not properly trained. It is imperative that you do your research before deciding on your surgeon and always chose someone who specializes exclusively in hair restoration.
Here is a very interesting case of a patient who was a frequent break dancer in the day. His continued head spinning cause the hair at the top of his head to fall out in the exact spot where the scalp received repetitive trauma. Anything that causes repetitive trauma to the scalp can cause the hair in those places to fall out.
I harvested approximately 150 grafts via FUE from the back of the scalp and we transplanted these grafts into the area devoid of hair.
The results are show after 1 year. The patient is thrilled.
Marc Dauer, M.D.
FUE grafts transplanted into scalp scar from break dancing