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 wanted more fullness to his eyebrows. We extracted his donor follicles via FUE. In the video the patient shares his experience undergoing the procedure and his satisfaction with the results.
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
Here is a patient who had a previous hair transplant strip procedure with a large chain Hair Transplant operation by a physician who had been performing hair transplants for over 30 years. The patient came to me requesting more density in the frontal scalp, but also complaining of a wide strip scar that was elevated with severe numbness. He also complained because the Physician who had performed his last procedure created a second strip scar deviating at one point from the first. He wanted me to take out the unsightly scar and consolidate the 2 scars into one.
When I started to dissect out the strip I noticed small blue thread and assumed it was a small retained suture that dipped below and was missed in the suture removed. To my amazement what I then discovered was that almost the entire length of the strip scar was closed below the skin with non absorbable nylon sutures. These are sutures that are only to be used on the skin surface and removed. They were placed into the subcutaneous layer below the skin and created a significant amount of scarring and was also giving the patient numbness. I removed the suture, which was caked in scarring at this point, and consolidated the 2 scars into one. The results are shown in the photos.
This should be a warning and reminder to prospective patients that when choosing your hair transplant surgeon make sure to do tremendous research into the person performing your procedure. Experience and focus on the singular discipline of hair restoration are imperative, but just as important is the fact that your surgeon should not have a cavalier attitude towards hair transplants, no matter how long they have been performing the procedure, and must convey and strong sense of sensitivity and respect for the art and science of the procedure, as well as keeping up to date on the latest developments in the field. The field of Hair Transplant surgery is the wild west and there are more unqualified individuals performing bad procedures than good. You only have one chance to do things right, so take the time to chose the proper physician who will give you the greatest chance of successfully achieving your goals.
Marc Dauer, M.D.
Showing the strip scar before revision.
This shows the nylon suture retained in the tissue below the skin and the scarring.
Here is the strip scar immediately after revision and removal of the scarred tissue and retained suture material.