Follicular Unit Extraction
F.U.E. otherwise known as Follicular Unit Extraction is a newer method of removing donor hair follicles that we are artfully utilizing at our hair transplant practice in Los Angeles. With FUE we use specialized instruments measuring .7mm- .95mm in size and remove each follicle individually. The main advantage of this method versus FUT (folluciular unit extraction) is that in FUE there is individual extraction of hair follicles with a specialized tool versus the removal of a strip of skin with FUT. This means that FUE leaves no linear scar in the donor region. Just small dots that are not visible unless the hair is shaved down to the skin.
Dr. Dauer is an expert in performing F.U.E. and routinely teaches other physicians around the world the art of performing FUE. Dr. Dauer has many different state of the art FUE tools and can choose the one best suited for the individual patient’s hair type. If this is something you are interested in, he can explain this procedure in more depth on the day of your consultation.
How is Follicular Unit Transplantation Performed?
The real key to performing this procedure successfully is to transfer an intact follicular unit from the donor area to its destination. In order to remove follicular units from the back of the scalp without damaging them, the donor tissue must be removed in one piece.
The individual Follicular Units are then separated from the donor strip and trimmed under a microscope to create the ultimate micro graft. These micro grafts are then placed in very close proximity and in an irregular pattern that mimics how they naturally grow in the scalp. The end result is a hair transplant that looks natural because it is applied in the same patterns as the way hair actually grows.
Complete stereo-microscopic dissection has been shown to produce an increased yield of both the absolute number of follicular units, as well as the total amount of hair upwards of 25% when compared to other techniques.
Also, the ability to do this successfully, and in a session of 1500 or more grafts (“a mega session”), has only come about in the past few years. The very small insertion sites permit many follicular unit grafts to be safely transplanted in a single procedure allowing the entire hair restoration process to be completed as quickly as possible. At this time only a small group of experienced hair transplant physicians perform this procedure.
When performed by a skilled surgical team at our Los Angeles hair transplant practice, follicular unit transplantation can provide totally natural looking results in as few as one or two sessions.
Why Aren’t All Transplant Physicians Using Follicular Units?
The reason that not all hair transplant physicians in Los Angeles are using follicular units is because it takes time to change and adapt to these cutting edge advancements in technique. Follicular unit grafts require more time, skill, and expense to create compared to the mini/micro grafts.
Many hair transplant clinics, including the large commercial operations, find it more profitable to do standard mini/micro graft procedures because one doctor can do two or three patients a day using this older and less demanding hair transplant technique. This produces more revenue for the clinic but less ideal results for the patient.
Follicular Unit Grafts
It is possible to achieve the appearance of a natural, dense hair on a consistent basis with natural follicular unit transplantation. This method requires more grafts and a higher level of technical skills from the doctor and their medical team, in order to achieve the desired result. Many people refer to follicular unit transplantation as the “gold standard” by which all hair transplant techniques are measured.
FUT- Follicular Unit Transfer aka “The Strip Harvest Procedure”
Follicular Unit Transfer, FUT, is a hair transplant technique in which a strip of hair is excised from the donor region of the scalp. Subsequently, the strip is dissected into individual hair follicles and transplanted into areas exhibiting hair loss. Typically, the strip width ranges between 1-1.5cm and its length is determined based on the number of hair follicles to be harvested. To reduce the appearance of the linear scar that results from the FUT method, we must minimize the amount of tension on the wound closure. Another technique utilized to minimize the appearance of the linear scar is trichophytic closure, which involves cutting off the tips of the hair follicles on the edge of the wound, thus causing the transected hair follicles to grow back through the scar. Good surgical technique will also contribute to the creation of a small hair transplant strip scar.
At our Los Angeles hair transplant office, we have found that a well healed hair transplant strip scar measures between 1-3mm wide and its length is dependent on the number of hair follicles harvested. The length of the scar increases with the number of hair follicles needed for the hair transplant. Usually, a well healed FUT scar allows a patient to wear their hair as short as a 4cm on the sides and back of their scalp without seeing any evidence of the strip scar. Moreover, in certain instances where a patient has particular types of hair, the individual can wear their hair even shorter without exhibiting the hair transplant strip scar.
The dissection of the strip into naturally occurring follicular units takes place under a high magnification microscope. The principle behind this step is simple. We divide the strip into the naturally occurring follicular units that occur in the scalp so they are inserted into areas of hair loss with the same number of hairs per follicle that they originally had in the donor region, thus optimizing our ability to create a completely natural hair transplant result.
The FUT and FUE procedures involve identical methods of implantation. Dr. Dauer creates all of the incisions, while paying close attention to the location, angle, orientation, and distribution of the transplanted hair follicles. These are vital factors that contribute to the final “artwork” that is the hair transplant. Dr. Dauer’s experienced full time staff of hair transplant nurses then places the hair follicles into the insertion sites that Dr. Dauer carefully designed.
The sutures used to close the donor zone are typically removed after 2 weeks. Out of town patients can have their sutures removed in their hometown, and often times Dr. Dauer has colleagues in many major cities around the world willing to assist with this. The FUT hair transplant procedure is typically performed with hair long enough to cover the sutures in the donor zone, which means 1/2 inch or longer.
Contact Marc Dauer, M.D. to find out how our Los Angeles hair transplant team can help you regain the look and feel of the hair you used to have.