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Follicular Unit Extraction

  • Modern hair transplantation techniques were first described in Japan in the 1930’s. The procedure, in its more crude form, was popularized by Dr. Orentreich in the 1950s (1). Over the last century the procedure has been refined, and now individual follicular units are transferred with less invasive incisions made on the balding scalp.

  • Is a surgical technique that takes hair from one part of the scalp with ample and stable hair (typically back of the head) and moves it to an area of thinning or balding

  • Can be used for management of pattern alopecia, traction alopecia, and in special cases scarring alopecia

    • If indicated, when treating primary cicatricial alopecia the hair loss condition should be treated and/ or stable for at least one year.

  • Can be performed in men and women of all racial and ethnic backgrounds.

  • Follicular unit extraction - FUE

    • 1st described in 2002 (2)

    • Involves removal and dissection of individual 1-4 follicular units (FU) directly from the stable potion, non-balding area (typically posterior of the scalp. The FUs are transferred to tiny slits on the balding scalp.

    • Small circular scars can be expected from this procedure.

    • Automated FUE devices may make the process faster and easier for some hair transplant surgeons (ISHRS | ABHRS)

  • More than one procedure may be necessary to obtain the desired result.

  • May also be combined with FUT depending on the individual’s needs and the surgeon’s preference.

  • May also be combined with scalp micropigmentation to improve the scalp coverage

  • For many people, it is essential to make sure medical therapy is continued in order to obtain maximal results.

  • Afro-textured hair FUE

    • Special care must be taken with afro-textured hair FUE. 

    • The curved follicle is susceptible to transection during graft removal

    • We use multiple FUE devices designed to tackle various hair types, and one specifically targetted for the curved follicle.

    • Donor area FUE scars may present with small light cirular scars.

    • In general, patients of African descent have less follicular density (2), reducing the number of follicles available for transplant. 

    • The coiled hair shaft may allow for improved scalp coverage.

REFERENCES: HAIR TRANSPLANTATION

  1. Orentreich N. (1959). Autografts in alopecias and other selected dermatological conditions. Annals of the New York Academy of Science, 20(83), 463–479

  2. Rassman WR, Bernstein RM, McClellan R, Jones R, Worton E, Uyttendaele H. Follicular Unit Extraction: Minimally invasive surgery for hair transplantation. Dermatol Surg. 2002;28:720–7.

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