Follicular unit extraction (FUE) is an innovative for follicular hair transplants. Follicular unit extraction is a state-of-the-art extraction technique for preparing follicular unit transplants. It is for a method of Direct Hair Implants (DHI) technique which is a minimally invasive hair transplant procedure available today. It does not use scalpels, stitches or a donor skin strip for preparing hair transplant units.

FUE is the latest innovative technology in hair transplantation. Since 1959, when Ostenreich standardized hair transplantation, there have been numerous advances. After the big punches that gave a moth-eaten appearance to the occipital donor area and a doll's hair look to the recipient area came the era of harvesting using a multi-bladed knife, which had the advantage of leaving only a thin linear scar.

Nevertheless, in view of our patients' demand for less painful and disabling techniques, what is looked for today is redistribution of the hair with no scar and optimum natural appearance in the grafted area. FUE fulfils both criteria. This delicate technique, however, increases the operating time and number of assistants needed, and hair may be lost in the process. 

Follicular unit extraction does not require a donor strip to be excised from the donor area and therefore does not involve any dissection of follicular units. The follicular units are instead directly extracted one-by-one using custom-made, precise micro-surgical tools less than a millimeter in diameter. The surgeon will extract individual hair follicles from the back of the scalp from among the donor hair follicles. This leaves only tiny, almost pin prick wounds where each hair follicle is extracted which heal quickly.

Follicular unit extraction is simple, painless, with the donor area healing within 2-4 days as compared to 7-8 days required for follicular hair transplants using the more standard And there is no risk of nerve damage being caused by the hair transplant procedure.

The greatest benefit of Follicular unit extraction and the DHI technique is the possibility of quality control during the hair transplant procedures. The hair transplant doctor needs only a single surgical assistant to help him during the follicle hair transplants. The procedure also ensures maximum care to the grafts. The hair transplant doctor can decide upon the exact number of grafts to be removed and transplanted, while he is removing them one-by-one.

Thus, F.U.E, the latest development in hair transplantation, is a “scar-free technique” that meets the high demand for follicular units implants. It cannot, however, replace the strip technique for some patients.

Method :

Follicular micrografting follows the principle of regular micrografting but preserves the follicular units. These are made up of 2, 3 or 4 hairs growing through a single pore. Follicular units are distinct anatomical entities, and each hair within a f ollicular unit has its own follicle. The hairs making up a unit emerge from the scalp through a single common orifice, and sometimes through a secondary orifice. An FU is comprised of 2 to 3 hairs on average, and is harvested using a punch 0.8 to 1.2 mm in diameter. It has been proven that harvesting diameters less than 1.25 mm , due to centripetal healing, leave no residual scar in the occipital or temp ora l donor area. Between each harvest, however, it is necessary to leave at least five follicular units in order not to create a gap, not to hinder healing of the punch hole, and, above all, to leave a dense enough donor area. As the human scalp averages 100 to 150 hairs/cm2, it was previously necessary to harvest one or more strips about 25 cm2 in surface area to obtain 3000 hairs ( 25 cm x 1 cm ).

To obtain the same number of hairs (3000) while leaving sufficient hair behind, the donor area must be prepared by cutting the hair very short (about 2 mm ) over an area that is six times wider ( 25 cm X 6 cm ). The adage to always keep in mind is that “a good grafter is a good harvester”. That is all the truer with this technique as the hairs have to be harvested over their entire length, from the bulb to the shaft, and in very large numbers. One should not hide behind a pseudo-scientific rationale in case of transection, saying that everything will regrow with sometimes additional regrowths. This transection must be very precise in order to get the stem cells responsible for hair multiplication. In the most favourable cases, it gives only a very small percentage  of additional regrowth with 50 % of atrophic hair, after many hours of preparation (5 hours for 300 transected hairs). As we can see, the follicular unit must be removed intact. This requires optimum operator training, optimum cutting equipment, and automation to reduce the operating time.

Advantages of Using Direct Hair Implant
Hair transplant procedure for direct follicle implantation is performed only with state-of-the-art instrumentation. The standard instruments for the procedure consist of custom cut lateral slit blades, hypodermic needles, and the innovative DHI implanter. A hair restoration surgeon prepares a protocol of follicle hair transplants specifically for each patient so as to ensure a perfect and most natural look. The non-invasive hair transplant procedure involving direct placement of follicle hair transplants causes minimal trauma to the scalp and does not cause any pitting, indentation, or scarring.

Body Hair Transplant
The best thing about Direct Hair Implants is that hair from all over the body can be used. The technique has received much favor with the patients because it helps them to remove the excess body hair and at the same time allows them to restore scalp hair without any significantly invasive surgery being performed on them.

Body hair follicular grafts removed through the follicular extraction technique are utilized only for enhancing the density in the vertex posterior region of the scalp, and not for the hair line. Results of direct hair transplants for most of the patients have been positive and it is hard to differentiate the body hair transplants from the head hair. The body hair transplants have shown growth patterns similar to head hair with no difference in texture.

Another advantage of the Direct Hair Implants Technique as a hair transplant procedure is that it allows the hair transplant surgeon to extract as many grafts as is actually needed. The transplant surgeon can extract and place up to 1200 grafts per day. And the subsequent follicular hair transplants can be done immediately after the first session if they are so desired by the patient.

Direct Implants Technique as a hair transplant procedure is fast catching up, but it all depends upon the individual to decide the most appropriate technique to use. Whatever center you choose for your surgical hair restoration, always make an informed decision about your hair restoration surgery.