EXPERT GUIDE

FUE Hair Transplant


Pete Scott, MD

This text was written according to the highest scientific standards and reviewed by medical experts. Find out more about our quality assurance.

Written by Erin D. Updated on 14 Jan 2024

The FUE is one of the most popular method for modern-day hair transplants. It is believed by many patients to provide the most natural-looking results, with very little scarring. This helps to disguise the fact that the patient had a hair transplant and make it as unnoticeable as possible. But what are the risk? And how much does it cost? Learn everything on this page.

What is the FUE method?

The follicular unit extraction (FUE) method is a minimally-invasive hair transplantation technique used by hair transplant clinics and surgeons across the world. It is used to restore natural hair growth by taking hair follicles – one by one – from the donor area, usually the back of the head but other parts of the body may be used, of the patient and inserting them in bald or thinning areas. The extraction punch size is dependent on the hair type, e.g. afro hair transplant or straight hair transplant, and can be between 0,6mm and 1,2mm.

Most common hair transplant method

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Origins of the FUE method

While hair transplants originated in Japan and the USA during the early 1900s, the modern day FUE method was only developed in the early 1990s. In the beginning the results looked quite unnatural (“hair plugs“). It didn’t become widely available though in North America until 2002. Since its initial development it has rapidly evolved and become a widespread technique used by hair transplant surgeons today.

The FUE method has evolved from the traditional follicular unit transplantation (FUT) method in order to reduce scarring and provide a more natural-looking hairline. It also reduces tissue shock to the hair follicles and increases the survival rate of the hair grafts.

How does the FUE hair transplant method work?

Hereditary hair loss, or male pattern baldness, is the most common form of hair loss in men. By the age of 70, nearly 80% of men are affected by this. Male pattern baldness is caused by a predisposition to hypersensitivity to the hormone dihydrotestosterone (DHT) which causes hair loss. It does so by binding to the hair follicle and weakening it over time.

The FUE method works by extracting hair follicles from an area of the body that is DHT resistant to the balding areas on the top of the head, e.g. into the receding hairline or in the crown region. These follicles once implanted will continue to grow in the bald areas for the duration of the patient’s life.

FUE hair transplant punch size

According to the medihair hair transplant cost study the FUE method is globally slightly more expensive than the FUT method. This is due to the fact that the method is much more time consuming. Therefore, this method is especially popular in low labor cost countries like Turkey or India.

 

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FUE hair transplant procedure

The FUE method is a multi-step process which can last many hours to perform a high-quality transplantation. In some cases, it can even take multiple days for a large number of grafts. The steps to the procedure are:

  • The head of the patient is shaved down completely so the hair transplant surgeon can identify the individual hair groupings. These groupings contain 1-4 hair follicles.
  • A thin, hollow needle is used to extract these groupings with circular movements creating a small wound behind.
  • These grafts are then removed with fine tweezers and stored in a sterile solution until they are ready to be inserted.
  • The surgeon creates small incisions in the balding area, called recipient channels, where the hair grafts are to be inserted.
  • The surgeon finally uses special, angled tweezers to insert the grafts into the recipient channels.

After our global hair transplant statistics the hand-held & motorized FUE method is the most common FUE technique:

FUE hair transplants frequency of methods

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FUE vs FUT methods

The FUE and FUT methods consist of the same three phases: extraction, storage and insertion. They follow similar processes for the storage and insertion processes. However, they differ greatly in their extraction techniques.

While the FUE method involves removing individual groups of hair follicles, the FUT removes an entire strip of skin from the donor area. The strip of skin is then dissected into the individual hair groupings, to be inserted into the recipient channels. This leaves behind a very thin, long scar at the back of the head. While this scar isn’t large, it can be noticeable with a close shaven hairstyle. This can be undesirable to many patients who want their transplant to be disguised as much as possible. Also, the FUE technique is the most common method for beard transplants and eyebrow transplants.

However, with the FUT method a large number of grafts can be quickly transplanted and unlike with the FUE method, the head does not have to be shaved.

Hai Transplant FUT or FUE

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The advantages and disadvantages of the FUE method

Pro Cons
The FUE method is minimally-invasive, it causes only very small circular scars to be left behind after the transplant has healed. Due to the hair follicles being removed individually the procedure for the FUE method is more time-consuming. It can take multiple sessions to fully transplant the desired number of grafts.
The individual hair groupings yield a very natural result, in contrast to large grafts consisting of more than four hair follicles. The growth rate with the FUE method is often lower than with the FUT method.
The FUE method reduces shock loss to the transplanted hair growth which increases the survival rate of the hair follicles. The growth rate with the FUE method is often lower than with the FUT method. Patients must have their head completely shaved for the surgery, this isn’t ideal for many patients.
The FUE method allows the exact number of grafts to be extracted, the FUT method can lead to an overharvesting of the donor area. The FUE method is more expensive than the FUT method as it requires more extensive manual labor and takes far longer.

Before and after FUE Method

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Preferred candidates

Patients over the age of 40, with an ample donor area suffering from androgenetic alopecia or male pattern baldness are optimal candidates for hair transplants. At this age the hair loss has been defined relatively well and it is easier to identify hair that is resistant to DHT.

If they have certain hair characteristics such as curly or wavy hair or thick hair, they will have more natural results than those with thin, straight hair. This is due to the fact that wavy or curly hair gives a fuller appearance when transplanted than straight hair. Dark hair which contrasts against light skin is easier to transplant than hair and skin that are similar in color.

Average age of patients at first hair transplant

The FUE method is more suitable for candidates who don’t require a large number of grafts to be transplanted and prefer to wear short hairstyles. Thus, the FUE technique is especially suitable for norwood scale types 1 – 4.  It is typically better for older patients than the FUT method because it is less invasive, and older patients have more difficulty with healing from hair restoration procedures. Furthermore, temple hair loss and transplantation is one of the most challenging hair transplant procedures due to the angle of the graft. Therefore, temple hair transplants should only be performed by proven experts in this field.

The FUT method is preferred when a large number of grafts need to be transplanted, especially when the patient does not have a full donor area. This method doesn’t thin out the donor area hair the way the FUE method does.

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Possible side effects

  • Risk of infection: There is a low risk of infection during hair transplantation as this is a surgery and infection is always a possibility. However, because the scalp has strong blood circulation infection is less common for this procedure.
  • Bleeding: Minor bleeding should be expected after the hair transplantation. The scalp is opened in several places which will cause bleeding, this can be treated easily by applying pressure with gauze.
  • Scar pain: The wound closure from the extraction and insertion steps can be painful for some time after the hair transplantation.
  • Swelling: Another minor side effect which can be expected is swelling in the head especially around the scalp and eye area. The swelling subsides within several days for the vast majority of patients.
  • Scab formation: Small scabs can be expected to form in the treatment area, which fall off after two weeks at the latest.
  • Itching, tension and numbness: Immediately after the operation, the patient may experience a temporary feeling of tension and numbness.
  • Hair shedding: During the storage phase the hair follicles lose their connection to the blood supply, this can cause a shedding effect after the grafts are implanted. This side effect only lasts 1-6 weeks and afterwards new hairs will grow from the follicles.
  • Shock loss: Some patients may experience hair loss in areas near the transplanted grafts from tissue trauma. This side effect is known as shock loss and is only temporary.
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Further developments of the FUE method

With the growing popularity of the FUE method it is no surprise that new technology has been developed to further the abilities of this method. Technological development is seen by many as the next big step for the hair transplantation industry.

The most common development of the FUE method is the Direct Hair Implementation (DHI). A special, “CHOI pen” is used to extract the hair follicle then implant it directly into the scalp without the need to make an incision first, hence the name. This technique has a very high survival rate as the grafts are removed from the scalp and blood supply for a much shorter time.

 

The ARTAS method is another development of the FUE method of hair transplantation. This method uses the ARTAS robot to remove and implant the hair grafts, this is an attempt to remove manual error from the hair transplant process. However, this method only works for a very select few candidates. Individuals with curly hair, or light-colored hair are not able to use the ARTAS robot as it is very difficult for the machine to detect the hair follicles. Due to the expense of the machinery, it is not commonly used in hair transplant clinics.

The NeoGraft transplantation method is a semi-automated form of the FUE method, which is growing in popularity in Northern America. It uses a special “wand” of sorts to remove the hair grafts with suction rather than having a surgeon manually remove them. The NeoGraft method decreases the removal time for the transplantation and trauma to the scalp, which increase the survival rate of the hair grafts.

There are several downsides to these advanced forms of the FUE method. Each of these methods is significantly more expensive than a traditional hair transplant, and many experts argue the results do not look significantly better. The expenses for the technology are also high so these kinds of transplants are offered in a select few locations.

Frequently Asked Questions

Is an FUE hair transplant permanent?

Which is better the FUE or FUT hair transplant?

Does transplanted hair thin?

What is the success rate of an FUE hair transplant?

How many hairs are transplanted in an FUE hair transplant?

Sources

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