Punch grafts, scalp reductions, scalp extensions… In the past, as the names of these earlier procedures indicate, undergoing a hair transplant was a painfully unpleasant process. Men with receding hairlines and balding scalps often resorted to the unnatural-looking, and often ridiculed, toupee to avoid the pain, slow healing, and scarring of a transplant. Because of this, the hair transplant business was staggering in the late twentieth century. Surgeons knew that hair restoration techniques needed to evolve. Fast forward into the beginning of the twenty-first century… Thousands of bad comb-overs and strip incision scars later, the new technique that hair restoration surgeons were waiting for was finally perfected. The hair transplant community eventually embraced follicular unit extraction (FUE). Surgeons praised the method and potential patients were curious about it.	Before
	After
	FUE procedure Crown before and 17 weeks later.

But what exactly is follicular unit extraction? And is it really more effective and beneficial than older methods of hair transplantation?

Follicular unit extraction involves the removal of small groups of hair follicles (usually between one and four) from the donor site and their reinsertion into the receptor site. These small grafts allow for equal distribution of hair in the balding area of the scalp and produce more natural-looking results. In fact, once the receptor site has completely healed, it is virtually impossible to detect that any sort of hair transplant procedure has taken place.

The differences between FUE and the older methods of transplantation are noteworthy.

Firstly, the FUE procedure is quicker and less painful than any other hair restoration technique. FUE is performed with a punch-like scalpel that cuts the skin around the follicle. This facilitates the removal of about one to four follicles from the donor area at the same time. Also, the advanced method of follicular perforation™ allows the surgeon to make a shallow punch on the surrounding tissue, ensuring that the graft be released from the tissue with minimum traction and with better ease. The extracted follicles (called grafts) are then inserted into small slits that have been cut in the recipient area. These slits do not need suturing, heal quickly, and are completely undetectable once the new hair begins to grow in about seven to ten days.

Secondly, FUE is beneficial because the recovery process is much faster and less painful. In most patients, the grafts become fully secure in about eight days after surgery and the surgical wound in the donor area usually heals within one to two weeks. Some discomfort may be present, but usually analgesics like Tylenol or codeine will help. Generally, normal activity may be resumed one to two weeks after the procedure. In older methods of hair restoration, bleeding, suturing, and bandaging were parts of the long and painful recovery process.

Thirdly, 100% of hair loss sufferers are candidates for FUE. In the past, hair restoration was not as widely available to every hair loss sufferer as it is today. There were various criteria that each candidate had to meet to be eligible for a hair transplant. Such criteria included the patient’s age, color and texture of hair, skin complexion, amount of donor hair available, and future hair loss projections. However, because the methods involved with follicular unit extraction are so advanced, such criteria are not much of a concern. For example, the amount of donor hair on the head is not an issue when determining candidacy because the procedure allows for the extraction of hair from other parts of the body.

Fourthly, the incidence of complication during the FUE procedure is lower than with other transplantation methods. In a study, published by Dr. Masumi Inaba, of over 150 patients treated with FUE, researchers found that patients suffered only from mild discomfort from sitting still for several hours at a time. Furthermore, only four out of the 150 patients experienced donor area shock, while two more patients experienced a more limited variety of patchy circular alopecia (hair loss). Nevertheless, all patients made full recoveries within five weeks.

Lastly, FUE patients recover without visible scars in the donor or recipient area. Unlike previous methods, like strip incision, where an unattractive linear scar was exposed in the donor area, FUE does not leave ugly, unbearable scars on the head. Instead, the tiny slits that are cut in the recipient area are conveniently hidden by new hair. The final result of FUE in all patients is that of a seamless, natural, healthy-looking head of hair.

For all those who are suffering from hair loss and are searching for the best method of restoring their youth, follicular unit extraction should be considered. It is a hair restoration method that discards the use of the painful linear donor incision and regards 100% of hair loss patients as proper candidates for the procedure. It is widely predicted that within the coming years, follicular unit extraction will make further advancements and become the method of choice for every hair restoration surgeon and patient.

About the Author

Dr. Robert Jones has been practicing medicine since 1979. Dr. Jones is president of the International Society of Follicular Unit Surgeons. He’s a member of the International Alliance of Hair Restoration Surgeons, the International Society of Hair Restoration Surgery, the International Society of Cosmetic Laser Surgery, and the American Society for Laser Medicine and Surgery. www.torontohairdoctor.com