Why Follicular Unit Extraction Has Become Increasingly Popular

[Bill - Seemiller]

Of all the recent advances within the field of medical hair restoration, one that seems to garner the most attention from both hair loss patients and hair transplant surgeons is follicular unit extraction (FUE). Thus, it’s no surprise that this popular procedure garners a lot more attention and discussion at each year’s ISHRS scientific meeting. View the “Highlights of the 2011 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting in Anchorage, Alaska” for what leading physicians are saying about FUE and other hot topic hair loss related issues.

 

But why is follicular unit extraction hair transplant surgery so popular? Will state of the art FUE hair transplants ever replace today’s “gold standard” follicular unit transplantation (FUT) procedures? Or can follicular unit extraction (FUE) and FUT hair transplant surgery peacefully co-exist?

 

Whether it’s the less invasive nature, lack of the linear scar associated with the traditional follicular unit hair transplant (FUT) procedure, or potentially faster healing time, demand and popularity of FUE has increased greatly over the last several years. While most hair restoration experts believe that FUE has been traditionally overhyped or oversold to eager patients, it’s become evident that FUE is here to stay.

 

The lasting power of follicular unit extraction seems to stem from both patient demand and the dedication of talented hair restoration experts who continue perfecting the procedure, researching new extraction mechanisms, and creating new, more precise FUE tools.

 

By evaluating these dedicated physicians, refined methods, and unique follicular unit extraction devices, we invite you to learn more about “The Evolution of Follicular Unit Extraction (FUE), Physicians and its Tools” and why the procedure continues increasing in popularity and demand each day.

 

To discuss the evolution of FUE with other hair loss sufferers and leading hair restoration physicians, you are encouraged to share your thoughts on this forum by creating your own topic or providing your input on others.

 

Best wishes,

 

Bill

[jeroenwaning]

Is follicular unit extraction just a fancy word for hair transplant? I have been reading some articles about FUT, or follicular unit transplantation. FUT is new in science and is somewhat focused around stem cells. It actually integrates with your own DNA. I am curious to see whether this would also be a surgical procedure or whether it will be some radical new drug. Do you have any information about this type of new treatment? It is still new in science and is not available to the public, but perhaps you have some insight. Here is the article that sparked my interest:

 

(promotional link removed)

 

Thanks,

 

Jeroen

[Bill - Seemiller]

Jereon,

 

Welcome to our discussion forum. There are two distinct yet popular and effective techniques associated with the more generic term "hair transplant surgery". The gold standard Follicular Unit Hair Transplantation (FUT) includes harvesting a linear strip of scalp tissue containing hair follicles from the scalp, trimming follicular units (hair groupings as they occur naturally in the scalp) under microscoping dissection and then transplanting them into tiny recipient sites made by a skilled surgeon. Follicular Unit Extraction (FUE) involves "blind dissection" or the removal of individual follicular units one at a time from the donor area via a surgical instrument. Follicular units are still placed into tiny recipient incisions by a qualified physician the same way as is done via FUT. Both methods come with a unique sets of advantages and disadvantages that have been discussed and described throughout the community.

 

The procedure you are referring to is "Hair Stem Cell Transplantation". This is a very fascinating procedure however, its stll in its infancy stages and requires a great deal of additional research and experimentation before it is adopted as a viable surgical option by the hair restoration community as a whole.

 

You are encouraged to click on any of the links above for more information.

 

Best wishes,

 

Bill

[michaeljames]

Is follicular unit extraction just a fancy word for hair transplant? I have been reading some articles about FUT, or follicular unit transplantation. FUT is new in science and is somewhat focused around stem cells. It actually integrates with your own DNA. I am curious to see whether this would also be a surgical procedure or whether it will be some radical new drug. Do you have any information about this type of new treatment? It is still new in science and is not available to the public, but perhaps you have some insight. Here is the article that sparked my interest:

 

(promotional link removed)

 

Thanks,

 

Jeroen

 

Hey Jeroen,

 

Modern Hair Transplant has two primary surgical forms Follicular Unit Transplant [FUT] and Follicular Unit Extraction [FUE]. The difference here is the method of harvesting the follicular units for transplantation and the manner in which the donor units are transplanted into the scalp. There are very valid reasons why one person will opt for one of the other, the details to specific for a comment. I have linked the terms so that you can familiarize yourself more with these two different forms of hair transplant procedure. Hope this helps, Michael

Edited August 9, 2012 by michaeljames
typo

[HARIRI]

I would like to share this presentation of Dr. Bisanga "Hair Transplant Technique FUE/ FUT Compete or Complete"

 

(promotional video removed)

[chrisdav]

Good video Hariri.

[Bill - Seemiller]

Guys,

 

Please keep promotional content off this thread and off this forum.

 

Thanks,

 

Bill

[michaeljames]

Hey Mate,

 

FUE is a type of hair transplant procedure. Many people prefer it because they do not wish to have a scar left from the strip method procedure. There are vary conditions and personal patient reasons why the FUE procedure would be chosen over the strip removal method of hair transplant surgery. Both of these procedures are forms of Follicular Unit Transplant (FUT.) The harvesting of the follicular units grafts is just different. FUE is not related to stem cell treatments for hair loss. Gene therapy for hair loss is still in the research phase. All the Best! Michael

[Levrais]

I would like to share this presentation of Dr. Bisanga "Hair Transplant Technique FUE/ FUT Compete or Complete"

 

(promotional video removed)

Hariri, can you pm me the link?

 

Thank you

[Hassan]

Dear All,

Here I want to share my story in hair transplantation. We have a little bit genetic and a litte bit resullted from stress hair loss. Firstly 4 fours year I had trabsplanted hair and used FUT technique on my operation. After 1 year of the operation, I was Ok (not satisfied too much) but after 2. year nearly all the transplated hair went away. As you know FUT technique had so many pain and so many scars. Then last year one of my friends living in Dubai told me that he went Istanbul for this operation. He had really gave me good feedback about the institution carrying out his operation. I saw his results and unhopefully take him their numbers.

Now I want to give my thanks to them from here. Really thank you Welltur Hair Transplantation

I contacted with them firstly and filled their application form with my photos. They are taking care everthing with their Arabic and English speaking represenatatives.

I am welcomed by them at the airport and transffred to their hospital having 5 stars hotel luxury. They carried out the operation with FUE technique and this means that there is no pain and no scar and stitch.

On the other hand, I was able to count the grafts to be transplanted on my hair; they have a system on which they out the donor hair in 100 pcs and by this way you are able to count how many hairs they transplanted.

3.500 graft transpalted during this operation. they hosted me for 3 days in their hospital and I did not pay for these 3 days accomodation and dressing for these 3 days even for lunch and dinner.

I really had good time for 3 days and they gave an Arabic speaking guide to see the sightseeing of Istanbul. Even on my second day I went for shopping.

Now I am satisfied with my hairs after this 1 year passed.

I really say thank you them and recommend the ones who want to make transplantion.

Edited January 24, 2013 by Future_HT_Doc

[s2thoudriver]

Another bit of positive feedback from Istanbul.

 

Glad you had a good procedure!

[NW3VKY]

I would like to share this presentation of Dr. Bisanga "Hair Transplant Technique FUE/ FUT Compete or Complete"

 

(promotional video removed)

 

 

I looked it up on YouTube and it appears that he advocates using a 1.0 mm punch, as .75 or .8 mm is too small for 4 unit FU. Also, he advocates combining FUE and FUT, as necessary for max yield.

[Mickey85]

I looked it up on YouTube and it appears that he advocates using a 1.0 mm punch, as .75 or .8 mm is too small for 4 unit FU. Also, he advocates combining FUE and FUT, as necessary for max yield.

 

Bisanga is basically 50/50 FUE/FUT. He does amazing work for both. For FUE he uses a manual punch set much like Feriduni, Lorenzo and De Reys. The punch set contains about 5 or 6 gauges with varying gauges to accommodate for body hair and 3-4 graft scalp hair.

 

Bisanga is not of the school of thought where FUE can be used for high Norwood cases like Lorenzo, Erdogan, De Reys and Umar. He is in a good middle ground like Feriduni where he will use FUE to treat upto a Norwood 3 and maybe 4 if the donor area is dense enough.

[Bobilero]

Bisanga is basically 50/50 FUE/FUT. He does amazing work for both. For FUE he uses a manual punch set much like Feriduni, Lorenzo and De Reys. The punch set contains about 5 or 6 gauges with varying gauges to accommodate for body hair and 3-4 graft scalp hair.

 

Bisanga is not of the school of thought where FUE can be used for high Norwood cases like Lorenzo, Erdogan, De Reys and Umar. He is in a good middle ground like Feriduni where he will use FUE to treat upto a Norwood 3 and maybe 4 if the donor area is dense enough.

 

 

My personal favourite surgeon all round i must say is Bisanga. Solid consistent work with flair also. The results i have seen albeit online from Lorenzo also were phenonmenal.

[Mickey85]

My personal favourite surgeon all round i must say is Bisanga. Solid consistent work with flair also. The results i have seen albeit online from Lorenzo also were phenonmenal.

 

bisanga is amazing but lorenzo pushed the bar for what can be achieved via fue. he works on almost any norwood rating. he clearly showed that fue can be used for more than just hairline or temple recession. i doubt he would be in business this long if he was not consistent. he is booked out til 2014....

[KO]

I am starting to see your point about FUE. The biggest knock against FUE is that it has a lower yield. But if you think about it, not that many clinics consistently put out mega sessions on a regular basis, apart from say HW, Rahal, Shapiro, or Dr Path etc.

 

So many times I see a respected clinic put 2500 grafts on a NW5+, and obviously the result is going to be thin. Yet we see posters go "great result, very natural!", and I'm sitting there thinking "this is it?". If you're only going to put a small no of grafts....why not do FUE?

 

That being said, I believe some are better candidates for strip than FUE - men with stable patterns, moderate hair loss, and a strong donor (the ideal HT candidate basically), in those cases, there may be no need to do FUE when a single strip session would do well.

[britboy]

I read the article “Highlights of the 2011 ISHRS (International Society of Hair Restoration Surgery) Scientific Meeting in Anchorage, Alaska” but nothing about Choi technique which I am interested in.. :-(

[s2thoudriver]

"The biggest knock against FUE is that it has a lower yield"

 

This is a very old and missleading statement, no doubt spread around the forums by avid FUT followers and various FUT surgeons who don't want to invest their time and money in perfoming top class FUE sessions.

 

FUE does not have a lower yield at all. As discussed many times on here, FUT grafts are only as good as the technicians discecting them from the strip, just as FUE extractions are only as good as the surgeon doing the harvesting.

 

As always said, any surgery is only as good as the skills behind the hands performing it.

 

Regards

 

Rob

[MAGNUMpi]

 

As always said, any surgery is only as good as the skills behind the hands performing it.

Yes. Thats why I am happy that FUE is becoming so popular. I think that if more doctors focused on it the bar would be raised in terms of yield etc. Some guys do need a good old fashioned FUT to get them where they want to be, but the times are shifting and I think its good for the industry overall. To eliminate the linear scar and still get the exact same yield would be a positive step for all future HT patients.

[s2thoudriver]

"Some guys do need a good old fashioned FUT to get them where they want to be"

 

Why??

 

You can do all you need in 1 or 2 FUE sessions, no-one NEEDS to have FUT

 

From what i have seen and reserached over the last few years, the only people who should ever consider FUT are those who a) can't afford FUE or b) are too scared to get on a plane and live in an area where only FUT is still practiced.

 

If you go to places that are at the forefront of cosmetic procedures, it is highly unlikely FUT will even be an available surgery option any more.

 

When i was researching having my HT in Turkey, not one person i emailed or spoke to did FUT any more as they had all moved on to the latest FUE. Some had not been practicing FUT for 4 years prior to then, which says it all really.

 

Regards

 

Rob

[JohnnyDrama]

Rob, from my research....not everyone is an FUE candidate. This is why I still believe FUT certainly has a role.

 

E.g. a 30 year old has extensive loss. Say he has 2 procedures, so first is 3,500 FUE to address frontalthird/half of scalp, then 2 or 3 years later he has another 2,000 FUE to crown/touch up frontal region.

 

He is now 32/33 with a tapped out donor region. In 5-10-15 years time he is likely to have more loss.

 

By adding FUT, it gives him so much more grafts to give him a look he will be happy with when 40 plus.

 

Don't get me wrong, I love that top class FUE is an option now, as you probably know I have just gone ahead with it and can appreciate it first hand. I went to a composite clinic that does not shy away from telling patients that FUT may be in their best interests, from that individuals point of view. If I was told this, I would more than likely have gone the FUT route. Not that I would have wanted to, but I would have trusted that my long term prospects would have been better if FUT were included. Thankfully I was told otherwise, but I would have bitten that bullet if it were presented.

[s2thoudriver]

You have exactly the same amount of follicles in your head whether you have FUT or FUE.

 

I think if you have to resort to FUT, it should be the last option after all FUE has been exhausted and that's only if you have great scalp elasticity and accept that there's a strong chance of scar stretching.

 

Personally, if i get to that point I would just buzz it at that point and live with the coverage is got. (I'm lucky enough to have enough donor for another 3,000 FUE if I decide I want it in the future, which is more than enough coverage).

 

Rob

[1978matt]

Rob, from my research....not everyone is an FUE candidate. This is why I still believe FUT certainly has a role.

 

E.g. a 30 year old has extensive loss. Say he has 2 procedures, so first is 3,500 FUE to address frontalthird/half of scalp, then 2 or 3 years later he has another 2,000 FUE to crown/touch up frontal region.

 

He is now 32/33 with a tapped out donor region. In 5-10-15 years time he is likely to have more loss.

 

By adding FUT, it gives him so much more grafts to give him a look he will be happy with when 40 plus.

 

Don't get me wrong, I love that top class FUE is an option now, as you probably know I have just gone ahead with it and can appreciate it first hand. I went to a composite clinic that does not shy away from telling patients that FUT may be in their best interests, from that individuals point of view. If I was told this, I would more than likely have gone the FUT route. Not that I would have wanted to, but I would have trusted that my long term prospects would have been better if FUT were included. Thankfully I was told otherwise, but I would have bitten that bullet if it were presented.

 

Agreed.

 

The safest part of the 'Safe Zone' is the area shaded black below. All these 25yr olds taking 6000 FUE from outside this area run the risk of that hair thinning out over time.

 

People can be NW2s at 40 and end up a NW6/7 at 60.

 

My personal view is that everyone should consider at least one good strip procedure. If you need a top up 20 years later and still got great hair on the back and sides then maybe that is the time to go FUE.

 

There's no one size fits all approach.

[MAGNUMpi]

Ive read so much about the possibility of getting more grafts via FUT but then I've been in 3 different consultations with doctors and they have all said I would have the same amount with FUT and FUE.

What is the definitive answer here?

I guess yield would tilt the scale in favor of FUT but isn't FUE yield getting better and better?

The age old question of FUT or FUE...!

It does seem that FUT generally yields better in the photos Ive seen but then again if more doctors could get results like Lorenzo etc. it would be a much closer race.

Well no harm in discussing it. Im glad all the posts in this thread have been friendly.

[Blake Bloxham]

Britboy,

 

What did you want to know about the "Choi technique?" I assume this is FUE with the Choi implanter used for graft insertion. Let me know, and I'll explain further.