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FUE with African American Hair


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We continue to struggle with African American hair. Some recent postings have illustrated this, and I wanted to take the opportunity to respond.

 

As many Forum readers know, African American hair can sometimes have a high percentage of follicular units with a severe curl beneath the skin. For those of us who practice FUE, this can present a real problem: a straight punch cannot capture a severe curl, no matter how experienced or talented.

 

Fortunately, most African American patients have graph morphology where tissue comes out cleanly, with minimal transection. I show these patients in my before and afters, and this works most of the time. But what about those patients who have the severest of curl?

 

Some would simply answer to increase the punch size. I believe this is a poor answer due to any punch that exceeds 1.0 mm has the probability of causing visible scarring in the donor area. This presents the exact problem FUE is trying to solve. Much better to perform FUT if this the case, where at least with the scar you are receiving intact grafts.

 

While at the recent ISHRS conference in Malaysia, myself and other physicians who practice FUE were in discussion over best practice for these patients. My approach for new African American patients is to inform them that if this is one of those rare cases the tissue comes out transected, there will be the need for repeat procedures, and keep the punch size small to avoid scarring.

 

The other option is to perform test grafts, and if there is a large amount of transection, then to opt for FUT, or reconsider hair transplantation entirely. However, I believe that even in the most severe African American cases good growth maybe obtained, it just will likely take more than one procedure to get there.

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  • 2 months later...

Thank you for the insight. I find this interesting because in my short time researching FUE hair transplants, I feel I have not been convinced that a FUE HT is a procedure which can give people of African heritage consistent results.

 

Can you please provide some more information on the issues some black people with curly hair face?

 

My background is east african. The texture of the hair in immediate family varies significantly, but i would not describe it as kinky.

 

I currently live in Australia and i'm concerned about flying overseas to get a HT, only to be disappointed by the results because my hair type is not suitable for a FUE procedure.

 

Do you have any suggestions for people in my situation?

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