FUE Steps, Terminology, and Technician Role

[Vesperian]

Hello everyone,

I would like to some confirmation and clarification on terminology so to understand some information I was told by staff of a hair transplant clinic I’ve been researching.

Firstly, 1) is it accurate to break down the total steps of FUE into graft design, extraction, graft opening, and implanting/placing? 2) Are those the proper terms for the steps and are there other accepted and more commonly used terms for any of the steps?

Regarding the information I was told by the clinic’s staff.  They told me that the doctor “does the graft extracting (scoring) and site making (where the grafts will be placed), while technicians pull the grafts after they've been scored, count them, then place them in the sites.”

3)  So presumably graft extracting and scoring mean the same exact thing?  Does the term “site making” mean the same exact thing as “graft opening”?  What is the difference then between scoring and site making?

4)  Is there a name for the step where the “technicians pull the grafts after they've been scored”?  That sounds like extraction, but they say the doctor “does the graft extracting (scoring).”  That makes it sound like the doctor does the scoring and the staff does the actual extracting.  Does that means there are 2 steps in extraction?

So, ultimately, based on what I’ve been told, 5) who exactly does what? And does how they’ve described the role assignment align with good hair transplant procedure?

I know from some online comments that some people prefer for the doctor to do all the steps, but it appears only an extreme minority of practices do that.  I see some opinions saying that it is most important for the doctor to do the extraction and graft scoring for the implantation, but then it’s common and fine for techs to do the implantation, with Hassan & Wong being cited as a highly regarded practice that does just that.

Thank you for any help on clarifying a lot of this confusion.

Edited September 17, 2023 by Vesperian

[Turkhair]

Clinics would delegate the whole process to techs but they’re forced to do the incisions because it’s a very hard thing to do. Go too deep, go too shallow, nick an artery, use wrong angles etc etc so many factors. I have seen some crap clinics have the doctor come for a second, quickly does incisions at a rate of 1 million incisions per hour then leave. All the techs then have to do is put the grafts in. These clinics advertise it as the doctor does the implantation. 

Seems like your clinic wants to advertise the doctor does the extraction when all he’s going to do is poke poke poke your scalp (mark or score or whatever) at rate of million grafts per second then quickly leave the room and have techs do the extraction anyway lol

 

I hope that explains it for you 

[A_4_Archan]

@Vesperian

There will be some difference in terminology used by some clinics to name the steps but the widely used terms for 3 major phase are extraction(taking out graft),incisions(creating holes/slits on your scalp) and implantation (putting extracted grafts into those holes/slits)

1. Extraction: 

   - In this step, hair grafts are harvested from a donor area, which is usually the back and sides of the patient's scalp. These areas are genetically resistant to hair loss.

   - There are two methods for graft extraction: Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE).

     - FUT: A strip of scalp containing hair follicles is surgically removed, and then the grafts are dissected under a microscope.If this method is used for extraction than the leading surgeon should only perform this step as there are lots of complexity attached to this.

     - FUE: Individual hair follicles are extracted one by one using a specialized tool.This step need more of precision so avoid transection of grafts and preferably be performed by the leading surgeon or by technician who has a lot of experience with this.

   - The choice between FUT and FUE depends on the patient's needs and the surgeon's expertise.

 

2. Incisions:

   - After graft extraction, tiny incisions(holes/slits) are created in the bald or thinning areas of the scalp where the grafts will be implanted.

   - The size, angle, and density of these incisions are crucial for achieving a natural-looking result.This step is extremely important and needs very good skills to achieve natural and dense outcome and should be performed only by the leading surgeon.

 

3. Implantation of Grafts:

   - The harvested/extracted grafts, whether obtained through FUT or FUE, are than implanted into the slits/hole made during incisions phase..Experienced techs are able to perform this step without any damage to grafts and usually this phase is performed by techs everywhere barring 2-3 clinics.

 

Now if your doctor is doing DHI(direct hair implantation) than there will be only 2 major step that will be extraction and implantation..at first the extraction is done and than the grafts are directly inserted into the scalp using implanter pens..this means the incisions and implantation takes place at the same time.This should only be performed by the leading doctor.

 

Thus the entire process is meticulous, requiring attention to detail and artistic skill and choosing a good surgeon is extremely important for a successful outcome.

I hope this helps you...best of luck.

 

 

Edited September 18, 2023 by A_4_Archan

[Vesperian]

@A_4_Archan

Thank you immensely.  Your overview of the terminology is wonderfully concise and thorough.

 

I’ll ask the clinic’s staff to further clarify their word usage to better understand how the roles are split between doctor and technicians.

 

From just what I quoted from the staff in my initial post, it seems like the clinic does not do DHI, is that correct?  I haven’t read about DHI in a long time, and I’ll surely do more research on it later on, but since it was brought up, I‘d just like to quickly ask, is DHI considered a better method than regular implantation and is it practiced amongst only a minority of clinics?