Surgical hair restoration is a field of medicine that is constantly evolving as the result of physicians constantly seeking to meet the needs of their patients. Follicular Unit Extraction (FUE) is a method of obtaining donor hair for Follicular Unit Transplantation (FUT) procedures and one of those innovations that has been developed to give an alternative harvesting technique for patients who are looking for an option other than the traditional gold standard single strip method. Patients who are concerned about having a linear scar, who want to wear their hair very short or whose scalp is too tight for strip harvesting, are typically good candidates for FUE procedures. These are the patients that physicians had in mind when they were developing FUE as viable option and alternative.
Unlike the strip method in which only the precise donor strip is shaved and a linear incision made with the grafts being microscopically dissected from that strip, FUE requires that the entire donor zone be shaved and the follicular units are extracted directly from the scalp, one follicular unit at a time, which is a time and labor intensive process. The follicular units are taken from the known donor area by using a .8mm to 1mm punch, making a circular incision around the top of the follicular units and removing the follicular units directly from the scalp. Once the donor hair is harvested, the recipient sites are created by your surgeon and the grafts are placed with the proper angle and direction by the hair surgery technicians, as is with all follicular unit transplantation procedures.
Due to the extended length of time required to properly extract the follicular units, time for recipient site creation and graft placement may be proportionately decreased. This may shift the surgeon’s time and focus away from planning and designing recipient sites (the artistic component) to the donor area and the mechanical extraction of the follicular units unless the sessions are kept small or are done over several days in succession.
Follicular Unit Extraction Instruments
Follicular Unit Extraction instrumentation and techniques have evolved in recent years. The latest improvements have made FUE more viable, by offering instrumentation capable of harvesting more grafts with less damage and less scarring.
Recent improvements include:
- Smaller punches that reduce spotty scarring
- Motorized punches that refine the way Surgeons score the upper layer skin
- Restricted depth of scoring to better protect the follicular unit grafts
- Understanding the need to limit extractions in order to prevent obvious scarring
SAFE System for FUE
Ziering Surgeons utilise Dr. Jim Harris’s “SAFE System” instrumentation for Follicular Unit Extraction. The specially designed instrument is a motorized blunt dissection device.
- Isolates the follicular units from the surrounding scalp area
- Allows the Surgeon to extract follicular units directly from the scalp
- Minimises damage to follicles
FUE has moved forward with the latest technology and techniques and a good result can be achieved in the right patient, though it is certainly not the best option for all. The single strip harvest procedure used in Follicular Unit Technique transplantation remains the preferred method of graft harvesting for most patients.