FUE hair transplant (All you need to know)

Published on October 15, 2021
Updated on October 19, 2021
Extracted hair follicles on a gauze-lined petri dish, with fingertips holding tweezers placing a new follicle on the plate
Follicular Unit Excision (FUE) transplants involve the extraction of individual hair follicles.

When hair transplantation first started in the mid 20th century, only one type of surgery was available: hair plugs. This type of transplantation was performed using 2.5-millimeter to 4-millimeter circular punch grafts. These surgeries were successful, but the transplanted hair grafts were so large that they grew out in tufts. People ended up with bizarre, doll-like hairlines that looked absurd.

Fortunately, we’ve come a long way since hair plugs. FUE hair transplants are the modernized, miniaturized version of this technique. FUE, which stands for follicular unit extraction (or follicular unit excision), was developed in 2002 and has been growing in popularity ever since.

What is a FUE hair transplant?

FUE hair transplant surgery uses punch grafts, just like hair plugs did. However, according to a review in Actas Dermo-Sifiliográficas, this surgical procedure uses tiny punches that are 1 millimeter in size or slightly less.

FUE’s small punch grafts allow surgeons to extract individual follicular units, which contain between 1 and 4 hairs. Each follicular unit is then transplanted to areas of the scalp that have been affected by hair loss.

Where are FUE hair grafts taken from?  

FUE hair grafts are generally excised from the back or sides of the scalp. These parts of the head generally aren’t affected by androgenic alopecia. However, it’s also possible to extract follicles from other parts of the body, like the legs or beard, and transplant those to your scalp. Your surgeon may recommend extraction from one or multiple regions depending on the extent of your hair loss.   

What is the average FUE timeline?

Most people considering FUE will go in for several consultations before getting this procedure done. Your surgeon will need to determine whether or not this is a suitable procedure for you, assess your hair density, decide where the hairs should be extracted from, and figure out how many grafts are required for this procedure to be worthwhile to you. 

Many doctors also suggest starting a hair loss treatment, like minoxidil. According to StatPearls Publishing, using minoxidil before and after a hair transplant helps prevent or reduce post-procedure side effects, like hair shedding. A study in the Journal of the American Academy of Dermatology says that it can also accelerate hair regrowth following your transplant. 

The Actas Dermo-Sifiliográficas review says that it takes around 1.5 to 3 hours to perform a 1,000-graft FUE hair transplant. If your surgeon advises you to get more than 2,000 hair grafts, they might suggest spreading the procedure over 2 days. 

FUE hair transplant recovery is usually straightforward, with minimal complications. A study in the Pakistan Journal of Medical & Health Sciences reported prescribing hair transplant patients antibiotics and painkillers to be taken for the first 5 days post-procedure. Since the punch grafts are so small, you’re essentially just waiting for them to scab over and heal. 

If you keep your scalp clean and avoid rubbing or irritating your scalp, your hair transplant should heal nicely. Most people experience some hair shedding within the first month of their transplant. If you were advised to start minoxidil before your procedure and have continued applying it after, you may not experience this side effect.  

FUE hair transplant recovery time might be fast, but seeing the effects of the transplant is pretty slow. The Actas Dermo-Sifiliográficas review says that it can take 6 to 12 months to see the results of this procedure. However, if you’re using minoxidil, you might start to see hair regrowth much faster. Everyone is different, so don’t be discouraged if your newly transplanted hair follicles take a while to start producing hair.

Is a FUE hair transplant permanent?

Hair follicles that have been transplanted during the FUE procedure are likely to permanently keep producing hair. You can consider them to be just like any of your other healthy hair follicles. However, if you’ve gotten your FUE hair transplant to counteract the progression of the most common form of hair loss, pattern baldness, your final transplant’s results can’t be considered permanent. 

Male pattern baldness is a progressive condition caused by a combination of genetics and hormones. According to the Plastic and Reconstructive Surgery Global Open journal, people with this type of hair loss have a large number of hair follicles that are sensitive to a particular androgen called dihydrotestosterone (DHT). DHT is what causes your hair follicles to shrink and produce thinner, weaker hair. 

When you receive a hair transplant, the follicles are taken from an area of your scalp or body that isn’t affected by pattern hair loss. The follicles are essentially not sensitive to DHT in the same way. While they can permanently continue producing hair, the other hair follicles along the top of your head will continue to be affected. Those hair follicles will still end up shrinking, and over time, your hair density will decrease. 

Since pattern hair loss is a progressive condition, FUE isn’t the best first choice of treatment. If you’re young or feel that you’re at risk of going bald quickly, you might want to look into an FDA-approved treatment like minoxidil, finasteride, or low-level laser therapy before getting a transplant. These solutions can stop the progression of your hair loss and help your follicles produce thicker, healthier hair. 

You can still use a hair loss treatment and get a hair transplant, just make sure to let your doctor know which product you’re using. Chances are they’ll suggest one of these treatments to help maintain your transplant results, anyway.

How much is a FUE hair transplant? 

FUE hair transplant cost can vary widely based on the country your procedure is in, your surgeon’s experience, and most of all, the number of grafts you’re having transplanted. A review published in the Philadelphia College of Osteopathic Medicine (PCOM) Digital Commons reported that hair transplants range from $2,500 to $20,000 per surgery. Another review from the PCOM Digital Commons reported that the FUE hair transplant cost per graft ranged from $6.50 to $12. 

Most FUE transplants involve the transplantation of 1,000 to 2,000 hair grafts. This means that the cost of a FUE hair transplant is likely to be at least $6,500 and could possibly be as much as $24,000. 

Of course, it’s very likely that you can get more bang for your buck if you go abroad for your hair transplant. Countries like Turkey, India, and even the United Kingdom may offer transplant surgeries at a fraction of the price. 

Regardless of your choice, make sure to choose an experienced surgeon. FUE is a challenging, time-consuming surgery that’s still fairly novel. It’s only been around for about 20 years and has only become very popular in the last decade. This procedure’s high costs are partially due to the limited number of specialists who can perform it successfully. 

In the hands of an inexperienced doctor, you could end up with scarring or hair plug-type results. They could also damage your hair follicles during the extraction process, resulting in more hair loss and poor post-transplantation hair regrowth. 

If you’re still interested in a hair transplant but don’t think you can fork up such a large amount of cash, you might also want to consider a FUT transplant. FUT, which stands for follicular unit transplantation, is a much easier and less expensive procedure. The downside is that this surgery leaves a very obvious scar.

Choosing a hair transplant: FUE vs. FUT

When they started to realize how absurd hair plugs looked, hair transplant surgeons realized they needed a better surgical method. They also needed a way to fix the appearance of hair plugs and restore a more natural-looking hairline. This led to the development of FUT transplants. 

FUT involves a procedure that’s fairly similar to FUE. The main difference is how both procedures start. Instead of extracting follicles one at a time, a strip of skin is extracted from the back of the scalp. The wound is closed, and follicles are then removed from the piece of skin.

Extracting the strip of skin makes a huge difference to both the surgeon and the patient. For the surgeon, the excision of follicular units is much easier to perform accurately under a microscope. This results in a faster, easier, and more affordable transplant procedure.

The downside is that for the patient, the recovery time is much longer and more uncomfortable. The UK’s National Health Service says that it takes up to 2 weeks for stitches to dissolve. And even in the weeks following that, you need to be careful about the way you move your neck and may need to temporarily cut down on strenuous physical activity. 

It’s not always necessary to choose one transplant procedure over the other. Depending on the severity of your hair loss, your doctor may recommend performing both FUT and FUE surgeries. FUE hair transplants are also often done as a follow-up procedure to FUT transplants.

FUE vs. FUT hair transplant scarring

A successful FUE hair transplant results in a natural-looking hairline and causes minimal scarring. A study in the Journal of Maxillofacial and Oral Surgery says that people are likely to experience hypopigmentation following FUE transplants. Hypopigmented scars look like small, circular, discolored marks. Fortunately, FUE-induced hypopigmentation can be easily masked through scalp micropigmentation

Once healed, a FUT hair transplant is guaranteed to leave a long, linear scar. Some scars can be easily hidden by growing your hair out. Others need further surgical or cosmetic procedures to be successfully hidden. 

Ironically, FUE is the most effective strategy for people hoping to hide a FUT scar. But don’t worry, the FUE hair grafts don’t need to come from your scalp. A study in the Journal of Plastic, Reconstructive, and Aesthetic Surgery mentioned using beard hair as an alternative. Rather than shaving your neck and under your chin, you can simply relocate those hair follicles and use them to hide your scar.

Is a FUE hair transplant right for me?

FUE hair transplants are a great solution for anyone who has access to a reputable surgeon and doesn’t mind spending a large amount of money. FUE transplants are much better than FUT hair transplants, which have long recovery times and leave a visible scar.  

However, while FUE hair transplants might seem like a magical solution to counteract hair loss, they’re not necessarily permanent. People who are still experiencing the early-to-mid stages of pattern baldness need to know that they may require further transplants as their hair loss progresses.

For example, if you plan to get a FUE transplant to restore your hairline and temples, be aware that you’re still likely to see hair loss progress around your crown. If you don’t use an FDA-approved hair loss treatment to prevent this from happening, you’ll almost certainly need a second hair transplant in the future.

In fact, most hair transplants recommend the use of additional treatments at some point. Minoxidil, a popular FDA-approved hair loss treatment, is often recommended pre- and post-transplant. This topical solution can reduce side effects, accelerate hair regrowth, encourage healthier, thicker hair to grow, and prevent your hair loss from getting worse. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

HAIR LOSS

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