The technique gaining more recent attention is called follicular unit extraction (FUE). Just as the fut procedure this is done under local anaesthetic and is an outpatient procedure. Usually the whole back of the head has to be shaved as using the fue technique you are essentially thinning out the hair at the back so it’s important to keep a distance between the extraction holes to prevent from noticeable thinning being apparent in the donor area. Tiny circular incisions are made using a versi handle, biopsy punch or similar instrument around each fu. Once the graft is released, it is gently removed using tweezers or forceps and handed to the assistants for preparation.
The test of the procedure is exactly the same as using the strip harvesting (FUT) technique, little incisions are made in the bold area and the fu´s are placed there one by one.
FUE does take longer to perform than strip harvesting and this generally results in a higher cost for the procedure. In an average eight hour FUE session, a skilled surgical team can complete 1000-1500 grafts. A strip harvesting procedure, as mentioned above, can complete as many as 3000 grafts in a session.
The primary benefit of FUE is that no stitches are needed and the reduced incidence of scarring. Remember, though, that a well-trained surgeon can achieve almost zero scarring with strip harvesting, so there is some debate over the efficacy of FUE regarding graft quality and FU survival rate. Furthermore, FUE cannot be said to be completely scar-free. Rather, the process leaves small dots where the grafts where, it’s important for potential patients to know that all surgeries can have some incidence of scaring.
Nevertheless, new equipment is making the FUE process increasingly attractive, as it’s enabled grafts to enjoy better survival rates. Proponents of the strip harvesting method have argued that FUE grafts are less likely to survive from extraction to placement, because they have very little tissue surrounding them and because the fu’s can be damaged during the extraction (follicles are extracted blindly versus being dissected under magnification with FUT). There are many studies that suggest that survival rates are lower using the FUE technique but not all FUE surgeons agree with this conclusion—claiming it’s very dependent on surgical skill. Due to the variance in studies done thus far, the debate between the two techniques persists.
In both the strip harvesting and the FUE procedures, patients can be assured that there is little if any pain involved. While the procedures may sound uncomfortable, patients are often surprised by how gently they’re treated. The procedure itself is often painless, and the following few days of healing are generally free of any significant pain. No bandages are needed for either method, but patients are generally advised to not wash their hair for two to three days following the surgery, while the grafts are still not firmly grown into its new location.