FUE Hair Transplant: The Good, The Bad, and The Ugly

Hair transplantation surgery has dramatically evolved over the subsequent the last five decades. Throughout the evolution of hair transplant surgery, techniques have come and techniques have discarded. Today, single strip excision with stereomicroscopic dissection of the excised strip remains the most common type of hair transplant surgery performed according to a 2013 ISHRS practice survey. In the last decade, however, a refinement of an outdated punch extraction technique, now referred to Follicular Unit Extraction (FUE) is becoming more popular, and hair transplant surgery has never been the same.

The Good:

FUE is a surgical technique that removes individual hair or follicular units, “one at a time” from the posterior donor harvesting site. This method of hair transplantation is a minimally invasive procedure that involves using small circular punches ( 1.0 mm) to remove the individual follicular units from the back of the scalp, and then reimplanting the harvested follicular units back into the scalp in the balding recipient areas.

FUE hair transplantation requires the surgeon to possess higher skill sets in order to perform the procedure successfully, and this technique consistently yields successful outcomes in terms of hair density, natural-looking hairline, and it eliminates donor linear scarring. Other patient concerns are that it is not easy procedure to perform by the surgeon, and it requires the patient to ethically consider the alternative single strip excision technique because of prolonged harvesting time, and a very short hair cut required by the patient when harvesting grafts.

FUE hair transplantation is generally pursued for the treatment of androgenetic alopecia, also known as male pattern baldness. This genetic hair loss condition results in balding of the crown, frontal hairline, and temple points. The essence of the good though is, with an experience hair surgeon the benefits from Follicular Unit Extraction results in a natural hairline.

(Actual Patient of Dr. Williams one year after 2028 grafts transplanted using FUE)

The Bad, & The Ugly:

Now, I am sure that you are thinking, if this technique is so great and revolutionary how can anyone think FUE is a bad procedure? There are actual blog sites dedicated to disparaging FUE hair transplantation and telling prospective patients to choose a different surgical technique, i.e., STRIP.

Truth be said, obtaining great results from your hair restoration surgery comes down to three very important facts:

#1: Selecting An Experienced Hair Restoration Surgeon

It is important to have a properly trained and experienced physician performing the procedure. I am sad to report this detail is often overlooked because patient’s are searching for “the best deal.”

Private companies promoting FUE devices are interested primarily in making a profit and not patient safety and aesthetes outcomes.

These companies may have other allied businesses that physicians may contract with. These physicians without sufficient hair restoration training hire out to non-physician operators or hair technicians, to perform the hair surgery from start to finish. No surgeon or physician is involved and the outcomes can be terrible.

Some companies market these FUE devices to plastic surgeons, dermatologists, med-spas and aesthetician skin clinics where untrained physicians use hair technicians to perform the hair surgery. Unbelievable as it may seem, without appropriate training and lacking concept of basic hair restoration fundamentals, plastic surgeons and dermatologists are practicing hair restoration surgery using hair technicians.

When at their hair surgery consultation, patients should ask if the surgeon is involved in the pre-operative, intra-operative, and post operative phases of surgery. Patients should ask if the physician harvests the grafts and create the recipients sites necessary to produce natural hairlines. Patient’s also need to remember if a hair surgical facility is offering a semi-expensive procedure at an extraordinary reduced fee, there is usually a reason, and it’s not a good one.

#2: The Experience of the Hair Transplant Surgeon Performing FUE.

The training and experience of the hair restoration surgeon is key to successful cosmetic outcomes. A patient may experience a bad cosmetic outcome if they are not careful with selecting the properly trained surgeon to perform the FUE surgery. This is because a surgeon may be inadequately trained or lack experience.

The following photo is from another hair surgeon who had their FUE performed by a physician with inadequate training. You will observe in this photo the donor site has been over harvested, and the surgical operator ( a hair technician or inadequately trained doctor) went beyond the safe donor harvesting area with a very large circular punch.

(Photograph of patient with unacceptable over harvesting of the donor zone)

#3: Daily Medical Treatment Program for Hair Stabilization

A medical stabilization program to halt or at least slow the progressive nature of hair loss is central to maintaining your hairline. This program includes topical Minoxidil twice daily, a DHT blocker such as Finasteride, and if funds are available using laser light therapy such as the Capillus. Why bother having hair restoration surgery if you are not going to make the effort to stop your current and future hair loss. Failure to stop hair loss will put a patient in the position of spending the rest of their life chasing their receding hairline.

For years, hair restoration surgeon, Dr. Ken Williams, has helped women suffering from hair thinning and hair loss with both surgical and non-surgical treatment options. Please call our office at (949) 333-2999. Or Visit www.OrangeCountyHairRestoration.org.