FUE Hair Transplant

Orange County Hair Restoration and Dr. Williams are one of the most experienced hair restoration surgeon and facilities performing Follicular Unit Excision (FUE). Our office uses the world’s most recognized FUE donor harvesting devices- Mamba Trevillini, ARTAS, WAW, and Cole PCID systems. These state-of-the-Art FUE devices are the result of extensive research and development providing a minimally invasive hair restoration  procedure.

The natural aesthetically appearing hairline is a result of the artistic qualities of the surgeon.  Dr. Williams experience as a hair restoration surgeon and his staff refines the hair transplantation surgery experience and consistently achieves aesthetic natural appearing hairlines.  FUE donor harvesting is now  the hair restoration procedure of choice. In 2009, Dr. Williams was one of the first and most recognized dedicated FUE hair restoration offices in the western United States. With FUE technology and instrumentation advancement, better FUE devices have emerge such as the Mamba Trevillini, WAW and PCID.

FUE with the ARTAS system is a physician controlled advanced automated device designed and developed by Restoration Robotics. Our office was one of the original facilities in 2013 to acquire the ARTAS device, and we have earned the “Center of Excellence Award” from Restoration Robotics because of our expertise in the use of this FUE device. While the ARTAS remains a recognized FUE device,  new advanced harvesting technology punch designs and devices have emerged with lower transection rates and better appearing graft quality.

Most importantly our physician, Dr. Ken Williams, is involved in every aspect of the patient’s hair surgery experience. Unlike other FUE hair surgery facilities that have non-physicians performing hair surgery, Dr. Williams, intimately performs all the the Critical-to-Quality Steps (CTQS) of the hair transplantation surgery. His clinical expertise and “hands-on” approach with his patients results in reduced graft transaction and higher harvesting rates.


Two Harvesting Methods for Hair Transplantation – Strip vs. FUE

Currently, there are two primary surgical harvesting   methods used in performing hair transplantation, i.e., Linear strip excision (sometimes erroneously  referred to as FUT)  and FUE. With the linear strip excision harvesting technique, a section of scalp is excised with a scalpel. The scalp is then brought together with sutures that may leave a small donor linear scar in the back of the scalp. Next, after specialized slivering and graft creation, the hair follicles or  grafts are inserted  into tiny recipient sites or slits, that are created  with the proper direction and angle by Dr Williams in the balding recipient areas. The follicles with a single hair are placed in the front rows to define and create a natural hairline. The more dense natural occurring follicular units are placed by hand in areas where hair density is needed behind the frontal transition zone.

In comparison,  FUE is a minimally invasive technique, and a minimal depth scoring punch  is used to incise the skin. The punch is then advanced into the dermis where it cuts and loosens the follicle from the surrounding dermal tissues. The small naturally occurring hair follicle units are then removed and placed in special bio-enhanced holding solutions to preserve follicle viability until they are directly implanted into the scalp. With the FUE procedure, Dr. Williams prefers using harvesting “large fatty grafts” using a 0.90 to 0.95 mm circular punch. Fatter grafts that are closer to the size of strip created grafts, tend to clinically have better graft survival rates. After harvesting the grafts via FUE, the process of recipient site implantation is exactly the same as the linear  strip harvesting technique.

Surgical Cutting of Scalp with FUE

FUE with the WAW, Mamba,  PCID, or Safe System are the most recently developed FUE hair transplant devices. Unlike linear strip excision, FUE  does not involve excising a large portion of the scalp. FUE does create potentially small ( 1.5 mm) punctate scars, but  no sutures, staples, or scalpel are required. Postoperative bleeding is minimally present and  surgical recovery is realized in a few days. Patients are able to resume limited physical activity the next day with minimal restrictions. Athletes or physically active patients may resume their normal strenuous workouts one week after the procedure.

Up to 2500 to 3000 Grafts harvested Per Day

Quality of grafts at Irvine Institute of Medicine and Cosmetic Surgery-OC Hair Restoration

Quality of grafts at Orange County Hair Restoration

Hair restoration surgery with FUE removes individual hair follicles from the scalp in their naturally occurring groupings of 1-4 hairs. At OC Hair Restoration, Dr Williams is able to typically harvest or surgically remove and implant 2500 to 3000 grafts in one (1) surgical setting using 0.9 mm or 0.95 mm punches. The typical length of the surgical session varies from patient-to-patient. In some cases because of various patient factors and number of grafts harvested, cases will end as quickly as five (5) hours, but in some patients an eight (8) hour session may be required.

Quicker Recovery, More Grafts, and No Donor linear Scars with FUE

Magnification view of hypopigmentation from FUE technique

Magnification view of hypopigmentation from FUE technique

Compared to early manual hand held FUE, modern day FUE devices allow more follicles or grafts to be harvested in a single surgical session. With the 21st technology devices such as the Mamba Trevillini, ARTAS, WAW, Cole systems, FUE harvesting allows patients to have a greater number of hair follicles transplanted into their balding areas of scalp in a single surgical session. Most importantly, as compared to the linear STRIP excision technique, there is no observed linear donor scar when the hair is worn short. It should be noted, FUE causes scaring of the scalp that may result in small multiple 1.5 mm areas of donor area hypopigmentation. In certain skin and ethnic skin types, the areas of hypopigmentation may be more prominent if the scalp hair is cut very short or is shaved.

Small round areas of hypopigmentation from FUE observed when hair is cut short

Small round areas of hypopigmentation from FUE observed when hair is cut short

Traditional FUT (STRIP) Method Before & After

Intra operative FUT Incision

Intra operative FUT Incision

FUE Before & After Photos

View More Results

FUE TechniqueFUT STRIP Technique
Use of Scalpel, Sutures, or StaplesNoYes
Surgical Operating Time-2500 Grafts5-8 hours5-8 hours
Invasiveness of Procedure++++
Typical Hair Length PreferenceShortMedium
Short Hair Required Prior to ProcedureYesNo
Donor Site Linear ScarNoYes
Maximum Follicles Harvested Per Session2500 – 30002500-3000
Typical Healing Time of Donor Site5-7 days10-14 days
Local Tumescent Anesthesia / Oral SedationYesYes
Postoperative Tight Scalp SensationNoYes
Risk of Bleeding & Nerve DamageNoLow
Donor HypopigmentationYesNo
Risk of Donor Site infectionVery LowLow