Follicular Unit Extraction (FUE) is a minimally invasive hair transplant technique that involves extracting hair follicles from the safe donor area individually and implanting said hair follicles into the recipient area one at a time. Although the FUE hair transplant method is more time-intensive, it results in minimal, non-visible scarring and shorter recovery periods. Patients who choose the FUE method can expect more natural looking results. It is the preferred method of hair transplantation of qualified dermatologists across the world.
Follicular Unit Extraction (FUE) now known as Follicular Unit Excision is a method of hair transplantation. In this method, individual hair follicles are harvested from the safe donor area and implanted in the recipient area. When the safe donor area is not sufficient, hair follicles can also be extracted from alternative donor areas. Alternative donor areas are other parts of the body such as the beard, the chest, the arms, or the legs.
Over the past few years, the FUE hair transplant method has become the gold standard of hair restoration. It is the preferred method of doctors worldwide, including our surgeons at Civas Hair Transplant due to its precision, its versatility, and its ability to create more natural-looking results.
Follicular Unit Extraction (FUE) hair transplant works by excising hair follicles, also known as FUs, one by one from the safe donor area (usually located at the back and the sides of the head) and implanting them in the recipient area (bald spots or sparse areas suffering from hair loss).
A specialized tool called an extraction punch is used by our hair transplant surgeons to extract the FUs one by one. This ensures that minimal trauma or damage is done to the hair follicles and the surrounding tissue.
Each hair follicle is then individually implanted into micro-incisions made by our hair transplant surgeon in the recipient area. While most patients undergo an initial shedding phase after the hair transplant procedure, the newly transplanted hair grafts will typically start growing around the 2nd or third month, with the final results becoming apparent a year after the procedure. Patience is KEY!!
FUE (Follicular Unit Extraction) hair transplant procedure can be broken down into several steps which will be explained in detail in the step-by-step guide below.
Step 1: Consultation
Before undergoing a Follicular Unit Extraction hair transplant procedure, it is vital to consult with a hair transplant specialist, preferably a dermatologist, such as the ones at Civas Hair Transplant to determine whether you are a suitable candidate. Following a dermatoscopic examination, our doctor will determine the cause of hair loss, the treatment plan, the technique to be used, and the number of grafts required for a successful outcome. Our doctor will work closely with you to understand your preferences and expectations and create a personalized treatment plan tailored to your specific needs.
Step 2: Hairline Design and Operation Planning
During the hairline design stage of the process, your scalp will be prepared for the hair restoration procedure. By taking various factors such as facial anatomy, hair density, hair type, hair structure, available donor hair, etc. in mind, our doctor will then design a natural-looking hairline that complements your facial features. Our doctor will also decide on the graft placement to mimic your natural hair pattern, angles, and distribution.
At Civas Hair Transplant, we are truly dedicated to creating natural-looking and aesthetically pleasing hairlines. Over the years, our dermatologists have developed their own technique to ensure that each patient’s new hairline blends naturally with their existing hair and frames their facial features nicely. The remaining grafts will also be placed to ensure maximum coverage and the illusion of maximum density.
Step 3: Anesthesia
The administration of anesthesia is a crucial part of the Follicular Unit Extraction Hair Transplant procedure. Since hair restoration is minimally invasive, the procedure is done under local anesthesia. While the initial injections can be slightly painful, when done correctly, your scalp will be completely numb throughout the rest of the procedure. This step of the process must be performed by our dermatologist doctor. This ensures that you will have a safe, pain-free and stress-free experience throughout.
At Civas Hair Transplant, our doctors have created their own anesthesia administration technique. By using a combination of nerve block and infiltration anesthesia, we can achieve an almost painless and long-lasting effect with only a minimal dosage of the local anesthetic solution.
Step 4: Incisions (Channel Opening)
Once your scalp is prepped and fully numb, Civas Hair Transplant surgeons will start by making micro-incisions in the recipient area using specialized blades, sapphire blades or DHI needles, depending on the areas to be treated, your hair structure and your skin structure. This step is also known as channel opening. These micro-channels are strategically placed by our doctors to give you maximum coverage and density. The size, direction, angles, and depth of the channels are determined by our doctor to ensure that the grafts are placed in a way that mimics the natural growth pattern of your existing hair and contributes to a natural hair transplant result.
Creating incisions in the recipient area for graft placement is an art-form that requires careful planning. The grafts should be placed to ensure maximum coverage and the illusion of maximum density. This requires the expertise and skill of an experienced hair transplant surgeon.
Step 5: Excisions (Extraction)
The next step in a Follicular Unit Extraction Hair Transplant procedure is the extraction phase. Extraction consists of selecting the best quality grafts and harvesting them one by one. The first part of the extraction process consists of selecting the right tools to excise the grafts intact.
A specialized tool called a punch is used for excision in an FUE hair transplant procedure. The extraction punches work by scoring the skin around the hair follicle and separating it from surrounding tissue to excise them. These punches come in different sizes, shapes, and sharpness.
From 0.7mm to 1.1mm, these punches are available in different diameters to adapt to the diameter of the hair follicles. The right size of diameter allows our hair transplant surgeon to extract the hairs intact and with low risks of transsection.
Each punch also varies in sharpness from blunt to sharp and this allows our surgeon to precisely extract the grafts intact without causing unnecessary trauma to the surrounding follicular unit tissue.
The punches also differ in shapes such as cylindrical, conical, trumpet, or serrated which allows them to fit around the follicular unit perfectly and minimize tissue damage.
Once the appropriate punch is selected, our hair transplant surgeon will also determine the depth at which the punch penetrates the skin for the successful extraction of intact hair follicles.
After the selected hair follicles have been separated from surrounding tissue, our team will collect the hair follicles and store them in a holding organ solution until they are ready for implantation.
Step 6: Sorting and Counting of FUs
Sorting and counting of the hair follicles happen simultaneously with the extraction process. While our doctors harvesting the hair follicles, our nurse technicians will sort and count them one by one. Using magnification, they will separate them into groups of 1FUs, 2FUs, 3FUs, 4FUs, etc., and store them in a special organ-holding solution until it is time for implantation.
Step 7: Graft Placement (Implantation)
Once extraction, sorting, and counting of the grafts are completed, the phase of implantation can begin. Implantation consists of delicately inserting the grafts in the slits/incisions previously made by our hair transplant surgeon. This requires technical precision to ensure that only 1 FUs are added to the hairline to ensure that the hairline is smooth and looks natural. Double and triple hair follicles are strategically added behind the hairline to create more density.
At Civas Hair Transplant, implantation is performed by our skilled nurse technicians. Trained by our doctors and backed by years of practical experience, our team of nurse techs will expertly place the sorted hair follicles in the channels under the supervision of our doctors.
Step 8: Bandage Application
After implantation of the hair follicles is completed, the FUE hair transplant process is almost over. At this stage, your scalp will be cleaned followed by the application of a topical antibiotic lotion to support healing and to eliminate the risks of infection. Your head will then be bandaged to protect the donor area. Please note that the recipient area will be left uncovered. This is done to minimize friction and reduce the risk of dislodging the newly implanted grafts.
Step 9: Post-Op Instructions
After the FUE hair transplant procedure, it’s time to focus on what comes next- recovery. It is important to follow the post-op instructions that have been carefully prepared by our doctor to obtain optimal results. These cover aftercare for the donor and recipient areas, medication, activities that should be avoided during the recovery period, etc.
An FUE hair transplant doesn’t end with the procedure itself but extends long into the recovery period. By following the guidelines set up by our doctor, you contribute significantly to your hair transplant results, minimizing the risks of complications and speeding up the healing process.
There are several subcategories of the Follicular Unit Extraction Hair Transplant technique, each with unique approaches and technologies.
In the manual FUE hair transplant technique, our surgeon uses a manual punch to extract individual hair follicles from the safe donor area. This allows the surgeon better control and precision during the extraction process but it can be very time-consuming and can cause fatigue, which can affect the quality of the grafts extracted.
In the motorized Follicular Unit Extraction Hair Transplant technique, our surgeon uses a motorized punch tool to extract hair follicles. A micromotor is attached to the punch device. The settings of the micromotor punch, such as speed, rotation, etc., can be adjusted to the needs of each patient. This speeds up the extraction process, reducing overall surgery time. It also allows the extraction of a larger number of grafts. However, if not handled properly or in the hands of an inexperienced technician, this can increase the transsection rate and cause follicle damage.
The DHIor Direct Hair Implantation technique is a modified FUE hair transplant technique. It involves using a specialized tool called a Choi pen that facilitates simultaneous extraction and implantation. This can considerably reduce the out-of-body time, which can improve survival rates and growth. However, the lack of prior graft placement planning can cause an uneven distribution of hair follicles in the recipient area. The graft survival rate also decreases due to repetitive trauma caused by inserting the grafts into the Choi pen.
TheSapphire FUE hair transplant technique is a modified version of FUE hair transplant technique. Instead of traditional steel blades, sapphire blades are used to create micro-channels in the recipient area. While sapphire blades can create smaller incisions leading to potentially faster healing, the advantages over traditional Follicular Unit Extraction Hair Transplant technique might not be as major as marketed by some clinics.
At Civas Hair Transplant, our doctors determine whether traditional steel blades, custom steel blades, or sapphire blades will be used for the creation of recipient holes depending on the skin structures, hair type, hair structure, etc. of the patient.
During U-FUE or Unshaven FUE hair transplant, hair follicles are implanted in the recipient area without the need to shave the patient’s hair. This allows patients to maintain their existing hairstyle after the procedure, providing a more discreet option to patients who prefer not to shave their heads. However, it is more time-consuming, and can only be performed in cases where only a small number of grafts (<1500) is required.
There are different versions of Unshaven FUE hair transplant:
The long hair transplant technique is another modified Follicular Unit Extraction Hair Transplant technique that involves transplanting long hair grafts rather than the traditional short or shaved hair follicles. This technique allows patients to see the full results immediately after the procedure. However, if it is not performed correctly, there is a higher potential for transsection and follicle damage. There is also a risk of trauma to the grafts if they get caught in the existing hair. As it is more time-consuming, it can only be done in cases where only small numbers of grafts are required.
Please note that while you will be able to see the final results right after the procedure, you will still go through shedding due to shock loss after the first month and you will have to wait for your hair to grow back like in the traditional FUE hair transplant method.
In the Robotic FUE hair transplant technique, a robotic system (ARTAS) is used in the extraction of hair follicles. While this allows for high precision in graft selection and reduced fatigue for the hair transplant surgeon, it is still a very expensive option, inaccessible to most. Additionally, improper handling of the device could cause trauma to the hair follicles due to heat emission. Robotic FUE hair transplant is still in the experimental stages and the risk of transssection rate is still too high to be acceptable.
Follicular Unit Extraction Hair Transplant is often preferred by patients and doctors over other hair transplant methods as it has various benefits. The main reason to choose FUE hair transplant is its minimally invasive nature. This results in less pain and a quicker recovery period compared to traditional methods such as FUT hair transplant.
Follicular Unit Extraction Hair Transplant also provides more natural-looking results. Since hair follicles are extracted and implanted individually by our hair transplant surgeon, this leads to minimal scarring. It also allows our surgeon to place the grafts closely to one another resulting in a denser hair coverage.
FUE hair transplant technique is also versatile. It can be customized and adapted for all types of loss patterns, hair types, and hair structures. It can be used to cover a whole head with hair or to fix just a small bald area. Hair follicles can be extracted from any hairy part of the body. Additionally, it can also be performed on different parts of the body such as the beard, the mustache, and the eyebrows.
Lastly, FUE does not involve large incisions, therefore reducing the risk of scarring and complications and making it a safer choice for many patients.
Follicular Unit Extraction Hair Transplant has several advantages:
Follicular Unit Extraction (FUE) Hair Transplant is generally considered a safe procedure due to its minimally invasive nature. However, like any surgical procedure, it carries some risks and side effects such as:
It is important to choose a certified hair transplant surgeon such as the ones at Civas Hair Transplant and follow the post-op care instructions they provide to manage these side effects and avoid permanent damage to the grafts.
Here are some key factors to determine whether you are a suitable candidate for Follicular Unit Extraction Hair Transplant:
Type of hair loss: FUE hair transplant is more suitable for patients with androgenetic alopecia (AGA). It can also be used for other types of hair loss such as traction alopecia, primary alopecia as long as the disease is not active, and secondary alopecia.
Extent of hair loss: Patients with small to medium-sized bald spots usually have more successful FUE hair transplant procedures as more density can be added leading to a more natural appearance. Patients with larger bald spots might require more extensive planning or multiple sessions to achieve the desired results.
Availability of donor hair: A suitable candidate for FUE hair transplant should have enough healthy hair available in the donor area located at the back and the sides of the head. If a patient is experiencing thinning and affected by miniaturization due to AGA in the donor area, they might not be suitable for a FUE hair transplant. In that case, body hair can also be used to obtain the required number of grafts.
Age: While there is no age limit for FUE hair transplant, it is recommended to wait till the patient is in their early twenties so that their hair loss pattern becomes more stabilized. From their 20s-30s, a careful evaluation by a dermatologist is essential before considering a hair transplant procedure.
Realistic Expectations: Patients should discuss their expectations and what is feasible with our hair transplant surgeon to ensure the best results. FUE hair transplant can drastically improve hair density but in some cases, it might not offer full density.
Overall health: Good health is important for a patient to be able to undergo a hair restoration procedure. Chronic illnesses could interfere with recovery and affect healing. It is important to disclose your medical history to our hair transplant surgeon before the operation.
Follicular Unit Extraction Hair Transplant usually lasts 7-8 hours on average. The duration of the procedure depends on various factors such as the number of grafts to be extracted, the difficulty of the procedure, the skill and speed of our doctors and medical team, whether manual or micromotor extraction is performed, etc. Usually, the patients are allowed to take breaks periodically so they can relax. You should plan for a full day at the clinic on the day of the surgery.
Follicular Unit Extraction hair transplant is considered a permanent solution to hair loss. The hair follicles harvested from the safe donor area are genetically not sensitive to hair loss. Once they are transplanted, they will continue to grow in the recipient area for a lifetime. However, if the hair follicles are harvested outside the safe donor area, they might fall out over the years. This relies heavily on the skill and expertise of our hair transplant surgeon to determine, outline, and stay within the safe donor area.
It is important to note that while transplanted hair are permanent, patients might continue to experience hair loss and thinning of their existing hair. This can affect the overall results of hair transplantation. It is vital to consult with our dermatologist hair transplant surgeons to discuss medical treatment for the preservation of existing hair if you would like to avoid a second or third transplant session in the future.
Follicular Unit Extraction (FUE) hair transplantation technique is usually well tolerated by patients due to its minimally invasive nature. Local anesthesia is used to numb the scalp during the procedure. While the initial injections might be slightly painful, once the anesthesia takes effect patients do not feel pain during extraction and implantation.
After the hair transplant procedure, patients might experience some soreness or discomfort. This can be managed using painkillers prescribed by our specialists.
At Civas Hair Transplant Clinic, we use our own special technique for administrating anesthesia. Developed by our doctors, this ensures that our patients experience minimal discomfort during and reduced swelling after the procedure.
Most patients will undergo an initial period of shedding called shock loss after a Follicular Unit Extraction hair transplant. You will then start to see initial growth 2-3 months after the procedure. While initial growth might be thin and sparse, the hair will thicken and become denser over time. There will be significant changes in appearance around the 6th month mark. While this timeline can vary from patient to patient due to various factors such as hair type, hair structure, skin type, diet, lifestyle, etc., it usually takes 12-18 months to see full results and a full head of hair.
Recovery from a Follicular Unit Extraction (FUE) hair transplant usually takes 1-2 weeks. It takes 10 days for the newly transplanted grafts to be fully implanted. It is very important to follow post-op instructions provided by our hair transplant doctor to ensure optimal results. You can return to their normal activities after the first 10 days, although you should avoid direct sunlight and engaging in strenuous exercises.
However, please note that growth of the newly transplanted hair begins around the 2-3 month mark and it takes 12-18 months to see the full results of a FUE hair transplant procedure.
Follicular Unit Extraction Hair Transplant does not end with the surgery, there is a whole recovery process after the procedure that is very crucial. The recovery process after FUE hair transplant consists of several stages and proper care must be taken during this period to ensure the best possible results.
Stage 1: First 10 Days After FUE Hair Transplant
It takes 10 days for the incisions to heal and for the hair grafts to be fully secured in the recipient area. During those critical first 10 days, it is essential to avoid touching, scratching, rubbing, or picking at the implanted hair follicles. During this period, it is common for patients to experience swelling, bleeding, soreness, and numbness on the scalp.
These are just temporary side effects and can be managed using medication. A cold compress can also be used for the swelling. It is also advised to sleep on your back with your head elevated after a Follicular Unit Extraction hair transplant to keep your grafts undisturbed. Strenuous exercises are to be avoided to promote healing. Gentle washing with a mild shampoo is recommended to keep the scalp clean.
After the first week, you will also notice crusts forming in the recipient area. Please do not scratch them and follow the instructions provided by our hair transplant surgeon on how to get rid of them.
Stage 2: First Month After FUE Hair Transplant
One month after your FUE hair transplant, you can slowly get back to your normal routine. You can gradually incorporate more physical activities into your daily life. Special care should be taken to avoid direct sunlight for the first 3 months. A hat or a scarf can be used to protect the scalp from UV rays. During this period, you might also experience shedding due to shock-loss. This is a normal part of a FUE hair transplant procedure and the hairs should start growing a few months down the line.
It is essential to take the medication prescribed and provided by our hair specialist to ensure proper healing and promote optimal hair growth.
Stage 3: 2-3 Months After FUE Hair Transplant
As you get to the 4th month after a FUE hair transplant procedure, you will notice a drastic change in your appearance. The newly transplanted hair will start to grow. While hair growth can be patchy and thin in the beginning, the hair will get thicker and denser over the next few months. The hairline will become more apparent bringing you closer to the final outcome of the hair transplant procedure.
Stage 4: 3-12 Months After FUE Hair Transplant
In most cases, it takes around a year to see the full results of a FUE hair transplantation. As your hair gets thicker and denser, you can now start experimenting with different hairstyles until you find the one that suits you best. It’s important to note that this timeline can vary from patient to patient based on their specific characteristics such as hair type, skin structure, lifestyle, diet, etc.
In certain cases, it can even take 18 months for the hair transplant results to become apparent. In this stage, the texture of your hair might also change. While at the beginning of hair growth, the texture of the hair might be more rough, it will become smoother and exhibit a more natural texture over time. This marks the completion of your hair transplant journey and you can now enjoy your new look and renewed sense of confidence.
It is vital to stay in touch with our hair transplant surgeon and your patient coordinator throughout to ensure a smooth recovery process.
Shaving the head for Follicular Unit Extraction hair transplantation is not always necessary depending on the extent of the operation, the areas to be treated, the number of grafts, etc. Our hair transplant surgeons prefer to shave the head completely for easy access and more visibility during the procedure. This allows for the best possible results compared to unshaven FUE which is more time and labor-intensive.
In other cases, our doctors can offer partial shaving or unshaven FUE hair transplants to suit the needs and preferences of the patient.
Hair loss in women can be caused due to several factors such as hormonal imbalances, female pattern baldness, traction alopecia, medical conditions such as PCOS, etc. Women can also undergo a Follicular Unit Extraction hair transplant to address hair loss and thinning.
However, women are more prone to diffuse hair thinning which requires a customized approach to address the issue. The availability of donor hair in women also differs from that in men impacting the success of the hair transplant. Consulting our dermatologist is essential to determine whether they are a suitable candidate for a female hair transplant.
The cost of Follicular Unit Extraction hair transplant can vary based on different factors such as the skill and expertise of the surgeon, the reputation of the hair transplant clinic, the number of grafts harvested, the technique used, etc. Some clinics also offer all-inclusive packages to provide patients with a stress-free, hassle-free experience.
At Civas Hair Transplant, our prices vary from €3000 – €8000. Please check our price page for more details on the packages and the services provided by our clinic.
Civas Hair Transplant Clinic is one of the best hair transplant clinics with two expert dermatologists specialized in hair loss treatments and hair transplant procedures. It is important to note that the most crucial parts of hair transplant procedures are performed by doctors at our clinic. We believe that our experienced doctors and their scientific approach, years of research, and academic knowledge enable us to get amazing results.
Dr. Civas and Dr. Akpınar, two of the best hair transplant surgeons both recommend Custom Special Steel Blade Follicular Unit Extraction hair transplant technique. This technique has been developed by Dr. Civas and produces the most natural-looking results.
Incisions are made in the recipient area using special steel slits or scalpels that come in different sizes. One of the benefits of this technique is that the different sizes can be adapted to the thickness and diameter of the grafts. Smaller sizes of blades can be used for incisions on the hairline, where 1 FUs will be implanted. Larger sizes of blades can be used for other areas where doubles and triples will be implanted. This also allows them to place the grafts closer to one another resulting in a denser coverage and more natural appearance.
Additionally, using the Custom Special Steel Blade FUE hair transplant method, the depth at which the grafts will be implanted can be adjusted according to the needs of the patients. Blades are changed after every 150-200 incisions, resulting in a sharper and smoother channel opening process.
At our clinic, our doctors prefer using mostly coronal and sometimes sagittal channels. The coronal incisions result in a fuller, and the illusion of a denser look. With this special hair restoration technique, we can achieve higher density using a limited number of grafts.
Contact Civas Hair Transplant today to solve your hair loss problems using the hair transplant technique best suited to you and your needs. Fill out the contact form below and we will get back to you.
The aftercare following a FUE hair transplant procedure is as important as the surgery itself. Please follow the guidelines below to ensure proper healing and promote hair growth.
Do’s of FUE Hair Transplant:
Do’s of FUE Hair Transplant:
References
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