FUE Treatment Process

Hair transplantation has come a long way from the days of Punch Hair Transplant by Dr. Orentreich in the 1950s to Follicular Unit Hair Transplant (FUT) of 1990s and the very current Follicular Unit Extraction (FUE) technique.

 PRINCIPLE OF FUE

In FUE, the extraction of the intact follicular unit is the principle that the area of connection of arrector muscle to the follicular unit is the tightest zone. Once this is made loose and separated from the surrounding dermis, the inferior segment can be extracted easily.

PREREQUISITES FOR DOING FOLLICULAR UNIT EXTRACTION

• Very highly experienced and training of the surgeon
• Excellent lighting in the operation theater
• sufficient intensification for the surgeon and staff
• A Proper understanding of the angle of the hair below the surface of the skin.
• Punch size of 0.6–1.0 mm in diameter. This size is large enough to encompass the width of the follicular unit. Some surgeons have now started using punches of lesser size starting from 0.6 mm.
• Proper motion of the hand: The hand should be perfectly stable while doing the short twisting motion of the punch.
• A back-and-forth movement causes avoidable transaction and is irreconcilable with thriving FUE, as is a 360 degrees rotation of the punch.
• very Sharp punch/blunt punches: sharp punch in two-step technique to minimize
• the amount of twisting needed to cut into the dermis, and blunt punches are used in a three-step technique to decrease the follicular transaction rate.

How does it work?

• During the process, individual follicles – typically between 1 and 4 hairs – are removed under local anesthesia. The extraction procedure utilizes a microsurgical extraction instrument, between 0.6mm and 1.0mm in diameter, to remove the follicles.
• The surgeon, using specialist microsurgical needles, then punctures the scalp area that is to receive the grafts.

    How long does it take?

• The total time taken for the FUE procedure can vary, but it usually depends on how many grafts are needed. A smaller procedure, where only around 200 grafts are needed, can be completed in a couple of hours. However, a larger procedure of around 2,500 to 3,000 grafts will require a session that stretches over two days.
• On the day of surgery, the entire donor area from the back of the head is trimmed to 1–2 mm length. The patient lies in the prone position on the operating table. Local anesthesia with Xylocaine, 1% diluted with saline, is administered slowly over the entire donor area.
• The grafts are then extracted from the donor area with the help of 0.8 and 1 mm special microbunches. The extraction of follicles is done under 2.5 – 5× magnification.
• Step 1: With the sharp side of the micro punch, scoring of the scalp skin containing follicular unit is done.
• Step 2: Then blunt side of the punch is introduced in the same area and is twisted to loosen the follicular unit. At the same time the doctor applies counter traction to facilitate the penetration of the punch into the dermis.
• Step 3: The doctor gently takes out the graft with the help of forceps. The extracted grafts are then preserved in saline or cool Ringer’s lactate solution.
• The extracted graft may consist of 1 to 4 or rarely even 5 or 6 hairs. This is the most time consuming and tedious part of the whole procedure. After the extraction is over, the grafts are implanted in a similar way as in the rest of FUT.