FUE Hair Transplant FAQ

Patients that are interested in having a hair transplant have many questions such as:

What is FUE (Follicular Unit Extraction or Follicular Unit Excision)?
How is the procedure performed?
How long do the final results last?

We have compiled a FUE hair transplant FAQ in the hopes of further clarifying the procedure.

How does FUE work?
FUE, also known as Follicular Unit Extraction OR Follicular Unit Excision, is a hair transplant procedure in which the hair follicles or hair follicular units are individually removed from the donor area one by one. The follicles naturally occur in groups of 1-4 hairs in the donor area of the scalp. FUE can be performed by a manual, motorized or automated method depending on the individual patient. The excision method utilized varies based on the characteristics of the hair follicles such as hair shaft thickness, curliness, exit angle, etc.

What are the advantages of FUE?

Significantly less post-op discomfort or pain.
No linear scar.
Surgical wounds that are much smaller and less obvious and only require days to heal.
Individual hair follicle harvesting allows for donor hair to be extracted from areas that have been impossible to harvest using the more traditional methods such as zones located on the sides of the scalp as well as the beard or body.
Extraction of hair from dense donor areas of the scalp and redistributing those hairs to the balding areas in order to minimize the contrast of balding and donor areas. This strategic extraction allows for a more even appearance of hair in donor areas that minimizes the appearance of balding.

What are the disadvantages of FUE?

FUE is limited by the number of grafts which can be extracted/placed in a single day. In some cases, a 2 day mega-session may be scheduled.
FUE is more operator dependent and good hand-eye coordination is required in both extraction and placement of grafts.
FUE grafts are more delicate and special care is needed while handling and implanting them. Mohebi Implanter (Inserter) has been invented to eliminate the trauma that more traditional placing methods may bring to the grafts.

Does FUE leave a scar?

The method of individually removing the hair units allows them to be harvested one at a time without leaving a linear scalp scar. There will be some small punctate wounds immediately after the procedure in the donor areas. After 2 – 4 days, the wounds will close and the microscopic scars will be difficult or impossible to see.

Ideal candidates for FUE include:

Patients who prefer to wear their hair in a shorter style since FUE does not result in a linear scar
Patients with a small donor area from which to extract hair grafts or those who have a tight scalp
Patients with scarring from a prior FUT procedure may be able to conceal their scar during the second procedure with the option of placing FUE grafts directly into the scar line
Patients who have a limited amount of time set aside before returning to work
Patients who head towards more advanced classes of baldness and are willing to not only restore the balding areas but to also minimize the visibility of the typical horseshoe pattern seen in people with advanced baldness

What is Robotic FUE – ARTAS?

ARTAS Robotic Hair Restoration System

A robotic hair transplant, also known as R-FUE – ARTAS, is a procedure in which donor hair is removed from the back of the scalp through the use of a robotic arm. ARTAS makes use of imaging software and an image-guided robotic arm to harvest the grafts on an individual basis. The robotic system is great for use by beginners or operators that don’t have the manual skills or hand-eye coordination needed in other, more efficient, methods.

After the donor area is marked by the doctor, the patient is placed in a semi-prone position with their face placed in a donut shaped pillow. The dual punch system of the robotic arm allows for easy scoring of the grafts. ARTAS, with its current technology, is handicapped by its inability to extract hair from certain areas of the scalp, beard or body.

How much does FUE cost?
Each case is different with the cost based on a number of factors including the number of grafts needed and the desired final results, in terms of coverage, the patient is hoping to achieve. In general, the total cost of an FUE procedure is more than FUT strip per number of grafts. FUE hair transplant is also based on the technique used. Hair Transplant Cost is higher using the non-shaven or Celebrity Hair Transplant technique.

What is the recovery time after FUE?
Most patients set aside 2 to 7 days after their surgery to recover. While FUE scars usually heal within 2 to 4 days, it may take up to one week for the donor area to have a healed appearance that is free of scabs. Individual results may vary. Keep in mind Parsa Mohebi Hair Restoration offices see patients the day after surgery and two weeks after the procedure. Want to know more about what you should expect after an FUE procedure? Visit our After Hair Transplant Page.

Is FUE painful?

Typically, patients do not have any pain during the procedure and after receiving the location anesthesia. They may report little to no pain after the FUE procedure.

During the FUE procedure, a sedative is given followed by an infiltration of subcutaneous local anesthetic. On rare occasions, patients may experience some pinching or mild discomfort during administration of the local anesthetic.

After the FUE procedure, we provide patients with a mild pain medication such as Tylenol. Many patients end up not using any painkillers after the FUE procedure.

Is FUE painful?

Typically, patients do not have any pain during the procedure and after receiving the location anesthesia. They may report little to no pain after the FUE procedure.

After the FUE procedure, we provide patients with a mild pain medication such as Tylenol. Many patients end up not using any painkillers after the FUE procedure.

How many grafts will be needed?
The number of grafts in an FUE procedure depends on the size of the area to be covered and the desired density. Thick hair and grafts containing larger numbers of 3’s and 4’s give the illusion of a fuller head of hair. Unfortunately, this is genetically predetermined. We review patient goals and possible options before determining the number of required grafts during the initial consultation.

How long do FUE results last?
The results from an FUE transplant procedure will last a lifetime as long as the grafts are selected from the permanent zone where hair is not programmed to go through balding. Furthermore, hormonal changes should not affect the grafts. Some patients might see some thinning of their donor area as they age. In those cases, transplanted hair could go through the same phenomenon. However, this is not true for all patients.

Do FUE results look natural?
When performed by an experienced and skilled hair restoration physician, the final results should be so natural in appearance that others will not be able to tell that the hair was transplanted. To view our most recent before and after hair transplant results, visit our “Before and After” Photo page for our latest results on actual patients.

How long does FUE take?
The length of the procedure depends on the planned number of grafts being transplanted and the type of FUE procedure. In general, the procedure may take between 4 to 10 hours. If there are over 2500 grafts to be transplanted, AKA a mega-session, the surgery will be scheduled over a two day period. Celebrity Hair Transplant could be done without any shaving but it is more time consuming and we generally plan for up to 1500 grafts in each session.

What are the risks and complications of FUE?
Some of the most common complications of FUE include swelling, bruising, itching and pain. There is also the risk of bleeding/oozing as well as numbness of the scalp. One noteworthy risk to mention is “shock loss” which is a post-surgical loss of hair that can be greatly diminished if patients resume/start prescription medication given by the hair transplant surgeon and continue it for a period of 6 months after their surgery. You can find more information about this topic in general at hair transplant complications.

Will the new hair grow right away?
Shortly after undergoing an FUE hair transplant, the new hair will look more like stubble on the head. The transplanted hairs may grow very gradually for 2 to 3 weeks before they enter the resting (telogen) phase. During this phase the hair shafts of most, or all, of the grafts will fall out. The transplanted hair will grow once again as it enters the anagen phase after 2 to 3 months. Once hairs are in the anagen growth phase, they will grow as they normally would.

When will the final results be visible?
Once the transplanted hairs enter the anagen growth phase at 2 to 3 months, the new hair will start as thin and fine hair. Over the course of the next several months, the hair will become longer and thicker. At the 10 to 12 month period, coarse hair will start to become evident with the final results becoming visible about 12 months after FUE. Please note that every individual heals at a different rate and the results vary per patient.

What to know after the procedure?
On the day following the hair transplant, patients can return to our office for instructions on how to properly wash their hair after the procedure. Patients are told to wash their hair twice a day for the first 4 days after the surgery.

Patients are required to sleep in a semi-sitting position, at a 45-degree angle, in order to minimize swelling. Patients will be given a neck pillow to use at night to prevent accidental rubbing or movement of the grafts during sleep. After the 4th day, daily activities can be resumed but strenuous exercise should be avoided for a full week after the transplant.

Patients need to avoid direct sunlight on the grafts/scalp for the next 6 months. Sunblock SPF 30 or greater should be used every half hour when swimming or being out in the sun unprotected. A cap to cover the scalp/grafts will be given to patients after their surgery. More information about this topic can be found at after FUE transplant.

Is FUE the right choice?
The choice about undergoing a hair transplant is a personal decision. However, deciding between the two types of hair transplant procedures largely depends on the final goals of the patient. As FUE is becoming more efficient, more people inquire about FUE for their hair restoration purposes. Issues that play a role in the final decision include how to style the hair, the lifestyle of the patient and the quality of the hair. All of these topics will be discussed during the initial consultation appointment with the doctor. In order to make a more informed decision, take a close look at FUE vs. FUT.

Is there a need for follow-up or revision FUE?
As patients age, they can progress to a higher Norwood class of hair loss with further loss of their native hair. In these cases, patients can return for a second hair transplant to cover the newly balding areas. The previously transplanted hairs are permanent hairs and patients will not lose them. Some patients may need more transplantation to add density and fullness to the previously transplanted area or to make their hairline more solid as we do it in our Power Hairline procedure.