Follicular unit extraction (FUE)

The following tables summarize the pros and cons of Follicular Unit Extraction (FUE):

Advantages of FUE

  • No linear scar in donor area
  • Decreased healing time in the donor area
  • No limitations on strenuous exercise after the procedure
  • Less post-op discomfort in the donor area
  • Useful for those with a greater risk of donor scarring
  • Useful for repairing donor scars that cannot be excised
  • Provides an alternative when the scalp is too tight for a strip excision
  • Makes it theoretically possible to harvest non-scalp hair

Disadvantages of FUE

Follicular units in FUE are harvested from a much greater area of the donor zone compared to FUT-

  • In FUT, all the hair is harvested from the mid-portion of the donor area where the hair is most permanent. In FUE, to obtain a sufficient number of grafts, follicular units must also be extracted from the upper and lower portions of the donor region and these may not be as permanent. Therefore, over time, the hair transplanted from these areas to other parts of the scalp may be lost over time, continued thinning in the upper and lower parts of the donor zone may cause the FUE scars to become visible.

    Graft quality is not as good compared to FUT
  • Greater rate of follicular transection (damage to grafts) compared to FUT.
  • Grafts more fragile and subject to trauma during placement, because extracted grafts often lack the protective dermis and fat.
  • Inability to harvest all the hair from the mid-permanent zone results in decreased numbers of grafts.

The scarring and distortion of the donor scalp from FUE makes subsequent FUE sessions more difficult.
In large hair transplant sessions, the entire donor area must be shaved

This may present a significant temporary cosmetic problem for working patients or those in the public eye

  • Capping occurs when the top of the graft pulls off during extraction.
    In Long-term, if the donor area narrows, the FUE scarring may become visible
  • Both FUT and FUE produce donor scarring; FUT, in the form of a line and FUE in the shape of small, round dots. With FUT, the line is placed in the mid-portion of the permanent zone and in FUE the dots are scattered all over the donor area. If a patient becomes extensively bald (i.e. the donor fringe becomes very narrow), the line of FUT will generally still remain hidden, whereas the dots of FUE will be seen above the fringe of hair. In the less likely scenario of the donor hair actually thinning significantly, both the line (of FUT) and the dots (of FUE) may become visible.

Since the extraction process is slower than strip harvesting, large procedures may need to be performed over two days.
FUE is usually more expensive than FUT.