In the November/December 2016 edition of the Hair Transplant Forum International, Dr. Paul Rose of the Hair Transplant Institute of Miami authored an essay reviewing Follicular Unit Extraction (FUE) – a minimally invasive method of transplanting individual hair follicles for natural-looking results. As one of the originators of the FUE procedure, Dr. Rose holds incomparable experience when it comes to method and accuracy.
What is Follicular Unit Extraction (FUE)?
FUE involves harvesting using a circular needle called a “punch.” Follicular units are removed from the donor area with a 0.8-1-millimeter circular tool in a scattered pattern to eliminate the linear scar associated with traditional donor strip harvesting. Because scars are tiny and dot-like in appearance, patients who undergo an FUE hair transplant have the freedom to wear shorter hairstyles post-operation.
Dr. Rose’s FUE Analysis
In his article, Dr. Rose discusses FUE and the potential for wounding and thinning at the donor site when a large portion (40 to 50 percent) of follicles are extracted at once. Ideally, physicians harvest one out of every seven units to maintain density. Based on this pattern, the average scalp containing 13,000 to 16,000 units would only be 14 percent harvested, or 1,800 to 2,200 grafts total. He points out that harvesting large quantities of follicular units makes transplants more apparent – the opposite intention behind the procedure itself. It’s safe to assume that surgeons reporting as many as 6,000 FUE grafts are creating areas of baldness greater than 6mm2 – eliminating the possibility for shorter haircuts without obvious thinning. In addition, many patients lack three to four hair units, raising the risk for obvious thinning at the donor site when too many units are removed.
Dr. Rose recommends that patients should be advised of the potential for this thinning at the donor site prior to surgery. Follicular Isolation Technique (FIT) uses partial follicular unit removal to curtail further thinning. Finally, Dr. Rose recommends micro-pigmentation to disguise thinning at the donor site. In an ideal world, devices that decrease wound size could minimize donor wound concerns.
At the Hair Transplant Institute of Miami, we utilize the ARTAS® physician-guided machine – the most advanced method of harvesting hair from the back of the head. In addition, our Mosaic® hair restoration technique, developed by Dr. Rose and Dr. Nusbaum, mimics personalized follicular patterns for optimal results.