Follicular Unit Extraction

Follicular unit extraction – FUE Hair Transplant Delhi, India is a relatively popular procedure for hair transplant in Delhi, India. This technique involves individual extraction of follicular units or grafts rather than the entire strip. This is useful in patients who keep short hair and do not want the scar to be visible in the head.

The process involves individual extraction of hair grafts from the donor area using very fine instruments and punches. This technique does not leave a linear scar in the donor area, only small dots at the back. The disadvantage is the requirement for shaving the entire head for this procedure

Follicular unit extraction (FUE) is increasingly becoming more popular with patients and treating doctors alike for management of hair loss. Some of the reasons for this are:

1. Absence of cut and stitches at the back
2. The doctor need not be a plastic surgeon, even lesser trained doctors like dermatologists, MBBS doctors, dentists and even untrained technicians can learn how to do this and in fact a vast majority of such treatments are being done by technicians who are being hired by untrained doctors.
3.  Perceived improved healing and lesser pain in recovery.

However its gaining ground in terms of number of cases vs. FUT does not indicate that it is a better technique. There are many intricate details that need to be understood to understand the process of hair transplant and as a patient, decide on the technique and the clinic.

MODIFICATIONS OF THE FUE PROCESS INCLUDE:

1.  Manual using hand punches – the conventional technique using manual pencil type punches. This is a slower technique though there is a precise control of the depth of the punch made. Slowly being discarded by most people.
2.  Manual using electric drill – the preferred technique at Divine Cosmetic Surgery. Use of electric drills , with disposable punches of 0.6-1.2mm used. Fast and in experienced hands very precise. We at Divine Cosmetic Surgery can harvest 1400-1600 grafts per hour with this technique.
3.  DHI type process – very similar in terms of extraction to the above mentioned technique, uses implanters similar to Choi implanters to implant the grafts. We believe this technique cannot give the high density achieved without implanters. We have discarded the use of this technique.
4.  Neo – graft (SAFER) – French based machine. Very expensive, and in our opinion , does not have the cost benefit ratio. The punches that need to be used are larger to achieve the suction pressure. If fine punches are used, the suction simply does not work, thus making the process prone to more scarring. Further the collection of the grafts in a canister makes the grafts more prone to drying up, sometimes grafts get lodged in the suction itself, causing damage. It is good for clinics which primarily hire technicians and the doctor himself has no training or experience to do a hair transplant.
5.  ARTAS – a state of the art purely robotic device, expensive, very very expensive. Unlikely to make an entry to India too soon.

ADVANTAGES

1.  Strip is not removed thus leaving no scar.
2.  More comfortable in the initial post op period.
3.  Very useful for small sessions, touch up procedures, eyebrow, hair line procedures.

DISADVANTAGES

1. Lesser number of grafts can be done in one session and a maximum of 1400-1600 grafts (equivalent of 4000 follicles) can be done. If requirement is more, then the next session will be performed after 3 months.
2. There is about 10 percent wastage of grafts since this is a relatively blind procedure of extraction.
3. The hair per graft yield is a little less than in the strip procedure due to transection of some roots in the FUE hair transplant procedure.

The result in both the hair transplant techniques are almost the same, there is almost no difference in terms of density, distribution and appearance after a hair transplant in the 2 techniques.

SUMMARY

FUE is an excellent technique, however the treating doctor must appreciate the short comings. Patients must assure themselves that the doctor is trained to carry out the procedure, and the procedure is not being done by technicians. FUE is not indicated in very curly, thin and thin curly hair forms. It is an excellent idea to combine FUE with FUT in redo cases and in megasessions.