ALL YOU NEED TO KNOW ABOUT FOLLICULAR UNIT EXTRACTION
Hair has always been an integral part of the concept of human beauty. Throughout the years, techniques to maintain retain and even to bring back lost hair has evolved. Hair transplantation is one of the latest techniques to battle baldness. Strip harvesting and Follicular Unit Extraction are two of the different modalities of hair grafting involved in transplantation.
Follicular unit extraction(FUE) or follicular unit separation extraction (FUSE) or Fox or Wood’s technique are various names of a technique of hair grafting developed by Bernstein and Rassman. In FUE, individual hair follicles are extracted by two-step or three-step procedures using 1 mm long needles. The level of finesse and skill required are as high as the results are! With the advent of FUE, scar less grafting has become a real possibility.
The major principle in FUE is based on the fact that the area of attachment of the arrector pili muscle to the follicular unit is the tightest zone in the hair unit. Once this is made loose and separated from the surrounding dermis, the inferior segment can be easily extracted. Also, when individual hair follicles are extracted, the chances of them being cared for are more than when extracted as a bunch, as in strip harvesting.
FUE uses 0.6-0.1 mm long punches or needles to literally scoop out hair follicles and then transplant them onto the recipient site. Single strip method with elliptical excision of a donor has to be done, followed by suturing. The procedure can be two-step or three-step with the use of different instrumentation. Each hair follicle has to be meticulously treated to prevent transection, which if it happens does not allow the graft to be taken up leading to graft failure.
The greatest advantage is that the success rate is pretty high, with minimal scarring. Since each hair unit has to be pulled out slowly and individually, to prevent transection, the technique is much more precise and accurate. Again, scarring is reduced since individual suturing is also done. In other techniques such as strip harvesting method, the probability of having a linear scar in the donor site is very much increased. Since the procedure involves the use of micro-sized needles, the postoperative period is comparatively pain-free.
Disadvantages include the need for high-quality instruments, magnification, lighting and other paraphernalia. As mentioned above, the technique requires great precision, accuracy and finesse. The dermatologist or surgeon needs to be experienced and have the fine hands of a lady to be able to pull it off. Also, the procedure is blind, in that it is not possible to identify the bulge of the hair from outside. As the difficulty level increases so do the cost! FUE is also not suitable for those people unwilling to sport short hair, particularly women.
Hair transplantation surgeries were always considered tough and difficult, but also extremely elegant and sophisticated. With the advent of FUE, hair transplantation has been elevated to the level of minimally invasive surgeries, with reduced post-operative scarring and pain.