What is “Follicular Unit Extraction” or “FUE”?

FUE is a relatively new technique whereby individual 1-3 haired follicular unit grafts are removed from the donor area at the back of the scalp, 1 at a
time, using very small 1.0 mm circular punches. The benefit of this technique is that the traditional scalpel used in taking out a donor strip
is not used. The resulting hole when a 1mm punch is used is so small that the hole does not need to be sutured and will heal with a very small scar.
Some physicians market this procedure as , ‘Scalpel – less and scar less’. This is misleading since a scalpel is used, not a straight linear scalpel as
is used in the more traditional strip excision method, but a circular scalpel (biopsy punch), in stead. The skin is still cut and a scar is still
made. It is just a very small scar. To be fair, the scar from the traditional scalpel is also very small, if done properly. A benefit of FUE
is that there is the possibility of shaving the hair on the scalp right off, if the patient wants a shaved head at some future time. However a very big
downside is that in young men with ongoing male pattern hair loss or in men with pre-existing male pattern hair loss, in order to get enough hair using
the FUE technique thousands of holes need to be removed from the back of the scalp, the procedure can take 1-3 days, and the entire back of the scalp
needs to be shaved. If a patient requires 1, 2 or 3 large sessions requiring 1000 – 2000 follicular unit grafts per session , then as one can imagine,
the back of the scalp will begin to look very moth eaten, and scars will most likely be seen when the hair is shaved.

Dr Cotterill’s opinion of FUE is that it is a very nice technique to be offered in certain select circumstances. But FUE is not appropriate for full, large sessions.

Dr. Cotterill will offer this technique, in addition to the traditional strip excision technique, in the following circumstances:

• If a patient requires a very small session such as to fill in a scalp scar or to fill in an eyebrow, and the patient does not like the idea of a linear ( straight ) scar in the donor area.
• If a patient requires only one, very small session and wants to be able to shave their hair right down to the scalp.
• If a patient has had extensive procedures in the past, and has only very limited donor area left and requires a very small session to the scalp.
• If a patient requires a very small session, has limited donor hair, and wants to use hair from another part of the body, such as the chest.

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