Follicular unit extraction (FUE) is a method of hair restoration often used to correct male and female pattern baldness, and it can also address hair loss associated with many other conditions. You may have heard it’s necessary to shave your head before getting this procedure, but now it’s possible to perform the surgery with little to no shaving, using a No-shave technique.
How does FUE Hair Transplantation Work?
FUE uses the back and sides of your own scalp as a “donor” site from which grafts, each containing one, two, three, and sometimes even four healthy hair follicles, are extracted one at a time. These grafts are removed with a small punch tool, leaving tiny holes at extraction sites that typically heal up as barely if at all perceptible tiny dot scars. While usually obtained from the areas of the scalp where the hairs are permanent, hairs for transplanting can also be obtained from the beard, chest and back with a technique called BHT (or Body Hair Transplantation). These grafts are then placed into tiny recipient sites made in the areas where hair is desired.
To Shave or Not to Shave?
One hesitation for having the FUE procedure to correct hair loss is because the patient, usually a male, does not want to the back and sides of his head- the standard approach. However, using the No-Shave technique, it is actually possible to leave most of the hairs on the back and sides of the head their normal length, so that just the hairs that are extracted are trimmed short. The result- the patient has no signs of having had any procedure the very next day, as the existing hairs simply create a normal full head-of-hair look.
The No-Shave technique is not offered by most hair transplant surgeons as it requires a carefully trained team to work around the existing longer hairs, plus takes somewhat longer to perform. In addition, FUE cases performed by the robot cannot be done by the No-Shave technique, for the robot requires all the hairs to be shaved.
Robot Hair Transplants?
A consideration when it comes to using a robot for a hair transplant- or for that matter, any surgery such as prostate surgery- are the findings from a landmark article that appeared in the prestigious British medical journal “The Lancet” (Volume 388, No. 10049, September 10, 2016). The conclusion of the article: “We encourage patients to choose an experienced surgeon they trust and with whom they have rapport, rather than a specific surgical approach”. In fact, the single most important step in a hair transplant is the design of the restoration and the making of recipient sites- the aesthetic components that determine a natural result.
Preparing for Your Procedure
If you decide to have an FUE transplant to restore lost hair- or for restoring thin eyebrows or beards- talk with your transplant surgeon before the procedure if you need to stop taking certain medications so that there are no complications, and for all the other recommendations to assure you have the best healing. Also be ready, in cases of male pattern hair loss particularly in a patient less than 40 years old, to consider adjuvant medical therapy to help slow down the progressive balding process.
A successful FUE transplant requires a skilled and experienced surgeon, which includes the ability to obtain the best possible grafts with or without shaving of the head, the obtaining as needed of body hairs, and most importantly the know-how to design an appropriate hairline/restoration. Be discerning when searching for a surgeon to perform the procedure, and always ask for before and after pictures to assess patient outcomes before making your final choice.