Follicular unit extraction (FUE) is a method of graft harvest whereby punches of various types are used to remove follicular units from the donor region one at a time.1 The principal advantages of this technique to patients are chiefly the lack of a linear scar and more rapid healing of the donor region. In general this technique will allow patients to cut their hair to approximately one-fourth inch or less. For physicians, FUE offers a technique for repairing pluggy-appearing or inappropriately placed hairlines and also the ability to harvest  additional grafts in patients who have little or no scalp laxity. Over the past 5 years FUE has gained a degree of popular acceptance by patients such that it is the fastest growing procedure in hair restoration.

There are 2 basic punch types used to perform FUE, sharp and dull tips, and within each category there are manual and powered versions. The sharp dissection techniques typically involve limited depth punch insertion to decrease the risk of follicle transection. The blunt punch dissection technique allows for a deeper level of dissection, thereby decreasing the force required for graft removal.

This article provides the reader an overview of the uses of the FUE procedure with attention paid to donor area management, procedure considerations, and instrumentation.

Consecutive male patients of AGA who underwent hair transplantation by FUE method in two centers between the period of January 2016 and June 2017 have been included in this study based on inclusion and exclusion criteria. Photographic images, trichoscopy and Likert's scale were used to assess patient's improvement in hair density after the transplantation procedure. Statistical methods using SPSS software was used to analyze the results. Institutional ethical clearance and patients' written consent for procedure and images was obtained. The study was an observational retrospective study using data and images from records for which consent and ethical clearance was obtained from patients and the institution.

Because of uncertain hemodynamics in the graft bed, a preliminary surgery with 100 grafts was performed to verify the engraftment of all 100 grafts. Then, 1330 grafts were transplanted in the remaining bald region, producing satisfactory results. As demonstrated in this case, successful hair transplant can be achieved in split-thickness skin grafting sites by paying careful attention to hemodynamics in the recipient site. FUE is minimally invasive with the formation of a small scar in the donor site, and thus is a useful treatment modality for various types of hair loss.

Hair transplantation by follicular extraction method provides good hair cover in AGA in males. This modern dermatosurgical technique with its many innovations is a very helpful technique to improve quality of life in male pattern baldness.

Hair Therapy & Transplantation is an Open Access peer-reviewed publication that discusses current research and advancements in diagnosis and management of kidney disorders as well as related epidemiology, pathophysiology and molecular genetics.

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Anabell Rose

Editorial Assistant

Hair Therapy & Transplantation