FUE – A Few Words about Transplant Methods

The advances in the field of hair transplant over the past 15 years has been incredible. Discovery of follicular units and the ability to microscopically dissect hair into follicular units ensures a completely natural appearing hair transplant. There are two major methods of harvesting hair follicles and we’ll discuss both of these in this article.


By far, the STRIP method is the most established. When using the STRIP method, the hair transplant surgeon takes a thin strip of skin from the sides or back of the head. Using a microscope, a technician then dissects this strip into follicular units, or grafts. The grafts are then placed into the thinning or balding area in small holes. When performed by an experienced and talented surgeon, the results are amazing.

In a very small number of cases, the donor site did not heal well or became widened, leaving a visible area of scarring. A technique to transplant hair into the scar and decrease its visibility was developed. Each hair was individually harvested using a punch biopsy tool. This marked the birth of the follicular unit extraction, or FUE.

FUE (Follicular Unit Extraction)

At its beginnings, FUE was used and designed for cases where only a small number of grafts were needed. The FUE method does not allow the surgeon to see the grafts’ roots until it is removed from the scalp. This results in a high transection rate, where the follicle is damaged and cannot grow. This loss was acceptable as only a few grafts were needed. The small scars left by the FUE method led some physicians to begin promoting it over the STRIP method. There are some important facts about FUE that you should know.

  • While it has been promoted as a “scar-free” surgery, this is false. Many times, the scars are small enough that the hair can be worn short without concern. Each punch leaves a mark, so that repeated surgeries can produce enough scarring to become visible.
  • During repeat procedures, it is difficult to find healthy grafts among the scarring.
  • In some cases, graft failure occurs when using the FUE method. The reasons behind this are not clear at this time.

Recent Technology

There have been some advancements recently in technology that shows some promise. An automated machine is available that harvests follicular units using the FUE method. While introduced as a breakthrough in the field of hair transplant technology, this machine is actually in its seventh generation. While the technology has improved, many transplant surgeons are waiting for some practical results before routinely employing the device.

However, some physicians are beginning to use the machine, without the benefit of years of experience in the field of hair transplants.  This is concerning, since the surgery is delicate and requires a great deal of practice to perform with consistent success.

A good hair transplant is performed by a quality surgeon and a team of highly trained professionals. Your doctor should design your transplant, while planning for future hair loss. Choose a surgeon who can give you the natural look you desire, while preserving as much donor hair as possible.