Follicular Unit Extraction

An Update on the State of the Art

Most of you, who have researched hair transplantation surgery in the past few years, would likely have come across the term FUE. This is the abbreviation for the donor harvesting technique called Follicular Unit Extraction. We compare this technique to the more conventional and more commonly performed “strip harvesting” method.

These are two very different approaches to donor hair harvesting from the back and sides of the scalp. It is only this harvesting part of the transplantation that differs between FUE and the strip harvesting method. The actual grafting of follicular units into the recipient areas is the same in both. In other words, both approaches result in a Follicular Unit Transplant; sometimes referred to as an FUT. This creates a little potential for confusing the terms, or causing one to believe that an FUE is entirely different from an FUT. Actually, FUE only differs by the method of how the donor follicles are obtained.

While the strip method of harvesting remains the more common method, there can be no denying that FUE continues to gain momentum and popularity as the techniques and equipment to best perform the extractions has become increasingly efficient and sophisticated. These advancements in extraction technology have been coupled with a growing body of experience and expertise amongst a relatively small but growing percentage of hair restoration surgeons.

FUE; when performed by an experienced hair restoration surgeon; generates results comparable to conventional strip methods without the risk of creating a linear donor area scar as residual evidence of the transplant. This is the primary benefit that FUE offers. It may be particularly attractive to the person who desires to wear their hair extremely short in the back, or perhaps has already been wearing their hair shaved or cut very short to “conceal” their hair loss. Often these clients want to reserve the option of wearing their hair short now, or in some foreseeable future.

Although modern day closure techniques make donor area scars of lesser concern, it is true that shaving the head, or wearing the hair very short after strip harvesting may reveal the linear scar cosmetically. Although FUE is technically not “scar less” as some would market it, it is true that the small 1mm extraction sites heal quickly with minimal if any visible scar that quickly and easily heals and blends in with even very shortly cut hair.

For others who don’t wear their hair very short (less than ½”), nor foresee wanting to shave or cut their hair very short in the future, FUE may not offer the same practical advantage. Even a modest amount of donor area hair length easily conceals the great majority of scars, and unacceptable scars can easily be corrected or revised. Still, this fact does not preclude FUE from being an acceptable alternative in just about any situation. There are still many clients who prefer FUE for reasons unrelated to concerns over linear scars that might be made visible with short hair. Some simply prefer not to have an incision, or perhaps have a fear or uneasiness about any kind of traditional “surgery”. These fears may have kept them from the enormous benefits that can be obtained by a hair transplant procedure. For them, FUE is a way past this barrier.

Others still, simply desire to have the latest techniques and the most advanced technology at work in making their hair restoration a reality…….nothing wrong with that.

FUE typically involves a degree of greater cost. However, the “value” of a hair restoration procedure is hard to put any price tag on! It’s something that continues to return year after year; and in both real and intangible ways that are related to self-image, confidence, and one’s sense of return to wholeness.

The engineering and manufacturing of specialized FUE equipment has accelerated the popularity of FUE, while at the same time making this otherwise tedious process easier for both patient and surgeon. The manufacturers of FUE devices have even successfully “branded” the names of their devices onto the procedure itself. The great majority of these “brand named” FUE devices are improvements of the control of hand held devices that still require a very experienced and practiced surgeon to manipulate, and most still require substantially greater time to complete a like number of grafts when compared to the strip method.

I have continued during this time to gain FUE experience with the basic “hand engine”; the fundamental and common part of almost all “branded” FUE devices. I have patiently watched to see if FUE would actually become a viable alternative to strip harvesting. I would say it certainly has.

I have also watched closely to see which FUE technology is poised to step out into the open above and beyond the rest. In my opinion, which has been formed after several years of performing FUE, there is a technology that has emerged as the “future-now” of the FUE transplant, and could possibly be poised to revolutionize the hair transplant industry entirely.

The technology I speak of is robotics. Precision robotic FUE has now an achieved technology that has emerged and has been made available to a very select group of hair surgeons worldwide. Presently there are fewer than 35 robotic units in use in the US. To call it “impressive” would be a gross understatement! It’s more like mind-blowing!

The machine is called the ARTAS Robot, and is manufactured by Restoration Robotics; Inc. This is the same company that engineered and developed the Da Vinci Robot that is now used in hospitals across the nation and worldwide to perform minimally invasive cardiovascular procedures such as heart valve repairs. The technology is rapidly spreading into urological procedures and other general surgeries as well.

ARTAS was developed with a clever foresight of how the hair transplantation procedure, and particularly FUE, could be greatly benefited by robotic technology and the precisions laser guidance systems and robotic motions that cannot be reproduced with the human hand. It is much faster, even as it is also more precise in targeting, spacing, and extracting high quality follicular unit grafts for transplantation.

In my estimation, from first hand, real life observation, ARTAS is the future-now of FUE hair restoration. When the future and now meet each other in time, it’s time to make a move!

For more information about ARTAS, FUE, or to receive a free consultation, please contact The Holt Hair Restoration