FUE Hair Transplant

FUE, or follicular unit extraction, now popularly known as follicular transfer (FT), is an advanced hair transplant surgery technique. It involves taking individual hair follicles from the scalp and implanting them in the area where the bald patch is present. This technique was invented to replace the follicular unit transplantation or FUT technique. It has become very popular in the last decades, and many people prefer this method for hair transplantation over others.

With age, the hair growth cycle of the person is affected. The follicles can no longer regrow hair. Thus, the old follicles are replaced with new follicles that still possess the ability to grow hair. Once the newly implanted hair follicles get ample blood flow, new hair will start to grow in the area where hair is thin or not growing at all.

What happens in FUE?

FUE hair transplant surgery is performed in the following steps-

The back of the scalp or donor area is prepped, and local anesthesia is administered to numb the region.
There are various methods available for the extraction of the graft. The chosen method will differ based on the availability of the instruments and the surgeon’s skills.
Typically, a punch device or 3rd generation micromotor is used to extract the grafts one by one.
Around 0.6 to 0.9 mm punch grafts are extracted from the scalp.
Each graft is examined carefully under magnification by a technician and then separated. Only good grafts are used for transplants.
Once the extraction is complete, the surgeon prepares the recipient area considering the patient’s expectations and the donor area’s limitations.
The surgeon decides the angle at which the hair will be implanted, its direction, and the density to give the best results.
Forceps or implanters are used to insert the grafts into the scalp. In most cases, the doctor first creates a pocket for each graft and then places the graft carefully.
After implantation is complete, the recipient and donor area are again sterilized, and a bandage is placed around the donor area.
The recipient area is left open, and the patient is given proper instructions to care for the grafts.

As FUE hair transplant surgery is a daycare procedure, the patient is discharged on the same day.

Side Effects of FUE Hair Transplant

The following side effects can occur after getting FUE hair transplant-

Both the donor and recipient areas will be numb and sore for 1-2 days after the surgery.
The head will swell for 2-3 days after the procedure. The swelling may persist for 2 to 5 days at least.
Shock loss may happen, which will result in losing hair, but it is natural.
The scalp may itch, especially when scabs start to form.
Redness may be present in the donor area for a month. It will go away once the new hair starts to grow.
Folliculitis or small pimples may start to form in the hair follicles if they become inflamed.

How to prepare for FUE?

The preparation for the FUE hair transplant usually begins a week before the surgery is planned. You will be given the following instructions-

Stop taking aspirin and other blood-thinning medicines a week before the surgery.
Avoid drinking alcohol and smoking completely.
Get a complete blood panel test to examine the coagulation profile, RFT, LFT, ABsAg, FBS, and other components.
Drink 1 liter of fluids the day before surgery and try to get a good sleep.
Trim your hair as suggested by the doctor.
On the day of surgery, take a proper head bath with a gentle shampoo. Avoid using hair sprays, gel, or any other styling products.
Wear loose and comfortable clothes as you will be sitting in the clinic or hospital for 4-8 hours approximately.
Take a meal before the surgery. It is best to have a light breakfast and other meals of the day as usual.
Avoid bringing any valuables to the clinic or hospital, as they will be removed.
If the doctor has prescribed some medications, especially antibiotics, take them as directed.

What to expect after FUE?

Immediately after the surgery, you can expect to have tenderness and mild pain in the head. There will be bandages over the scalp for 1-2 days. You can return to work after 4-5 days if you feel fine. In 2-3 days, you may notice that the donor and recipient area is swollen and bruised, which is completely normal. This will resolve on its own in the next few days.

Within 2-3 weeks, the transplanted hair will start to fall out, and you will notice new growth only after 1-2 months. The hair growth usually takes 6 to 9 months to reach 60%. The doctor may prescribe some medications, such as minoxidil, for faster hair growth.

Who is the ideal candidate for a FUE hair transplant?

A person is considered an ideal candidate for FUE hair transplant when the following indications are present-

The patient wishes to keep his/her hair short, which means that a thin linear scar is not acceptable.
If the patient requests for FUE procedure and has enough grafts that can be harvested to meet his/her needs.
Patients who have limited hair loss and require only small sessions.
The patient has inadequate laxity (or the skin is too tight) to excise a strip.
If the patient has tried FUT hair transplant and the existing scar makes it difficult to create another strip.
The patient who is prone to thickened linear scars or wide scars.

Benefits of FUE

The FUE hair transplant technique is beneficial for patients in various aspects.

Minimal Scarring- FUE involves taking individual follicles from the scalp. So, instead of leaving a linear scar across the scalp like FUT, FUE will cause tiny circular scarring that will be undetectable.
Quick Healing– The smaller the wound is, the quicker it’ll heal. As the punch blade makes a small hole less than 1 mm in diameter, the skin heals quickly. Instead of taking 2-4 weeks, the skin will heal within the first week.
No Stitches-The punched hole is so small that it doesn’t require stitches at all. The wound will be left open to heal on its own.
Yield Superior Results– FUE technique is minimally invasive and allows the surgeon to harvest healthy follicles precisely. The survival rate of grafts taken through FUE is above 90%. Thus, the hair quality is maintained, and the results are better than other techniques.
Less Pain & Discomfort After Surgery- The level of discomfort in FUE transplant is minimal. As the technique is not intrusive, the damage to the scalp is less. You won’t have to worry about tearing the stitches or creating tension on your head.
Faster Recovery– Being a minimally invasive surgery, FUE transplant allows the patient to recover quickly. There will be less downtime, and it will be easier for the patient to resume daily activities.
Boost Confidence– Losing hair can have a negative impact on an individual’s confidence and self-esteem. Restoring the hair also restores the person’s confidence and improves his/her emotional state.

Dos & Don’ts After FUE

Dos

Use your pillows to lift your upper body and sleep in an elevated position. This is important to ensure that the grafts don’t get dislodged.
Once the bandages are removed, wash your hair with warm water carefully. Be gentle until the scalp has healed properly.
Wait for at least 10 days before resuming your normal routine.
Give your body enough time to rest and heal.
Eat a healthy and balanced diet to promote healing and keep the hair in good condition.
Take proper follow-ups with the doctor to ensure that the grafted hair is healthy and the skin is healing properly.

Don’ts

Do not rub or scratch your head until the wound heals.
Avoid drinking alcohol entirely, as it can act as a blood thinner and affect the healing process.
Do not indulge in sexual intercourse for 3-5 days, at least after the FUE transplant.
Do not exercise or engage in strenuous activities.
Avoid direct sun exposure and if you are going out, apply sunscreen for protection.
Do not smoke for at least a month to get the best results.
Avoid wearing a helmet, cap, etc., or covering your head with anything for 4 weeks.
Do not use chemical products on the scalp until allowed by the doctor.

Recovery Timeline

The recovery after an FUE hair transplant is short and quick.

In the first few days, the head will be swollen and bruised, and you will feel discomfort. The doctor will prescribe antibiotics and pain medications to ease your pain.
In the next 3-5 days, scabs will start to form over the grafts. Make sure that you don’t scratch them off. Allow the scabs to fall off on their own.
In 7 days, the donor area will be almost completely healed. Some itching may also be present, which will disappear gradually.
Within 2-3 weeks, you can start shampooing your hair like normal. If scabs are still present, you can be a little aggressive in removing them, as the scalp will be soft during the wash.
In the next 2-3 months, the hair will first fall off and then start to grow naturally.
In 4-6 months, the growth will continue, and the hair quality will improve. The hair will look thicker and gain length as well.
After 6 months, you can start styling your hair as they continue to grow.

It will take around 12 to 18 months for your hair to regain complete strength and quality. Make sure that you follow the doctor’s instructions carefully throughout this period.