FUE stands for Follicular Unit Extraction and transplantation. The hair follicles come in strands of one, two, three or four hair units that are rooted together. At SpaMedica we have specialized machines to extract healthy units of hair follicles which are grafted and implanted on the bald sites.
Before and After Gallery
Length of Procedure
Good candidates for FUE hair restoration are those individuals that desire no linear scar at the back of their scalp and have either genetic hair loss or a post-traumatic hair loss. Good candidates should also have realistic vision and expectation for the procedure. Candidates can include both male and female who are experience patterned-baldness and hair thinning. Patients who seek hair transplant are advised to wait until they are 25 when the hair patterns are more predictable.
What is FUE Hair Transplantation?
FUE hair transplantation is an acronym that stands for Follicular Unit Extraction and transplantation. The word follicular unit comes from the embryological way that hair actually grows. The natural pattern of hair on your scalp is in what are called follicular units.
A follicular unit is the genetically determined way that a hair shaft grows in relation to its bulb or root. The follicular units can be harvested in singles, doubles, triplets and quadruplets which are rooted together in a single bulb unit. Harvesting the extracted follicles itself ensures that genetically related hair families stay and grow together leading a potentially more natural, wavy, growth pattern when transplanted.
The most advanced and modern way to undergo this hair transplant is to harvest the hair from the preferred donor site at the back of the scalp, with a FUE technique that is automated and robotic. Robotic FUE harvest technologies, called Artas® Hair Transplant and Automated FUE hair transplant technologies, NeoGraft® Hair Transplant, are the fastest, most accurate and efficacious way to harvest hair without a linear scar. Thus, FUE hair transplantation is quite different than the commonly chosen alternative, the older and more traditional strip graft technique.
Patients can expect to spend the entire day at surgical centre undergoing their hair transplant procedure. We recommend you bring your own iPod and earbuds for auditory entertainment.
The FUE hair transplantation procedure is divided into two parts. The first part of the day involves extraction from the back of your scalp, an area called the occiput and the temporal regions. This part of the procedure takes approximately four hours, depending on the number of FUE grafts that are required to establish and restore the hairline and hair density to your desired levels. During this procedure, you are comfortably semi-reclined in a massage chair, similar to the type of chair you might see at an airport massage centre.
Following the Artas robotic harvest of your 4, 3 and large 2-hair follicular units, you then lie completely flat on your stomach on a massage bed with your face resting comfortably inside the doughnut while the NeoGraft automated FUE hair transplant system is used to harvest the more delicate small single-hair follicular units and double-hair follicular units that are going to be used for your frontal hairline restoration.
The SpaMedica FUE hair transplantation technique deploys what is called a “stick-and-place”, a methodology perfected at SpaMedica using automated FUE, resulting in the densest, most natural-looking hair that you can achieve. In the stick-and-place technique, a small hypodermic needle creates a small slit between your recipient hair, or along the balding frontal hairline, and as the needle is removed, the graft is inserted. This FUE transplantation process takes approximately 2-4.5 hours, depending on the number of grafts that need to be placed.
Thus, when planning an FUE hair restoration day at SpaMedica, using the Artas robotic and NeoGraft automated FUE extraction and automated implantation techniques, one should plan for an 8-10 hour day, depending on the number of grafts needed and placed.
Contraindications for FUE Hair Restoration and Transplantation
A few of the absolute contraindications to Follicular Unit Extraction hair transplantation would include autoimmune or inflammatory conditions that led to the hair loss as well as patients who are unrealistic or individuals who may be pregnant at the time of the procedure or have open sores, lesions or cancerous growths in either the donor site or the recipient site.
The SpaMedica FUE hair transplantation procedure using the NeoGraft automated and Artas robotic FUE extraction hair transplantation systems are completely painless, once the local anesthesia is injected. The injection of local anesthesia naturally comes with some mild to modest discomfort, but a non-steroidal anti-inflammatory and oral relaxation medication is given prior to the procedure (one of the reasons you come early) will induce and facilitate a relaxed state for the FUE hair transplantation and will also minimize inflammation and discomfort.
The initial recovery following FUE hair transplantation involves the first two to three days. During these two to three days, a soft dressing is used to cover the very tiny 0.9 to 1.2-millimetre donor site extraction holes at the back of the scalp. This dressing is in the form of a wrap that goes around the front of the forehead, securing the bandage over the back. It is important to note again, there is no cutting, scalp or sutures used during this procedure. The transplanted hairs at the top of the head are left open to the air. During this period of the recovery, you return the following day to have your wrap removed and a new dressing applied. One or two days following that, the dressing is removed once again and this time it is left off (usually by day 3). At this point, you’ll be shown how to gently wash and shampoo both the donor site and recipient site. By the third day, you can start to wear a baseball hat; however, it is important that this baseball hat only contacts in the back of the scalp and just above your eyebrows, but there is no fabric touching the actual transplanted hairs. The transplanted follicular units, if traumatized or touched by the fabric of a baseball cap, could become dislodged, fall out or die.
The second part of the recovery occurs between days 3-12. During this next 7-10 days, the stubble at the back of your scalp, where the follicular units were harvested, grows out to the point where you can no longer see the tiny 0.9 and 1.2- millimeter holes at the back of your head. At this point, if you have relatively long hair at the front and sides of your scalp where the hair restoration was performed, you will not need to wear a baseball cap, as the moderately long hair you have at the front, temporal and mid-scalp will hide the transplanted hairs. However, if you have short hair at the front and side, you may need to wait two weeks following the transplantation until all the scabs have fallen off until you’re able to return to work.
Most patients are able to return to work in 7-12 days, depending upon the nature of their job. Thus, if you are a male and you wear your hair fairly short, it is important to schedule a vacation of ten to twelve days following your transplantation session till you return back to work. If you are a male with male-pattern hair loss that wears their hair relatively long at the front and temporal areas of their scalp, or a female with long but thinning hair at the front and very long hair at the back, generally one can return to work within 7 days.
Once you have returned to work after two weeks, hair transplantation patients will experience 2 phase growth of FUE transplanted hair. It is important to note, that all patients are instructed to be patient and wait approximately 12-14 months until the full density and thickness of the hair restoration can be judged.
In those twelve to fourteen months following your FUE transplantation, you will notice a two-phase growth pattern.
- The first-phase growth occurs with those transplanted hair shafts that do not undergo a “shock hair” effect and just start growing almost immediately. Patients can expect that approximately 50% of their transplanted hair shafts, on average, will start growing within 3-4 weeks following the transplant and will become quite long within the first six months. For the other 50% of the transplanted follicular unit grafts, the hair shaft will often fall out along with the scab in the first 14 days. However, do not fear that the graft has died, because the hair bulb has survived and is still inside the scalp alive and well.
- Second-phase growth then occurs at 4-6 months where you feel another diffuse layer of stubble starting to grow. The second-phase growth takes another six months to get long, thick and dense. Thus, it is at 12-14 months, that the final result of your SpaMedica FUE hair transplantation can be judged.
At SpaMedica, you can expect the highest possible FUE graft transplantation survival rates, the lowest possible transaction rates and the lowest incidence of shock hair (telogen effluvium). Because the FUE hair restoration grafts are extracted from the preferred site at the back and sides of your scalp, and these are areas of your scalp that you are genetically programmed to never lose hair, the results of your FUE hair restoration are permanent and lifelong.
Patients are generally extremely happy with the results of their Artas and NeoGraft robotic and automated hair transplantation procedures. Our patients are well-selected and realistic, achieving over 85% FUE graft survival rate, less than 4% transection rate and a very natural hair design that they are able to customize with the help of Dr. Mulholland.
Dr. Mulholland during your consultation will outline a program of potential hair restoration treatments that may be performed over 10-20 years that you may require from ongoing genetic hair loss.
There is no specific maintenance required following your FUE hair transplant. Over 85% of the FUE grafts will survive and less than 4% of the FUE extractions are transected. By 12-14 months, you’ll get a nice hair growth and the hair that has been transplanted will grow permanently, as it has been extracted from the preferred sites at the back and side of your scalp that are guaranteed never to fall out.
However, you may require more hair as some of your genetic hair on the top of your head thins and falls out. This is not maintenance, but simply re-densification therapy depending on your genetic needs. At SpaMedica, Dr. Mulholland understands that multiple sessions may or may not be required over the course of your life and he will always design the type of hairline and densification approach that could be sustained and maintained throughout your life.
Patients come back multiple times for more FUE hair transplants as need. In general, up 10-15% of the donor site can be harvested at the back of the head in a single session, which usually means 3000-4000 follicular units. Over time, up to 50-60% of the donor follicular units at the back and sides of the scalp can be harvested and transplanted without the hair at the back of your head looking thin. This translates into 10-12,000 grafts that can be harvested and made available over time, to ensure your transplanted hair looks natural and thick.
You can safely go back into the same donor site at the back of the scalp after three months. Wait 12-14 months to go into the same recipient site (to avoid inadvertent trauma to un-expressed transplanted bulbs), but other recipient sites can be implanted 3 months after the one before.
There are other surgical options to Follicular Unit Extraction hair transplantation. As discussed, the strip graft procedure is still commonly performed, but the strip graft and other surgical techniques have more aesthetic and functional disadvantages compared to the FUE method. There are some non-surgical techniques that can be deployed, including topical minoxidil, topical growth factors and nutrients, as well as high-fluence, low-level light therapy and nutrient shampoos.
The SpaMedica non-surgical hair restoration program can be a popular place to start treatment for some patients, particularly young women and men, who often benefit from the SpaMedica combination program of laser therapy, topical growth factors, high dose, safe and effective 15% minoxidil serum and medicated shampoo. This non surgical hair restoration program uses a combination approach to non-surgical hair restoration as part of the SpaMedica postoperative FUE hair transplantation program and begins approximately two weeks following your hair transplantation.
Some individuals, particularly female patients, elect to start with SpaMedica’s non-surgical hair restoration program consisting of a home program of topical minoxidil, topical nutrient shampoo and six months of high-fluence, low-level light therapy, performed once or twice per week in the SpaMedica Yorkville clinic. This non-surgical hair restoration program is often quite successful in bringing back more diffuse densification for early female-pattern hair loss and also quite successful in male-pattern hair loss at bringing more hair into the anagen, or growth, phase from the sleeping phase, particularly in the male crown.
It is important to note that, there is very little that non-surgical procedures can do to stop the progression of your genetic condition or thinning hair. Propecia, also called Proscar® or Finasteride, is an androgen-blocking, oral medication that can significantly slow male-pattern hair loss, but care should be taken in having this prescribed, as some patients may be at risk for a higher incidence of aggressive prostate cancer.
Cost and Payments Options
The cost of your hair restoration and transplantation depends on the number of hair grafts for the follicular unit takes place.
The range in Follicular Unit Extraction hair restoration fees is as low as $5,999 for 500 follicular unit extractions to $12,999 for 3,000 FUE graft hair transplantation sessions. At SpaMedica, the cost also includes the postoperative, high-fluence, low-level light therapy and nutrient shampoo.