Follicular Unit Extraction (FUE) hair transplant is one of the common techniques of hair transplant used in Singapore and throughout the world. It involves the extraction of many individual follicular unit grafts from healthy areas of the scalp, and transplanting them into areas experiencing hair loss. It is different from Follicular Unit Transplantation (FUT), where an infact, very thin strip of the scalp containing healthy follicles is incised from the donor area (Usually at the back of the head) before being cut into individual grafts and planted.
In comparison, FUE hair transplant is more modern, and is often preferred over FUT in most cases.
Our hair follicles
A common misconception is that our hair grows in individual strands from independent follicles. However, the truth is that most mammalian (including human) hair grows in groups of 1 to 4 as a closely associated unit, known as a follicular unit. When transplanting hair, the entire follicular unit has to be extracted together and not just individual follicles to minimise transection rates (case where a graft is irreversibly damaged).
How is FUE carried out?
Before the actual transplant, a consultation session with the doctor is required to assess if the patient is suitable for hair transplant. This may include a simple health assessment, and the examination of the patient’s hair and scalp.
During the procedure, which will be carried out under local anaesthesia, the doctor will mark out the desired hairline and other important points on the scalp. Small incisions are then made on the transplant areas where hair follicles will be implanted. After which, a FUE micro-punch with a diameter of 0.7 to 0.9mm is used to make small, circular incisions around selected follicular units, which are then carefully extracted. A team of trained technicians will scrutinise and inspect every graft individually, before sorting them based on the number of follicles in each unit. The grafts are then implanted into the required areas, taking into consideration the growth direction and density of the patient’s original hair. This is important to ensure that the results look as natural as possible without a “wig-like” appearance.
Myths of Hair transplant
- FUE Hair transplant is painful
The idea of “pulling out” and replanting hair follicles seem to paint a bloody image in many minds, and it is not surprising to see why many would think that hair transplant is painful. The truth is, most, if not all hair transplant procedures are carried out under local anaesthesia. The only pain felt by patients are usually only the initial injection of the anaesthesia itself. After which, there should only be some mild pushing and pulling sensation felt on the scalp, and it is not uncommon for patients to fall asleep in the process. Then again, mild soreness and itching is to be expected on both the donor and planting sites after the transplant when the anaesthesia wears off, which can be easily alleviated with prescribed painkillers.
- Results of FUE hair transplant are immediate
Hair follicles are sensitive structures, and patients should not expect their newly transplanted hair to immediately start growing them a full head of hair.
Often, the shock of the transplantation will cause the newly implanted follicles to shed their existing hair, even if the transplantation is completely successful and the follicles are completely healthy. The initial shedding is completely normal and is to be expected. Typically, new hair will begin to grow from the transplanted follicles about 2 to 4 months post-procedure, after the follicles have recovered from the shock and adapted to their new homes. For most patients, the best results are seen from 12 to 15 months after the procedure
- You can only do hair transplant when bald
This is definitely not true. In fact, it is better for hair transplant to be carried out in the early to mid-stages of hair loss to ensure that sufficient hair can be extracted from the donor areas. The less existing hair a patient has, the more difficult it is for a successful and satisfactory procedure. Also, unlike most other transplantation procedures, it is not possible to transplant hair between persons, even if a willing donor is available.
- Hair transplant results are temporary
All things considered, hair transplant is actually one of the best long-term, if not permanent solutions to hair loss. This is because the most hair loss cases arise from unhealthy follicles, and have nothing to do with the surrounding scalp. The transplanted follicles will grow hair like they used to in the donor area, as long as the transplantation is successful. That being said, not all hair loss patients are suitable for hair transplant.
A consultation with an experienced doctor is necessary to determine the viability of the procedure. As long as the patient is a suitable candidate and takes good care of their new hair, hair transplant will more often than not provide long-lasting, or even permanent results.
- It is always good to transplant more grafts
It is definitely true that number of grafts are important in a hair transplant procedure, as more transplanted grafts mean denser hair. However, attempting to transplant a large number of grafts (more than 2500) in a single session to reduce costs is often not ideal, as it can result in high rates of transection and low rates of survival.
An experienced hair transplant doctor will know that hair follicles can only survive outside the body for a maximum of 6 hours, even in the best conditions, and even the most experienced team will struggle to transplant a large number of grafts within that time limit. With this in mind, the recommended number of grafts in a single hair transplant session should be kept at 2000 grafts or under ideally.
For reference, a standard FUE procedure has a survival rate of 85%-99% when performed under ideal conditions.
- There are other treatment methods which can completely replace hair transplant as solution to hair loss
There are indeed newer treatment methods, like Regenera Activa scalp treatment, which involves injecting a solution made from a patient’s hair grafts into areas experiencing balding. Having performed this procedure myself, I would not deny its effectiveness.
In fact, I would recommend it over FUE hair transplant in some cases, when patients only suffer mild hair loss symptoms, simply because Regenera Activa is less costly, less time consuming, less invasive, sees results faster than FUE hair transplant. However, Regenera Activa’s effectiveness is only limited to patients with mild-to-moderate hair loss symptoms and will simply not do enough for those with more severe hair loss. Moreover, follow-up sessions are required about once every 12 months for Regenera Activa to remain effective. FUE Hair transplant, although time consuming and takes longer to see results, is long-lasting and effective even for patients with severe hair loss. Individuals looking for a long-term solution should definitely consider this over other options.
Is FUE hair transplant worth it?
Although more innovative treatments like Regenera Activa have seen success, they cannot completely replace FUE. Saying that Regenera Activa can completely replace FUE hair transplant is akin to saying that a pair of scissors can completely replace the knife: Both are effective in their own ways, but the 2 cannot replace each other. Overall, despite the many myths surrounding it, we cannot deny that a FUE hair transplant performed by a skilled and experienced team remains irreplaceable as a long-term effective solution to most hair loss problems.
