Category: FUE

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FUE Scarring, Healing, and Other Questions – Hair Loss Information – Balding Blog

  1. will FUE transplanted grafts grow in donor strip scar tissue?
  2. Do you recommend GraftCyte for healing of graft recipient sites?
  3. If a person wanted to have as much hair as possible and not care about having any hair at all on the back and sides of thier head, simulating a rock musician look or marine type cut. Can one successfully FUE that entire area artistically and move it all to the top?
  4. would the tiny dot scars left by the FUE punch eventually be able to tan or blend as not to be too noticeable in person?
  5. And finally if one is nearly totally bald on top – say a 5 vertex – how many grafts will give a thick head of hair on top, not the 50% theory but rather full density, 8000 10,000 or more?

thank you

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I will answer your diverse questions in the order you wrote them:

  1. Yes, and it is a good method of revising scars of the scalp and can also be used for bad scars in donor area.
  2. Yes, GraftCyte contains copper peptide with a mild cleansing effect and we recommend using it for post operative patients who have a tendency to hold on to the red color after the surgery. It may enhance the healing of the recipient and donor area (claimed by the manufacturer) and it may be helpful to control scabbing and crusting of incisions.
  3. This is not practical and I doubt that any doctor would do this. We generally FOX-test most of our patients and the result dictates whether the patient would be a good candidate for FUE procedure or not. We do not recommend FUE for the patients with negative FOX (having high transaction rate).
  4. The scar of FUE is usually not noticeable, but it is there and does not contain pigment cells (as a rule) so the hairless spot will be noticed by discriminating eyes if the scalp is shaved.
  5. As a general rule, you need 3000+ grafts (about 6000 hairs if you are Caucasian with average density), to cover an area of the size of an adult hand with a reasonable density. For more density, for those with dark hair and light skin, or very fine straight hair, a redo procedure may become necessary.

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FUE on Women? – Hair Loss Information by Dr. William Rassman

I am one week away from my 8th month post-op. 1600 hairs were transplanted into my top scalp. I also asked the surgeon to take care of a thin area around the crown would sounds much like the person who wrote to you about: “Diagonal Balding Line on Scalp ….. It starts about where my cowlick is and runs diagonally for about 4-5 inches…..”

The area does not seem to be improving so I am getting my mind around getting a FUE procedure done when I reach the 12 or 15 month mark.

What do you think about FUE on females?

I am worried about shock loss as I did have a noticeable amount.

Please write …

God Bless

Hair transplantation in women is often unwise unless there are certain situations where the transplant can actually benefit the patient and the donor hair is normal. Many women do not have normal donor hair, impacted by miniaturization, which means that the hair will grow in weak and most of the miniaturized hairs will not grow. Sounds like you may have a problem with goals, diagnosis, and setting expectations that are realistic. I find that if a transplant doctor does work on many women patients, that doctor is often less reputable. I find that less than 20% of women qualify for a hair transplant, which means that the donor hair is healthy in adequate quantities and the goals are realistic and confined to small areas. FUT or FUE can be done on women and men, but first you need to probably get a second opinion before going down that road again.

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FUE Donor Exchange? – Hair Loss Information by Dr. William Rassman

Dear Dr.

This is the scenario, I am 28 male, balding on the front 1/3 of my head, I am currently using Proscar and Rogaine. I am most likely going to lose the rest of my hair and be a worst case hair situation one day if I don’t act on it now. So here are my questions:

1. Would you recommend I do FUT or FUE hair transplant as I want to reserve the right to shave my head of use the clippers on 0 blade if things don’t work out with the way I want it to look?
2. If you said FUE, would you do donor exchange which DR. [name removed] recommends in order to not deplete the donor hair and less visable scarring?
3. In the FUE scenario, how do you find a doctor who is going to give you the best price and the best job? Is it ok if a doctor is in 3 surgeries per day or would you reommend a doctor who is just working on 1 patient?

I will answer your questions in the order you asked them:

  1. FUE will give you what you want if you eventually want to shave your head.
  2. In my opinion, replacing hair from the body into the FUE donor sites in the back of the scalp (”donor exchange”) is crazy and I doubt that there is much proof that this technique results in anything worthwhile. Why would you consider being a guinea pig and paying for that privilege?
  3. This is a Buyer Beware market. Too many unsubstantiated claims are made and the search I performed on the internet to research your question. I found a site which had a blend of famous, credible doctors mixed in with the scum of this business. One of the ‘doctors’ on the site I just referred to, is not even a doctor (I previously looked into his credentials). FUE can be done in one surgery (our group did as many as 2600 in a single patient in a single session) or it can be done multiple day surgeries. Just because a doctor does these procedures, this does not mean that the FUE will produce viable hair. You won’t know the results for 8 months and by that time, the money you paid will clear the doctor’s bank account.

Sounds like human experimentation, metaphorically similar to something Dr. Josef Mengele did. This is an ethical and medical licensing issue for the doctor if you were to have this procedure and were not fully informed about the ‘experimental’ nature of this process. Even with adequate informed consent, the legality of performing such ‘experimental’ surgery without proper institutional review and approval, is ingrained in our legal system.

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Hair Loss InformationWhich is Better – FUE or Strip Harvesting of Follicular Units? – Hair Loss Information – Balding Blog

Does follicular unit extraction (individual follicles are removed from the back of the head creating a tiny round punctate scar) and FUT (follicular unit Transplant – where by a strip of hair is removed creating a line scar) produce better grafts? In your experience, what procedure out of these two causes the least amount of damage and would better serve the interest of the patient at the end of the procedure?

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Both techniques should give you real follicular units, but often the FUE in many doctor’s hands do not give real follicular units because they are transplanted as they are taken out (complete follicular units, more than one follicular unit, or parts of a follicular unit). Strip harvesting is better in most people, simply because the strip is highly efficient and very controlled in most doctors’ hands to prevent damage. FUE grafts are not always of the same quality as strip follicular units. The reason for that depends upon the particular patient and the particular method used for the extraction. In many patients, the grafts are extracted and devoid of fat and supporting infrastructure (very skinny grafts), which makes them more vulnerable to the environment and more easily damaged when transplanted.

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Large FUE Session Risks? – Hair Loss Information – Balding Blog

Hi dr.
I have been looking into hair surgery for the last 3 months. It is clear to me that I opt for FUE because I want to wear my hair short in the summer and long in the winter.

I have been offered a 2500 graft session in 1 day, using FUE. Although this dr. claims to perform such large sessions I can not find any information about large FUE session.

Are large FUE sessions safe or are there risks involved ?

Thank you for an honest answer

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A 2500 graft FUE procedure would require a real expert, so anyone that claims this type of result should easily prove his capability to do so by showing patient results. I would be skeptical — very much so, actually. Doctors claim whatever they want to claim, but do you want to put your future in someone’s claim if they can not really pull such a session off with 100% predictability? One doctor reported to me that he does 2000 graft FUE procedures all of the time, but from what I understand it is a follicular holocaust. Safety and integrity go together for the doctor’s claims. Let the buyer beware!

With regard to what you have to lose:

  1. money
  2. valuable, irreplaceable donor hair destroyed if yields are not in the high 90% range
  3. folliculitis from buried or transected grafts
  4. scarring

I am sure many more risks will come to mind as I think back on this question.

A large session FUE (in the 2500 graft session in one day) in theory can be done safely. I would strongly suggest that you ask the doctor to allow you to speak or even better, meet a patient or two that had 2500 grafts in a single day done by FUE, then observe the results and check with the patient who had it done about the results meeting his expectation.

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FUE vs FIT — Which Technique is Recommended? – Hair Loss Information by Dr. William Rassman

Overall what would be your recommendations for a procedure that would better serve the interest of the patient the FUE or the FIT?

The difference between FUE (Follicular Unit Extraction) and FIT (Follicular Isolation Technique) is essentially in a name. The originators of the technique called FIT, in my opinion, could not get credit for an inventive breakthrough, so they simply changed the name. With that said, the FIT doctors use what they think is a different instrument (a sharp punch with a depth guard), something I used in the early days when I was originally exploring the technique and found no real advantage because any alteration in the angle of a sharp punch will cut through the graft and kill is. I believe that the use of a sharp punch of any type causes too much damage, so I rarely use it except for special cases where my biopsy shows that it has value and will not damage the hair. The best interest in patients is served by the least damage in the extraction process when these procedures are selected. There is enough difference between the tissues of one patient vs another patient that fine tuning the instrument (which instrument will be best for that particular patient) is critical (my opinion).

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Scarring in Donor & Recipient Area, Body Hair, FUE – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I’m considering going in for a FUE hair transplant and I understand that there is minimal scarring involved. I was reading up on the New Hair Institute web site and noticed there are many “mini” scars. Will these scars be only in the donor area or where there is transplanted hair?

I’m also considering using body hair as a viable source for donor hair. I’ve seen a few surgeons doing this. Have you personally performed such an operation? I would love to hear your thoughts on this procedure.

Best regards.

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Follicular Unit Extraction (FUE) produces very small scars in the donor area, usually less than 1mm (there are 25mm to an inch). The only way most people could see these scars is a complete shave of the head (not a short hair cut, which probably would not show any of these scars). In the recipient site, the grafts are always trimmed (in our office, anyway) to cut away the unnecessary skin so that these grafts should not produce any visible scar in the recipient area. My understanding from the recent ISHRS meeting in San Diego, is that most surgeons doing FUE do not trim the grafts and therefore may get very small recipient area scars.

I have commented on body hair transplants before, but I’ll recap the biggest problem with them. Due to the short growth cycle, body hair will not show up very well (quantity) because for every body hair that is transplanted, less than half of them will be in growth phase at any one time. That means that less than 50% of the hairs will grow according to what you can see. At the meeting in San Diego, one doctor who does a lot of body hair transplants showed two patients who had them done. The growth in numbers was far less than 50% of what the two patients and the doctor reported was put in at the time of the surgery. The only good news about what I learned at the meeting with regard to body hair is that the length of the hair does double to what the person had in the chest or back (natural position). I would want to have a face to face meeting to understand your focus on the body hair, why you wanted it, and to see what else was available to meet your needs.

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Hair Loss InformationFUE Training and Tools – Hair Loss Information – Balding Blog

I’ve read your blog with interest, especially having just returned from the ISHRS at San Diego. Could you comment more about the types of punch biopsy that you use, and where one can purchase them. Also, can arrangement be made where I can get some hands-on/observation training on the FUE technique?

Any help would be appreciated.

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I am generally not in a position to train doctors. It takes many months to learn and master the FUE technique. Generally, I believe that a year fellowship is the right solution for the doctor who wants to learn this process. Structured learning is the right way to learn. The instruments are not available for sale yet.

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I Was Told My Grey Hair Would Be Too Difficult to Transplant Using FUE – Hair Loss Information – Balding Blog

I am a 58 year old male with grey hair and would like to have 1000 graphs using FUE but have been told with my grey hair this is too difficult. The graphs would strengthen my hair line and fill in at the crown. Was offered 1400 FUT, previously had 800 micros with good result-but an unpleasant experience. FUE not so invasive. I believe I am a Norwood grade 3-thinning at crown and an adult hairline.

Regards

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Transplanting gray hair using the FUE technique is difficult, but you can dye it the morning of surgery and then go ahead with the FUE. Problem solved!

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Hair Loss InformationScars from FUE – Hair Loss Information – Balding Blog

I may have heredity loss or loss as the result of medication. I just wanted to confirm that the Fox procedure does leave tiny scars at the donor area (where the hair is taken from)? Also, does the fox procedure also leave tiny scars where the hair is implanted. Please review and let me know of your thoughts.
Thanks in advance

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1 Year After FUE – Parted
1 Year After FUE – Shaved

 

At the point where the follicular units are removed, there may be small punctate scars, but not at the recipient site, as the skin is trimmed once the grafts are outside the body. The skin disc that was removed in the FUE from the above photo were created by a 1mm punch, today the punch size measures 0.9mm. Trimming of the excised FUE grafts are critical to minimizing the transplantation of skin for the recipient area, which is clearly not the objective. When these FUE grafts are trimmed, the skin disc is reduced to 0.1-0.2mm in size, thereby minimizing scars at the recipient site.

For more on FUE / FOX Procedure, please see: