Follicular unit extraction (FUE)

Follicular Unit Extraction (FUE)

What is a Hair Transplant?

Hair transplant also known as hair restoration or hair transplantation is a surgical technique in which new hair follicles are transplanted from a hair-loss resistant area to a balding or hair thinning area. In fact, Hair Transplant is a permanent replacement treatment to restore the hair in the balding area.

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Read more about : Hair transplant in Iran before and after

Read more about : Hair transplant surgery, Before and after procedure Video

Read more about : Hair transplant surgery, Before and after procedure Video

General information about FUE Procedure

The following table describes general information about FUE Procedure including FUE Procedure cost in Iran, recovery time, and to name but a few.

General Information

 

Cost

$ 500 - 1100

Anesthesia

Local

Hospital Stay

No/The same Day

Back to Work

5-7 Days

Duration of Operation

6-8 Hours

Minimum Stay in Iran

3-5 Days

 

What is Follicular Unit Extraction (FUE)?

The FUE hair transplant procedure is a technique where the required amount of hair groupings of 1, 2, 3 or 4 hairs called follicular unit grafts are extracted from the patient’s bald resistant donor areas (usually the sides and back of the head) and are then transplanted in the balding or thinning areas of the patient’s scalp.

Instead of conducting the conventional strip excision method, each of the individual follicular unit grafts are extracted from the patient’s donor area by utilizing micro-motors containing special leads. The tiny dots that occur as a result of the procedure are so small that they even do not require any stitches; and owing to this, unless viewed under a magnifier the remaining small scars are hardly noticeable.

Before FUE Procedure

When to consider FUE Hair Transplant

. If you have thinning hair

. If you have bald spots

. If you have a receding hairline

Preparing for your procedure

How do I prepare for a FUE procedure?

Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history, and perform a physical exam to determine your fitness for surgery.

In advance of your procedure, your surgeon will ask you to:

. Stop smoking at least six weeks before undergoing surgery to promote better healing.

. Avoid taking aspirin, certain anti-inflammatory drugs and some herbal medications that can cause increased bleeding.

. You may be asked to take a shower and wash your hair with regular or antibacterial soap.

. Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery.

FUE procedure is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.

Read more about : What should I do before hair transplant?

What can I expect on the day of FUE procedure?

FUE is usually performed with local anesthetic and is performed in an accredited facility. This may be a hospital, clinic or office-based surgical suite. FUE procedure take six to eight hours to complete. Your surgeon will give you an estimate of how long your surgery will last based on the details of your surgical plan. You will receive instructions on how to prepare and what to expect. This is what you can anticipate:

. The donor area(s) will be trimmed so that the surgeon can access and remove the hair grafts.

. The entire head will be shampooed and cleaned to prevent infection.

. Oral or IV anesthesia may be administered to help you relax during the surgery.

. A local anesthetic will be injected into the scalp.

. The surgeon will extract the hair follicles and transplant them into the skin.

. Usually, the surgeon will space out the grafts to achieve maximum retention.

. Afterwards, the scalp will be cleaned and covered with gauze.

. You may have to wear a pressure bandage to aid healing.

Read more about : FUT method

Who are the Ideal Candidates for a FUE Procedure?

. Men who have been losing their hair due to male pattern baldness for more than five years or who have progressed to a Norwood class 3, which is the earliest stage of male hair loss, or above.

. Men who have realistic expectations and who understand that their hair loss might continue to progress even if they are taking prescription medication to stop the progression.

. Men who have been balding for many years and whose pattern has stabilized and are interested in growing hair to provide a more youthful appearance.

. Men and women who have lost hair due to trauma or burns.

. And someone who has adequate hair growth or follicles that can be used for transplant.

Who should avoid undergoing FUE procedure?

. This procedure is done under the effect of local anesthesia, so it does not directly interfere with the functioning of the heart, etc. But, there are always risks to the patients having serious heart diseases and they should consult with the surgeons before taking the treatment.

. Heavy drinkers and smokers are also not allowed to undergo the treatment because of the risk of internal and external bleeding. If they have to take the treatment, they have to abstain from their drinking and smoking habits at least a few weeks before the time of the procedure.

. People with diffuse hair loss have inadequate donor supply hence they are advised against undergoing a hair transplant. They have a higher risk that the grafts are too weak and will not take at the recipient area.

. Those who suffer from thinning hair may also not be suitable for FUE surgery since there are no distinct bald patches and not enough space to implant the new hair. There is a risk that the new grafts will be rejected or that they will dislodge the neighbouring hair.

. Also, the risks of a FUE procedure can be minimised if your scalp is normal or loose. People with a tight scalp are not the best candidates for the procedure, as it would be difficult for the surgeon to insert the grafts.

Read more about : Do and don'ts after hair transplant?

What are the Advantages and Disadvantages of FUE technique?

Pros:

. This procedure works well to provide long term results for male pattern baldness, hair thinning in women due to hormonal fluctuations and in cases of scalp injuries.

. FUE is more cost effective than medication treatments as the whole cost is incurred in one procedure versus a lifetime of treatment.

. Natural hair growth is the main aim of this procedure, making its effects long lasting.

. The results of the surgery is in the patient’s control, with the eventual aesthetic beauty achieved as per each patient’s vision.

. In procedures like eyebrow transplants, the results look natural in comparison to tattoos or makeup.

Cons:

. Infection of the hair follicles, scalp swelling and itching are the most common side effects of the surgery.

. In some instances there is a chance of losing transplanted hair, and this is referred to as “shock loss.”

. There are small chances for hair follicles to die off before the hair regenerates. And this often causes bumps on the scalp.

. It might take months for hair to grow into the area

. Multiple sessions spanning over one to two years might be required

Risks and Side effects

What are the risks and Side effects of FUE procedure?

Like any surgery, a FUE procedure involves certain risks. But with the right specialist by your side, they can be kept at the lowest level possible. In addition, the occurrence of adverse events after a FUE procedure is considered to be relatively low compared to other surgical procedures. Here is an overview of the possible risks associated with a FUE procedure.

. Poor results

It may happen that the result does not meet your expectations. Either the hair density is too low or the hair grows in an unnatural direction and creates a non-aesthetic image. Failure to match the natural hair growth direction may also result in an unsatisfactory appearance. However, with a trained specialist who has been performing hair transplants for years, you need not be afraid of this risk.

. Pain during or after a FUE procedure

Anaesthetic injections may be a bit uncomfortable as they need to be done at several points in the scalp. The use of needles and syringes may scare off some patients.

However, the modern FUE method, is minimally invasive and done under local anaesthesia. Therefore, the patient will not feel any pain during the procedure.

. Inflammation and swelling

Of course, wounds can swell and redden after surgery. These risks of a FUE procedure are bound to occur at least for a short time after the surgery has been performed.

The tiny openings that occur during the FUE hair transplant usually heal without complications. Also, if the patient applies some antiseptic and soothing cream, inflammation and swelling will be relieved in 1-2 days. You can also reduce swelling by sleeping on a high pillow with your head elevated.

. Itching

Itching is quite common after surgery, it means that the wounds are in the process of healing. However, you must desist from scratching the itchy areas, since it can displace the newly implanted grafts as well as increase the risk of infection.

. Bleeding

Bleeding may occasionally occur within 2 weeks after the operation. To avoid or minimise it, the patient should never scratch the scalp or pick the scabs. Avoid strenuous physical activities, drinking alcohol, smoking, and taking aspirin within at least 7-10 days as well. If bleeding takes place, put a clean gauze cloth on the bleeding areas and gently apply pressure with your fingers.

. Infection

In the FUE method, the risk of infection is very low due to the less intrusive nature of the procedure. The doctor will most likely prescribe antibacterial cream to the patient to prevent any infection. However, keeping the hygienic standards is particularly important here, which is why it is necessary to check the reputation of the clinic beforehand.

. Scarring

With the stitchless FUE method, you do not have to expect apparent scars. The visibility of scars, however, will also depend on how well the wounds can heal, if the scalp is loose or tight and how densely the surgeon implants the grafts.

. The grafts fall out

Some patients experience what's known as "shock loss," which causes all of the transplanted hair to fall out at once. However, it's very unlikely that this hair loss is permanent and typically new hair will grow in its place. This risk can be diminished by a comprehensive preoperative examination of the patient. It is possible to predict how good the grafts will take by assessing the quality of the scalp and hair.

During FUE Procedure

During procedure

How does the procedure work?

FUE transplants are relatively unobtrusive and are performed under local anaesthetic, so as to reduce complications or the need for long stays. The process is reasonably simple and quick, and undergoing FUE in the vast majority of cases have no complications for patients, most of whom can return to work the following day.

FUE hair transplants are all carried out under a microscope by experienced professionals to ensure absolute precision and to help create as natural a restored hairline as possible.

FUE is a newer technique and unlike other hair transplant procedures, FUE works on an individual hair basis. Each hair is extracted as a whole unit, complete with the necessary glands and then transplanted to the new area. Although less invasive, the procedure is very intricate and this can lead to an FUE procedure taking slightly longer than the FUT method. By taking more time, the healing period is reduced and the levels of success are greater. Whilst no procedure is scar free, the scarring of FUE is limited to small dots which become invisible after a short amount of hair growth.

Using FUE, we expose the follicles to as little in the way of damage as possible, and this gives each transplanted hair the best chance of survival. Because the follicles have been taken from an area of hair unaffected by DHT – the hormone causing male pattern baldness – the new hairs are unaffected and will not be subject to the same patterns of loss.

Read more about : Is hair transplant permanenet?

The Stages of FUE procedure

The Stages of FUE procedure are as follows:

. Collection: The grafts are removed one by one from the scalp by the tool “micro motor” which has a hole and a sharp point. With this method, depending on the patient’s graft size, the points changing between 0.7-1.25 of diameters are used. The grafts, whose sides are split from the hairy skin, are collected by the technicians individually.

. Canal Stage: At this stage micro sized tools called “handle”, which are appropriate for the grafts’ height and thickness and exhibit a little sharp surface, are being used. Once the recipient area is receptive to no pain or discomfort, the micro-lateral incisions will be made with specific interest in angle, depth, orientation and density.

. Plantation: The grafts that were collected in the collection stage are planted in the holes which were opened in the canal stage. The plantation stage is also very important. Hairs are placed in the canals that were appropriately opened for the collected grafts, one by one with highest care. In this stage, like our natural hair, it is of utmost importance that the grafts, which contain one strand of hair, are planted in the front.

After FUE Procedure

Recovery and Aftercare

Recovery

After a FUE procedure, your scalp may be very tender. You may need to take pain medications for several days. You should wear bandages over your scalp for at least a day or two. Your surgeon may prescribe an antibiotic or an anti-inflammatory drug for you to take for several days. Most people are able to return to work 3 to 5 days after the operation.

FUE procedure may take several hours to several days to complete. In part, this depends on the amount of work performed by the surgeon. You will go home the same day of the procedure.

Once the surgery is done, the area may be swollen, so your surgeon might inject triamcinolone into the area to keep the swelling down.

You’ll likely feel pain or soreness at the transplant site as well as in the area where hair was taken from. For the next few days, your surgeon may prescribe:

. Pain medications, such as ibuprofen (Advil)

. Antibiotics to prevent infections

. Anti-inflammatories, such as an oral steroid, to relieve swelling

. Medications such as finasteride (Propecia) or minoxidil (Rogaine) to help stimulate hair growth.

Aftercare

Here are some aftercare tips for FUE surgery:

. Wait a few days after the surgery to wash your hair. Only use mild shampoos for the first few weeks.

. You should be able to return to work or normal activities in about 3-5 days.

. Don’t press a brush or comb down over the new grafts for about 3 weeks.

. Don’t wear any pullover shirts and jackets until your doctor say it’s OK.

. After surgery go home and rest.  Keep your head up about 45 degrees. A recliner will be helpful.

. You can work out again after 1 month

. You can swim and do steam baths after 1 month

. You can wear hats after 10 days, and hard hats after 4 weeks

. A headwrap will be placed around your head for the first night. The next morning, take scissors and just cut the headwrap and remove it. Don’t pull it off, or you might pull out some grafts. Don’t leave it on more than the first night either, your head will swell more later on if you do so.

Don’t worry if some hairs fall out. This is part of the process. Transplanted hair may not grow much or seamlessly match the hair around it for a few months.

The cycle of hair growth after FUE procedure

. Day 0: the day of the surgery is counted as day 0.

. Day 1-5: The first 2 weeks after a FUE procedure are the most critical ones. During the first 5 days, patients may experience swelling of the forehead and at the back of the head, which is the donor area. The skin may also look red at the areas where all the tiny incisions were made for the newly transplanted hairs. This redness usually resolves after the first week or 2. After only a few days, the donor area is no longer tender.

. Days 6 – 10: At this point, patients no longer experience any swelling and the redness should only be faint or completely gone. For each follicular unit transplanted, a “crust” will form which is the attached skin layer drying out. This scab can be gently removed by soaking and gentle rubbing with fingers. By day 10, all the crusting should be gone and the transplanted hairs will appear like a “crew-cut” haircut.

. Week 2- 3: The transplanted hairs will start to shed at this point, and by the end of the 3rd/4th week, most will be gone. This is a normal part of the healing process and is totally expected. The newly transplanted hairs go through a shedding process as the actual hair shaft is released, but the actual follicular unit and bulb are totally intact starting to grow a new hair shaft. Patients may feel like the operation was a failure but this is part of the normal hair cycle.

. End of Month 1 – Month 2: The hair follicles have entered into the resting phase of their cycle. The length of the resting phase can vary before they start to grow again. At this stage, patients will appear exactly as they did prior to surgery with regards to the amount of hair present.

. Months 2 – 4: The new hairs should start coming out. For some patients, their transplanted hairs start growing early in the timeline; for others, they start growing later. Patients will see the new transplants, but they will be thin at this stage as they begin to emerge from the scalp. Most of the native hair will be growing back at this time. The donor area is healing and any redness at the donor site will resolve.

. Month 6: Transplanted hair has entered the anagen phase and begins to grow (finally…progress!). At this point usually, the doctor used to see you in follow up.

. Months 6 – 9: Patients will start to see a considerable amount of hair emerging from the scalp. The hairs are thinner; many of the transplanted hairs will be over 3 inches or longer and is able to be groomed. Toward the end of this period, the hair will show textural changes and start to thicken up. The donor area will be completely healed at this point. The original donor laxity is restored by month 9.

. 1 Year: Patients have achieved about 80% of the hair growth of the transplanted hairs. Most of the hairs will have emerged from the scalp. At this point, further density is unlikely to noticeably improve without further surgical and/or nonsurgical intervention (PRP). It’s time to focus on outcome maintenance!

. After 1 year: For some patients, they achieve the full appearance by 1 year; others will take longer for the hairs to emerge and increase their density and thickness.

Additionally, as the hair grows longer, that provides a fuller appearance since the volume of hair is increased at the transplanted area.

Are there any Post-procedure Scars?

Since FUE procedures involve removing hairs individually from the scalp, there is no linear scar left behind. However, there will be tiny puncture marks that tend to heal by themselves after scabbing in the days following the procedure. These tiny wounds typically heal within three to seven days.

How long will the results last?

The results last for a lifetime; however, some patients may find that after the procedure, they continue to lose some of their original hair or their new head of hair may not look as full as they would like. In these cases, it's not uncommon for patients to schedule a second surgery.

FUE procedure Cost

4 Factors affecting the cost of FUE procedure in Iran

  1. City the average FUE procedure cost in Iran varies from city to city. For example the cost of FUE procedure in Mashhad and Shiraz are lower than Tehran.
  2. The clinic FUE procedure cost may vary due to different medical facilities. This means that, some clinics are equipped with modern and up-to-date medical facilities which make their prices higher. Some centers offer special prices for a FUE procedure. But it is better to avoid clinics with suspiciously low FUE procedure costs.
  3. The number of graft a patient needs. It is difficult to determine the average FUE procedure cost because it depends on a number of grafts a patient needs. The bigger the number of grafts is necessary, the higher the cost it is.
  4. Doctor’s skills and experience. Doctors with vast experience and positive patients’ reviews may ask for a higher fee increasing the FUE procedure price. The choice of a highly-skilled doctor is a key factor to the procedure success. It is better to pay a higher hair transplantation price to be sure of the result.

On average, the cost of a FUE procedure is between $ 500-1100 in Iran.

 

1What are the side effects of FUE hair transplant?
They can include: bleeding. infection. swelling of the scalp. bruising around the eyes. a crust that forms on the areas of the scalp where hair was removed or implanted. numbness or lack of sensation on the treated areas of the scalp. itching. inflammation or infection of the hair follicles, which is known as folliculitis.
2Is FUE hair transplant permanent?
FUE is a permanent solution to hair loss, however, everyone is individual and how long the results last can vary. FUE hair transplants are where individual hair follicles are taken from the sides or back of the patient's scalp and are then transported to the balding area.
3What is better FUT or FUE?
FUT and FUE – The Benefits. ... However, FUE tends to have less tissue scarring than FUT. This is down to the fact that with FUT, linear strips of hair follicles are removed from the back of the scalp and then placed in circular incisions at the front.
4How safe is hair transplant?
Hair transplant surgery is normally safe when performed by a qualified, experienced board- certified plastic surgeon. ... In transplant procedures, there is a risk that some of the grafts won't "take."
5How long does it take to recover from hair transplant?
He may also prescribe an antibiotic or an anti-inflammatory drug for you to take for several days. Most people are able to return to work 2 to 5 days after the operation. Within 2 to 3 weeks after surgery, the transplanted hair will fall out, but you should start to notice new growth within a few months.
6Can you wear a hat after hair transplant?
Wearing a hat could compress, dislodge or move the grafts, resulting in an unsatisfactory outcome. Once the grafts have become a permanent part of your scalp, you can wear a hat. ... Some hair loss specialists recommend waiting as long as 3 weeks before wearing a hat to ensure that the grafts are completely anchored.
7What is the best age for hair transplant?
This is why we typically ask our patients to wait until they are close to 30 years old to get a hair transplant. At this point in your life, it's much easier for surgeons to identify your particular balding pattern and therefore give you a successful and natural-looking transplant.
8How long does the pain last after hair transplant?
Also, if you've had more grafts, it's likely that this will take longer to heal and you may experience pain for longer than others. Generally, scalp discomfort after hair transplants typically lasts between 1 and 2 weeks.
9Which type of hair transplant is best?
FUT vs FUE hair restoration. There are two types of hair transplant methods: FUT (Follicular Unit Transplant) and FUE (Follicular Unit Extraction). The best option for you will depend on your individual needs and the recommendations of your physician.
10Does the transplanted hair fall out?
The transplanted hairs will shed over time, but new hair will grow in its place from the transplanted follicles. On average, patients can expect to see about 60% new hair growth within 6-9 months in the affected area. Hair transplants can be a permanent solution to your hair loss problem.

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