Follicular Unit Extraction by Dr. Epstein.
The hair transplantation industry has come a long way since the dreaded “hair plugs” were the only option for restoring hair loss. Back then, clinicians would use surgical tools to extract small sections of the scalp where hair loss was occurring, and then transplant skin and hair from the back and sides of the head to “fill in” these regions. Needless to say, this approach produced pretty unpredictable results, as transplanted hair often grew back in patchy tufts, giving people’s hairlines an unusual, doll-like appearance.
Fortunately, modern hair transplantation techniques, namely Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT), are nothing like past methods. Both of these approaches are incredibly effective and produce beautiful, natural results. But FUE hair transplantation, one of the newest and most advanced hair restoration procedures, has the extraordinary advantage of creating little to no visible scarring and requires almost no downtime after the intervention.
- What is Follicular Unit Extraction?
- How is FUE Different From FUT Hair Transplantation?
- FUE Techniques
- Our Unique Approach
- Am I a Candidate for FUE Hair Transplantation?
- Candidates for Face and Body Hair Transplant
- The FUE Hair Restoration Procedure
- Recovering From FUE Hair Transplant
- Results and Aftercare
- Frequently Asked Questions
What is Follicular Unit Extraction?
Follicular unit extraction (FUE) hair transplants involve extracting, also known as grafting or harvesting, hair follicles and implanting them into a balding or thinning area to achieve a fuller appearance. Unlike follicular unit transplantation (FUT), sometimes called the “strip” method, the FUE technique doesn’t require removing pieces (strips) of scalp to extract the individual hair follicles, which leaves noticeable linear scars. Instead, the follicles are manually extracted, one by one, using tiny 0.8 to 0.9 millimeter punches that heal as undetectable dots in the scalp.
After extraction, each unit is carefully cleaned and inspected to ensure its viability. Then, the hairs are implanted individually into the areas of the scalp, face, or body where hair loss has occurred to enable new hair growth.
One advantage of the FUE technique is that donor hair can be harvested from almost anywhere in the body, including the beard, chest, and sometimes even the legs and arms. This is known as Body Hair Transplantation and can be a good option for people who don’t have available scalp donor hairs.
Result of 1600 FUE grafts to hairline
How is FUE Different From FUT Hair Transplantation?
The FUE hair transplantation technique is a newer, less invasive option for restoring hair almost anywhere in the body. Most patients choose it over the FUT technique because it produces significantly less scarring. Here’s how both methods compare:
|Each follicular unit is individually harvested directly from the donor area||A strip of tissue is removed from the back of the head to extract individual follicular units|
|Virtually undetectable dotted scars scattered throughout the donor area||Visible linear scar at the back of the head|
|Longer procedure||Shorter procedure|
|High success rate||High success rate|
|Shorter recovery period||Longer recovery period|
|Low pain after the procedure||Medium to high pain after the procedure|
|Allows to harvest follicles from almost anywhere in the body||Hair can only be harvested from the back of the scalp|
One year after 875 FUE grafts to hairline
FUE hair transplantation is a very effective technique that consistently produces excellent results, with one important consideration. Achieving aesthetically pleasing results requires extensive experience and a skilled artistic eye to design a nuanced, natural-looking hairline. This is why choosing the right surgeon is crucial for a successful transplant.
Dr. Epstein and his team at the Foundation for Hair Restoration are experts at combining modern hair restoration science with fine craftsmanship in every hair transplantation procedure. With over 25 years of experience and having performed thousands of successful interventions, Dr. Epstein has a reputation for being one of the world’s foremost hair restoration surgeons, and always ensures that he personally performs every hair transplantation procedure at his Miami, FL clinic.
The Follicular Unit Extraction (FUE) technique for hair restoration has many advantages over the traditional FUT/strip approach that include:
- No linear donor site scar
- Higher average hairs per grafts
- Truly typically painless recovery as there is no incision in the back of the scalp
- Same if not higher hair regrowth percentage when performed by an expert
- Allows for the harvesting of hairs from the beard and body that can be used to help restore scalp hairs
These are the FUE hair restorations techniques we offer at the Foundation for Hair Restoration:
* All patients are unique and individual results may vary.
Typically, FUE is performed by most surgeons by shaving the entire scalp, donor area (back and sides of the head), and recipient area (area into which the grafts are being transplanted). But in Dr. Epstein’s hands, there is no need for any shaving at all if the patient chooses to have the No-Shave FUE.
With no-shave follicular unit extraction, the only hairs trimmed are the donor hairs, leaving all the surrounding hair the same length. Suitable for both men and women, this technique makes the process and eventual outcome of the hair transplant surgery undetectable the very next day, as the scalp donor area does not need to be shaved.
The no-shave FUE is typically the method of choice for men and women with long hair who wish to return to their normal activities just a day or two after the procedure. This is possible because Dr. Epstein only trims the donor follicles instead of the entire area, hiding the grafting sites amidst the remaining full-length hair.
This technique does take more time to perform, and thus the limit of the number of grafts that can be obtained in a one-day procedure is around 1400 grafts. It also typically comes with a higher price, because of the additional meticulous work required.
Wondering if a no-shave FUE could be for you? Contact our office at 305-666-1774 or click here to schedule a consultation with Dr. Epstein today.
What makes it possible for us to offer No-Shave FUE?
- We do not use the ARTAS robot. As with nearly all of the world’s leading FUE practices, we use the WAW and Trivellini FUE system that incorporate oscillating rather than rotating movement, and have “fluted” punches that result in higher rates of hair regrowth and smaller donor site dot scars
- Our years of experience in performing non-robotic FUE
- Our commitment to providing each of our patients with a procedure that fits his/her lifestyle, which may include the willingness to spend a bit more for a procedure if it means being able to return to work- or go out to dinner as our patient Jordan above- immediately.
In Partial-Shave FUE, the only shaved hairs are those in the lower back of the head. This allows the hairs above this area to cover over the shaved area or blend in with the shaved area as in a “fade” hairstyle. The partial-shave FUE may be an appropriate method for medium to short-haired men and women who wish to go back to their normal activities soon after hair transplantation surgery without wearing a hat.
In standard FUE, particularly in more extensive procedures, the back and sides of the head are shaved to allow faster harvesting of the follicles. The surgery is also less costly than other methods, like the no-shave FUE, because as many as 2,600 or more grafts can potentially be transplanted in a single session.
With the standard technique, the donor area usually heals fully within two to three days, after which it will just look like it had a very close shave. It’s important to note that, regardless of the FUE technique, it is not necessary to trim the hairs in the recipient area, allowing the existing hairs to conceal the tiny crusts where the transplants were placed until they fall out after one week or so.
Our Unique Approach
At the Foundation for Hair Restoration, we believe that nothing beats the precision and accuracy of the human touch. That’s why Dr. Epstein prefers to perform every FUE hair transplant manually, with a custom-designed E-FUE System and the surgically-advanced WAW System, which uses a uniquely shaped hybrid punch that significantly minimizes the chances of damaging the follicles during harvesting.
An advantage to these systems is that they work well not only on typical straight or wavy hair but also on ethnically curly hair, including Afro-ethnic hair. This is superior to the “robots” or other proprietary “automated” drill systems that are heavily promoted and typically used by doctors with little FUE hair transplantation experience.
Am I a Candidate for FUE Hair Transplantation?
With today’s advances in hair restoration technology, it is possible to get good hair transplant results with almost every patient. That being said, some people are better candidates than others because of their hair color, hair texture, and scalp color. For example, patients who have extremely pale scalps and thick, dark, straight hair may have a little tendency to be more challenging to transplant naturally than others. However, good work will produce good results on almost any patient.
The best way of determining whether you are a candidate for FUE hair transplantation is to schedule a consultation with a hair restoration specialist, like Dr. Epstein. In general, good candidates are men and women who:
- Are between age 25-65
- Are in generally good health
- Have enough available donor hair
- Are experiencing hair loss due to trauma, injury, or genetic factors
* All patients are unique and individual results may vary.
Candidates for Face and Body Hair Transplant
Dr. Epstein is one of just a handful of surgeons in the hair transplant world who can actually harvest body and beard hairs for transplanting into the scalp, a procedure known as body hair transplant or BHT. This procedure is usually reserved for those who have no more scalp donor hairs and are seeking reparative and/or more extensive work, or those who want a greater amount of scalp coverage than can be provided by their scalp donor hairs.
Using special FUE harvesting techniques developed over the past decade of using body hairs, these chest and beard hairs can have regrowth rates approaching 70% or higher. One particularly common area that beard or chest hairs can be utilized is the linear donor site scars from prior hair transplants. As many as 3,500 chests and or beard hairs can be harvested over two days.
* All patients are unique and individual results may vary.
The FUE Hair Restoration Procedure
The first step of an FUE hair transplant is to meet with a professional hair restoration surgeon to discuss your needs and expectations. At the Foundation for Hair Restoration, you will meet personally with Dr. Epstein, who will perform a thorough medical examination and explain your options based on your hair type, availability of donor hairs, the extent of your hair loss, and your aesthetic goals. He will also give you instructions on how to prepare for FUE transplant surgery.
FUE hair transplants involve a number of steps, and depending on the number of grafts and extent of the restoration, the entire procedure can take from 6 to 9 hours.
After Dr. Epstein has administered anesthesia to the donor and recipient sites and you are comfortably settled into our on-site operation suite, he will use a special tool to extract grafts from the agreed-upon donor area one by one. The donor hairs are always extracted in a diffuse pattern so as to not leave any linear or noticeable scarring.
2. Graft preservation
As grafts are extracted, Dr. Epstein’s team immediately ensures the follicles are viable and well-preserved for implantation. This involves cleaning and sorting the hairs, and submerging them in a plasma solution that maximizes survivability.
Using a four-person team and implanter pens, the graft planting process proceeds smoothly and efficiently, assuring maximum regrowth of transplanted hairs.
Once all the necessary grafts have been harvested, Dr. Epstein implants each follicle individually using state-of-the-art implanter pens that minimize graft damage. This is one of the most delicate and important steps, because it requires implanting the grafts in the ideal angle, pattern, and distribution to create a natural-looking hairline.
Dr. Jeffrey Epstein talks about Hairline
Recovering From FUE Hair Transplant
Because the FUE technique doesn’t require cuts or sutures, patients are usually surprised at how quickly and straightforward recovery is. You may experience some swelling and discomfort during the first three days, but most patients can return to their normal non-strenuous activities within one or two days.
You will notice tiny pin-sized scabs that may look similar to a rash at the donor site. They will go away on their own within a week. Dr. Epstein will give you instructions on how and when to wash and comb your hair after the procedure; make sure that you follow them and contact the office if you have any questions during the recovery process.
Results and Aftercare
It will take some time before the results of your hair transplant become visible. Usually, the hairs that are transplanted fall out again after a few weeks. That can be alarming, but you can rest assured that they will return.
Typically, it takes about three months before the transplanted hairs begin to grow. Then, after about ten months or a year, you should see the final results from the surgery. Once your new hair has grown back, you can style it as if it had been there all along. You can trim it, dye it, and use any products you want in it.
Frequently Asked Questions
It depends on many factors, including the number of grafts needed, the location of the donor and recipient sites, the facility to choose to have the procedure done, and additional costs like anesthesia, lab work, and other medical tests as needed. On average, an FUE hair transplant session can cost anywhere from $5,000 to as high as $20,000.
Yes, an FUE hair transplant is a permanent solution to hair loss. Shedding is very common during the first few months after the transplant procedure, but don’t panic! New, permanent hairs start to grow 3 to 6 months after that.
Additionally, the hairs we transplant do not have DHT receptors, which is the cause of genetic hair loss. Therefore, no matter where we transplant them, they become permanent hairs and will not fall out.
Technically, no. Since the entire follicle and surrounding cells are removed from the donor area, hair will not grow back where those once follicles were. However, with the FUE technique, Dr. Epstein takes grafts only from high-density regions that can afford to lose a few follicles without looking depleted.
Dr. Epstein uses computerized technology to administer local anesthesia, so the procedure itself shouldn’t cause any pain. You may experience mild discomfort in the donor and recipient area up to a week after hair transplant surgery.
All hair transplant procedures will leave scars, but these scars are tiny and spread out randomly throughout the donor site with the FUE technique. This means that scars will be barely noticeable, visible only upon close inspection.
Cobblestoning can be a major aesthetic issue and is usually due to over-enlarged grafts from antiquated techniques. Fixing cobblestoning with FUE could mean several things, including using the FUE technique for obtaining additional grafts which can help camouflage some of the previously placed grafts and scarring of the scalp. Additionally, follicular unit extraction can be used to actually remove previously placed grafts, eliminating some of the scaring.
Every head of hair is different, so there’s really no best age for an FUE hair transplant. As long as you are an adult who is experiencing hair loss that can be treated with surgery, no untreated medical conditions, and adequate donor area, you can have an FUE hair transplant at any age.
- Can a Hair Transplant be Performed without Shaving the Head?
- Are You Ready for a Hair Transplant?
- Robotic or Automated Hair Transplants: The Wave of the Future?
- Are Hair Transplants to the Pubic Region Possible?
- Repairing a Bad Hair Transplant
Learn More About FUE Hair Restoration in Miami, FL
Want to learn more about FUE hair transplant in Miami and see how it can help you restore your confidence with a renewed head of natural, full hair? Call the Foundation for Hair Restoration at 305-666-1774 or click here to schedule an appointment with Dr. Epstein for a consultation today.
Why choose Dr. Epstein
- Dr. Epstein first attended Swarthmore College, then moved on to medical training at the University of Vermont College of Medicine.
- Trained in head and neck surgery/ear, nose, and throat at the University of Miami/Jackson Memorial Hospital, earning a fellowship from the American Academy of Facial Plastic and Reconstructive Surgery during this time.
- Then trained in the San Francisco Bay area and was awarded the Jack Anderson Memorial Award for achieving the highest score in the nation on his board exams.
- Has been recognized for many years as one of the Best Surgeons in America, and he has been continuously listed for years in Castle Connelly’s Top Doctor Guide, an unbiased rating of doctors in many different specialties.
- Founder and Director of the Foundation for Hair Restoration and Plastic Surgery.
- Unusual for his field, Dr. Epstein holds triple board certifications in the fields of hair restoration surgery, facial plastic surgery, and otolaryngology (head and neck surgery), and is a Fellow of the International Society of Hair Restoration Surgery.
- He is an Assistant Clinical Professor at the University of Miami, a Fellow of the American College of Surgeons, and was previously the President of the Florida Society of Facial Plastic and Reconstructive Surgery.
- To give back to the community, Dr. Epstein provides pro bono reconstructive surgery to children, veterans, and other people in need.