The follicular unit extraction technique (FUE), unlike follicular unit grafting (FUG), avoids altogether a linear donor site incision. Instead, each graft is harvested one at a time with tiny 0.8 and 0.9 mm punches which then usually heal as essentially undetectable dots in the scalp. We at the Foundation primarily utilize our custom-designed E-Fue System, as well as the recently developed WAW System, designed by a European colleague of Dr. Epstein, which utilizes a “hybrid” punch that further reduces graft transection to below 4%. Dr. Epstein has extensive experience with FUE, performing six to eight procedures weekly, assuring patients of the maximal outcomes.
Result of 1600 FUE grafts to hairline
Two weeks after 1500 grafts, the donor area has completely healed with the hairs growing out.
One day after 1900 FUE grafts, showing the donor area nearly fully healed.
One day after no-shave FUE technique
With our outstanding track record in FUE procedures (click here to view our FUE results), over 75% of our patients are able to shave their heads without any visible scars, the rest able to cut their quite short where there are tiny “dots” visible on close inspection. In order to obtain these grafts, usually the back and sides of the head are first shaved, then with the patient typically lying face down for the first two hours, we are able to harvest 1000 to as many as 1600 grafts from the back of the head, which then with the patient rotating onto his back sitting these grafts can be efficiently transplanted to assure the highest rate of regrowth. Later on in the procedure, additional grafts can then be obtained from the sides of the scalp, allowing us to extract as many as 2200 or more FUE grafts in a single-day procedure. Each graft contains one to three, sometimes four hairs, for the most natural appearing results. Also offered is a No-Shave FUE technique, which allows the patient to be presentable the very next day as there is no cutting at all of the back and sides of the head. Because of the longer time required to perform a No-Shave procedure, for more than 1500 or so grafts a second half day of surgery is sometimes required. Once the grafts are harvested, with the patient comfortably seated in a recliner-type surgical chair, Dr. Epstein then makes the recipient sites into which the grafts are then transplanted.
A relatively newer technique- Dr. Epstein was one of the earlier embracers of FUE in 2007 – FUE is in some ways more technically challenging than FUG, and there are few surgeons like Dr. Epstein who perform both techniques with such regularity. Over 90% of the hair transplant procedures done at the Foundation for Hair Restoration are done by the FUE technique. There are a variety of techniques for harvesting the FUE grafts. Dr. Epstein, working with Dr. Gorana Kuka, one of Europe’s most experienced FUE surgeons, who like Dr. Epstein is a plastic surgeon, developed the E-Fue System that combines the best in accuracy, hair regrowth, efficiency and ease for the patient, assuring the highest quality results. Also used is the WAW System, that has the lowest possible rate of graft transection (less than 4%) and utilizes punches of 0.8 to 0.9mm in size.
FUE can also be used to harvest grafts from body areas such as the chest, back, and beard. This technique of BHT is one that Dr. Epstein regularly performs, and is capable of providing thousands of additional hairs for transplanting. See here to learn more about BHT. FUE is also a great technique for obtaining grafts that are to be placed into a donor site scar from a prior procedure to help reduce its visibility. In addition to their application in the scalp, FUE grafts can be used in beard and eyebrow restoration.
The key aesthetic step in FUE is the making of the recipient sites. It requires the aesthetic judgment and skills of an experienced surgeon who knows how to create a natural appearing hairline. If there is one area in which Dr. Epstein is known for, it is here in this key aesthetic step of recipient site creation.
In no-shave follicular unit extraction, the only hairs trimmed are the donor hairs, leaving all the other hair the same length. The trimmed donor follicles are therefore hidden amidst the remaining full-length hair, and a completely normal appearance post-transplant is achieved. Suitable for both men and women, this technique makes both the process and eventual outcome of a hair transplant undetectable the very next day, as the scalp donor area does not need to be shaved. This is the technique of choice for those men primarily who wish to avoid shaving their head and thus can return to work and be in public a day or two after the procedure. The no-shave FUE 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, and does have a higher fee because of the additional meticulous work required. To find out if you are best treated with no-shave FUE, please contact our office.
One day after 1400 grafts obtained by the No-shave FUE technique.
Options in FUE
Dr. Epstein and the Foundation offer three options how the FUE procedure is performed, each differing in the degree of shaving of the donor area. Here are typical illustrations of these three options. Please note the hairs in the recipient areas where the grafts are transplanted are not shaved.
How many grafts are needed for FUE?
In a typical FUE case, 900 to as many as 2,400 grafts can be obtained in a single day, a testament to the experience and expertise of Dr. Epstein and his team in extracting then planting grafts in an efficient yet meticulous fashion. It is the doctor who will determine the ideal graft count to achieve the patient’s desired results.
The occasional patient will return for a second day of grafting, most commonly for those who are having more than 2,200 grafts total.
Are You a Good Candidate?
Together in consultation with Dr. Epstein, the right procedure will be decided upon, after careful consideration of your goals and the nature of your hair loss.
Contact the office to schedule your consultation today.
Body and Facial Donor Hair for FUE Grafts – Not Scalp to Body, but Body to Scalp
Dr. Epstein is just a few of a handful of surgeons in the hair transplant world who can actually harvest body and beard hairs for transplanting into the scalp. These procedures are 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 the scalp donor hairs. Using special FUE harvesting techniques that they have developed over the past seven years 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 to the linear donor site scars from prior transplants. As many as 3,500 chest and or beard hairs can be harvested over two days.
One year after 875 FUE grafts to hairline
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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, 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.