Follicular Unit Extraction (FUE)

For as long as hair loss has been a problem, men and women have looked for solutions to hide, halt, or reverse it. The current pinnacle of hair restoration methods is a process known as follicular unit extraction (FUE) hair transplant surgery, which we perform in Palo Alto for patients from San Jose, Sunnyvale, Santa Clara, and throughout the San Francisco Bay Area. However, the field did not advance to this point overnight. In fact, it has undergone a vast evolution over the past several decades.

Since the original days of “plugs,” hair restoration surgeons have used progressively smaller and smaller grafts to achieve an increasingly natural result. Ultimately the field advanced to using single follicle grafts (micro-follicles) in order to achieve completely natural, robust hair restoration. For many years, these grafts were created by cutting out a segment of hair-bearing scalp and dividing that tissue into individual grafts.

While the restoration results were fantastic, patients were left with an unsightly linear scar, curved like a smiley face, on the back of the head. In recent years, however, the field has taken a giant leap forward by eliminating the linear scar through the development of follicular unit extraction, which rapidly and accurately gathers healthy individual follicles from areas where hair grows in abundance. These follicles are then transplanted to places on the scalp that need it most, creating natural-looking results.

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Palo Alto, San Jose (650) 332-8105


What happens at a FUE hair transplant consultation?

Because every successful endeavor requires planning, the team at the center doesn’t improvise with your hair. Before any follicular unit extraction procedure, a doctor will conduct a thorough consultation to make sure that FUE really is the best method for achieving your sought-after results. We will start by reviewing your hair restoration goals and setting realistic expectations based on your unique situation. We will take photos to establish visual references. In some cases, we will draw out a new hairline to show you the transplanted hair’s projected aesthetic impact to get a better idea of what the ultimate results could be.

There is no “one size fits all” approach to follicular unit extraction, as your scalp is totally unique, and so is the manifestation of your hair loss. Aesthetic considerations include the density of hair that will be left in the donor site; the density to be created in the recipient site; the former, existing, and intended hairline; how long the new hair will be worn; and more. Successful follicular unit extraction demands a doctor with an artistic eye to go along with medical and technical know–how.

You may also need to have the donor site trimmed close to the scalp before any FUE hair transplant begins, which should be taken into account when it comes to deciding on if and when follicular unit extraction will be scheduled.

Is NeoGraft better than manual FUE?

Today’s evolved technology means hair restoration is now the best it’s ever been, including the harvesting step. When performing follicular unit extraction, the doctor will use a NeoGraft® device to collect individual or very small groups of hairs one follicle unit at a time. This is truly what sets FUE apart from previous hair transplantation methods, as the state-of-the-art automated system allows for large sections to be harvested while being the least invasive transplantation option available. Unlike other methods that relied on cutting strips from the scalp, NeoGraft® offers minimal downtime, no numbness at the donor site, no staples, no stitches, and best of all: No strip scar.

Follicular unit extraction is sometimes performed manually, though the automated method is ideal whenever and wherever possible.

When it comes time to perform the actual harvest, our team will use a magnifier to take an extremely close look at the scalp and remove the healthy hairs with a micromotor that punches a tiny hole as it removes each unit. Follicular unit extraction with NeoGraft® is a powerful harvesting method, allowing the doctor to collect hair efficiently without removing a chunk of scalp by controlling:

  • the micropunch diameter
  • the micrometer speed
  • the hair follicle orientation and depth
  • distance between extracted follicles

Each follicle holds one to four hairs, so the follicular unit extraction process is a meticulous one, especially when you consider that it may ultimately involve the extraction of thousands of hairs in all.

The area where a follicle was punched out of the scalp during follicular unit extraction will bear a small, circular mark that will shrink to a tiny dot as it heals on its own, and will further vanish as the donor site’s hair grows out to its pre-trimmed length.

How do you make the results from FUE hair transplant look natural?

Now that follicular unit extraction has provided the hairs, anywhere from 2,500 to 3,000 grafts, we’re able to use these follicles to re-create the density, directionality, and robustness of a natural head of hair. The end result is imperceptible from a natural head of hair, because the units are deliberately and carefully placed, one by one, into the recipient site to mimic natural hair growth. And remember: With follicular unit extraction, your scalp will be unmarred by an unsightly line at the back of the head.

Much like the marks at the donor site, the incisions at the recipient site will heal into unobtrusive spots, as well as be covered by the transplanted hair.

How long after hair transplant do you see results?

In the weeks after a follicular unit extraction treatment, some hairs will fall out, and the newly transplanted follicles will be gathering strength to generate new hair, which is typically noticeable at around four months. It should take about half a year for the transplanted hair to grow in and reveal a significant change.

Which is better FUE or FUT hair transplant?

While follicular unit extraction has become the standard of care for hair restoration, there are some cases where the strip-harvesting method is appropriate. This can be determined on a case-by-case basis, and will be discussed at your initial consultation.

People facing hair loss often compare follicular unit extraction and follicular unit transplant as they consider their options. Remember that the two methods offer similar, but not identical results, and the major difference between the two is in the harvesting: FUE involves gathering small batches of individual hairs, while FUT takes a strip of scalp, leaving a linear scar. Learn more about how the two compare here.

There are also non-surgical methods that can help in certain cases, which also will be discussed during your initial follicular unit extraction consultation. You may even learn that your hair loss is temporary or does not require any sort of minimally invasive procedure at all.

The most important point to remember about all of these options is that they aim to provide you with the head of hair you want: full, healthy, and natural looking. If follicular unit extraction is the right choice for you, know that you will be getting the best treatment medical science has ever devised for hair restoration.

Why Two Surgeons Are Better Than One

“We use each other as a sounding board in every procedure which creates a confidence level that every step is the best possible decision for the patient.”