Follicular Unit Extraction: A Minimally Invasive Hair Transplantation Method

    August 2002 in “ Dermatologic Surgery ”
    William R. Rassman, Robert Bernstein, Robert E. McClellan, Roy B. Jones, Eugene W. Worton, Hendrik Uyttendaele
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    TLDR FUE is a less invasive hair transplant method suitable for many patients, but it has limitations and may not replace traditional techniques.
    In 2002, William R. Rassman and colleagues introduced Follicular Unit Extraction (FUE), a hair transplantation method that extracts individual follicular units without a linear donor incision. The study involving 200 patients found that FUE is a minimally invasive alternative to traditional hair transplantation, suitable for about 60% of patients, particularly those needing fewer than 600 grafts per session. The FOX Test was developed to determine candidate suitability, with 25% being ideal and 35% good candidates. FUE requires a larger donor area and has varying success rates based on the patient's FOX Class. Histological analysis showed that FOX-negative patients had a thicker dermal sheath, while FOX-positive patients had a thinner, more elastin-rich sheath. Despite its benefits, such as quick healing and minimal scarring, FUE has disadvantages including potential donor area damage, cosmetic issues, and longer operating times. Walter Unger, MD, concurred that FUE should be limited to specific cases and is unlikely to replace Follicular Unit Transplantation (FUT) as the standard technique.
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