Follicular Unit Extraction: A Comprehensive Overview of Techniques and Best Practices

    James A. Harris
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    TLDR FUE provides minimal scarring and quick recovery in hair transplantation, and surgeons not using it may lag in technology.
    The 2013 document outlines Follicular Unit Extraction (FUE), a hair transplantation method that allows for individual follicle extraction without a linear scar, suitable for patients desiring short hairstyles or those with low-density or tight donor areas. It discusses the importance of careful donor management to prevent overharvesting and shock loss, and describes various techniques for donor area preparation, anesthetic application, and graft extraction using both sharp and dull punches, with manual and motorized systems, including the robotic ARTAS System. The document stresses the need for proper graft handling and postoperative care, and recommends that surgeons new to FUE practice on strip procedure patients to achieve low transection rates. It concludes that FUE offers minimal scarring and rapid recovery, and suggests that surgeons not offering FUE may fall behind in technological advancements.
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      Clinical studies by Dr. Barghouthi and Dr. Bloxham indicate that Verteporfin, when used with FUE and FUT hair transplantation methods, shows promise in hair follicle regeneration and minimal scarring due to its ability to inhibit Yes-associated protein (YAP). Microneedling at depths of 3-3.5mm, combined with Verteporfin, could potentially reactivate dormant follicles, although the optimal dosage and application method are still under investigation. Concerns remain about the DHT sensitivity of regenerated follicles, highlighting the need for further research to optimize trauma levels and Verteporfin concentrations to achieve effective and scar-free hair regeneration.

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