What is Follicular Unit Extraction

Follicular unit extraction or direct follicular unit microextraction – Dr. Jeffrey S. Epstein’s Thoughts

It can be argued that the single most important incision made in hair restoration is the donor site incision.

As a fellowship trained, board-certified facial plastic surgeon, Dr. Epstein is obsessed with achieving the smallest scar in this area, so as to allow the patient the ability to keep the hair cut short- as short as a #2 or even a #1 razor.

In recognition of the quote by Sir Gillies, one of the world’s most famous plastic surgeons, “Plastic surgeon, by your incision you will be judged”, Dr. Epstein has conducted scientific clinical studies to assess the optimal technique of donor site incision and closure.

Parallel with this research, a relatively new technique was developed, initially by a doctor in Australia , that faced this challenge with a fresh approach- avoiding an incision altogether.

Rather, in a pain-staking fashion, individual follicles from the back and sides of the head, could be extracted using a tiny circular-shaped punch- leaving no scar in the donor site. Thus, follicular unit extraction was born.

Over the past 12 months, Dr. Epstein has painstakingly developed his own version of this technique, which he calls direct follicular unit microextraction (or FUM).

Using 1.3 mm ultra-sharp punches, (FUM) permits the harvesting of hundreds of grafts in a single procedure- all without the need for an incision in the back of the head.

Each follicle, after being extracted, is still carefully dissected free from the surrounding non-hair bearing skin under microscopic visualization, then can be implanted into tiny incisions in the donor site.

There are several limitations and downsides to direct FUM.

First, not all patients are candidates- in particular, those with curly hair, or very fine hair, are at too great a risk for damage and thus poor growth of the harvested follicles.

Second, the time required to perform the procedure is considerably greater- 400 to 500 follicular units in a single 3-hour procedure is about the maximum number of grafts that can be transplanted.

Finally, the cost is greater than the more traditional microscopic follicular unit grafting- 3 to 4 times as much.

But in spite of these limitations, patients regularly undergo FUM by Dr. Epstein. Patients who prefer this procedure are those that are willing to pay the higher fee, undergo several procedures, and have more limited hair loss which does not lend itself to a megasession (2000-plus graft) procedure.

Donor site healing is quicker and sutureless, and healing of the transplants is as rapid as that with traditional follicular unit grafting.

Follicular Unit Grafting (FUG) vs. Follicular Unit Extraction (FUE, FUM, or FOX)

I am often asked by prospective patients about the relatively new technique of follicular unit extraction (FUE), also called the FOX technique, ITS advantages and advantages versus disadvantages compared to follicular unit grafting (FUG).

Over the past 6 plus years, for a very good reason, FUG has earned its status as the gold standard in hair transplantation. The FUG technique, where from a single donor strip every graft is dissected one at a time under the microscope by a team of assistants then planted into tiny incisions in the scalp, is capable, when performed by artistic surgeons, of creating truly natural appearing results.

Over the past several years, a lot has been written about FUE, where instead of the grafts being dissected from a donor strip, the grafts are “harvested” one at a time using 1.0 mm punches.

It is my experience, and in my best surgical judgment, that this much hyped newer technique of FUE has a few applications, but will not replace follicular unit grafting as the technique of choice.

Hair Transplant in Pakistan

Because of increasing fashion awareness and enhanced media exposure, Pakistani people are becoming more and more groomed and self conscious. Fashion is not just realm of ladies now. Fortunately, Pakistan is not less than any other country in the technological advances and new innovative technologies. For fashion conscious persons, hair transplantation surgery has become increasingly popular to get your lost hair back.

Large numbers of hair transplant centers have been indulged in serving the sufferers with their marvelous hair transplantation surgery throughout the Pakistan. These clinics are highly equipped with latest technologies, innovative apparatus and modern tools, hygienic environment, team of knowledgeable and experienced surgeons. The collaborative effort of adept hair transplant surgeons, trained doctors and consultants make it possible to satisfy the clients with best possible outcomes. The miracles of hair transplantation don’t end here. Doctors and surgeons are on the goal of continual betterment and efforts are being put to treat clients efficiently to make hair transplantation more successful in Pakistan.

Standardized tools and globally acceptable methods of hair transplantation surgery are being utilized to give you natural results without any visible scars and wounds. An appropriate treatment is being given to you after complete examination of your scalp, evaluation of hair loss pattern, determination of the quality of donor hair and reviewing the history of hair loss as well as other medical information concerning your health in the clinics of Pakistan. Restore your lost hair naturally and permanently without scars and side effects with minimum healing time by experiencing hair transplantation surgery in Pakistan.