INTRODUCTION

A recent trend in surgery is to devise techniques that result in less trauma, less scarring, and a more rapid recovery. In hair restoration surgery, the donor area is most affected by these three postoperative sequelae. To address these concerns, a technique of graft production called follicular unit extraction (FUE) has been developed. Hair follicles naturally grow in units of one to four hairs (Figure 4.1). Instead of harvesting a “strip” or ellipse of skin from the scalp, which is then divided into follicular units, the follicular units are removed individually from the donor area. This technique has provided a less invasive method for graft production, and it results in the absence of a linear scar and much less pain and discomfort at the donor site.

Although it is primarily used for scalp graft production, FUE has also been used to produce grafts from various sites on the body including the chest, back, extremities, neck, and pubic areas. This technique, called body hair transfer (BHT), will also be covered in the context of FUE.

The reader should note that many of the statements are based on anecdotal evidence from the author's experience and from other physicians' reports as there is a paucity of published reports on FUE. This may be due to reluctance of physicians to share their knowledge in order to retain a marketing advantage or simply due to the relative infancy of this technique.

Recent internet publicity has elevated expectations about what FUE has to offer the field of hair restoration.