FUE (Follicular Unit Extraction) - MaxHarvest™ - Most Effective Advanced Hair Transplant Techniques by Dr. Brett Bolton

Are You Trying to Choose Between Follicular Unit Extraction vs. Follicular Unit Transplantation?

FUE, also known as follicular unit extraction, is touted as a breakthrough hair transplant technique. The “breakthrough” is the “no scar surgery.”  The truth is there is no scarless surgery. You will have a different type of scar with follicular unit extraction.  Instead of a linear line the follicular unit extraction will leave a polka dot scar throughout the donor area.

The reason follicular unit extraction has gotten so much attention is because patients are scared of the horizontal scar in traditional FUT surgery.  Every doctor is different. Some surgeons are so skilled that the resulting scar is nearly undetectable even through short hair. Another doctor might leave a half inch wide scar after surgery.

In reality, there are only a small number people who would actually benefit from the few advantages of follicular unit extraction.   A person who will have very little hair loss throughout his life might benefit from FUE. For patients with minimal hair loss now, Dr. Bolton proactively plans for the future and places hair where hair loss will take place.

If a person likes to wear their hair extremely short or even shaved then it would be better to get FUE because of the scar. Also, in the rare situation when a patient is out of donor and needs to go outside the “safe zone”, follicular unit extraction might be beneficial.

The Issue of Scarring

Unfortunately, all doctors are not created equally.   You have some patients with horrible scars and others with scars that are barely visible.  FUE is a reaction to horrible scars.  Everyone sees the bad scars.  A good scar is not visible. [ Click here to see videos of Dr. Bolton's Hair Transplant Scars ]

Advantages of FUE?

When you look at the advantages of follicular unit extraction you realize that the pool of patients who would truly benefit from this type of surgery is tiny.  Proponents of follicular unit extraction say the advantages are decreased healing time, reduced chance of hypertrophic scarring, increased donor area. 

Decreased healing time?  It takes 5-8 days for the follicular unit extraction to heal.  With sutures it takes 7-10 days to completely heal.  Is a two day difference in healing at double the cost worth the 'advantage'? 

Donor area is enlarged?   Do you really want hairs that aren’t immune to DHT for your procedure?  You can take hairs outside the donor area with a strip, too.  You just wouldn’t want to do so. Taking hairs outside the donor area risk implantation of hairs that are genetically pre-programmed to fall out.  A patient who is in a desperate situation might want to take body hair and hair outside the donor area but not a person who is coming in for their first or second procedure.

	With FUE extraction the punch biopsy instrument can accidentally damage or destroy follicles by nipping the root. The root can also be torn when pulled out. Less harvested follicles means less hair for your transplant.

"...Dr. Bolton points out that follicular unit extraction is an evolution of the old plug style removal. "

Proponents of follicular unit extraction who are ethical will admit the disadvantages of follicular unit extraction are that you can’t get as much hair per procedure, and the removal process makes subsequent procedures more difficult. With follicular unit extraction there is more damage to the follicle in the removal process, the process of removal becomes the primary objective as opposed to the artistic focus of the transplant itself. Smaller grafts mean less dense results, and spotty scarring in the donor area are typical with follicular unit extraction. Follicular unit extraction may be warranted in rare cases where the patient has a prognosis of minor hair loss over his lifetime.  The reality is most people will not fit the category of limited loss and are paying twice as much for less density and lower growth yield with follicular unit extraction.  Dr. Bolton points out that follicular unit extraction is an evolution of the old plug style removal.  The removal for a plug was done with a 4mm punch and left an open round scar.  Today follicular unit extraction is a 1mm punch that leaves an open round scar.  Dr. Bolton is happy to do this procedure if the patient wants this technique but he does feel that very few people benefit from it.  Few doctors would turn down the opportunity to double their revenue for the day with follicular unit extraction.  Dr. Bolton puts his patients first and offers tremendous value, results and undetectable scars.