FUE Hair Transplant technique developed in 2004 and gradually improved particularly after launching the motor-based FUE in 2010.
Dr. Civas has been performing FUE operations since 2006. In 2006 he could only extract 1500 to 2000 grafts using FUE. However, due to advancements in medical technology, by 2010, he was able to extract a total of 2700-4000 grafts per day, depending on the patient’s available donor hair..
What is FUE hair transplantation?
During FUE hair transplant, the surgeon directly harvests individual follicular units from the donor area, which eliminate the need for a linear incision.
During this procedure, the surgeon uses 0.6mm-1mm punches to make small circular incision around the upper part of the graft, and then directly extracts it from the scalp.
This technique does not leave a linear scar, making it good for patients who want to wear their hair short. Additionally, it’s suitable for patients who have healed poorly from traditional strip harvesting or have a very tight scalp.
This method is mainly used to hide a long scar from a previous hair transplant surgery
A significant advance in Follicular Unit Extraction (FUE hair transplant) has been the addition of “blunt” dissection to the original technique of “sharp” dissection followed by extraction.
Dr. Harris presented the three-step technique at the ISHRS in 2004. In this technique, first, the surgeon uses a sharp punch to score the epidermis, cutting only the upper part of the skin. Second, the surgeon uses a blunt punch to separate the follicular unit grafts from the surrounding deeper dermis. And finally, the surgeon removes the follicular graft from the scalp using fine forceps.
This method is better than the old one because it reduces damage to the follicle.
The blunt-tipped punch pushes the follicles together, reducing the risk of cutting them off.
Removing and transplanting grafts safely is crucial for achieving the desired result. A good hair transplant surgeon must design the hairline and the angulation of incisions very carefully to ensure that the results are undetectable. That’s why finding a skilled hair transplant surgeon is essential.
Please keep in mind that hair transplantation requires both medical expertise and artistic skill, which directly depend on the ability of the hair transplant surgeon.
Modified FUE Hair Transplantation
Dr. Civas is an expert FUE hair transplant surgeon. He has interacted with over tens of thousands of hair loss patients in over 20 years of hair transplantation and dermatological experience.
His constant education and experiences have made him develop a modified FUE technique which he uses on his hair replacement patients.
The FUE technique obtains hair follicles one by one from the donor area by making tiny incisions around the hair follicles and extracting them with special punches.
We recommend the modified FUE technique because of its benefits, like:
- Speed of the procedure: In Civas Hair Transplant we can transplant up to 3500 grafts in a session with the modified FUE technique. More than 3500 grafts are not safe.
- Use of very high-quality and specialized punch instruments. Semi-hand graft removal technique that ensures high precision in harvesting the grafts.
- High graft survival rates.
- Quick recovery of both the donor and the transplant areas.
- Painless anesthesia administration.
- Proven 50% less swelling after the transplant, due to the high-quality hair transplant solution used.
Some features of the modified FUE technique are:
- Using both manual and motorized methods; the motor is used to pull the grafts, then they are removed by hand. This ensures minimal damage to the follicle.
- Punch sizes differ with the graft size; 0.6mm for the 1s Follicular Units (FUs), 0.8mm for the 2s and 3s FUs, and 1mm for 4s FUs.
- Soft hairline created by only the 1s FUs.
- Use of very high-quality and specialized punch instruments.
- Implantation through lateral slits to bring out more thickness and density.
- Emphasis is placed on the reconstruction of the hairline to give a more natural look.
- Completely painless anesthesia application technique.
- Use of very high-quality anesthetic solution.
- The patient is fully recovered and can resume his normal duties 3 days to 1 week after his surgery.
- The surgery is not invasive, small cuts that heal quickly and disappear 2-3 weeks after the hair restoration.
- The success rate of 90-97%
The major advantages of the modified FUE technique are:
- Faster implantation – transfer up to 4000 grafts in one session.
- The procedure is entirely painless.
- Grafts are harvested with great accuracy.
- Minimal follicular damage.
- High graft survival rates.
- Quick recovery of both the donor and the transplanted areas.
- Proven 50% less swelling, due to the high-quality hair transplant solution used.
Sapphire Hair Transplant
Sapphire hair transplantation performed using special devices manufactured from the gemstone sapphire/ sapphire mineral via FUE technique, resulting in a better and perfectly natural looking finish. During Sapphire FUE technique, hair follicles are taken with the FUE technique, before being placed in the bald area, micro channels are opened into the scalp of the recipient and the follicles are implanted in these minuscule channels.
The change and increase in technology advancements taking place on a day to day basis, has paved the way for the development of new, more innovative hair transplant techniques. This technique has significantly shaped the landscape of modern hair transplantation. With sapphire hair transplantation, you can reach the quality of hair you desire and the strong image appearance.
Advantages of Sapphire FUE Hair Transplant
- The recovery period in the classical FUE Technique is usually approximately 1 month after the operation, but in the Sapphire FUE technique, the head heals in a week which is a more faster healing process.
- The scars are much less when the channels are opened with sapphire blades than other techniques.
- Channels opened with Sapphire Blade protect hair follicles better and increase their efficiency.
- Hair direction is more natural with sapphire FUE.
- It can be planted more densely.
- The productivity of planted grafts is more efficient.
What is the difference between Sapphire FUE and Classical FUE?
- The blades used during Sapphire FUE hold anti-bacterial qualities and are much sharper, stronger than in normal FUE.
- Minimum tissue damage, compared to making the incisions with metal bistouries.
- Sapphire tips are sharper compared to the metal slits, this enables the implantation of a higher number of grafts with the sapphire FUE technique.
- A higher amount of grafts can be implanted with the Sapphire FUE technique.
- The recovery period after classical FUE can take a bit longer.
- Higher success rate and better results compared to classical FUE.
- The results after this procedure are denser and look very natural.
Does a Sapphire FUE hair transplant leave scarring?
Sapphire Hair Transplant uses blades made of sapphire instead of regular steel blades to create incisions on the scalp for implantation. It uses sapphire stone as the material for the blades; this influences the shape of the blade and consequently the overall end result.
Sapphire blades have a V-shaped pin as opposed to the regular U-shaped pin of steel blades. This sharp edge of sapphire blades however helps make more accurate incisions resulting in smaller channels; and thereby eliminating the risk of irritating the neighbor hair follicles and scarring.
All cuts during a hair transplant procedure will leave some degree of scarring but the good news is with sapphire FUE the scarring is less and almost invisible. It is best to discuss the details of the procedure with your surgeon since all doctors have slightly different pre and post operative instructions.
What is the duration of the surgery?
The duration of a sapphire FUE hair transplant depends on how many grafts needed to be extracted and transplanted, if the grafts are many in number the duration is more than the usual time and vice versa but it normally takes 8-10 hours on average for it to be completed.
Are you a good candidate for Sapphire FUE Hair Transplant?
You should know beforehand if you are a suitable candidate for Sapphire FUE hair transplant. During our online consultations, the foreign representatives provide all the information as advised by the main surgeon. Deciding to undergo a hair transplantation procedure does not automatically make you a candidate for the operation as there are several parameters.
The following factors should be considered for good candidacy:
- Do you have hair loss stemming from conditions such as a trauma, androgynous type of hair loss or traction alopecia, you can opt for Sapphire FUE transplant as a hair restoration method.
- Just like with any type of hair transplant technique, the density of your hair at the donor site is one of the most prominent determining factors regarding the Sapphire FUE.
- If you a have sufficient number of hairs at the back your scalp also known as the donor area, then you will be considered as a good candidate for the surgery.
- Whether you have relatively minor hair loss or shed a major amount of your hair, you are still able to undergo Sapphire FUE operation without complications.
- Age is a determining factor in this case, for patients who are too old or even too young it’s advisable for them to consult the main surgeon before the surgery.
Unshaven FUE Hair Transplant
U-FUE stands for Unshaven FUE Hair Transplant or Undetectable FUE, where hair transplantation is done without shaving the donor or the recipient area. In the traditional FUE, all hair must be shaved to facilitate extraction and placement of grafts since most of the hair transplant surgery equipment only works with shaven hair.
In U-FUE, there are several variations of U-FUE that are currently being practiced. In some practices only the grafts to be extracted are cut then extracted, while the rest of the hair stays untouched.
In some practices, the donor hair is extracted in its original length and is implanted as long hair to minimize the downtime. Both approaches are limited in terms of the number of grafts that can be transplanted in one session. This procedure tends to be more involving hence slower than the traditional FUE.
In another variation that we practice, the donor hair is shaved, but the recipient area is not; so the grafts are transplanted within existing hair. In this variation, you can achieve maximum graft transfer compared to the other 2 variations.
The major advantage of U-FUE is that it limits the downtime, and reduces the degree of detection. However there is still a slight chance of traces of the surgery to be noticed on the recipient area.
If the patient has long hair, the scabs and redness can be concealed by their existing hair. The disadvantages are it is more involving and cumbersome, the procedure takes longer, less grafts can be obtained with this method and it is more expensive. With an experienced hair transplant doctor, you can get great results with the least inconvenience.
What is the cost of U-FUE?
The cost of U-FUE is 1.5€ per graft. The average number of grafts that can be transplanted by this method is 2000-2500 grafts. Take a look at the cost of transplant in Turkey page to compare the costs of other procedures.
Who are the most common candidates for Unshaven FUE Hair Transplant? Why choose FUE?
- Women and men who do not want to shave all hair.
- People who directly interact with customers in their careers and do not want their surgery noticed (TV personalities, bank officials, sales and customer service professionals).
- People who do not have sufficient leave time to wait till full recovery and some hair growth.
FUE and FUT Hair Transplant
FUE and FUT are the main techniques used to harvest follicles from the donor region. FUE involves extracting grafts one by one from the donor area using special instruments. FUT involves dissecting the grafts from a strip of the scalp obtained from the back or the sides of the head. In both procedures, the traces of the hair transplant are visible only for a week. Patients can resume normal daily activities the second day following the procedure, new hair growth starts to appear in 2 to 3 months and is generally completed in 10 to 12 months. See hair transplant procedure.
Please beware that surgeons that are not fully qualified in both techniques would probably just offer one technique. It is better to select a physician that is able to do both techniques at expert level. With a well-trained hair transplant technician and a hair transplant surgeon, quick healing, minimal trauma, natural angles, direction and the distribution of grafts can be easily achieved in both FUE and FUT. Dr Civas, an ABHRS (American Board of Hair Restoration Surgery) certified surgeon, has an artistic hand and expert skills that always bring out natural looking results with both FUE and FUT.
How does FUT work?
- In FUTa thin strip of hair is taken from the back and/or sides of the scalp, and the area is stitched back such that the hair from above and below the scar completely covers the scar in a way that it is not noticeable.
- The donor strip is placed under a series of special dissecting microscopes where the individual follicular units, of one to four hairs, are carefully dissected into tiny grafts.
- These grafts are stored in a special holding solution and refrigerated while awaiting placement in the bald or thinning scalp (the recipient area).
Meticulous stereo-microscopic dissection is a crucial part of the procedure, to achieve maximum yield from the donor strip.
- With lateral slit technique, recipient sites (tiny incisions) are then made in the bald scalp where the grafts are to be inserted. This technique ensures fuller denser and natural appearance. You do not need to shave the existing hair at the recipient area since the doctor can work within the existing hair.
- Once the recipient sites are made, the grafts are carefully inserted into the scalp. The 1FUs are placed at the hairline; the 2′s immediately behind them and the larger 3 and 4FUs are placed in the central, forelock area. The recipient site sizes are matched to the different size follicular unit grafts, so that a snug fit is created. This facilitates healing, enhances growth of the follicles and permits a very easy post-op care.
How does FUE work?
- In FUE a relatively large area in the back and sides of the scalp is shaved to approximately 1-mm in length.
- Instead of removing a single strip, as in FUT, a tiny circular incision is made around each follicular unit group. The grafts are then extracted, one-by-one, directly from the scalp.
- The tiny wounds are small enough to be left open and heal on their own, which takes about a week. The remainder of the procedure is similar to FUT.
FUE and FUT – Which is the best method?
This section summarizes a comparison of the two techniques. When comparing FUE and FUT / strip technique patients should consider the following:
FUT / Strip Technique
- FUT does not require shaving all the hair.
- FUT leaves a thin linear scar at the donor area, however if done carefully the scar can be unnoticeable.
- As FUT is an invasive technique it cannot be used in patients with susceptibility to keloids.
- Healing process is longer than FUE
- Microscopic dissection must be carefully done in order to maximize graft survival hence bring out desired results.
- With this method natural results can be achieved by highly qualified surgeon and team.
- Advances in medical technology using latest devices inFUE allow high quality hair transplantation in good candidates resulting in higher graft yield.
- Grafts are removed one by one using manual or motor devices. It does not require a strip cut out of the donor area.
- Only tiny scars could be temporarily visible on the nape of the scalp that heal naturally without need for stitches or bandages, hence no significant trace even you trim your hair to zero cut.
- FUE technique patients heal faster than FUT, less pain is experienced and one week after the transplant, the patient is completely healed.
- Can be used with body hair transplant, where donor hair comes from the body (chest, legs, beard).
- In repairing a poorly performed hair transplant, FUE provides the flexibility to reposition and rotate grafts.
- This technique allows graft transfer to inaccessible areas.
- Exhibits natural results in facial hair transplant i.e. eyebrow, beard transplant.
- FUE requires shaving. By the end of 10-15 days post-op nobody will be able to detect the procedure.
Robotic FUE Hair Transplantation
In Robotic FUE graft extraction is done with a specific punch with a motor in which you the surgeon can automatically set-up the speed of the turn. This method tremendously speeds up harvesting so that around 1000 or more grafts can be extracted in an hour. Today, the technique is still evolving with the computer-assisted robotic FUE which allows selecting the healthiest grafts through its image processing intelligence. However, if Robotic FUE is performed by inexperienced physicians and technicians the results could be substandard, with problems like low graft survival and visible scarring. Another disadvantage is that the heat emitted from the device may damage the grafts.
Currently, the most advanced robotic system is the ARTAS system. Harvesting of the grafts is made more efficient by the precision of the robot. The physician controls the specifications of the robot in relation to the patients hair. The robot then extracts the grafts faster and more accurately. It can also be used to create recipient sites where the grafts will be placed.
The advantages of Robotic FUE,
- Limited transection due to high precision
- Accuracy in graft extraction
- Higher graft survival rates
- Perfection in the aesthetic outcome of the results in terms of hairline and density
- Increased speed of the procedure, so many procedures can be done in parallel
- Easier and more precise graft extraction for afro hair type patients
We have not yet invested in the robotic technology in our practice. As of now, all our procedures are manual. As the technology improves, we intend to train out team within the next few years and adapt to the new technology.