FUE Hair Transplants
As of February 2017, Dr. Behnam has performed over 1,432 FUE hair transplant cases and almost 1.3 million FUE hair transplant punches in his Los Angeles office.
During this period, he has optimized his methods to maximize hair transplant graft growth rate and get the best results. He has worked on straight hair, curly hair and Asian hair. His expertise in FUE hair restoration have made him a leader in FUE hair transplantation.
Below, Dr. Sean answers the most common FUE hair transplant questions.
What is FUE?
There are two different methods of performing the hair transplant procedure, strip harvesting hair transplantation or Follicular Unit Extraction (FUE). This page is dedicated to explaining the FUE hair transplant method and listing a series of frequently asked FUE hair transplant questions. Please scroll down for FAQ.
FUE stands for ‘Follicular Unit Extraction’. Follicular Unit Extraction is an advanced and automated hair transplant procedure where individual hair follicles or hair grafts are removed one at a time from the back of the scalp and transplanted into the recipient areas. FUE hair transplant does not have the disadvantages of linear scars associated with strip hair transplant.
FUE hair transplants involve making micro punches of about 1 millimeter (to harvest the hair) with a very specialized instrument allowing for the majority of the scalp tissue to be left intact.
As demonstrated with the before and after photos above, Dr. Sean can make the graft survival with FUE hair transplant reach approximately 95%, just like the FUT (strip) method. Correct technique and planning, has to do a lot with great graft survival and the final outcome.
FUE hair transplant is an instrument-dependent hair transplant procedure. Hence the type and the quality of tools used for FUE hair transplantation significantly affects its artistic outcome. The creation of increasingly better FUE hair extraction has closely paralleled the advances in the FUT hair transplant procedure. Dr. Sean has now performed over 2,000 hair transplant procedures, 1,000 of which have been FUE hair transplants. He has six different machines and a lot of the tools he has engineered.
It is important to note that the creation of recipient sites and the placing of hair transplantation grafts are exactly the same in both FUE hair transplantation and FUT (strip) hair transplantation procedures. The only difference is the way hair transplantation grafts are harvested. Hence as far as final cosmetic look is concerned, both methods should and must provide the same cosmetic results if done by the same surgeon.
Using Acell For FUE hair transplantaion
Acell is a protein scaffold that is derived from pig bladder. It contains growth factors and it promotes wound healing. Overall, studies have indicated that it reduces scarring. At the ISHRS (International Society of Hair restoration) meeting, it was demonstrated that the use of Acell in FUE hair transplantation decreases the size of punch scar from 1 millimeter to 0.6 millimeter, meaning that once the site of the punch heals, the scar is much smaller than the punch size itself.
This can be demonstrated by the picture below, where we performed FUE hair transplant using 1 millimeter punches and we asked our patient to come back one year later. We shaved the area that the FUE hair transplants were done. Please look at the result. It is very difficult to decipher that many punches were made in that area.
Another study has demonstrated that 54% of grafts removed via FUE hair transplantation would regenerate in the donor area. This does not mean cloning. But, it probably indicates that if part of a graft is not fully removed using the punch, Acell may help it regenerate.
Again, Acell does not do magic, but its use in FUE hair transplant promotes minimal scarring and even some regeneration of some hair follicles in the donor area.
In terms of wound healing and pain, FUE hair transplantation is also noted to have a faster healing time, less post operative pain (no pain in most instances) and there is no need to remove stitches or staples, compared to the strip hair transplantation method.
In our practice many professional athletes prefer FUE hair transplantation for this exact reason and since they can resume strenuous activities and contact sports much sooner.
Since FUE hair transplantation procedure does not leave a linear scar, it is also preferred by patients who want to wear their hair short. People with tight scalp also prefer FUE hair transplantation to minimize scaring as a result of tightness of the scalp.
Is is important to note that with Dr. Sean strip method (FUE) , the linear scarring is minimal because of the techniques he uses. In fact, most of his patients who have the strip FUT method can still wear their hair down to a number two. However, if someone wants a shorter haircut, then FUE hair transplantation is preferred.
FUE in Los Angeles
Dr. Sean has performed a lot of FUE hair transplant procedures since 2008, and his experience and expertise are crucial in achieving great results. On average, each hair graft has 2 to 3 individual hairs.
First, the recipient sites (sites where the grafts are placed) are created. Once we know the exact number of grafts that are needed, the back of the scalp is then shaved and each individual hair graft is removed.
The grafts are then placed one at a time back in to the recipient area. The beauty of the procedure is that there is no linear cutting. The placing of grafts in the recipient area is performed the same way it is done in the traditional strip method.
The pictures above demonstrate how fast the donor area heals. The picture on the left was taken immediately after 1,100 grafts were extracted. The picture to the right was taken 6 days later. The sites have healed pretty well.
The skin has healed, and the hairs surrounding the extraction sites are growing. In this individual, by the 6th day, no one would notice he had a procedure done. In this example, Acell wound healing material was used to accelerate the wound healing process.
More pictures are available in our office (310-315-4989).
Please see the below examples.
The picture to the left was taken before the procedure. The needed area is shaved. Please notice that we only shave what we need so the the area can be easily covered with your own hair. So, after the procedure, your own natural hair can cover up the donor area.
Is there a linear scar associated with follicular unit extraction?
The whole point of follicular unit extraction is to prevent the linear scar that is seen on the back of the scalp that is seen with strip method transplants. With FUE’s, individual grafts are removed one at a time.
Below is an example of the donor area one year after 1,100 grafts were removed. As demonstrated we have shaved the area and its hardly noticeable that anything was done. We also take advantage of Acell, which is a growth factor used for wound healing.
Then you are taken to procedure room and the required donor area on the back of the scalp is shaved. The back of scalp is numbed. The frontal scalp is numbed as well.
Dr. Behnam puts all of the recipient sites in the front of the scalp. He then individually extracts one graft at a time from the donor area. Lunch is provided. According to the patient, this is one of the most relaxed days when they have had.
Since the graft under the skin curls, Dr. Behnam uses special techniques to curve his punch as he extracts the grafts so they are removed without being damaged. When it come to FUE hair transplants, experience counts, especially when extracting curly hair.
Can follicular unit extraction be used to cover the scars from old transplant surgeries or scars from the facelift?
Can follicular extraction be used to transplant hairs from other body parts such as chest, arms, or legs to my head?
Typically, there are four phases to the process of healing a wound:
- The Inflammatory Phase involves bleeding, narrowing of blood vessels, clot formation, and release of chemical substances that will begin healing.
- Next is the Proliferative Phase in which a matrix or latticework of cells begins to form scar tissue.
- The Remodeling Phase begins after 2-3 weeks when the matrix becomes more organized, strengthening the scar tissue.
- The Epithelialization Phase is the process of laying down new skin covering the scar tissue.
Efforts to improve wound care treatment have focused on developing anti-inflammatory drugs and improving surgical techniques.
The ACell includes a combination of ECM, growth factors, and proteins which stimulate and guide the process of tissue regeneration. The body recognizes the ECM signals and recruits the appropriate cell factors which differentiate according to what they should be. The process is a recapitulation of developmental biology.