whitelotus
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Hi everyone, I've been searching about FUE and FUT almost a year now and I will write down what I think about FUE. Hope this helps someone!
FUE Procedure and Techniques
One of the challenges of Follicular Unit Extraction (FUE) is the limited size of the procedure that can be performed in a single session or across multiple sessions. This limitation stems from two primary factors: the capacity of the donor area and the labor-intensive nature of the technique, where each follicular unit (FU) is individually extracted. While the duration of the procedure is secondary to the patient’s well-being, the primary focus must always be on achieving optimal results in both the donor and recipient areas.
As with the Strip technique, the scope of FUE procedures has expanded over time, supported by advancements in donor management, extraction patterns, and an improved understanding of factors like skin laxity. Dr. Bisanga, for instance, has honed his technique over the years by reducing punch sizes and deepening his knowledge of skin and hair variations. Despite these refinements, FUE remains a manual and labor-intensive technique, requiring careful adherence to its limits to avoid compromising the results or the patient’s health.
The essence of a hair transplant is to transfer genetically resilient hair from the donor area to the area of loss, ensuring healthy growth and sustainability for future procedures. To achieve this, it is essential to maintain strict protocols, including the appropriate choice of instruments (e.g., punch size), a well-informed extraction pattern, and effective donor management.
Punch Size and Technique
Choosing the optimal punch size is crucial. It’s not about selecting the smallest or largest punch but rather one that can extract a single intact FU with minimal transection or damage, leaving behind little to no visible scarring. As the technique evolves, preferred punch sizes may vary. For example, Dr. Bisanga initially used larger sizes but now predominantly employs punch sizes between 0.75 mm and 0.8 mm for most extractions.
A significant aspect of FUE’s success lies in understanding the nuances of skin and hair, such as directional and angular changes during extraction. The type of punch tool—whether blunt or sharp—can vary based on the doctor’s preference. Since FUE is a blind invasive procedure, the tactile feedback between the doctor’s hands and the skin is critical. Proper handling minimizes resistance and ensures precision in the punch’s movement, reducing the risk of peripheral damage. For instance, increased resistance may necessitate a larger punch size to ensure accurate FU extraction, which can inadvertently cause greater surrounding tissue damage.
Impact of Large Sessions
A less frequently discussed topic is the impact of large-scale FUE sessions on the donor and recipient areas. Although FUE is minimally invasive in terms of punch size, the overall invasiveness depends on the size of the procedure and the harvesting protocol. Dr. Bisanga advocates for extracting no more than 30% of the safe donor area density across multiple sessions, even if the donor density is high.
Repeated incisions in close proximity can cause trauma to the surrounding skin, leading to miniaturization of adjacent hairs, impaired healing, and changes in skin laxity. In severe cases, overharvesting can render future procedures unviable. In the recipient area, multiple incisions can impede healing, compromise blood flow, and reduce graft survival rates. The cumulative effect of open wounds challenges the body’s ability to repair itself and sustain graft viability immediately post-operation.
Additionally, harvesting large numbers of grafts in one session increases the risk of uneven extraction patterns and overharvesting. This can diminish the long-term availability of donor hair due to peripheral damage and skin changes. In most cases, a maximum of 3,000 grafts can be safely extracted while adhering to an educated extraction pattern and achieving high yield.
Looking Ahead
With greater transparency in tools, techniques, and protocols, the consistency and reliability of FUE results are expected to improve. Patients should view FUE as a credible hair transplant technique, complementing the Strip method. Both approaches have their pros and cons, and the choice between them should depend on the patient’s unique needs and circumstances.
FUE Procedure and Techniques
One of the challenges of Follicular Unit Extraction (FUE) is the limited size of the procedure that can be performed in a single session or across multiple sessions. This limitation stems from two primary factors: the capacity of the donor area and the labor-intensive nature of the technique, where each follicular unit (FU) is individually extracted. While the duration of the procedure is secondary to the patient’s well-being, the primary focus must always be on achieving optimal results in both the donor and recipient areas.
As with the Strip technique, the scope of FUE procedures has expanded over time, supported by advancements in donor management, extraction patterns, and an improved understanding of factors like skin laxity. Dr. Bisanga, for instance, has honed his technique over the years by reducing punch sizes and deepening his knowledge of skin and hair variations. Despite these refinements, FUE remains a manual and labor-intensive technique, requiring careful adherence to its limits to avoid compromising the results or the patient’s health.
The essence of a hair transplant is to transfer genetically resilient hair from the donor area to the area of loss, ensuring healthy growth and sustainability for future procedures. To achieve this, it is essential to maintain strict protocols, including the appropriate choice of instruments (e.g., punch size), a well-informed extraction pattern, and effective donor management.
Punch Size and Technique
Choosing the optimal punch size is crucial. It’s not about selecting the smallest or largest punch but rather one that can extract a single intact FU with minimal transection or damage, leaving behind little to no visible scarring. As the technique evolves, preferred punch sizes may vary. For example, Dr. Bisanga initially used larger sizes but now predominantly employs punch sizes between 0.75 mm and 0.8 mm for most extractions.
A significant aspect of FUE’s success lies in understanding the nuances of skin and hair, such as directional and angular changes during extraction. The type of punch tool—whether blunt or sharp—can vary based on the doctor’s preference. Since FUE is a blind invasive procedure, the tactile feedback between the doctor’s hands and the skin is critical. Proper handling minimizes resistance and ensures precision in the punch’s movement, reducing the risk of peripheral damage. For instance, increased resistance may necessitate a larger punch size to ensure accurate FU extraction, which can inadvertently cause greater surrounding tissue damage.
Impact of Large Sessions
A less frequently discussed topic is the impact of large-scale FUE sessions on the donor and recipient areas. Although FUE is minimally invasive in terms of punch size, the overall invasiveness depends on the size of the procedure and the harvesting protocol. Dr. Bisanga advocates for extracting no more than 30% of the safe donor area density across multiple sessions, even if the donor density is high.
Repeated incisions in close proximity can cause trauma to the surrounding skin, leading to miniaturization of adjacent hairs, impaired healing, and changes in skin laxity. In severe cases, overharvesting can render future procedures unviable. In the recipient area, multiple incisions can impede healing, compromise blood flow, and reduce graft survival rates. The cumulative effect of open wounds challenges the body’s ability to repair itself and sustain graft viability immediately post-operation.
Additionally, harvesting large numbers of grafts in one session increases the risk of uneven extraction patterns and overharvesting. This can diminish the long-term availability of donor hair due to peripheral damage and skin changes. In most cases, a maximum of 3,000 grafts can be safely extracted while adhering to an educated extraction pattern and achieving high yield.
Looking Ahead
With greater transparency in tools, techniques, and protocols, the consistency and reliability of FUE results are expected to improve. Patients should view FUE as a credible hair transplant technique, complementing the Strip method. Both approaches have their pros and cons, and the choice between them should depend on the patient’s unique needs and circumstances.
