Ideal Candidates for FUE
The ideal candidate for FUE is someone who has one’s hair stabilized with medical therapy like finasteride and minoxidil, who is preferably older (the younger the riskier like in one’s 20s, for example, due to the risk of unpredictable future hair loss), who has great donor hair to supply not only the transplant but also reserves for future use, and who is realistic about goals of the transplant.  Obviously, the patient must also be medically safe to undergo a surgical procedure.

Many other factors can affect the outcome of the result that derives from a patient’s anatomy. For example, wavier hair, thicker hair, and hair that has a low contrast in color to the scalp are all favorable characteristics that make hair look denser.

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FUE Procedure Steps
The FUE procedure varies from surgeon to surgeon in terms of setup, execution, sequence, instrumentation, staffing, anesthesia, etc. To describe the procedure in great detail may mislead the reader into thinking that what is described are actually universal steps recommended for all surgeons, and that is simply not the case. However, the fundamental components of the procedure remain the same.

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Outlining Donor and Recipient Areas
The first step of any hair transplant procedure, after reviewing the goals of the transplant with the patient, is to outline the donor and recipient areas including hairline design, and then to confirm that the patient is satisfied with the proposed areas for transplant. For example, if the crown is the area the patient wants to transplant, but the surgeon performs a transplant only in the hairline, then that would not be a good situation.

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Administering Anesthesia
Then, the patient is administered anesthesia to numb the scalp in preparation for the procedure. Some surgeons prefer sedation, orally, intramuscularly, or intravenously, to further enhance comfort during the procedure.

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Preparing Recipient Sites
If recipient sites (the slits into which the grafts will ultimately be placed) will be made first, then the surgeon typically harvests a few grafts from the donor area to test that the grafts will fit the recipient sites that the surgeon will make, and then the surgeon makes those sites.

Remember: Not every surgeon will opt to make the recipient sites before harvesting the donor grafts.

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Harvesting Grafts
Based on the number of recipient sites made, the surgeon will then plan the number of donor hair grafts for harvesting. Again, some surgeons prefer to harvest the grafts first, and then make recipient sites with the harvested number of grafts.

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Grafts Placement
Finally, donor hair grafts are then placed into the recipient sites, most often by the trained staff. Hair grafts are placed at appropriate angles and orientations which is crucial for the right aesthetic look for one’s hair. This step requires a lot of experience and precision.

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FUE Recovery
FUE recovery, as already mentioned, is faster and can be less uncomfortable in many cases. In most cases, FUE is performed with a shaved donor area. In the donor and recipient areas, tiny scabs will form and remain present until they are gently rubbed away usually 1 to 2 weeks later although different surgeons have different policies. After the scabs are gone, most patients return to their “invisible” state where the hair grafts fall out (but the root is still there) and they wait for the transplanted hair to grow over time. It takes several months at a minimum, as hairs grow about 1 cm per month, and oftentimes a year or more for the full result to appear.
Use of postoperative bandages, sprays, etc., along with other policies like return to exercise, water exposure, etc., vary among surgeons, so it is important to follow the instructions given by the surgeon you choose rather than any information found on other websites that you may peruse or visit.

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FAQs

Is a FUE hair transplant permanent?

Yes, a FUE hair transplant is permanent. In general, hair grafts transplanted during FUE by an experienced hair surgeon skilled in FUE should survive in most cases. However, if grafts were not chosen correctly in the safe donor area, those grafts may fail over time. Further, if grafts were taken that were miniaturizing, that is, susceptible to hair loss, by mistake, those grafts would also most likely not survive.

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Do I have to shave my head for FUE?

Yes, in most cases, but not always. Shaved FUE is the most common way of performing the procedure. Non-shaved FUE may be performed in select cases but requires much more labor and time and is usually charged at a higher price.

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What is the failure rate of FUE?

With modern instrumentation and the experience of a qualified surgeon, the failure rate is very low. However, with newer surgeons or with black market cases with unlicensed individuals performing the surgery, failure rates can be much higher.​

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Does the donor area for FUE grow back?

No. Donor hair, once removed, is gone forever. This is why the judicious use of donor hair with the intent of always having enough hair for future use defines the parameters of safe hair surgery.