Donor Area: Follicular Unit Extraction

ABSTRACTFollicular unit extraction (FUE) is one of the widely practiced minimally invasive follicular harvesting techniques employed during hair transplantation. FUE technique has an advantage of utilising lower occipital area and supra-auricular region as a safe donor area described by Unger, in addition to the standard occipital donor area used in strip method (follicular unit transplant). Despite its potential advantages such as rapid recovery, minimal scarring and reduced post-operative pain; its widespread acceptance is limited due to various factors in variable contribution like steeper learning curve and potentially higher follicular transection rates (FTRs). The main practical drawbacks in harvesting FUE from lower occipital donor region that lie inferior to the standard donor area, is its acute angle (10°–15°) of emergent hair from scalp skin, higher variance angle (15°–35°) between hairs below the skin and hair exit angle above the skin and comparatively loose scalp, preventing to provide stable platform for punching. Hair transplant surgeon faces difficulty in aligning and engaging the FUE punch leading to very high hair follicle transection rate, and therefore, it is not a preferred site for harvesting follicles in FUE. Authors description of modified technique using reverse rake scalp elevator helps in negating the acute angle of the hair follicles exit from scalp skin and reducing the variance angle between emergent hair and hair below the skin in lower occipital region thereby reducing FTR. Furthermore, an added advantage of reducing the overall operative time and surgeon fatigue, improve donor area healing, availability of a comparatively larger donor area which increases the confidence of the beginners. This method will be of help as it is easy to duplicate and follow by novice hair transplant surgeons and also for those who are routinely doing mega hair transplants sessions.

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Minimizing injury to the donor area in follicular unit extraction (FUE) harvesting

Journal of Cosmetic Dermatology ◽

10.1111/jocd.12267 ◽

2016 ◽

Vol 16 (1) ◽

pp. 61-69 ◽

Cited By ~ 5

Author(s):

Georgios Zontos ◽

Ken L. Williams ◽

George Nikiforidis

Keyword(s):

Donor Area ◽

Follicular Unit Extraction ◽

Follicular Unit

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Overview of Follicular Extraction

Indian Journal of Plastic Surgery ◽

10.1055/s-0041-1739244 ◽

2021 ◽

Author(s):

Anil Garg ◽

Seema Garg

Keyword(s):

Hair Follicle ◽

Hair Follicles ◽

Body Parts ◽

Manual Method ◽

The Past ◽

Donor Area ◽

Different Types ◽

Follicular Unit Extraction ◽

Follicular Unit

AbstractFollicular unit extraction (FUE), now named as follicular unit excision, is one of the methods of harvesting hair follicles from the donor area for implanting in the recipient area. The occipital scalp area is the most common donor area, but nonscalp donor areas like beard, chest, and other hairy body parts can be used as donor hair follicle area. The extraction of the hair follicle leaves a tiny circular scar over the donor area. Over the past 20 years, various devices for FUE have been developed, starting from manual, simple motorized to highly advanced motors with rotation, oscillation, and vibration. Similarly, different types of punch are used: dull, sharp, ultrasharp, serrated, hybrid and specially designed punch blade for long hair follicles harvesting in various diameters from 0.7 mm to 1.1 mm. The follicles can be harvested either by manual method or by motorized method.

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