FUE techniques

“ What is that new method for hair transplantation that everyone now is using? Do you know anything about it?”

“I heard it is too demanding!”

“It must not be easy to learn how to harvest grafts and not to transect them!”

“But, patient love this procedure because recovery period is so much easier and plus they are not left with a scar on their donor area.”

“How am I supposed to learn how to do this?”



FUE (Follicular Unit Extraction) is indeed the latest and certainly the most refined method for harvesting hairs for transplanting, and patients love it for it avoids altogether any donor site incision scar and it is perceived as “less invasive”.  More and more doctors like FUE as well, because it bypasses the need for a large team of assistants, lowering the barriers to entry.  An FUE procedure can be effectively executed with two or three assistants carrying out graft extraction, graft preparation (usually minimal unless eyebrow or beard work is being performed), and graft placement,  depending upon the level of involvement of the doctor.  While this amount of involvement varies by doctor choice and is dictated by local jurisdiction laws and medical board guidelines, it is our position that the doctor needs to be actively involved with the process, not only overseeing it but also in hairline design, planning of the procedure, and the making of all recipient sites.

One of the key purposes of this course is to do just that-  to train doctors not only in specific techniques of graft extraction, recipient site formation, and hairline design, but also in understanding how to approach the surgical and non-surgical patient to assure the best course of treatment.  While years of experience is the best teacher, it is our goal to summarize and simplify many of these decision making processes to make course attendees “better hair doctors”.

Another way this course is of value is in training a doctor’s assistants to fully carry out the key elements of the FUE procedure.  Having your own team of one or two assistants able to carry out graft extraction and graft preparation, as well as graft implantation, is a small investment that will yield huge dividends-  avoiding the dependence on outside “trained for hire” assistants.  Your own assistants are always available for procedures, are a good financial investment, and lastly are committed to you achieving the best outcomes for all your patients.

By definition, FUE means individual extraction of grafts that carry one, two, three or even more hairs called follicular units.  It is done with a small punch that varies in size from 0.7-1.0 mm. Ten years ago, only manual punches were available on the market so doctors needed to rotate manually this tiny tools that was exhausting and time consuming procedure. Thanks to the technology, today we have different automated devices on the market- drills, Neograft, Artas that tremendously ease and speed up the procedure.

The process of harvesting grafts starts with trimming patient’s donor area very short (1-2 mm) so the angle of the hairs could be visualized. Once numbed, extraction is performed as doctor guides this punch around every follicular unit very precisely to a certain depth in order not to cause transection.


Critical steps in performing good FUE harvesting is:

  • selecting who is and who is not a good candidate for FUE based on patient’s hair quality and density and expectations;
  • selecting good chair for yourself because extraction lasts up to two or more hours depending on the number of the grafts;
  • selecting the right size of your punch depending on the size of FUs and hair width;

Enlarged view of follicular units


Critical steps in performing advanced FUE harvesting is:

  • determining how you are going evenly to use patient’s donor area;
  • determining which follicular units you want to harvest based on the knowledge which one are less prone for transection;
  • determining how big your units should big based on the area you would like to cover (single hair unit vs. two or three hair unit);
  • determining what the most efficient way to extract grafts with the lowest possible transection rate.

Quality of grafts harvested with FUE

Mistakenly viewed as an easy method (“it is just a graft extraction”), FUE technique carries many details that took years to be recognized by doctors so the procedure is done more efficiently. Experience will enable every doctor to develop their own little secrets regarding this method. We are here to share with you ours.

Welcome to our course!


Dr. Kuka and Dr. Epstein performing FUE procedure

International Alliance of Hair Restoration SurgeonsCastle ConnollyAmerican Academy of Facial Plastic and Reconstructive surgeryUniversity of MiamiAmerican Board of Facial Plastic and Reconstructive surgeryFlorida Society of Plastic SurgeryAmerican Board of Hair Restoration Surgery American Hair loss Association