Hair implants have been around for about 60 years now. In the beginning they used "punch grafts" which resulted in what is commonly referred to as "hair plugs" or "the dolls head look." These implants were obvious, unsightly, and a black eye on the hair industry. Follicular unit transplantation (FUT) has been around now for about 20 years and is considered the gold standard in the industry. Plugs are now just a sore spot in history. However, there is a new technology called follicular unit extraction (FUE). This new procedure is a smaller, but mirror image of the old "plug" technique. And people are paying are not only paying for it, they are paying more for it!
FUE is being sold as the “scar less” surgery. However, that is not true. Anytime a surgeon cuts into the human body with a sharp blade, there will be a scar. This is a fact. The only issue that comes to discussion here is whether it will be a linear scar or tiny red dot scars. The truth is the patient will be left with a large number of white and/or red polka dotted scars. These scars will be spread throughout the entire donor area. An FUT surgery will create a fine linear scar from the back of one ear to another in that same donor area. The scar will be extremely thin and fine if done properly by an experienced hair restoration surgeon.
Unfortunately, there are a small number of hair surgeons that use scare tactics such as showing patients badly botched examples of the linear scar. This creates an opportunity for the scared patient to agree to the FUE transplant. The cost is extremely higher, but the patient who is already traumatized from the hair loss, is open to anything that works and leaves no botched scar. The patient does not know that there are other issues that make the FUE procedure more difficult to perform. The only thing on the mind of the patient is a wide unsightly scar they do not want. What the patient needs to know is that these are worst case scenarios and if they do their research and really check in on their surgeon, their hair transplant will be undetectable and that linear scar will be covered by even a small amount of hair coverage.
The FUE procedure is even more labor intensive than the FUT. The procedure sometimes takes days, not hours, to complete. The claim is there is that it a less painful procedure, however, there is not much pain in either procedure since only local anesthesia is used. This is another scare tactic doctors will use because patients are always asking if it is painful.
One important issue to be addressed with the FUE procedure is follicular homicide. This is a term used when hair follicles are destroyed. They can be destroyed as simply as an inexperienced tech team member cutting them in half. There are going to be many cases of follicular homicide. The sad part is there is only so much donor hair in the back of anyone's head. However, this is not much of a focus during the pre-op consultation. Again all the focus is on horrible pictures of badly performed FUT surgeries all in an effort to get more money out of a person for the FUE procedure.
There are a few reasons why one would opt for an extremely expensive FUE technique. If a patient has had multiple previous hair surgeries and is left with bad scars it can work to fill hair into the scar areas. The thought here is there is not enough elasticity left in the donor area to extract another linear scar. So the FUE method would be used to help cover these scars up. However, this would be a very small procedure. Probably 300 hair grafts at most.
The actual cost for the FUE can be quite high. A few procedures and you are looking at $35 - $50,000. I have heard stories of that number being closer to $100,000. All because people are willing to pay for something they think is new and better. The fact is they are paying for the very old "hair plug" surgery all over again. However, they are paying a whole lot more for it! Please make sure to do your research. If you take the time to investigate properly you will choose the right surgeon and get the right result. You will maximize your donor area and experience minimal scarring and minimal discomfort.
So, before committing to an FUE surgery, research both the FUE and FUT and determine for yourself which surgery is truly right for you and your hair needs.