Fue hair transplant

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What is a hair transplant?

A hair transplant is a procedure in which a patient’s own hair follicle is transferred from one area to another area resulting in a permanent change. The hair follicle is taken from a donor zone of hair because that hair has better growth properties. The donor zone is most often located in the back or low sides of the scalp. The hair is moved to the recipient site, also known as the area of need. There are many ways to extract or harvest the hair from the donor site. The most modern and very popular technique is called FUE, also known as follicular unit extraction.

What is an FUE hair transplant?

FUE stands for follicular unit extraction (or excision). The follicular unit is the fundamental unit of hair growth, and this unit is extracted in an FUE. FUE describes a technique in how the hair is removed. Removal of the hair occurs during the first phase of the hair transplant and is termed the harvest phase.

During an FUE hair transplant, hair follicles are harvested from the donor site as individual structures with a micro-punch. It is easiest to the think about the follicle like the seed of hair growth. The hair follicle contains the cellular components needed to grow hair as well as the sebaceous gland that lubricates the hair shaft and a special muscle, called the arrector pili. All of this is contained in the follicle unit cylinder extracted with the micro-punch. By transferring the smallest unit of hair growth, the results from our hair transplants look natural and do look “pluggy”.

A major advantage of an FUE hair transplant is that there are no scalpels or sutures used. This means the procedure can be performed on patients with a tight scalp and this also means there is no linear scar. The procedure is also easier to recover from with minimal discomfort.

Why choose haircareMD for FUE hair transplant?

  • Expertise – 20 years of experience and dedication have helped our patients get superlative results.
  • Artistry – we are committed to creating natural results that will last a life time
  • Individual focus – no two hair transplants are the same. We will carefully consider your goals and optimize each variable to provide you a stunning result.
  • Planning for now and for the future – our results are focused on helping you look your best now while understanding that aging and hair loss are progressive. We will discuss all options to help keep your existing hair healthy and layer in the new transplant hairs in a way that they will age well.

Understanding Hair Growth, Hair Loss, and Hair cycles
The structure that grows the hair is called a hair follicle and is located inside the scalp. The follicle is about 6mm deep. The hair follicle will grow hair for 3-7 years in a stage called catagen. The hair then starts to cycle as it passes through a phase called telogen where it will shed, rest, and regrow.

It is important to understand the hair follicle may contain anywhere from 1-4 hairs per follicle (average is 2.3 hair/follicle). This is a natural grouping. This means that some hair follicles will have single hairs, which are helpful to restore the hairline and other follciles will have 2-4 hairs, which are placed more internally for density.

Because the hair follicle is a cylinder, we can control the exit angle of the hairs to create the natural and artistic results.

What causes hair loss?
The most common cause of hair loss in men and women is androgenic alopecia, also termed male pattern and female pattern loss. This is a genetically set, hormonally driven, progressive form of non-scarring alopecia. The hair loss in men and women share some similarities though present differently. In men, the hairline classically recedes and in women, the hairline is maintained and the part widens. In both men and women, hair thinning is due to a lack of hair growth but also due to a decrease in hair shaft diameter, termed miniaturization.

An FUE hair transplant replaces hairs that have been lost or even allows hair to be placed in a site where hair never grew at all.

Case Study – FUE Cases

  • Case 1 – This patient is shown 1 year after FUE (follicular unit extraction) hair transplant by Dr. Benjamin Paul to enhance the hairline and frontal hair.

  • Case 2 – This patient had and FUE hair transplant with a focus on hairline restoration with Dr. Ben Paul. He wished for a more defined and a lower hairline that would look good now and would age well.  Great care was taken to not over-lower the hairline and instead there was a focus on building density to achieve a timeless result.

  • Case 3 – This is a patient 1 year after FUE hair transplant to thicken his hairline. He has curly hair, which did not prevent any issue with harvest or placement during FUE led by our surgeon, Dr. Benjamin Paul.

HUE Hair Transplant

  • Case 4 – This patient is shown at 8 months after FUE with Dr. Benjamin Paul to enrich the hairline and frontal hair.  In this case, a few baby-hairs where placed at the hairline fringe to help the result appear as natural as possible.

  • Case 5 – This patient had an FUT (strip) in another office with little take. Dr. Benjamin Paul performed a second hair transplant with FUE (follicular unit extraction, the dots technique) and helped this patient achieve a fabulous improvement. The after result is 1 year after his procedure.
  • Case 6

9 Months After Hair Transplant (FUE)
This patient is 1 year after FUE hair transplant with Dr. Benjamin Paul for diffuse patterned alopecia, a subtype of male pattern hair loss. He was also started on oral medicine to improve the stability of his existing hair.

This patient is 9 months after hair transplant to restore his hairline. FUE, follicular unit extraction, was performed by Dr Benjamin Paul to improve both the position and density of the hairline.

What are the type of hair transplants?
During a hair transplant, hair is taken from the donor site and placed in the recipient site. There are two major types of hair transplant termed FUE (follicular unit extraction) and FUT (follicular unit excision). In both techniques, the fundamental unit of hair growth termed the follicle is isolated. The difference is in how the hair is extracted.

In FUE, a rotary micropunch is used to extract individual hair follicle units. Hair that is taken will not grow back in the site of harvest (think of uprooting to re-plant a tree) and may be placed in the recipient site to create new hair growth. This means there will be less hair in the donor site after an FUE and care is taken to make sure enough hair is left behind so that there is little to no evidence a procedure was performed. This also means there are only so many hairs that can be moved during FUE.

In FUT, a surgical strip is taken from the donor site. This long ellipse is removed by the surgeon and the skin is closed into a fine line closure. Sutures are required and are removed after 10 days. If patients keep their hair long enough (longer than a size 3 on a guarded razor), then the overlap of hair will easily hide the incision line. Once the strip is excised, it is divided under magnification into the individual cylindrical units, called the hair follicles.

At the conclusion of the harvest of both FUE and FUT, the hair follicles will be sorted as individuals. As discussed, the hair follicle can have 1-4 hairs per follicle. The single hair follicles are sorted and placed in the hairline. The follicles that contain more hairs are placed internally to enhance density. From the front, one cannot tell if FUE or FUT was performed since both transfer individual follicles. The difference is in the harvest technique.

What are the reasons someone with have an FUE hair transplant?

FUE has become popular for many reasons. The single biggest reason someone may choose FUE is to avoid a linear scar line in the donor site. FUE allows more flexibility in wearing a short haircut. As FUE does not involve sutures or scalpels, the recovery is rapid and there is minimal discomfort in the after care.

What are the types of FUE?

An FUE, follicular unit extraction, is a procedure that harvests the single follicle with a punch. Originally, the punch was handheld and static. Now we exclusive used motorized technology. The first motorized punches were rotary. We still use these punches but now also use oscillo-rotary punches. This advancement in motion reduces trauma to the hair follicle, which improves viability. There is even a hair robot, called the ARTAS, which we own. This is a rotary device that assists in punching the hair follicle. The robot has limited applications as it is limited by head shape, hair shape, and hair strength.

How is FUE performed?

To perform FUE, the hair must cut short. For larger hair transplants, this means that the back and sides of the scalp are trimmed to 1.2mm length, which is the length of an unguarded razor. There are times that for more limited work, a window (or windows) of hair can be cut and the long hair above can cover the donor shave. This form of long hair FUE has been performed successfully in our practice since 2016 and has helped countless men and women.

Though some are trying to perform long-hair FUE without any shave, the technology requires a larger diameter punch which leaves bigger and more noticeable scars, has a lower success rate, is substantially slower, and does not allow as many hairs to be transferred. For these reasons, we are not currently offering unshaven long-hair FUE. Our philosophy is to produce an amazing results that are consistent to reliable enhance your density.

Once the hair is trimmed, local anesthetic is injected to numb the scalp. The harvest then begins with the patient in the face-down position on a plush table, similar to a massage table.

We are focused on using the smallest punch possible to extract the full content of the hair follicle. This will ensure optimal viability with minimized evidence of harvest and a more rapid heal. The physician will determine and calibrate your punch diameter. The harvest can take anywhere from 30 minutes to 3 or more hours depending on the amount of harvest being performed. We will discuss the specifics of your harvest during the consultation.

What is the best method to perform FUE?

The best method of FUE will extract the hair follicles intact with the smallest punch possible. The type of drill and the size of the punch matter a lot. We routinely use sub-milimeter punches when possible (over 97% of cases) as this will produce a substantially smaller scar dot, that is sometimes nearly invisible. Larger punches may be necessary for very curly hair. The best technology available is an oscillorotary punch. It is superior to the Artas robot in that the robot only rotates. Oscillation is less traumatic to the hair follicle and optimizes viability.

How do you implant hairs?

Once the hair is extracted, the hair is implanted into the scalp in two phases. The first phase is called site making, where pockets are made in the recipient site to receive the hair follicles. To do this, the physician delivers numbing medicine and uses special, proprietary depth gauge needles to make the “sites”. This phase takes 1-2 hours. Patients are on their back for this phase.

The hair is then inserted with special hair forceps under magnification. For placement, it is customary to have two vetted, highly trained team members working simultaneously. This will improve the efficiency and reduce the amount of time your hair spends outside of your head, which improves viability. Each team member has an average of 15-20 years of experience, and we are proud to have the most experienced hair team in NYC.

Is an FUE a permanent change?

Absolutely, an FUE hair transplant is a permanent change. During FUE, the hair with the best growth potential is harvested from donor zone. Upon transfer, these donor hair follicles will keep their genetics and grow in the new site with these better growth prosperities. The original term for this is “donor dominance”. We are careful during your consultation to review the projected progression of your hair loss to ensure your hair transplant blends into your current hair and will also age well. The result from an FUE hair transplant is permanent, but at the same time, moving hair during a transplant does not stop the progression of hair loss. Happily, there are ways to complement a hair transplant that can help preserve your original hair and this too will be discussed during your consultation.

How is FUE different than FUT?

FUE and FUT are different in how the hair follicle is extracted from the donor site. In both FUE and FUT, the hair follicle is harvested from the donor site. In FUE, follicular unit extraction, hair is removed with a micro-punch. In FUE, there are no linear scars, scalpels, or stitches. In FUT, a surgical strip of skin is removed and sewn closed from the donor site. There is a fine line scar. The strip is hand-divided under magnification into the individual hair follicles. Both FUE and FUT are excellent forms of hair transplant that are performed today.

What are hair plugs?

Hair plugs are an old form of hair transplant where many groups of follicles are transferred together. This may be anywhere from 10-100 hairs. This old technique taught us that hair can be transferred but left us hoping for better aesthetic possibilities as the results do not look natural. Happily, modern hair transplant does not look pluggy at all.

How does FUE compare to other non-surgical hair loss treatments? Is there a permanent, non-invasive treatment to hair loss?

Hair transplant with follicular unit extraction (FUE) is a permanent form of hair restoration in that the donor hairs keep their better inherent growth potential upon transfer. A back hair placed into a recipient site, let’s say the front of the scalp, will not become a front hair. All forms of hair transplant are permanent.

Non-surgical hair restoration has tremendous value in someone dealing with hair thinning as hair transplants do not stop the progression of hair loss. Non-surgical options such as medicines, PRP, vitamins, light treatment, and mesotherapy enrich the microenvironment around the hair follicles and signal the follicle to grow better. Like a fertilizer in a garden, any improvement from non-surgical hair restoration is lost when the treatment is stopped. At this time, there is NO permanent, non-invasive treatment for hair loss because the genetic core of the hair follicle has not been altered.

The FUE transplant experience at HairCareMD

What happens during the first visit consultation?

  • During your first visit, you will meet with the physician to discuss your concerns. Your underlying cause and pattern of hair loss will be identified. The medical and surgical options for treatment will be reviewed. We ask that you do not put any hair powder or root spray in for your consultation if possible, so we can evaluate a clean scalp.

How do I prepare for a FUE hair transplant?

  • If you are a candidate for an FUE hair transplant, we will provide you with thorough paperwork to get you prepared for your FUE hair transplant. For most patients, the instructions are simple, and patients are asked to pick up all medicines before the day of the procedure.
  • For most patients, no medical clearance is required as the procedure is performed under local anesthesia. For patients with medical complexities, we ay require that you obtain a medical clearance. If a clearance is needed, we will let you know in advance and support you with this process.

The procedure – what to expect on the day of the follicle unit extraction transplant

  • The morning of the procedure, you will meet with the physician and discuss your plan for the day. The hairline will be drawn.
  • For FUE, the hair in the donor site will be shaved. We do not routinely shave the recipient site. There are times for the donor site that we can shave small windows to allow the long hair to hide the donor harvest, making the recovery even more invisible that work was done.
  • You will lie face-down for the harvest. Local anesthesia is gently injected. There are patients who ask for a deeper level of anesthesia, and we are happy to be able to provide this upon advanced request. The harvest takes 30 mins to 3+ hours depending on the amount of hair needed.
  • For the rest of the day, you will be on your back.
  • The second major portion of the transplant is the site making. In this step, “sites” or pockets are made by the physician. This sets the artistry of the result and is a key reason to choose our office. Artistry varies significantly between clinicians and offices. The sites do not just determine the distribution and spread of the hair follicles, but also sets the exit angulation, which is very critical to creating a natural result that you will love for years to come.
  • The final step of a hair transplant is placement. For this step, hair is placed into the sites. This process will be performed with two skilled team members working simultaneously. Your physician will be guiding the team and adjusting the aesthetic as needed.
  • At the conclusion of the hair transplant, most patients have a wrap placed on their head.
  • The instructions for after care will be reviewed prior to discharge.

What is the recovery from FUE hair transplant surgery

  • Patients have minimal discomfort and are able to work from home the next day.
  • The wrap on the head is removed at home the next day. If you feel uneasy removing your wrap, you will be given an option to have a skilled team member visit your home or hotel to remove the wrap.
  • Most patients can wear a baseball cap the next day.
  • Patients are encouraged to gently wash the hair two days after the procedure using a modified cup and pour technique that we will teach you.
  • Activity that produces sweating or rubbing on the grafts is limited for two weeks.
  • Most can return to workplace after once week.

What is the follow up after an FUE hair transplant

  • Patients return to the office 7-14 days after the procedure for a check in
  • We next see patients 6-12 months after the procedure, or sooner if any questions or concerns arise.

When can I expect to see results

  • The hairs that are moved in an FUE will grow for 3 weeks to 3 months then shed. At 3-6 months, the follicle has “taken” and is resting under the skin. At 6-18 months, the hairs grow in and then grow for life. Classically, patients see 80% of the result at 8 months.

What are the advantages of FUE?

The main advantage to FUE is the absence of a linear scar. The procedure has no scalpels or sutures. The recovery is efficient and leaves little evidence of the harvest itself for most patients.

Who is a candidate for FUE?

FUE is excellent in primary hair transplant for those with straight, pigmented hair. It can be performed in some cases of wavy or curly hair, though is more challenging. FUE can be performed on grey or thin hair, though this is also more challenging. FUE is excellent if someone has a tight scalp either congenitally (from birth) or from prior FUT or other scalp surgery. FUE allows for the choosing of individual hair follicles so for smaller projects, such as side burn restoration, FUE is excellent as we can select the best matching follicles for the project.

What is an Artas iX hair transplant?

Robotic hair transplant uses a machine called the Artas iX to assist in the harvest of FUE. The robot is used instead of a manual drill to assist in extraction. To learn more about ARTAS iX, please visit our robotics page.



Do you charge by the graft?

We do not charge by the graft. We are interested in producing holistic beauty, and charging by the graft does align with this mission. We will discuss the cost for the scope of work for your FUE hair transplant and expectations in your consult. The price will not change on the day of your procedure.

How many grafts can you transplant?

The graft count is limited by the donor site. Since the hairs taken from the donor site do not grow back in the donor site, we are careful not to over-harvest the donor site. Each patient will have a different safe number of harvestable grafts. During your consultation, we will review the proper amount of hair that should be moved.

How many grafts do I need?

Patients visit our office to look their best. This does not necessarily mean that we have erased all evidence of hair loss, as this is not always possible. Our goal is to help craft a plan that helps you look your best in the short term and also age beautifully with smart long-term plan.  The number of grafts that are needed will depend on the donor site density as this may limit the amount that can be taken, the size of the recipient as this will set the surface area, and the nature of the hair itself.
As a rough guide, the following chart may assist you in understanding how many grafts are needed:

Is 1000 grafts enough?

In our office, 1000 grafts can produce a substantial change for the right patient. 1000 grafts can improve the hairline or improve a bald spot.

Should I transplant all my hair?

It is not recommended to fully deplete all the donor hairs in the donor site.  Our goal is to use the donors hairs in the best possible way to enhance your aesthetic.

Can women have FUE?

Women can have FUE. The procedure works for small projects. FUT is usually a better option for women as more hair can be transferred and the donor site is not shaved. During your consult, your doctor can discuss this with you further.

Does FUE work for all types of hair?

FUE works best for straight pigmented hair in men. The procedure can be performed on curly hair, grey hair, or women though FUT may produce a better result.

Can FUE fix bad results from other clinics?

FUE can improve the aesthetic from other offices, especially when there is a lack of density in the recipient site and there is still donor hair left behind.

It is uncommon to place FUE hair into and FUT scar.  A scar revision or micropigmentation is more appropriate for most.

Is there an age cut-off for FUE? Am I too old for FUE?

FUE can be performed on any adult. We have successfully performed FUE on patients in their 8th decade. The nature of the donor hair ultimately determines who is a good candidate for FUE. As we get older, there is an element of aging to the donor hair. The hair can become too thin or too sparse for harvest. During your consult, you can discuss your candidacy for FUE with your physician.

How long does a procedure take?

FUE can take anywhere from a few hours to a full day depending on the amount of work required.

Is PRP combined with a hair transplant?

PRP may be combined with your transplant to reduce inflammation. To learn more about PRP, please visit our PRP page https://haircaremd.wpengine.com/artas-robot-hair-transplant-nyc/

What are the alternatives to a hair transplant

Hair transplant is a permanent form of hair restoration. This places new hair in regions of need, but does not stop the progression of hair loss. Alternatives to hair transplant are non-surgical and require continued use to see continued results. Please visit https://haircaremd.wpengine.com/services-hair-transplant/ to learn more.

How long till I see new growth

An FUE transplant routinely requires about 6 months to start seeing the improvement continues up to 18-24 months. The recovery is slow and varies a fair amount between patients. It is often said that 80% of patients will see 80% of growth at 8 months.

Do you offer virtual consultations as well as in-person consultations?

Yes – please visit https://haircaremd.wpengine.com/contact-us/ to schedule either an virtual or in-person consultation.

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HairCareMD – Hair Transplant NYC
225 E. 64th Street New York City,
NY 10065
(212) 832-7419


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