Follicular Unit Excision (FUE)

Follicular Unit Extraction has now been changed to Follicular Unit Excision. This reflects the importance and special surgical techniques required to make incisions and extractions in hair transplant surgery. In this blog we explain why this change has been made.

Follicular Unit Extraction now Follicular Unit Excision

Both Follicular Unit Extraction and Follicular Unit Excision refer to the same surgery. So what is the correct name we should be using?

What is an FUE Hair Transplant?

This is a type of hair transplant surgery where each hair follicle is taken out individually. FUE is carried out by using a small circular punch to cut around a hair follicle. Using specialised surgical tools these hair follicles are then removed and re-implanted into bald areas. Over time this will help recreate hair where it has been lost.

This technique differs from FUT (Follicular Unit Transplantation) where a strip of scalp is taken and hair follicles are isolated from this strip. Patients who have FUT have a visible scar line across the back of the head. In FUE this is avoided by having small dot scars at the back of the head. As these small dots are spread out they are not noticeable if someone grows their hair out.

Why the change from Follicular Unit Extraction to Follicular Unit Excision?

The change in name has been made to emphasise the highly skilled surgical nature of a hair transplant. The International Society of Hair Restoration Surgery (ISHRS)- the global leading authority on hair loss and prevention treatments implemented the change in 2018.

Dr Ricardo Mejia, ISHRS Board Member explained the main reasons:

When performed by qualified, properly trained hair restoration surgeons, hair transplantation is a safe and highly effective procedure to correct hair loss. However, it is a cosmetic surgical procedure and any attempt to downplay the significant surgical aspects of FUE to appear less invasive is misleading and potentially dangerous to patients

Dr Ricardo Mejia

Dr Meija explained that the term “extraction” in Follicular Unit Extraction, implied that the procedure only involves extracting or plucking out hairs without any need for surgery. And in some countries because the term “extraction” can have non-surgical implications, the surgery can be carried out by non-surgeons.

…over the past 15 years, the term “extraction” has been used to minimise the surgical nature of this surgery in order to imply a non-surgical procedure that only involves “extracting” hairs, as if they were being plucked out of the scalp without surgery. This misleading messaging has given rise to the worldwide expansion of follicular unit excision (FUE) surgery being performed by non-medical and unlicensed personnel- essentially spawning a black market for hair transplantation that has resulted in cases of serious cosmetic damage with scarring and hair loss, infections and even deaths

ISHRS website

Amending FUE terminology is one more way that we can inform patients about the true surgical nature of the procedure so they can make better decisions about their choice of physician and treatment

Dr Ricardo Mejia

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