What to Expect During a Follicular Unit Extraction Procedure – Step by Step

Follicular unit extraction is an advanced surgical hair transplant technique that replaces thinning or balding areas with new, permanent growth. 

Unlike traditional strip harvesting, follicular unit extraction (FUE) does not leave a noticeable scar in the donor area. This is possible thanks to the use of 0.8mm and 1 mm punches.


Follicular unit extraction (FUE) is a hair restoration procedure that involves moving individual hair follicles from a thicker part of your scalp to a thinner area with less or no hair. The resulting “plugs” look very natural. Unlike the traditional strip hair transplant method, follicular unit extraction leaves no visible scars in the donor area.

For a person considering a hair transplant, they first need to decide whether or not an FUE transplant is right for them. A doctor can tell if a person is a good candidate for an FUE hair transplant by doing the FOX test, which involves taking a few grafts and determining how easy it is to extract them. If the surgeon struggled with getting the grafts out or did not extract all the complete follicular units, the patient should be switched to a standard strip technique.

The procedure is relatively safe and comfortable, with minor possible side effects, including bruising, swelling, and sensitivity at the donor and recipient sites. Patients may also notice small white dots on their heads where the follicles were harvested, but these marks will disappear over time or be camouflaged with longer hair.

Follicular unit extraction is a quick procedure to help you resolve male pattern baldness and other hair loss conditions. It is a great option for people who want to address their hair loss but want to avoid dealing with the long recovery associated with more standard procedures like strip harvesting.


The incisions for follicular unit extraction (FUE) are made using a small punch that can be manual, motorized, or robotic (SmartGraft or NeoGraft). The surgeon will make circular incisions around each hair follicle to free it from the surrounding skin. The follicular unit is a full-thickness skin graft containing epidermis, dermis, and intradermal fat.

The surgeon will score the follicular unit with the sharp side of the punch under 2.5 to 5x magnification. Then the dull side of the punch is introduced into the incision and twisted to loosen the follicular unit. The follicular unit is then extracted with forceps or a specialized device.

When the depth of punch penetration is not deep enough to release the follicular unit, transection may occur, leading to de-capping or injury to the follicles. For this reason, a proper technique of cutting the incision with the punch is important. Some surgeons use a two-step dissection method, whereas others like to use blunt punches that have been tapered to lessen the amount of twisting needed.

The incisions left after follicular unit extraction are very small and can be easily camouflaged with your natural hair. Shaved, they will appear as tiny little white spots on the scalp. Because of its minimal invasiveness, patients experience minimal post-operative pain and discomfort and quick recovery time.


During the harvesting phase, your doctor will use an advanced handheld device to ensure the procurement of strong and healthy follicular units. Unlike FUT hair transplants, which involve removing a strip of scalp, the follicular unit extraction technique offers no linear scar in the donor area. This allows you to keep a short haircut without worrying about visible scarring.

Using a small needle-like instrument called a punch, the surgeon will create tiny holes into your skin to remove the individual hair follicles from the scalp. The follicles will be moved to a different part of your head, where they will be nourished by blood vessels and begin growing new hairs. This process is relatively quick and painless, except for a few tiny white dots where the punches have been removed.

While these tiny scars aren’t noticeable, they will fade over time or be covered by your new hair growth. It is important to remember that not all hair transplant doctors have the same experience with this procedure. 

He will prepare the follicular units for placement and manage your entire treatment to deliver an outstanding result. The results will become visible after three to four months as the grafted follicles grow new hair.


Follicular unit extraction allows for a less invasive hair transplant technique. It involves replacing the old follicles that cannot regrow hair with new follicles that will. This process helps you to grow a full head of natural hair, even if you are experiencing baldness or thinning hair.

With this procedure, your doctor will use a needle to create a small hole in the skin to extract the follicular unit. Then, they will insert the graft into the area where you want to add more hair. Depending on the type of hair loss you are experiencing, you might need more than one session to get the desired results.

After extracting the follicular units, you must keep your hair long enough to hide the small scars. However, with recent developments in punch technology and system technology, it is now possible to achieve better results with shorter haircuts.

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