FUE (Follicular Unit Extraction) is a hair transplant technique that removes individual follicular units from the donor area using a 0.7 to 1.0mm micro-punch, then implants them into thinning or balding areas. Each session can transplant up to 5,000 grafts with a 90 to 95% survival rate, and recovery takes 7 to 10 days.
What FUE Actually Is
FUE is one of two primary methods for hair transplantation, the other being FUT (Follicular Unit Transplantation, or strip method). Both achieve the same end result: permanent hair relocated from the back and sides of the scalp to areas of thinning or baldness. The difference lies entirely in how grafts are harvested from the donor area.
In FUE, a surgeon uses a small cylindrical punch tool to score around each follicular unit and extract it individually. No scalpel incision is needed, no strip of skin is removed, and no linear scar is created. The result is thousands of tiny dot scars, each less than 1mm in diameter, scattered across the donor area.
For a detailed side-by-side analysis, see our FUE vs FUT comparison.
The Follicular Unit
A follicular unit is a naturally occurring grouping of 1 to 4 hair follicles that share a single exit point from the skin. These groupings also contain sebaceous glands, a small muscle (arrector pili), and supporting connective tissue. FUE extracts these units intact, preserving the complete biological structure needed for the hair to survive and grow in its new location.
Single-hair follicular units are typically placed along the hairline to create a natural, gradual transition. Multi-hair units (2 to 4 hairs) are placed behind the hairline for density and coverage.
The Three-Phase FUE Process
Phase 1: Extraction
The surgeon shaves the donor area (the back and sides of the scalp, where hair is genetically resistant to pattern baldness) to approximately 1 to 2mm in length. This allows clear visualization of follicle direction and angle.
Using a motorized or manual micro-punch tool sized between 0.7mm and 1.0mm, the surgeon scores a circular incision around each follicular unit. The punch cuts through the epidermis and dermis to a depth of approximately 4mm, isolating the follicle from surrounding tissue. The graft is then lifted out using fine-tipped forceps.
Punch size selection depends on hair characteristics:
| Hair Type | Recommended Punch Size | Reasoning |
|---|---|---|
| Fine, straight | 0.7 to 0.8mm | Smaller punch reduces scarring; straight follicles are easier to isolate |
| Medium texture | 0.8 to 0.9mm | Balance of scarring and graft integrity |
| Coarse, curly | 0.9 to 1.0mm | Larger punch accommodates curved follicle path beneath the skin |
Extraction follows a scattered pattern across the donor zone rather than a concentrated area. This approach, called diffuse harvesting, prevents visible thinning in any single region and preserves the donor area's cosmetic appearance.
Phase 2: Graft Handling and Storage
Once extracted, each graft is placed immediately into a chilled holding solution. Standard clinics use chilled saline. Advanced clinics use HypoThermosol or ATP-supplemented solutions that extend graft viability from 4 to 6 hours (saline) to 8 to 12 hours (advanced solutions).
Trained technicians inspect each graft under magnification. Damaged grafts (transected follicles, stripped protective tissue) are set aside. The transection rate, meaning the percentage of follicles damaged during extraction, is a direct measure of surgeon skill. Rates below 5% are excellent. Rates above 10% indicate a need for technique refinement.
Grafts are sorted by follicular unit size:
- 1-hair units: Reserved for the hairline and temples
- 2-hair units: Placed in the transition zone behind the hairline
- 3 to 4-hair units: Used in the midscalp and crown for maximum density
This sorting ensures that implantation mimics the natural distribution of follicular unit sizes across the scalp.
Phase 3: Implantation
The surgeon creates recipient channels (small incisions or slits) in the balding area using a needle, steel blade, or sapphire blade. Each channel is made at a specific angle, depth, and direction to match the natural hair growth pattern of that scalp region.
Channel creation is considered the most artistically demanding part of the procedure. The angle and direction determine how the hair will lay once it grows. Frontal hairline channels are typically angled at 10 to 20 degrees for a flat, natural appearance. Crown channels follow the natural whorl pattern.
Once channels are created, grafts are inserted one by one using fine-tipped forceps or implanter pens (in DHI technique). The graft must sit at the correct depth: shallow enough for the hair to emerge from the skin, deep enough for the follicle bulb to contact surrounding tissue and establish blood supply.
Why Donor Hair Is Permanent
Hair on the back and sides of the scalp carries a genetic resistance to dihydrotestosterone (DHT), the hormone responsible for androgenetic alopecia (pattern baldness). This resistance is a property of the follicle itself, not its location. When a DHT-resistant follicle is moved to the top of the scalp, it retains its resistance and continues growing permanently.
This principle, called donor dominance, was established by Dr. Norman Orentreich in the 1950s and remains the biological foundation of all hair transplantation.
FUE Specifications at a Glance
| Specification | Detail |
|---|---|
| Punch size | 0.7 to 1.0mm |
| Recovery time | 7 to 10 days |
| Maximum grafts per session | Up to 5,000 |
| Graft survival rate | 90 to 95% |
| Scarring | Small dot scars (no linear scar) |
| Donor area shaving | Required |
| Procedure duration | 4 to 8 hours |
| Anesthesia | Local |
Who Should Consider FUE
FUE is the most popular hair transplant method worldwide, accounting for an estimated 80% of all procedures performed. It is particularly well suited for patients who want to wear short hairstyles (since there is no linear scar), those with limited donor density who cannot afford the tissue waste of a strip excision, and younger patients who may need multiple sessions over time.
For a full candidacy breakdown, see our guide on who qualifies for FUE. For pricing details, check the hair transplant cost guide.
Want to find out if FUE is right for your hair loss pattern? Upload a photo at myhairline.ai/analyze for a free AI assessment of your Norwood classification and personalized procedure recommendations.
FAQ
What is FUE hair transplant and how does it work?
FUE (Follicular Unit Extraction) is a hair transplant method where individual follicular units are extracted from the donor area using a 0.7 to 1.0mm micro-punch tool. Each graft, containing 1 to 4 hairs, is then implanted into tiny channels created in the thinning or balding recipient area. The transplanted follicles establish blood supply within 48 to 72 hours and produce permanent hair growth.
How many grafts can be done in one FUE session?
A single FUE session can transplant up to 5,000 grafts, though most procedures involve 1,500 to 3,500 grafts. Sessions exceeding 4,000 grafts may be split across two consecutive days to minimize the time grafts spend outside the body and to maintain high survival rates of 90 to 95%.
Does FUE leave visible scars?
FUE leaves tiny dot scars in the donor area, each 0.7 to 1.0mm in diameter. These scars are virtually invisible once surrounding hair grows to a few millimeters in length. Unlike FUT (strip method), FUE does not produce a linear scar, making it the preferred method for patients who wear short hairstyles.