FUE: Follicular Unit Extraction or Excision – which is the correct term?

2nd November 2018

FUE extraction or excision

If you’ve been researching the hair transplant technique FUE online you have may noticed that there appear to be two different terms with that acronym: Follicular Unit Extraction and Follicular Unit Excision.

In fact, both these terms refer to the same procedure. But which is the correct term?

The correct technical term for the hair transplant technique known as FUE is now Follicular Unit Excision. This was updated in March 2018 by the International Society of Hair Restoration Surgery (ISHRS) from the traditional term Follicular Unit Extraction, to emphasise the highly-skilled, surgical nature of the procedure.

What is FUE?

FUE is a surgical hair transplant technique that involves transferring hair grafts from the area of the scalp where hairs are genetically programmed to continue growing for life (the ‘donor area’) to areas affected by hair loss.

Unlike the other main hair transplant technique FUT (Follicular Unit Transplant), where a strip of donor skin is removed from which to dissect the follicular units, FUE extracts individual follicular units directly from the scalp. This done using a 0.8mm to 1mm ‘punch’ and can be carried out manually or using one of several different surgical tools. The surgeon will make microscopic slits in the recipient area of the scalp, and the individual grafts will be placed into these sites.

Whereas the FUT technique leaves a linear scar, following FUE there will be a series of tiny dot scars on the scalp which are so small as to be scarcely noticeable – making it ideal for people who prefer to wear their hair short.

Read more about how FUE works here.

Why has the name been changed from Follicular Unit Extraction to Follicular Unit Excision?

The FUE procedure – removing individual hair grafts and placing them into microscopic slits – is a highly skilled surgical technique requiring a qualified surgeon.
On March 6, 2018, The International Society of Hair Restoration Surgery (ISHRS) announced an update of the terminology from Follicular Unit Extraction to Follicular Unit Excision in order to reflect this surgical nature of the technique.

Dr Ricardo Mejia, MD, ISHRS Board Member and Chair of the Ad Hoc Committee on Issues Pertaining to the Unlicensed Practice of Medicine, gave the following explanation for the name change:

“The purpose of clarifying that surgical graft removal with FUE involves excisions of hair and tissue is to make this terminology more scientifically, clinically and surgically accurate. 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.”

The reason the ISHRS has deemed it necessary to make this change is that in some countries the term ‘extraction’ has non-surgical implications, potentially leading to the wrong assumption that the procedure can be effectively carried out by non-surgeons.

As the ISHRS website states: ‘…over the past 15 years, the term “extraction” has been used to minimize 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.’

Dr Mejia continued:

“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—and avoid inadvertently paying to have surgery performed by someone not licensed to practice medicine.”

Unfortunately, the rise in poor quality hair transplants by unqualified practitioners, particularly in the field of overseas ‘medical tourism’, is a problem we have seen at The Maitland Clinic, as we regularly see patients who require corrective surgery for a botched transplant. (See the blog post: Why are hair transplants so cheap in Turkey?) so we can understand the rationale behind the change of name.

FUE at The Maitland Clinic

At The Maitland Clinic we provide a full range of hair restoration procedures, and our surgical team, led by Dr Edward Ball and Janna Shafer, are amongst the world’s leading exponents of FUE techniques.

Achieving a natural result requires both technical surgical excellence and an aesthetic understanding of how hair grows and what will work best for each individual patient. A successful FUE transplant is therefore a combination of science and artistry.

We’re proud of the exceptional results enjoyed by our patients. See a gallery of FUE before and after photos here.

We also provide an excellent aftercare service. After your procedure we’ll provide you with everything you need to take care of your scalp and your new hair grafts, including medication to manage any initial discomfort. Far beyond that, we encourage you to stay in contact with us for ongoing support and regular check-ups to monitor and maintain your hair growth. An FUE transplant is something that lasts your whole life – and our ongoing professional care reflects that.

To find out more about hair transplants and to arrange a consultation, please contact us through the form below, please call 023 9270 6122 or complete our contact form.