FUE: What is Follicular Unit Extraction?

FUE technology is ideal for 1) men who wear their hair very short, 2) patients who need small areas transplanted or 3) patients who need a small number of hairs to conceal a scar.

PAI’s Preferred Method


What is FUE?

Follicular Unit Extraction (FUE) is when individual hair grafts are harvested one follicular unit at a time directly from the safe zone with an extraction device.


Example of an ARTAS Follicular Unit Extraction

This leaves small circular scars with no necessity for stitches. This procedure is great for patients who like to keep their hair cut very, very short.

PAI Medical Group offers all the available transplant options including follicular unit extraction, the least-invasive treatment available on the market today.

At PAI Nashville, our preferred FUE transplant is the most advanced procedure available which is the ARTAS Robotic hair transplant.

circular FUE scars

Follicular Unit Extraction leaves small circular scars throughout the donor area.

Two Ways to Perform FUE in the United States Today
We Offer BOTH Options

Manual Follicular unit extraction tool

Manual FUE

Hand punch systems require a person to carefully harvest each hair or group of hairs from the donor area by hand.

Artas Follicular unit extraction

Robotic FUE

The robotic system uses robotic precision to more accurately harvest each hair or group of hairs from the donor region.

First Generation
Originally FUE (Follicular Unit Extraction) transplants were all done by hand using small surgical punches to harvest the hairs.  Because of the level of precision needed, this process took much longer than the traditional strip technique. It also resulted in a higher number of hairs being destroyed (see photo) due to transection.

What is Transection, and Why is it So Damaging?
Transection occurs when delicate hair follicles are damaged or destroyed while being harvested. This results when the base of the hair is inadvertantly nipped or severed due to alignment issues beneath the skin.  There are many factors that contribute  to  transection; one being patients with wavy or curly hair.  There was a high rate of transection in first generation hand held FUE procedures which negatively affected overall hair density.

FUE also requires years of experience to acquire sufficient skills to be proficient. Because it is very labor intensive and tiring, results varied widely among practitioners and outcomes were often not successful.

Every generation of FUE causes more transection than FUT

Second & Third Generation
Second generation devices like Neo-Graft and the Ellis system automate the FUE transplant process making it faster than before.  However, FUE is still considerably slower than the traditional strip technique. FUE it doesn’t allow for larger ‘mega-sessions’ popular with patients today who may need more hair transplanted than can be done by a single FUE session. Despite these limitations more and more patients are looking for the least invasive procedure and FUE meets that need. The most recent generation FUE device is robotic.  Robots are very good at repetitive and precise movements.  They are thousands of times more accurate than a human hand and don’t tire. Because harvesting small hairs by hand requires extreme precision and tireless repetition robotics are better suited for harvesting the hairs to be transplanted. The ARTAS robotic FUE system gently and painlessly removes for implantation to other areas of the head.

The NeoGraft
The NeoGraft system is widely used in the United States today.  It is popular with physicians who do hair transplants as a side-service and not a specialty because of it’s simplicity and ease of use. Additionally most Neo-graft systems are operated by a technician in the doctor’s office.

The Ellis System
The Ellis System is used by many hair transplant surgeons today who specialize in hair restoration surgery. It is an inexpensive and simple automated punch device that can be used to augment a strip harvest procedure or as a stand alone device that can be used for a full FUE case.

The ARTAS is the first robotic hair transplant system in the world.  It blends the skills of a highly trained hair transplant surgeon with unsurpassed precision and advanced digital mapping technology to harvest donor hair for the procedure.  The proprietary digital mapping technology used to harvest the donor hair decreases hair transection (hair death) which is something commonly associated with other FUE techniques.  Larger areas can be covered using ARTAS because of the speed and precision of the robotic assisted harvesting system.