The patient’s hair is first washed to remove impurities and their lubricating film produced by the sebaceous glands of the skin. Typically, the scalp is shaved for a FUE hair transplant. Hair in the harvesting area should be short enough (about 2mm) to allow the Punch to slide over the hair shaft without any constraints. Shaving the hair shirt reveals the true exit angle of the hair or follicular unit, which allows the Punch to be aligned so as to avoid sectioning of the grafts.

Once prepared for the procedure, the patient can choose a lying position or sit on a chair. The edges of the donor area and recipient area are usually drawn beforehand. Local anesthetic is injected in the scalp, after which the procedure can begin. The harvesting step of the procedure involves alternating between the same two actions: separating a series of grafts from the scalp using the Punch and then extracting them using micro-forceps. Depending on the speed of the practitioner and his assistants, it is possible to extract 400 to 700 grafts per hour. Hair transplantation is sometimes performed by two surgeons simultaneously on both sides of the patient’s scalp.

Micro-perforations (to place follicular units in the balding area) are made in the scalp using a micro-needle. During hair implantation, the patient can watch TV, read a book or listen to music to pass the time. Graft implantation can take several hours depending on the number of grafts desired. Once the follicular units are implanted, the scalp is cleaned and inspected by the doctor. The patient will receive specific postoperative instructions as well as a medication prescription.

Because the FUE hair transplant technique does not leave a linear scar, it adapts well to people who usually cut their hair short. Moreover, it is an asset for patients who are often involved in intense exercise, such as high-level athletes who need to resume training quickly after their procedure. In addition, other relatively common cases include patients who have had poor results after a FUT hair transplant technique, as well as those whose scalp is naturally very tight. In such instances, the FUE technique makes it possible to camouflage the scar by implanting hair and to harvest grafts in a targeted and individual way, even on a tense scalp.

Furthermore, some patients request the FUE hair transplant because they have heard that the procedure is minimally invasive or even non-surgical. However, the reality is that the FUE technique, like the FUT that preceded it, is actually a micro-surgical procedure. The key difference and innovation brought by the FUE, compared to the previous method, lies in the harvesting phase. Specifically, the FUE method uses very small circular micro-perforations that are spread throughout the sampling area and leave no visible trace after 48 to 72 hours.

Most of the transplanted hair will fall out about three weeks after the procedure. This signals the beginning of the resting phase, during which the transplanted follicles temporarily stop producing hair. This phase is completely normal and can vary from one patient to another, typically lasting between 3 to 6 months. In general, patients can expect regrowth as follows:

• Around 10% by the 3rd month,

• 20% to 30% by months 4 to 5,

• 40% to 50% by months 6 to 7,

• 60% to 70% by months 8 to 9,

• And finally, 80% to 90% by months 10 to 12.