Remember when you could look in the mirror and see a face smiling back at you framed by a full head of hair?
Of course you do—because that memory haunts you every time you look in the mirror today at your thinning or balding scalp.
If you have been looking for a way to re-grow your thinning locks, you may have heard of FUE hair transplants.
What is a FUE hair transplant, and is it a viable hair restoration solution?
In this guide, I am going to give you the skinny on this process and what you can expect if you decide to go for it.
I’ll also give you some recommendations to help you find the best FUE hair transplant doctors.
Let’s get started by diving into the basics.
What is FUE?
FUE stands for “follicular unit extraction.”
It is a method which has been around since the late 1980s in Japan, where its origins can be traced to Masumi Inaba.
Despite having technically been in existence for quite some time, it is only in relatively recent years that FUE has become a popular technique.
This may be because it is a challenge to learn the necessary skills to perform.
As this journal article describes, “With the advent of FUE, the dream of ‘no visible scarring’ in the donor area is now looking like a possibility.”
The key reasons to choose FUE are:
The minimally-invasive nature of the procedure
The overall effectiveness of the technique
How Does the Follicular Unit Extraction Method Work?
You now have a general idea of what FUE is, but how does the method actually work?
There are a number of steps to the process:
First, you will have a consultation with the doctor who will be performing the procedure to discuss your goals. You’ll be able to pinpoint both the donor and recipient areas on your scalp during this conversation.
The doctor will next need to locate the best donor hairs. That means that the hair on that region of your scalp will require a trim.
Now it is time to remove the donor hairs from your scalp. To do this, the doctor will use a specialized instrument with a very minute tip. With it, he or she will create minuscule incisions around each of the follicular units which will be used for the donor hairs.
Once the incisions are made, an instrument which is similar to a pair of tweezers is used to pull out the grafts.
Every follicular unit contains around 1-4 hairs on average. Analyzing these microscopically, the team is able to come up with the optimal plan to distribute them on your scalp in the areas where your hair has thinned out.
Now it is time for another set of tiny incisions, this time on the spots where the donor hairs will be placed on your scalp.
The hairs are transplanted accordingly.
That’s it—the hard part is over. Or maybe not….
You are told that all you need after the surgery is to lay low and wait a few days for the delicate incisions to heal.
In my experience this initial healing phase was also challenging. Not being able to lay flat for sleep was brutal. The travel (6+ hour drive) was also tough. In hindsight, I think I overdid the ‘moisture’ sprays too but the itch was tough and the moist spray helped.
You’ll need to be patient after the healing phase is complete. It takes a few months to start seeing new permanent hair coming in. You will have a honeymoon phase before the new transplants fall out. That is shocking because once the scabs are gone and you wash your hair for the first time, you are left with a full head of hair (grafts in my case). It looks amazing and was the highlight for me. This gave me an idea of what my new hairline would look like once the transplanted grafts took root.
Unfortunately, not all of my grafts stayed. I would say a reasonable guess would be that I lost 20% of the transplant grafts.
FUE Advantages & Disadvantages
Why choose FUE over another popular method of hair transplantation such as FUT or strip harvesting?
Well, each method has a set of advantages and disadvantages, so there is not necessarily one true “best” method for every patient. But FUE may be right for you if minimizing invasiveness and facilitating fast and easy healing is important to you when getting a hair transplant.
Benefits of FUE:
If you want to avoid pain, FUE is the way to go. Indeed, you probably won’t even need painkillers while you are healing. If you went with FUT, you would have deeper cuts which would need to be closed using staples. And if you were to choose strip harvesting, that would entail removing actual skin from your scalp.
Within just several days, you should be all healed up. You probably will not need to take any sort of down time following the procedure.
The results of FUE can be so phenomenal that no one looking at you would be able to guess you ever had a transplant. Your hairline should come out looking entirely natural. *This was not the case for me due to overharvesting one specific area for donor hairs. The technician that measured my hair density (this is crucial measurement for the doctor) was either inexperienced or just not paying attention.
FUE does create scarring, but it is very hard to detect, even if you wear your hair short. This is a huge advantage over other methods. This is one of the main reasons why people choose FUE.*By comparison to strip surgery this is certainly true. However, you can certainly tell were the donor hairs were removed from. I keep buzz cut and my donor area is the first thing I “see” in mirrors. I freely admit this is better than seeing a NW3 in the mirror on my hairline but it does bother me.
Drawbacks of FUE:
Depending on your specific needs, you may need to shave a large portion of your scalp in order to get the transplant. Indeed, it is possible that multiple sections will need to be shaved in order to provide follicular units.As I mentioned above, the bigger concern is if the doctor / technician measures your density innacurately, you may be left with a ‘halo’ effect that is visibly thinner than the surrounding area.
Sometimes grafts are damaged during the process, though thankfully robotic aids can keep this to a minimum.
A FUE is not the most cost-effective option for a hair transplant. Then again, when it comes to cosmetic procedures, “you get what you pay for” certainly applies.
Your results depend on the quality and experience of your surgeon. This may not sound like a drawback at first thought but the cost for the best is much more than entry level surgeons.
Can you trust that you will receive the actual amount of grafts that you paid for? This is something I did not consider before surgery. Since the surgery is prepaid, you are basically locked into things before you get to the doctor’s office. To this day, I do not think I got the amount of grafts I paid for. I hope that I am wrong but you really have to trust that you are dealing with an honest broker in this respect.
FUE Hair Transplant Before & After Results
The best way to get a feel for what FUE can potentially do for you is to take a look at some hair transplant before and after pictures. You can see my hair transplant before and after results above from 2600 grafts.
But it is important to keep in mind that results can vary from person to person based on a variety of factors.
So your results could end up being in line with the FUE before and after photos you see, or if they could end up being more or less dramatic.
Something else to keep in mind about FUE results is that they will not be immediately obvious after the procedure. The swelling, redness and blood can be challenging. It was nothing I did not expect but the changes in your facial structure are alarming. I would not recommend this for someone with young children around.
Even though you should be able to distinguish the new hairline, it may be obscured somewhat by swelling, redness or scabs directly after the hairs are harvested and transplanted.
It should take anywhere from a few days to a week before your scalp is largely healed.
For me, I had extreme scalp tightness and sensitivity for several months.
During that time, you will need to be extra careful when you are taking care of your hair so that you do not damage or pull out the grafts before they are firmly rooted (which you can expect to happen by approximately the tenth day).
At this point, you will most likely enter that honeymoon phase before your transplanted grafts fall out.
Do not get overly excited about these results as they will fall out.
It takes several months for growth to begin so try not to worry too much about the final result.
In fact, most doctors say to wait a full year before final results are in place.
As this phase progresses, things may look a bit worse before they start to look better.
Here’s some of what you can expect:
Some of the new hairs may have a difficult time growing up through your skin, so you might get the appearance of ingrown hairs or acne in spots.
It is also possible that some patches of hair will grow in more swiftly than others initially. You can expect this to be temporary.
It is also possible that the new hairs will not look appealing at first. They may lack color and be extremely thin. This too should pass.
The results will become much more apparent at around the 6 to 8 month mark. Once again, you may not see the final results in terms of the color, thickness, and fullness of your hair until about a year has passed.
For some people, improvements may continue in the texture and volume of hair for another six months or so.
The harder you work to take care of your hair properly during this entire time frame, the better your results should ultimately be.
That means avoiding harsh hair treatments, not tugging at your hair hard when you comb it, and so on.
How Much Does A FUE Hair Transplant Cost?
Normally, hair transplants are considered to be elective procedures by insurance companies.
For this reason, it is difficult to get FUE discounted by your insurance provider. You will probably be paying the full cost yourself out of pocket.
That means that you need to be fully aware of the potential costs as far in advance as possible so that you can plan and save for the procedure.
In the early days of FUE, it was much more expensive than other types of hair transplants.
In the time since, new technology and better training programs have made it possible for FUE costs drop. While they still exceed those of other techniques, they are less steep overall.
On average, according to RealSelf, the cost for a FUE hair transplant is generally around $4,800.
That most likely is not based on US or Canadian surgeons.
On the high side, this type of hair transplantation procedure may run up to around $20,000 for those with Norwood V or higher levels of hair loss. My 2600 grafts (along with PRP stem cells) cost $12k.
A number of factors can impact the cost of a FUE hair transplant:
The number of grafts is one of the main factors which impact the cost of FUE. Naturally, it is going to cost much less for 500 grafts and it will for 3,000.
Follicular density may have an influence on your costs, as could details concerning your hairline and even how large or small your head is.
Sometimes, when you sign up for a hair transplantation procedure, you receive extra support. This may include advice on diet and vitamins or even therapy to help speed growth. These extras can raise your total costs.
You may also pay more or less for FUE depending on the geographical region where you get the procedure done.
Specific tools and techniques may be more or less expensive.
Individual cosmetic surgeons may also charge more or less based off of their qualifications and how in-demand for their services are.
Remember when you are shopping that the lowest cost is not necessarily the highest value.
If you’re going to be spending this kind of money and making a dramatic modification to your appearance, it is worth it to spend a bit more if it means the difference between an okay result and a phenomenal one.
What about going abroad, say to example for Turkey?
Quartz reports, “While a hair transplant costs up to $25,000 in the US and Europe, in Istanbul, it ranges from just $600 to $2,000.”
Unfortunately, most procedures in Turkey are performed not by doctors, but by technicians and nurses—even though this is illegal. For this reason, you may want to opt to get your procedure done in your own country.
That is not to say that there are great FUE transplant doctors in Turkey. In fact, one of the most well respected surgeons is from Turkey. With that said, you need to make sure the doctor will performing the procedure before you travel that far and are stuck with a nurse or technician instead.
How to Choose the Best Hair Transplant Doctor?
That brings us to our last topic.
How can you be sure that you are getting a qualified surgeon to perform your FUE transplant?
You should be able to locate detailed information on a surgeon’s training and experience. This should even include who the surgeon trained under. The longer the surgeon has been performing FUE, the better. This is a procedure where time and practice have a noticeable impact on results.
Reputable hair transplant surgeons should have reviews which are publicly available, and which are realistic in their discussion of both pros and cons.
Some surgeons specialize in hair transplants, while others may perform a range of cosmetic procedures.Neither is necessarily better than the other, but a surgeon who specializes in FUE probably has more experience with it, assuming they have been practicing the same number of years as a less specialized cosmetic surgeon. On the other hand, a more generalized cosmetic surgeon may be able to work with you on other aspects of your appearance at the same time.
Check for educational credentials as well as membership in professional organizations.
Find out what types of tools the surgeon uses for the procedure. Are they manual? Mechanical? Automatic? Robotic? The tools used can impact both the quality of the procedure as well as its cost.
Ask for references. The surgeon should be willing to provide you with actual references you can call and interview about their experience getting a hair transplant. Do not skip this. It is one of the most important research steps you can take. If possible, try to meet in person to view the finished product.
Find out what the role of other staff members is, and evaluate their competence as well. Make sure that the actual surgeon will be doing the majority of the work. But it is also important that auxiliary staff members can do their jobs effectively, so look into that too.
Recommended FUE Surgeons
Not sure where to begin in your search for the best hair transplant doctor to perform FUE?
We recommend that you compile a list of the surgeons in your area or that are within reach. Consult with at least 3 experienced FUE surgeons before making any decision. Ask for patient referrals and try to meet with them in person to inspect the work.
This can be challenging but you need to make a fully informed decision. Do not go with the cheapest option.
Would I do it again?
I get asked that often and to be honest I certainly would. Yes, I have a serious halo from over harvesting my donor area. Yes, I still get frustrated that I did not do more research before the surgery. That is why I wanted to share this online with you. Don’t make the same mistakes I did.
With that said, I am amazed when I see my before and after image. It seriously improved my confidence and I no longer think of baldness every day.
Hopefully soon, you can have your own story to share. Be diligent and don’t cut corners.