Download PDF
Facial Plast Surg 2024; 40(02): 146-157
DOI: 10.1055/a-2198-1352
Original Article

Concepts, Terminology, and Innovations in Follicular Unit Excision Hair Restoration Surgery

Aditya K. Gupta
1   Mediprobe Research Inc., London, Ontario, Canada
2   Department of Medicine, Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
,
Shruthi Polla Ravi
1   Mediprobe Research Inc., London, Ontario, Canada
› Author Affiliations
› Further Information
    Permissions and Reprints

Abstract

Follicular unit excision (FUE) has emerged as the preferred method for hair transplants. Standardized terms and definitions established by members of the International Society of Hair Restoration Surgery and prominent hair restoration surgeons have become the standard, enabling effective knowledge sharing. This chapter provides an overview of the terminology relating to the field.

The historical evolution of FUE and its pivotal role in modern hair transplantation is summarized. Anatomical terminology and graft-related definitions follow, providing insights into the scalp's complex structures and graft characteristics. The subsequent sections detail the terminology associated with graft excision and extraction, shedding light on the precise techniques and procedures employed. An exploration of various FUE techniques and the evolving landscape of FUE devices underscores the continual refinement of hair restoration practices. The chapter proceeds to discuss the “safe'” scalp donor zones, donor assessment terminology, and elements in identifying the optimal donor area for a successful FUE procedure. Additionally, punch dynamics and technique characteristics are examined, emphasizing their pivotal role in achieving superior FUE outcomes. The chapter concludes by discussing the classification of punches and graft evaluation terms, offering insights into the tools, and criteria used to assess graft quality and viability.

Keywords

follicular unit excision - hair restoration - hair transplant - FUE terminology


Publication History

Accepted Manuscript online:
25 October 2023

Article published online:
04 December 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Jimenez F, Alam M, Vogel JE, Avram M. Hair transplantation: basic overview. J Am Acad Dermatol 2021; 85 (04) 803-814
    CrossrefPubMedGoogle Scholar
  • 2 Epstein GK, Epstein J, Nikolic J. Follicular unit excision: current practice and future developments. Facial Plast Surg Clin North Am 2020; 28 (02) 169-176
    CrossrefPubMedGoogle Scholar
  • 3 Mohebi P, Angeles L. FUE Research Committee Chair's Message Standardization of the Terminology Used in FUE: Part III;. 2013 . Accessed 20 September 2023 at http://www.wikiquote.org.u
    PubMedGoogle Scholar
  • 4 Mohebi P, Angeles L, Cole J. et al. FUE Research Committee Chair's Message Standardization of the Terminology Used in FuE: Part II. 2013 https://www.ishrs-htforum.org/content/23/6/210
    PubMedGoogle Scholar
  • 5 Mohebi P, Angeles L, Lorenzo J. et al. FUE Research Committee Chair's Message Standardization of the Terminology Used in FUE: Part I. 2013 https://www.ishrs-htforum.org/content/23/6/210
    PubMedGoogle Scholar
  • 6 Barsali F, Bisanga CN, Cole JP. et al. A 2019 Guide to Currently Accepted FUE and Implanter Terminology FOREWORD Revised Standardization of the Terminology Used in FUE;. 2019 . Accessed 18 September 2023 at https://www.ishrs-htforum.org/content/29/3/98
    PubMedGoogle Scholar
  • 7 Unger R, Shapiro R. Follicular unit excision terminology and overview. In: Hair Transplantation. New York, NY: Thieme; 2023
    Google Scholar
  • 8 Lam SM, Williams Jr KL. FUE terminology: characterizing donor area, grafts, techniques, and devices. In: Hair Transplant 360: Follicular Unit Excision (FUE). Vol 4. New Delhi, India: Jaypee Brothers Medical Publishers; 2022
    Google Scholar
  • 9 Mejia R. Redefining the “E” in FUE: excision = incision + extraction. Hair Transplant Forum Int 2018;28(01):
    PubMedGoogle Scholar
  • 10 Bansod S, Kerure A, Rohatgi S, Bilewar U. History of follicular unit excision. Indian J Dermatol Venereol Leprol 2021; 87 (02) 315-318
    CrossrefPubMedGoogle Scholar
  • 11 Kingsley S. Sharing experiences of follicular isolation technique—follicular unit extraction. Hair Transplant Forum Int 2004; 14 (06) 211-212
    CrossrefPubMedGoogle Scholar
  • 12 ISHRS. Popular hair restoration technique updates name to reflect surgical nature of procedure. Accessed September 17, 2023 at: https://ishrs.org/popular-hair-restoration-technique-updates-name-to-reflect-surgical-nature-of-procedure/.
    PubMedGoogle Scholar
  • 13 Gupta AK, True RH. Follicular unit excision terminology and overview. In: Unger R, Shapiro R. eds. Hair Transplantation. 6th ed. New York, NY: Thieme; 2023: 339-353
    Google Scholar
  • 14 Mohebi P. FUE terminology: characterizing donor area, grafts, techniques, and devices. In: Williams Jr KL, Lam SM. eds. Hair Transplant 360: Follicular Unit Excision (FUE). Vol 4. 2nd ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2022: 33-62
    Google Scholar
  • 15 Devroye J. Motorized FUE with hybrid punch. In: Williams Jr KL, Lam SM. eds. Hair Transplant 360: Follicular Unit Excision (FUE). Vol 4. 2nd ed. New Delhi, India: Jaypee Brothers Medical Publishers; 2022
    Google Scholar
  • 16 Umar S, Lohlun B, Ogozuglu T, Carter MJ. A novel follicular unit excision device for all-purpose hair graft harvesting. Clin Cosmet Investig Dermatol 2021; 14: 1657-1674
    CrossrefPubMedGoogle Scholar
  • 17 Trivellini R, Asuncion I. The Trivellini system and technique. Hair Transplant Forum International 2018; 28 (05) 188-190
    CrossrefPubMedGoogle Scholar
  • 18 Saxena K, Savant SS. Body to scalp: evolving trends in body hair transplantation. Indian Dermatol Online J 2017; 8 (03) 167-175
    CrossrefPubMedGoogle Scholar
  • 19 Gupta AK, Love RP, True RH, Harris JA. Follicular unit excision punches and devices. Dermatol Surg 2020; 46 (12) 1705-1711
    CrossrefPubMedGoogle Scholar
  • 20 Tykocinski A. Dealing with a hybrid trumpet punch. Hair Transplant Forum Int 2017; 27 (01) 14-16
    CrossrefPubMedGoogle Scholar
  • 21 Unger W, Nowell Solish David Giguere Vince Bertucci F, Coleman W, Loukas M, Unger R. Delineating the “safe” donor area for hair transplanting. Am J Cosmet Surg 1994;11(04):
    PubMedGoogle Scholar
  • 22 Garg AK, Garg S. Donor harvesting: follicular unit excision. J Cutan Aesthet Surg 2018; 11 (04) 195-201
    CrossrefPubMedGoogle Scholar
  • 23 Chouhan K, Kota RS, Kumar A, Gupta J. Assessment of safe donor zone of scalp and beard for follicular unit extraction in Indian men: a study of 580 cases. J Cutan Aesthet Surg 2019; 12 (01) 31-35
    CrossrefPubMedGoogle Scholar
  • 24 Kumaresan M, Mysore V. Controversies in hair transplantation. J Cutan Aesthet Surg 2018; 11 (04) 173-181
    CrossrefPubMedGoogle Scholar
  • 25 Gupta AK, Bruce A, Trivellini R. et al. Innovations hair restoration surgeons have made to adapt to the challenges of follicular unit excision. J Cosmet Dermatol 2020; 19 (08) 1883-1891
    CrossrefPubMedGoogle Scholar
  • 26 Trivellini R, Gupta AK. Hair transplantation Follicular Unit Excision (FUE): Introducing the multipurpose octagonal ring punch. J Cosmet Dermatol 2021; 20 (08) 2602-2605
    CrossrefPubMedGoogle Scholar