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Review
. 2019 Mar;82(3):262-268.
doi: 10.1097/SAP.0000000000001679.

Nonshaven Follicular Unit Extraction: Personal Experience

Jae Hyun Park  1 , Seung Hyun You, Na Rae Kim
Affiliations
Review

Nonshaven Follicular Unit Extraction: Personal Experience

Jae Hyun Park et al. Ann Plast Surg. 2019 Mar.

Abstract

Nonshaven follicular unit extraction (NS-FUE) is the most state-of-the-art surgical technique in the field of follicular unit hair transplantation. It is particularly appealing because donor area shaving, one of the most serious impediments for the patient, can be omitted. In this article, we present our surgical approach for NS-FUE. We selectively used the direct or the pretrimming method of NS-FUE according to indication, determined by considering the location and purpose of transplantation, the condition of the recipient site, and the patient's preference. A total of 658 patients underwent NS-FUE. Of these, 17 had pubic atrichia, 2 had pubic atrichia and also received hairline correction surgery, 6 received eyebrow transplantation, 19 had female pattern hair loss, 362 had male pattern baldness (MPB), 2 had MPB and also required eyebrow transplantation, 3 received hair transplantation for MPB and scalp scar, 9 underwent male hairline correction surgery, 192 underwent female hairline surgery, and 46 received hair transplantation for scalp scar. The average numbers of transplanted grafts were 573 for atrichia, 1300 for atrichia and hairline correction performed successively, 240 for eyebrow transplantation, 996 for female pattern hair loss, 1408 for MPB (with a maximum of 3000), 1050 for MPB and eyebrow transplantation, 998 for female pattern hair loss (with a maximum of 1910), and 141 for scalp scar. On average, the total transection rate was 8.2%, and the calculated density was 2.2.

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Conflict of interest statement

Conflicts of interest and sources of funding: J.H.P. has patent pending, ownership interest of Seson medical company. The other authors have none declared.

Figures

FIGURE 1
FIGURE 1
Forehead support system for NS-FUE. A patient resting on an electrically powered forehead support. A foot pedal (not shown) is used by the surgeon to move the support in both horizontal and vertical planes.
FIGURE 2
FIGURE 2
Multiple clips used to expose the scalp in a female patient with long hair. To minimize hindrance to the surgeon and the tangling of long hairs, punch insertion should be performed within the exposed 0.7- to 1.0-cm working zone.
FIGURE 3
FIGURE 3
Various shaving patterns. A, Total shaving, postoperative day 1. B, Partial shaving, postoperative day 1. C, Harvesting a large number of grafts in a microstrip shaving pattern can result in multiple linear scars. D, Nonshaven FUE, postoperative day 1.
FIGURE 4
FIGURE 4
Patient's palm is used for understanding of the extent of shaving.
FIGURE 5
FIGURE 5
Motorized elbow rest. An elbow rest allows the operator to occasionally rest the arm during surgery.
FIGURE 6
FIGURE 6
Operator-assistant cooperation system during NS-FUE.
FIGURE 7
FIGURE 7
Two methods of loading grafts into the implanter. A, A graft protruding through the slitting gap after loading. B, A graft placed entirely in the tip lumen when loaded.
FIGURE 8
FIGURE 8
Unilateral trimming of the epidermis. A, An extracted FUE graft, showing prospective trimming planes. B, A graft after unilateral trimming of the epidermis with one clean cut. C, A graft trimmed with the blade directed downward too much, which can cause damage to the bulge area.
FIGURE 9
FIGURE 9
The 2(3)-1-1 system. The passer withdraws the used implanter from the operator's hand, immediately replacing it with another loaded implanter in a very precise manner, allowing the operator to work with quick, small vertical movements within a range of 5 cm. Graft insertion thereby takes place swiftly and accurately, without soft tissue damage.
FIGURE 10
FIGURE 10
Follicular unit extraction grafts differ from FUT grafts in shape. A, An FUE graft. B, Two FUT grafts.
FIGURE 11
FIGURE 11
Female hairline correction with NS-FUE, 1400 grafts. A, Preoperative photographs. B, Surgical design. C, One year postoperation.
FIGURE 12
FIGURE 12
Male pattern baldness patient, 2000 grafts with direct NS-FUE technique. A, Preoperative photograph. B. Hair growth after 1 year.
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Comment in

References

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