Follicular Unit Extraction (FUE) in Black Men and Women

Follicular Unit Extraction (FUE) in Black Men and Women

In a hair transplant, there are two main ways of removing hairs from the back of the scalp or 'donor area' :

1. Follicular unit extraction (FUE) 

2. Follicular unit strip harvesting (FUSS)

Both methods can give great results and there are advantages and disadvantages of each. Men who plan to shave their scalp in the future (or wear their hair very short) prefer the FUE method because the linear scar is not seen.  

FUE Techniques in Black Men and Women

There are several factors that influence whether someone is a candidate for FUE.  One of these is the shape and curl of the patient's hair follicles.  It is much easier to extract hairs by FUE in men and women with straight hair than men and women with curly hair.   The structure of hair in black men and women is such that it is curlier than caucasian and asian hair.  The curlier the hair, the more difficult it is to predict the path that the hair follows under the scalp and the more likley these hairs are to be damaged by FUE.  We call this damaged 'transection.' Curlier hair is much more likely to be transected during FUE. It's for this reason that a proportion of black men and women are not good candidates for FUE.  

Compare the photos below of follicular units in a caucasian hair (above):

 with photos of follicular units from a black hair (below):

You'll note the hairs are much curlier in black hair.

Conclusion 

I often recommend performing a short 'test session' prior to hair transplant surgery to ensure 100 % that hair follicles will be easy to harvest on the day of surgery and to ensure that the follicles will not be subjected to excessive damage.  Indeed a 30 minute test procedure for the patient in photo 2 peformed 4 weeks before a scheduled hair transplant confirmed that it was still possible to extract follicle by FUE with minimal damage (transection).  

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Robotics in Hair Transplantation: Coming Soon to a Clinic Near You?

Robotic assisted devices and computers are now used in many different types of surgerical procedures. It is likely that the same trend may be seen in hair restoration over the next decade.

Restoration Robotics, a privately held medical device company in the United States, created a robotic device to assist hair transplant surgeons.  The so called ARTAS system consists of a chair where a patient having a hair transplant would sit and a robotic arm that a hair transplant surgeon would control using a computer interface.  The robotic arm would dissect hair follicles from the back and sides of the scalp. The hope is that the quality of hair follicle harvesting may be enhanced by the ARTAS system. The device received FDA clearance in April 2011 for men with brown or black straight hair.

The company announced last week that they have raised 41 million dollars in venture capitalist funding and will begin now to focus on how the technology can be marketed in the United States.