Follicular Unit Extraction (FUE) is a method of individually extracting, or “harvesting,” donor hair during a hair transplant procedure using a surgical punch tool. FUE is a minimally invasive treatment and involves no sutures, no staples, and no cutting, although a small biopsy-like punch of skin is removed.

What is the difference between FUE and FUT hair transplant procedures?

The FUE method of surgical donor harvesting involves removing follicular units one-by-one directly from the scalp. This individual graft harvesting is what differentiates the FUE hair transplant from a traditional Follicular Unit Transplant (FUT). During FUT, the donor hair is removed from the scalp in one thin, long strip and then subsequently dissected into individual follicular units using a High Definition (HD) camera-microscope and LED screens.


Follicular Unit Extraction (FUE) is a method of extracting, or “harvesting,” donor hair. The surgeon uses a Cole punch instrument to make a small, circular incision in the skin around a follicular unit, separating it from the surrounding tissue. The unit is then pulled directly from the scalp, leaving an exceedingly small open hole of 0.8mm – 1.2 mm.

This surgical process repeats until the hair transplant surgeon has harvested enough follicular units for the planned hair restoration. This process can take one or more hours. Extensive sessions are accomplished over two consecutive days. The donor wounds, approximately 1-mm in size, completely heal over 3 to 7 days. All that remains are tiny white scars buried in the hair in the scalp’s back and sides, almost undetectable.

The creation of recipient sites and the placing of follicular unit grafts are essentially the same in both FUE and FUT procedures.
The difference lies in the donor area’s appearance and the quality and quantity of grafts obtained.

Follicular Unit Extraction is an instrument and user-dependent procedure. Therefore, the type of tool used for this procedure, and the surgeon’s skills and experience significantly affect its outcome. The development of increasingly better extraction instrumentation has closely paralleled the advances in the procedure.

Dr. Woods initially conceived the use of direct extraction to harvest follicular units in Australia as the “Woods Technique.” However, he did not disclose the details of his procedure. The technique was first described in the medical literature by Drs. Rassman and Bernstein, in their 2002 publication.
FUE hair transplantation continues to evolve as more physicians learn about this procedure, gain experience with it in their practices, and offer improvements to the technique.



At Medical Hair Restoration, our surgeons have researched and practised various FUE techniques over the years. Our conclusion remains to offer manual FUE surgeries performed by skilled and experienced surgeons. The surgeon can match the punch tool’s size to each follicular unit far more precisely during manual FUE surgery. Manual FUE can be challenging because it is difficult to see the graft through the scalp. It is a practised skill to align and position the punch and judge the depth required to excise the graft. The outcome of manual FUE is more superior and natural-looking than any other method we have seen. FUE hair transplantation continues to evolve as more physicians learn about this procedure, gain experience with it in their practices, and offer improvements to the technique.

The incidence of transection may be higher using FUE than using FUT but is very dependent on the experience and surgical skill of the performing surgeon. Transection occurs when incisions are not made far enough from the surrounding hair. If the blade is at the wrong angle or too much pressure is applied to the scalp with a punch device, it may cause transection.