What is a follicular unit?

Each follicular unit contains groups of 1-4 hairs, and oil glands, nerves, blood vessels and muscles, wrapped in collagen. The follicular unit contains layers of specialized cells that support hair growth. There is a bulge which contains a nest of stem cells for hair regeneration. And, there are skin cells. Preserving the follicular unit ensures maximum survival and growth of the transplanted hair.

The evolution of hair transplantation techniques

Strip transplants: Follicular Unit Transplantation (FUT) was created to improve surgical hair transplantation. Until FUT was introduced, the dominant procedure was punch extraction which were popular in the ‘80s. Punch extraction created unacceptable cosmetic results, and caused significant scarring.

The FUT procedure obtains the hair follicles from a strip of skin on the back of the head, which creates a large linear scar, and requires a longer recovery. FUT also combines the use of a stereoscopic microscope to dissect the hair follicles. FUT provides a more natural result, and a 30% increase in yield. FUT is currently the gold standard in hair restoration surgery and dominates about 70% of all hair restoration surgeries.

In 2002, Follicle Unit Extraction (FUE) was developed in an attempt to eliminate the need for a large incision and scar.  It uses a punch system that has been highly refined to avoid damage to the grafts, and scarring.


In 2008, NeoGraftâ was introduced with the same rational, to eliminate the need for a large incision and scar. NeoGraft is a hand-held device that works with suction to suck up the grafts created with a sharp edge dissection that causes significant damage to the grafts, affecting graft survival. In addition, when the grafts are sucked into the machine, and again when they are pushed out with forced air, this causes mechanical trauma to the grafts.  An additional problem is that the forced air dries out the grafts instantly and they become unusable. The success of surgical hair transplantation depends on healthy grafts.

But NeoGraft did gain some traction due to its massive media and advertising campaign pushing the message that there is no strip scar from the procedure. However, the company completely avoided the issue of the quality of the grafts and the subsequent hair growth.

It was also novel for providing a “turnkey” hair transplant clinic so that anyone could buy a machine, rent a small space, and start offering hair transplants with a weekend training course. Neograft even sent teams of trainers to help these new clinics get up and running.

Some have characterized the NeoGraft device as essentially a hand-held dental drill, which uses a single stage sharp punch dissection.  Because the device is hand-held the success of the procedure depends on the operator’s skills.

Damaging the grafts during removal from the scalp is a major problem with hand-held devices, and contributes to poor hair growth, especially in an amateur’s hands.

Newer systems have been developed with the rise of robotics, with questionable success so far. But most important of all is the experience of the hair transplant surgeon and his dedication to the field. The device does not guarantee good results, it is the surgeon’s skill and expertise that counts.

At Powell Medical Hair Restoration, we are devoted to restoring your own natural hair with meticulous and accurate surgical procedures that are artistically executed to deliver exceptional results.

Dr. Powell is a master who understands the subtle distinctions and artistry that create the most natural- looking results. He and his experienced staff are dedicated to providing you with confidence boosting, youth enhancing results.

Schedule a free consultation to get your questions answered, and learn about your hair restoration options in San Diego, California.

FUE Special