Bienvenido a SuroTransplantaPelo.com
CALVICIE (ALOPECIA ANDROGENETICA)
Transplante de pelo solución definitiva
Somos especialistas en Trasplante de pelo.

Es un método que consiste en obtener las unidades foliculares (UF) directamente del área donadora sin la necesidad de hacer una incisión quirúrgica lineal. En este procedimiento se utiliza un sacabocado o punch que mide de 0.8 a 1mm de diámetro para realizar una incisión circular en la piel alrededor de la parte superior de la UF para así ser extraída directamente.

VENTAJAS Y DESVENTAJAS DE FUE

Los beneficios de la técnica FUE son:  para personas que no desean que se les vea una cicatriz lineal debido a que suelen utilizar el cabello muy corto, es decir de 1-2mm de longitud, para personas de mucha actividad física que necesitan reanudar sus prácticas inmediatamente después del procedimiento, en procedimientos correctivos donde el área donadora tiene muchas cicatrices o en casos en que se necesite obtener pelo donador de otras partes del cuerpo como el pecho, espalda, brazos y piernas.





















El motivo principal por lo que no se recomienda este método se debe a que la obtención de la UF se realiza utilizando un instrumento conocido como sacabocado que se va a introducir en la parte de la UF que se encuentra visible y que está por encima de la superficie de la piel y que al introducirlo en las capas de piel  para liberar y extraer la UF desde su raíz se ejecuta a ciegas.  El pelo que se encuentra por debajo de la piel cambia de dirección lo que propicia que las posibilidades de seccionar alguno de los cabellos que la conforman es altísima.





 A diferencia de la técnica de la tira donadora en que la obtención de las UF es bajo supervisión estereomicroscópica  las UF se obtienen de forma íntegra. Otro motivo por el que no se recomienda se debe a que si se extraen grandes cantidades de UF, es decir mayor de 1000 de la zona donadora dejará que sean visibles las cicatrices circulares.
La técnica FUE restringe el área donadora a la mitad debido a que se requiere de la preservación de cabello alrededor de las UF extraídas para camuflegear la cicatriz circular de 1mm que deja, por lo tanto limita el área donadora siendo que ésta es indispensable para obtener una completa restauración de la calvicie.     





Con la FUE se dejan cientos o miles de heridas circulares abiertas que van a cicatrizar y que por consecuencia va a distorsionar el tejido alrededor de las UF adyacentes a la cicatriz por lo que va a dificultar intervenciones futuras, además de que se hacen notorias al explorar el cabello. No así con la técnica de la tira donadora única en la que se conservan íntegros los folículos adyacentes a la cicatriz lineal y en futuras inrtervenciones se vuelve a obtener pelo donador del mismo sitio dejando siempre una sola línea de cicatriz no visible.

Para poder realizarla en la zona donadora se tiene que cortar el pelo a 1mm de largo para su visualización y así extraer la UF.

VENTAJAS DE FUE

1.- No hay cicatriz lineal.
2.- Es útil para aquellas personas que utilizan el pelo muy corto en la zona donadora, es decir de 1 a 2 mm de largo.
3.- El tiempo de recuperación es más corto.
4.- Se recomeinda en personas que tienen el riesgo de generar cicatrices gruesas.
5.- Se utiliza en pacientes que tienen en la zona donadora cicatrices anchas por cirugías previas o por traumatismos, que no son posible de retirar quirúrgicamente.
6.- Personas de mucha actividad física y que requieren reanudar inmediátamente después del procedimiento.
7.- Se recomienda para aquellos casos en que la cantidad de injertos es mínima, como cuando se trasplanta pelo en las cejas o en las "entradas".
8.- Cuando se requiere extraer pelo donador de la barba u otra parte del cuerpo.

DESVENTAJAS

1.- En los casos en que se realicen extracciones de UF en áreas extensas es muy probable que se vean las cicatrices, sobre todo cuando el pelo es delgado, también cabe la posibilidad de haber obtenido la UF en los límites superiores e inferiores del pelo donador donde es posible que el pelo no sea permanente y que al momento de implantarlos con el tiempo se pueda caer.
2.- Dado sus limitaciones muchos pacientes no son candidatos por esta técnica, por ejemplo las personas de pelo ondulado o rizado, comparado con la técnica de la tira única en que la mayoría son muy buenos candidatos.
3.- La cantidad de UF íntegras es mucho menor que con la técnica de la tira.
4.-Hay una gran dificultad para obtener de manera íntegra las UF.
5.- Las múltiples cicatrices y la distorsión del área donadora propicia que se dificulten sesiones subsecuentes.
6.- Hay una gran cantidad de UF seccionadas con la tácnica de FUE, por eso recomendamos que a su médico le comente que quiere ver como están saliendo las UF al momento de extrarelas.
7.- Los injertos obtenidos contienen muy poco tejido circunscrito que protejan a la UF y esto la hace más suceptible de ser dañada al momento de implantarlas a las zonas deseadas o que se sequen fácilmente al exponerlas al medio ambiente y propicia que su crecimiento sea pobre.
8.- Con FUE es necesaria la disección microscópica ya que la UF suele dañarse al momento de extraerla y se necesita retirar el tejido o cabello que no sirve.
9.- El número de injertos por sesión es limitado dado el tiempo quirúrgico que demanda está técnica. Para obtener una sesión de 2000 a 2500 UF se requieren de varias sesiones a diferencia de la técnica de la tira única en que se realiza en una sola sesión.
10.- FUE es una tácnica mucho más costosa.

HYPERLINK "http://www.bernsteinmedical.com/resources/guide-to-hair-restoration/chapter-9-follicular-unit-extraction/"
Follicular Unit Extraction
What is Follicular Unit Extraction?
Follicular Unit Extraction (FUE) is a method of obtaining donor hair for  HYPERLINK "http://www.bernsteinmedical.com/hair-transplant/follicular-unit-transplantation/" \o "Follicular Unit Transplantation (FUT)" Follicular Unit Transplantation (FUT), where individual follicular units are harvested directly from the donor area, without the need for a linear incision. In this hair restoration procedure, a 1-mm punch is used to make a small circular incision in the skin around the upper part of the follicular unit, which is then extracted directly from the scalp.
The use of direct extraction to harvest follicular units was initially introduced by Dr. Woods in Australia as the “Woods Technique,” but he did not disclose the details of his technique. The procedure was first described in the medical literature by Rassman and Bernstein in their 2002 publication “ HYPERLINK "http://www.bernsteinmedical.com/resources/publications/follicular-unit-extraction-minimally-invasive-surgery-for-hair-transplantation/" \o "Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation" Follicular Unit Extraction: Minimally Invasive Surgery for Hair Transplantation.” This paper gave the procedure its current name and described the FOX test used to identify patient variability. The procedure was further refined by Dr. Jim Harris by adding an additional step of blunt dissection to the technique.
Follicular Unit Transplantation and Follicular Unit Extraction are sometimes viewed as being two totally different procedures. FUE, in fact, is a type of FUT where the follicular units are extracted directly from the scalp, rather than being microscopically dissected from a strip that has already been removed. To say it another way, in Follicular Unit Transplantation, individual follicular units can be obtained in one of two ways; either through single-strip harvesting and stereo-microscopic dissection, or through FUE.
Therefore, when comparisons are made between FUT and FUE, what is really being compared is the way the follicular grafts are obtained (i.e. strip harvesting and dissection vs. direct extraction) rather than placed into the scalp. However, the harvesting method does have implications for the procedure such as the transection (damage) rate, distribution of follicular units, number of grafts per session, post-op care and the total graft yield.
Because FUE does not leave a linear scar, it may be appropriate for patients who want to wear their hair very short. The procedure is also useful for those who have healed poorly from traditional strip harvesting or who have a very tight scalp. Possibly the most important application of this technique is to camouflage a widened linear donor scar from a prior hair transplant procedure. In this technique, hair is extracted from the area around a linear donor scar and then placed directly into it.
Patients differ significantly with respect to the ease in which follicular units can be removed from the scalp. In some patients, extraction results in unacceptable levels of transaction (damage due to cut hair follicles). Patients considering FUE should be tested for ease of extraction (the FOX Test) so that those in whom extraction is difficult, or who show significant degrees of transaction, can be identified in advance.

The Pros and Cons of Follicular Unit Extraction
The benefits of Follicular Unit Extraction include; the lack of a linear scar for those who want to wear their hair very short, the ability to resume strenuous activity almost immediately after the procedure, its use in corrective procedures, and for graft harvesting in body hair transplants.
FUE’s main limitation, when compared to FUT, is that it is less efficient in harvesting hair from the permanent zone. As a result, FUE techniques require a much greater area of the donor zone to be harvested, and this hair may not all be permanent.
The first reason that FUE is inefficient in harvesting grafts, is that the lack of stereo-microscopic control in the extraction process causes more damage to follicles, compared to FUT-Strip. The second reason for the inefficiency of FUE is that with this technique, hair is extracted, but the intervening bald skin between the follicular units is not removed. If too much hair is removed, a greatly thinned or bald area will result in the donor region and the donor scars of the FUE may become visible. In contrast, with FUT-Strip, the bald scalp is removed along with the hair follicles. The remaining hair is redistributed in the donor area as the incision is sutured closed to leave a line scar covered with hair.
Consequently, there is considerably less total donor hair available with FUE, perhaps half as much as with FUT. This represents a significant disadvantage, since a limited donor supply is the main factor that prevents a complete hair restoration in many patients. To compensate for the inability to harvest all the hair from the permanent zone, the surgeon may eventually be tempted to harvest hair from the upper and lower margins of the original donor area and risk the hair being of poor quality or being non-permanent.
In FUT, the strip is taken from the optimal (central) part of the donor region so all the hair in this area can be removed and transplanted. After the strip is removed, the wound edges are sewn together to form a single, line scar.
In Follicular Unit Extraction the wounds, although small, are left open to heal, leaving hundreds to thousands of tiny scars. Although not readily apparent, this scarring distorts adjacent follicular units and makes subsequent sessions more difficult. This is an additional factor that limits the total available donor supply in FUE. In FUT, the scarring is consolidated into one single line – even after multiple procedures, with the surrounding hair left intact.
Although new techniques and instrumentation significantly decrease the amount of transection and damage during the extraction process, the inability to fully access the mid-portion of the permanent zone in a hair transplant procedure, significantly limits the total amount of hair that can be accessed through FUE, rendering it a far less robust procedure than FUT for moderate to advanced balding.
The table below summarizes the pros and cons of Follicular Unit Extraction.
Advantages of FUE
No linear scar
Important for those who wear their hair very short
Decreases healing time in the donor area
Useful for those with a greater risk of donor scarring
Useful for repairing donor scars that cannot be excised
No limitations on strenuous exercise after the procedure
Less post-op discomfort
Provides an alternative when the scalp is too tight for a strip excision
Extends the dimensions of the donor area (but not necessarily the total number of grafts, unless added to an FUT procedure)
Enables one to harvest finer hair from the nape of the neck to be used at the hairline or for eyebrows
Makes it theoretically possible to harvest non-scalp hair
Ex. beard or body hair
More useful when a limited number of grafts are needed
Disadvantages of FUE
With FUE, the follicles are harvested from a much greater area of the donor zone compared to FUT
As a result, the hair in the lower and upper parts of the donor area, where the grafts were taken from, may thin and this can make the donor scars visible.
Follicles harvested from borderline areas of the donor region may not be truly “permanent,” so that over time, the transplanted hair may be lost.
Greater patient variability in who are good candidates compared to FUT
Maximum follicular unit graft yield is lower than with FUT
Due to the inability to harvest all the hair from the mid-permanent zone
The scarring and distortion of the donor scalp from FUE makes subsequent FUE sessions more difficult
Greater follicular transection (damage) compared to FUT
Grafts are more fragile and subject to trauma during placing, since they often lack the protective dermis and fat of microscopically dissected grafts. This may result in poor growth
More difficult to capture the entire follicular unit – resulting in lower density
Problems of “capping”. This occurs when the top of the graft pulls off during extraction
Problems of buried grafts. This occurs during the blunt phase of the three-step technique when the graft is pushed into fat and must be removed through a small incision
More difficult to obtain a natural distribution of follicular units
For efficiency, the largest follicular units are targeted, but these may not be ideal for the hairline
Microscopic dissection may still be needed
If the number of single-hair grafts is inadequate
To remove hair fragments
After large numbers of grafts are harvested, fine stippled scars may become visible due to thinning of donor area
Size of session is limited
Requires multiple sessions to equal the size of a single FUT
FUE takes longer to perform than FUT, so grafts are usually out of the body longer, risking sub-optimal growth
Generally more expensive than FUT

Bernstein Medical - Center for Hair Restoration
Offering hair transplant surgery and hair loss treatment to patients
from New York, New Jersey, Connecticut, and elsewhere around the world

110 East 55th Street, 11th Floor, New York, NY 10022
Phone: 212-826-2400 - Toll Free: 1-866-576-2400
Email:www.bernsteinmedical.com