Follicular Unit Extraction (FUE) Hair Transplants on African American Hair?

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by Coalition hair transplant surgeon Dr. William Lindsey:

Do you find it difficult to perform follicular unit extraction (FUE) hair transplants on black patients? What’s your average transection rate for these patients? What sized punch do you use for white patients?

Absolutely. Ideal FUE patients are straight, thick-haired individuals and you can slide that FUE punch right down the shaft and get hair very easily. The curlier the hair the more it’s like trying to FUE out a corkscrew. That being said I think we’ve now done FUE on 25 black patients, most with a Feller 1.0 or 1.1mm punch.

I do have a 1.2mm punch that I’ve resorted to on occasion but I think its scar is a bit noticeable.  In guys with straight hair, white or otherwise, almost exclusively we use a Feller 0.9 or 1.0mm punch.

My use of the word corkscrew is a bit of an exaggeration. Nevertheless, unless you are planning to have a really short haircut and you are a poor scarrer, I’d always push strip hair transplantation. Cheaper, easier on patient and doctor/staff, and most importantly, more consistent at providing results.

I think follicular unit strip surgery (FUSS) provides pretty reliable results, at reputable offices, probably 90+% of the time. That corresponds with what I’ve seen in my office over the past 8 years, and what I gather from a few select hair restoration physicians that I know.

FUE is very variable. Even in the best of hands, I see one case per 2 months that have poor results from FUE by very good hair transplant surgeons with a good track record: Particularly thin-haired patients. I personally feel that FUE is like transplanting very fragile trees in your yard. If you so much as stun that root ball, that tree will either die or not do well. Same with hair. There is definitely more trauma to the root ball with FUE than with strip.

Dr. William Lindsey – McLean, VA
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David (TakingThePlunge)
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.
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