What Is the Follicular Unit Extraction (FUE) Hair Transplant FOX Test?

This below response from our Hair Loss Social Community and Discussion Forums was written by recommended hair restoration surgeon Dr. Ali Emre Karadeniz.

What is a FOX Test and why is it important for patients wanting a follicular unit extraction (FUE) hair transplant?

An FUE Test or ‘Fox Test’ is a very important step before proceeding with a large FUE session.

Unlike follicular unit strip surgery (FUSS), follicular unit extraction is a procedure that requires favorable tissue characteristics that allow for easy extraction of grafts without significant topping, shearing and transection of the grafts.

Unfortunately, the public widely thinks that FUE is a straightforward procedure that can be used on every patient. However, some patients are not good candidates for FUE. The challenge is that, this can only be found out after doing an FUE test, a test that has to be performed either at a separate visit or at the beginning of the procedure itself. Due to practical factors, we almost always get the chance to do the test at the beginning of the surgical procedure.

The test actually is a subjective evaluation of how easy the graft extraction is for the surgeon. The ease of extraction is directly related to the yield of good quality grafts. If the FUE test is rated ‘unfavorable’ by the surgeon, he should sit down with the patient and reevaluate surgical options. If the extraction is very unfavorable then the options should be doing FUSS or cancelling the procedure. If it is unfavorable, but still possible, yielding a lower graft number, then the patient should decide between proceeding with FUE, doing FUSS or totally cancelling the procedure.

It should be noted that, FUE-only clinics don’t widely use the FUE test, as an unfavorable  extraction would lead to being faced with cancelling the operation frequently. Not being able to offer stip surgery decreases the motivations of a hair restoration surgeon to find out if the extraction is going to be favorable or not.

It is hard to imagine an FUE-only surgeon doing an FUE test, occasionally cancelling the procedure after rating the test unfavorable and advising the patient to go to another clinic. Some of the patients that we hear about getting poor yield after having an FUE procedure are probably related to this problem.

Dr. Ali Emre Karadeniz
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David
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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