Follicular Unit Extraction: Evolution of a Technology

Follicular Unit Extraction (FUE) hair transplantation began as a clinical offering in 2002. Since that time, this minimally invasive hair transplant surgery has grown to a market size of approximately $1.2 billion annually (48.5% of the total hair transplant business world-wide) and is continuing to grow rapidly. This growth is driven by a rapid expansion of the provider pool. New doctors, previous not in the business, have been entering the field and bringing with them, new patients from their own patient populations. The problems that they are encountering are similar to the historic challenges which are outlined in this article updated by the newer instrumentation that has evolved since 2002. Service organizations have arisen where non-professionals are performing the surgery for physicians unable to do so. This article summarizes the evolution of the FUE technology, which has not followed traditional new technological surgical procedures for training new doctors. Physician innovation became critical in the dissemination of FUE and many doctors previously in the field have had difficulty keeping up. The idea of a minimally invasive FUE technology seems to take on a favorable ‘aire’ for potential patients and for those who heretofore would never have considered having a hair transplant is now coming forward. The authors believe that significant continued changes in the technology are an inevitable outcome of both the rise in the provider pool and the demand for these services. FUE has changed the labor pool as well. The authors have tried to outline the technical changes that impact both labor and the delivery of a better quality outcome provided that the doctors who rally to this opportunity get the proper training that they require. Proper training, unfortunately, seems to have taken a back seat as the financial incentives for the physician has put the cart before the horse.