FUE has it’s own set of problems that is creating a new generation of hair transplant repair patients. The original problems from this latest procedure manifested as poor growth or growth with damages grafts. This is not a problem unique to FUE as there are cases of poor growth and damaged grafts with all surgeries but the inherent challenges of FUE as a procedure produced many cases where patients did not receive the result they were promised. More importantly, the early days of FUE saw clinics using punches that were, by today’s standards, too large. Punch diameters of 1.2mm to 1.5mm were not uncommon but it was quickly realized that the punch sizes had to be reduced in order to create a true alternative to FUSS. Unfortunately, as punch sizes became smaller the learning curve to allow for consistent and healthy graft survival rates continue to prove problematic. It wasn’t until around 2010 that a degree of consistency with smaller punches of .8mm to 1mm in diameter became a reality. With FUE however a new type of hair transplant repair patient emerged, one that cannot be addressed with more FUE, FUSS or any surgical alternative. These are FUE patients where the donor zone has been depleted due to overharvesting. FUE overharvesting can manifest in two ways.
1. The entirety of the recognized donor zone is overharvested to the point that there is not enough donor hair remaining to make any cosmetic impact whatsoever if any is needed.
2. Sections of the recognized donor zone are over harvested leaving patches or gaps in the continuity of the donor zone. These cases require the hair to be grown longer but still does not cover the affected areas adequately.
These problems are often referred to as being salvageable with additional FUE procedures using alternative donor sources such as beard hair or body hair. To date, there are no documented cases of complete reversal or full cosmetic improvements using these alternative donor sources and at best only moderate improvements have been documented.
Currently, the number of FUE procedures being performed today is essentially on par with the number of strip procedures. This is quickly changing as it is predicted that FUE will be the dominant form of hair restoration surgery by the middle of 2017. The statistics support this prediction as it is estimated that two new FUE clinics are opening every week worldwide. There are few, if any, FUSS clinics opening that we know of. With this massive increase in the number of clinics opening worldwide the probability of inexperienced and unscrupulous operators performing FUE has also increased thus more patients are being harmed or, at the very least, are realizing undesired results due to lack of training on the part of the clinic.