Posted 31/10/2022 in Hair Transplant

Manual FUE Hair Transplant

Manual FUE Hair Transplant

Table of Contents

      Medically reviewed & verified by: Avrupa Hair Transplant Clinic.

    Written by: ClinicAdvisor®

    What is a  Micro FUE hair transplant?

    FUE hair transplantation is one of the modern hair transplantation techniques that has largely replaced the FUE method.

    This microsurgery procedure summarizes the most modern features of hair transplant surgery. 

    It is a minimally invasive procedure that aims to restore hair follicles from a donor site - usually the back of the head - and implant them into blading recipient sites. 

    The results of micro FUE usually are natural-looking and permanent. 

    This hair transplant technique extracts the follicular units from the donor area with a 0.6-0.7 mm diameter punch. The number of extracted follicles subsequently classifies the channels. The average is 2.3 follicles per follicular unit. 

    To give a natural look to the result, the single follicles are implanted in the first row of the hairline. 

    Those with two or more follicles are implanted in areas further back. For the implantation of the follicles, micro incisions are made and oriented in the same direction as the existing hair.

    Although this technique appears to be a positive technological development, it is not yet satisfactory. Indeed, the mechanical gesture is much more aggressive for the skin, and the risk of torn grafts increases.

    How is Manual FUE graft extraction performed?

    Contrary to the extraction with a motorized micro-punch, manual FUE transplantation is done with a manual punch. 

    The surgeon rotates the micro-punch around the follicle to separate it from the skin, then extracts it. 

    The surgeon thus better controls his intervention and adapts it better to the physiological conditions of the scalp. 

    This technique makes it possible to limit the risks of friction and heating of the follicles and to prevent damage to the neighboring grafts than with a motorized punch. 

    In addition, manual extraction is performed in a lateral slit, unlike the motorized micro-punch, which must be placed vertically to the scalp for graft extraction.

    Manual FUE vs Micro FUE

    The main difference between manual FUE and micro FUE lies in graft extraction. 

    The automated follicular transplant hair transplantation method is an automated version of the manual FUE method.

    In the micro FUE technique, the removal of follicular units is done by a small motorized punch in an automated manner. 

    The manual FUE is performed manually and removes the hair grafts from the donor area with a small blade. 

    How is the implantation of grafts performed in manual FUE?

    Once harvested, the grafts will be placed in a sterile solution, awaiting their transplantation into the recipient area within one hour of their extraction.

    For optimum results, the reimplantation of the follicles one by one is carried out manually, with a preliminary opening of the channels using either a steel or a sapphire blade. 

    However, for a less invasive result, the reimplantation of the follicles can be done using the DHI (Direct Hair Implant) method with a Choi implanter pen.

    What are the advantages of a Manual FUE hair transplant?

    Manual FUE has many advantages:

    • More precise

    • Less invasive and less traumatic for the hair epidermis

    • It guarantees better follicle survival, with a loss of the graft rate of 1 to 3%. In comparison, this rate can reach up to 10% with a motorized micro-punch intervention conducted by an experienced surgeon.

    • The neighboring grafts and the donor area are better preserved, and the epidermis is less damaged by the operation (absence of bruises and scars), 

    • Faster healing of the donor area, offering a more discreet transplant.

    • The follicles are re-implanted more densely, providing fuller and more natural regrowth. Another advantage: 

    • The patient is seated under his surgeon's scalpel, allowing him to be operated on in a more comfortable and less tiring way, especially when the sessions last several hours.

    What are some disadvantages of Manual FUE hair transplant?

    Using a manual punch requires the surgical expertise of great talent and takes more time than a robotic punch. 

    In one session, 7 hours maximum, an experienced surgeon will treat up to 2000 grafts—sufficient time to cover incipient baldness.

    But when the alopecia is advanced, it is necessary to distribute the graft over two to three sessions.

    The intervention is more extended and requires more experience; a manual hair transplant is also more expensive than a transplant by motorized micro-punch.

    Graft harvesting in manual FUE hair transplant

    What is the difference between Manual FUE vs. Robotic FUE?

    During a robotic FUE transplant, your doctor performs a simulation to project the desired result for your results before the surgery. 

    The number of necessary grafts is then calculated; it is determined according to the degree of baldness.

    The robot will then analyze your scalp and determine, using cameras, algorithms, and artificial intelligence, which follicles are best suited for transplantation. 

    The advantage of a robotic hair transplant is the robot's precision since the machines can generally recalculate the ideal hair position every 20 milliseconds.

    The hair extraction process will continue until the desired graft amount is obtained. And, of course, the doctor can take control at any time to refine the operation if necessary. 

    Once the extraction is complete, the machine will use the simulation created during the first consultation as a guideline for where to re-implant the hair. 

    The robot will thus be able to determine the best places, considering the angle of implantation and the density, while preventing any damage to existing hair.

    Depending on the extent of hair loss, it takes an average of 5 to 7 hours to perform the transplant procedure.

    What is the cost of Manual FUE?

    The cost of a manual FUE depends on the number of follicles extracted and the country in which it is being performed.  

    For example, a 2000 follicles manual FUE hair transplant in Turkey can cost about $2500 on average. While for the same procedure in the United States, you would be expected to pay around $10000. 

    Here's an idea of the average cost of manual FUE hair transplants in a few other countries. 

    • Turkey: $ 2000 to $ 4000
    • United States: $ 5000 to $ 12000
    • U.K.: $ 5000 to $ 10000
    • Spain: $ 4500 to $ 8000


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