Pretrimmed versus Direct Nonshaven Follicular Unit Extraction

Shaving the donor area is one of the major deterrents preventing hair transplant patients from selecting follicular unit extraction (FUE). A minimal shaved donor area is possible in strip surgery, but the strip method is not applicable if the patient wishes to avoid a linear donor scar, wishes to minimize postoperative pain, or has insufficient scalp laxity. In these cases, nonshaven FUE (NS-FUE) is potentially a very good choice.

A total of 42 patients were enrolled. Both pretrimmed and direct NS-FUE were performed during a single session in each patient. The 2 methods were compared regarding the time taken to punch 50 grafts, transection rate, and calculated density (number of hairs per graft).

The mean time taken to punch 50 grafts was significantly longer in the pretrimmed method than the direct method (3.4 minutes versus 2.6 minutes; P < 0.001). The mean transection rate was similar in both methods (8.8% for the pretrimmed method and 7.5% for the direct method; P > 0.05). The mean calculated density was significantly higher in the pretrimmed method than the direct method (2.23 hairs per graft versus 2.15 hairs per graft; P < 0.05). The length of the harvested hair was 1-4 mm in the pretrimmed method, compared with 0.4-0.8 mm in the direct method.

Depending on the proficiency and preference of doctors and the case indications, pretrimmed and direct NS-FUE are both useful techniques for hair transplantation.