No-Shave Long Hair Follicular Unit Excision Using an All-Purpose Skin-Responsive Device

Area of Science:

• Hair transplantation surgery
• Dermatologic surgery
• Regenerative medicine

Background:

• Current no-shave long hair follicular unit excision (LH-FUE) uses specialized punches with recesses to minimize hair shaft breakage and graft transection.
• These advanced techniques require significant surgeon skill and prolong procedure duration.

Purpose of the Study:

• To evaluate a novel skin-responsive FUE technique for LH-FUE that avoids recess-tipped punches.
• To assess its efficacy across diverse hair and skin types.

Main Methods:

• Retrospective analysis of 152 patients undergoing LH-FUE with a UGraft Zeus device across five international clinics.
• Donor zones were classified using the Sanusi FUE Scoring (SFS) Scale (Class I-V).

Main Results:

• Graft transection rate (GTR) ranged from 2.2%-4.3%, with higher rates in Class IV donors and thick-firm scalps.
• Hair shaft break rate (SBR) was 12.2%, and average graft excision rate (GER) was 440 grafts/h.
• Patient satisfaction was high (57.4% "very happy"), and surgeon willingness to perform no-shave LH-FUE increased significantly.

Conclusions:

• The skin-responsive FUE device enables successful no-shave LH-FUE without recess-tipped punches.
• The technique achieves low GTR and SBR, high GER, and improved patient and surgeon satisfaction.
• This approach enhances procedure efficiency and ease of use, promoting wider adoption.