Unshaven Follicular Unit Excision: Critical Analysis of Current Nomenclature and Proposal for Standardized Terminology

As unshaven hair transplantation grows in popularity, terminology has become inconsistent across publications and advertising. This creates confusion for patients and clinicians and undermines informed consent.

To map usage, identify confusion sources, and propose definitions for the spectrum of "Unshaven" follicular unit excision (FUE) approaches.

The authors performed a structured review of scientific literature, Google Trends for public-facing terms, searches of clinic and media webpages, and standardized prompts to artificial intelligence chatbots. Findings were synthesized into operational definitions and classification.

For the FUE procedure, the authors observed overlap, misuse, and conflation of techniques labeled "Unshaven," particularly between partially shaven methods and truly unshaven approaches. Synthesis yielded five categories with explicit procedural boundaries: Shaven FUE, Partially Shaven FUE, Unshaven FUE with pretrimming, Unshaven FUE without pretrimming, and Long-Hair FUE. For each, the authors outline defining steps, patient-visible outcomes, indications, and recommend patient-facing descriptors. The authors propose that 'Shaven' versus 'Unshaven' FUE terminology should be defined exclusively by the donor harvesting technique, irrespective of whether the recipient area is shaved.

The proposed standardized nomenclature clarifies FUE categories, improves counseling and expectation-setting, and supports transparent reporting, ethical advertising, and comparability across studies. The authors encourage adoption by clinicians, training programs, and journals.