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To achieve higher, more natural density with minimal scarring and donor depletion
Traditional FUE had significant drawbacks that often led to suboptimal results: graft damage, visible donor area thinning, and an inability to achieve high density. To overcome these drawbacks, various technical modifications were developed over time. Each emphasizes on the various aspects :
FUE-HD is one of such technique variations to overcome the drawbacks of traditional FUE. “HD” stands for High Density. We combined and modified the European and USA FUE techniques to accommodate for high density implantation. The incisons are smaller with less bleeding and trauma to the recipient site. This markedly reduces the downtime, and patients can resume normal activities just after a few days. Our system also combines the latest bio-technology.
Sara’s CommentFUE-HD is our advanced, 3rd-generation Follicular Unit Excision technique designed to overcome the limitations of traditional FUE and FUT strip surgery. By combining precision tools, biological science, and refined artistry, FUE-HD aims to achieve higher, more natural density with minimal scarring and donor depletion, making it our primary technique for most patients.
Minimizes graft transection (damage) during extraction.
Prevents a “moth-eaten” donor area through even, conservative harvesting.
Enables higher, more natural density in a single session.
Reduces surgery time and improves recovery compared to early FUE methods.
FUE-HD is our preferred technique, chosen for over 85% of our procedures. It is particularly well-suited for patients who:
Prefer a Minimally Invasive Approach: Unlike FUT, it requires no linear incision or stitches, leading to less discomfort and a quicker recovery.
Wear Short Hairstyles: The tiny, dot-like extraction sites heal with minimal visible scarring, avoiding the linear scar of FUT, making it ideal for buzz cuts or fades.
Have a Tendency for Scarring: The 0.8mm punches minimize tissue trauma, reducing the risk of noticeable scars or keloids, especially for those with sensitive skin.
Have Lower Donor Density: By distributing extractions across a wider area, it helps preserve the natural look of the donor zone, even when hair is limited.
Are Younger or Need Fewer Grafts: It avoids a permanent linear scar from FUT, and for smaller sessions, can often be performed with only partial shaving.
Are Not Candidates for FUT: Patients with prior strip surgery, tight scalps, or existing scarring can often still be treated successfully with FUE-HD.
In essence, FUE-HD offers a versatile, scar-minimizing solution for a wide range of patients and hair loss patterns.
The FUE-HD technique is not defined by a single tool or step, but by a unified surgical system where seven key innovations work in synergy. Each component is designed to address a specific challenge in hair transplantation—from graft survival and precision placement to patient comfort and healing. When combined, these elements create a protocol where the whole is greater than the sum of its parts, systematically maximizing the potential for dense, natural-looking results with minimal trauma.
Graft transection is the main drawback in FUE. In 2017 a new punch 0.8mm in diameter was developed with a wider opening in the shape of a funnel. This punch design reduces transection of the follicle during harvesting especially in Asians with thicker and longer hair follicles.
A smaller punch would leave even a smaller graft but at the expense of getting lesser stem cells for rejunveration.
After learning Dr John Cole ( USA ) CIT System, Dr Umar ( USA ) U-System, Dr Devroye ( Belgium ) WAW System, Dr Trivellini ( Italy ) Mamba Device, and many other technique and devices in the last 14 years, we feel that the human touch is as important as any latest technology.
We combine both manual and automatic extraction to cater for different skin texture and hair characters.
Patients might not have enough donor hairs to cover all balding scalp. We overcome this common problem by implanting good hairs along the hairline and parting side only. These hairs can be combed over to allow for a larger area coverage without exhausting all donor resources. Patients can always return for a second procedure to extend the coverage. Results in Class V to VI are impressive.
This innovation is called “Key Area Transplant”. We first presented this approach in 2010 ISHRS Annual Scientific Meeting in Bahama, and in 2025 CAHRS Meeting in China.
In 2018 we had developed a new technique using both hands for excision and extraction simutaneously to reduce the graft harvesting time. This so-called “Double Gun Technique” was first presented in the 2008 ISHRS Annual Scientific Meeting in Montreal, Canada,
In 2018 the ISHRS FUE Committee re-named it “Sequential FUE Technique”. Our technique is currently used by many doctors in Europe, and published in Dr Sam Lam’s FUE textbook.
With our skill we are able to cut a 3 or 4-hair follicular unit longitudinally into 2 intact halves. One half is removed for re-implantation as usual, while the other left behind to regrow.
Studies had shown that the remnant can regenerate completely. This technique has the potential to generate two hair follicles from one follicle with consistent results and preserve the donor area.
Grafts outside the body has a limited survival time and must be implanted ASAP. We have abandoned the use of implanters as they produce more tissue trauma by squeezing the graft into a metal tube, and with a bigger wound.
Instead we use forceps to grasp the upper hair shaft. The graft is directly inserted into a snug-fit holes. This is a 1-step procedure without the need to touch the roots or to squeeze the follicle into a metal tube of an implanter. The incisons thus created are smaller, allowing for denser packing.
The final result of hair transplant depends on how many grafts actually re-grow after the procedure. Damaged hair follicles may not produce new hair. Our FUE -HD combines the followings to enhance graft survival :
• ATP Energy Spray and Storage Solution
• Low Level Laser Therapy
• Tricomin Copper Peptide Hair Solution
FUE-HD produces superior graft quality by significantly reducing transection rates.
We achieve this through our proprietary 0.8mm wide-mouth punch, designed with a funnel shape that gently surrounds and protects the follicle during extraction.
This precision engineering, combined with our hybrid manual-automated technique, minimizes damage to the delicate follicular structure and stem cell tissue.
The result is a higher yield of intact, viable grafts—giving each transplanted follicle its best chance to survive and grow, ultimately leading to better density and more natural long-term results.
Possible for under 2,000 Hairs
More hair can be extracted for female or those with high donor density
Keep at least 4cm of hair at the back of the head to cover the square slot
Usually required for large area transplant
Recommend to keep very short hair for 1-2 weeks before for the friends to get used to
We will trim it further on the day of procedure
With smaller incisions, patients can resume normal activities after a few days.
FUE-HD is an advanced follicular unit extraction technique designed for maximum graft survival and natural aesthetics.
Using a 0.8mm punch and direct implantation, it is performed in a single, continuous session under conscious sedation.
This approach prioritizes patient comfort, minimizes trauma, and ensures optimal growth by avoiding the pitfalls of multi-day procedures.
FUE-HD is designed for patients requiring precise, high-density restoration with minimal downtime.
Candidacy depends on your donor hair density, scalp characteristics, and the specific goals for your target area.
A detailed evaluation is necessary to determine if your expectations align with what this single-session technique can achieve.
To allow for ultra-precise extraction, the donor area requires careful preparation.
Donor Hair Shaving: The donor area is shaved short or undercut to enable the use of a micro-punch. For partial shaving, our surgical team designs the shaving zone to be as discreet as possible, especially for patients with longer hair.
Patient Positioning: You will lie face down (prone) during the harvesting phase. Your head may be gently repositioned for optimal access, with breaks provided every 45-60 minutes for comfort.
Graft Yield: A typical FUE-HD session transplants 2,400 to 3,600 grafts, depending on your unique donor supply and the coverage required.
Your comfort is paramount. We employ Level I Conscious Sedation, which combines:
Ultra-fine local anesthetic injections.
Mild oral sedatives.
This protocol maximizes comfort while allowing you to remain responsive. Most patients sleep peacefully through the entire procedure.
Our protocol is built on precision and biological preservation.
Extraction Tool: A custom-designed 0.8 mm punch minimizes transection and reduces visible scarring.
Implantation Method: Forceps-based direct insertion allows surgeons to control the exact angle, depth, and direction of every graft for a perfectly natural result.
Graft Preservation: Immediately after extraction, grafts are stored in a Lyposomal ATP Solution to preserve stem cell integrity and enhance potential growth rate.
Single-Session Philosophy: The entire procedure—extraction and implantation—is completed in one day to ensure follicles are implanted promptly, maximizing viability.
We firmly believe a single-day protocol offers superior safety and outcomes. Multi-day procedures introduce unnecessary risks:
Increased Medical Risk: Repeated anesthesia injections increase discomfort and potential complications.
Threatened Graft Survival: Additional trauma can disrupt the blood supply critical for healing.
Potential for Damage: Grafts implanted on Day 1 risk being disturbed during Day 2 extractions.
Patient Fatigue: Lying prone for two consecutive days causes undue physical strain.
Unpredictable Yield: Graft counts and planning become less precise on a second day.
The procedure is efficient, with a straightforward recovery.
Surgical Time:
Extraction: 2–4 hours
Implantation: Approximately 2 hours
Total Procedure Time: 5–6 hours, completed in one day.
No stitches are needed. The 0.8mm micro-wounds heal naturally.
A light dressing is worn only overnight.
Swelling is rare. Most patients return to light activities within 2–3 days.
Due to strict sterile protocols, routine antibiotics are not required.
Any minor donor area tenderness typically resolves within a few days.
Understanding the nuances of a technique is key to making an informed decision. Send your photos and questions for a free preliminary review. Our medical team will evaluate your donor area and hair loss pattern to determine if the FUE-HD protocol is the right approach for your goals, and provide a detailed, step-by-step explanation of what you can expect.
Images & Information shown are for reference only
Information on this website is provided for general educational purposes only and does not constitute personalized medical advice. It is not intended to promote our service or imply superiority over another.
Individual results in hair restoration vary significantly and no outcome can be guaranteed. The before-and-after images shown represent possible results — not promises. We recommend seeking independent medical advice to discuss your options … Read More
Pre-Consultation Review
If you want to get a personalized answer from our medical team, you can reach us using this form here. We will cantact you as soon as possible.
Our practice adheres to guidelines established by leading international organizations in Hair Restoration.
International Society of Hair Restoration Surgery is the leading global medical association that establishes international practice standards and patient safety protocols.
The American Board of Hair restoration Surgery represents the highest standard. To maintain rigorous certification requirements the physician must demonstrate surgical expertise.
Worls FUE InstituteI serves as the premier educational body focused exclusively on Follicular Unit Extraction methodology. The institute ensures consistent application of safe FUE.
