FUE – Potential Complications

  1. Loss of hairs inside the grafts from amputation/transection of the hairs, i.e. some of the amputated hairs die.
  2. Stripping of the critical growth centers of the hairs within the graft during the extraction process.
  3. Loss of the hair bulb or dermal papillae (the dermal papillae, which is located at the very bottom of the hair bulb, is responsible for hair re-growth after hair cycling from the telogen phase into the anagen phase).
  4. Buried grafts (grafts that are pushed below the skin becoming foreign bodies with potential cyst formation or even abscesses producing possible infections in some patients).
  5. Wasting valuable hair resources. Once a hair is lost, it is lost forever.
  6. Necrosis (gangrene) of the donor area in large FUE sessions has been reported at the September 2008 ISHRS meeting in Montreal. It is not clear why this has occurred, since so little information on this potential complication has been presented.


Above: Slightly damaged FUE grafts removed with the standard FUE technique. The grafts appeared ‘raggy’ and inconsistent with regard to graft thickness. Note there is amputation of one hair out of three hairs in the graft (A), amputation of the entire lower half of the hair follicle in this graft (B), one hair on the top of the graft was amputated (C) and bottom hair is damaged with a kink see clearly in the graft (D). The hairs amputated in grafts (A) and (C) will probably not grow and the hair in graft (B) may grow into a very fine hair as a lower half amputation usually does grow. The single hair in graft (D) will probably grow normally but this does not apply to the single hair fragment on the top of the graft. A 0.9mm punch was used for the extraction and the graft selection here was to show some of the types of problems that reflect the current surgical techniques practiced by most physicians doing the manual FUE procedure today.