Pretrimmed versus Direct Nonshaven Follicular Unit Extraction

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