One of the most significant advancements in the hair transplant industry is Advanced FUE Hair Transplant (CIT) (Follicular Unit Extraction), an upgrade introduced by Dr. John Cole. CIT has brought remarkable breakthroughs in FUE hair restoration. It is administered with the fastest motorized instruments and improved with an ACell treatment.
By combining CIT with ACell, Dr. Cole has solved some of the most frustrating FUE challenges and enhanced the procedure’s aesthetic results. CIT + ACell will help you heal faster after surgery and minimize scarring in the donor area. (Who wouldn’t want that, right?)
This guide will help you understand more about Dr. Cole’s advanced FUE methods (including their pros and cons). I hope that by the end of the guide, you can make an informed decision about whether (or not) this procedure is most suitable for you.
What’s FUE and How’s It Done?
FUE is a hair transplant surgery that works by evening out hair to combat the effects of hair thinning and balding. The doctor uses a minimally intrusive procedure to remove hair from areas with the most density, such as the back of your head. They then transplant these donor hairs into the areas with the least hair density.
During an FUE, the specialist uses an FUE surgical instrument or forceps to punch the donor area to extract a graft. The grafts typically include one to four hairs. The procedure removes hair and a small cylindrical skin patch containing stem cells. It’s important for the doctor to extract some skin during the procedure because hair alone has insufficient stem cells needed for graft survival and hair regeneration after transplanting.
Given the circular tips of FUE wounds, the scars form as dots, significantly contrasting with strip surgeries that leave linear marks.
These tiny holes/dots left on the donor region are too small to be stitched. So, instead, the doctor will bandage the donor area. You can remove the bandage the next day and let the scabs fill up naturally, a process called secondary intention healing. Since these are tiny wounds, complete healing often takes a week to 10 days.
[Secondary intention healing is the process by which injuries are left open and allowed to cure by filling in with new tissue (granulation tissue). This type of healing occurs when the wound edges cannot be brought together (as opposed to primary intention, where the edges are sutured or closed). It is typically used for large, deep wounds or injuries with a high risk of infection.]
If done effectively, graft extraction removes hair and stem cells from the donor region. So, hair won’t grow back within the scars in the donor region.
The Pros and Cons of FUE
Follicular Unit Extraction has various benefits, including:
- Smaller scars: A properly executed FUE is a better choice than strip surgery (FUT) in terms of aesthetics. Unlike the latter, which produces more visible linear scars, this hair restoration technique creates dot scars-which are barely visible.
- Minimally invasive hair surgery: Many FUE patients perceive this procedure as less invasive than alternatives like the FUT hair transplant procedure because its scars aren’t the typical linear marks associated with most surgical procedures.
- Flexibility for future procedures: Some procedures, such as strip surgeries, lead to issues like traction alopecia, which kills hair around the donor area. Fewer follicles mean there won’t be as many grafts if you want to address hair loss later. The FUE hair transplant procedure ensures that the donor area remains dense and healthy, allowing you to get more grafts from it. Plus, it eliminates the need to distribute new grafts between other hair loss regions and those, such as from traction alopecia, which you could avoid.
- Shorter hairstyles: Do you want to wear short hairstyles after your procedure? FUE is an excellent choice for styles such as buzz cuts because of its less noticeable scars.
With these new developments, not only do we have the potential to help more hair loss sufferers, but patients can expect even better aesthetic outcomes than ever before. Most significantly, progressing away from strip surgery means that patients can receive these results without the threat of a tell-tale linear scar.
The top shortcomings of FUE include:
- Requires high expertise: This procedure is more challenging than alternative techniques like FUT and requires a longer duration to master. If you compare an average FUE vs. an average FUT doctor, FUT would have a better graft yield. However, a great FUE physician can achieve the same yield without the risk of traction alopecia associated with strip surgery.
- Dot scars: If your doctor harvests more in one area, it can thin out your hair and make the scars easily noticeable.
- Risk of over-harvesting and zoned look: If your physician doesn’t have the necessary expertise or experience, they might harvest too much from a donor area, leading to a “moth-eaten” or “see-through” effect. Additionally, regions outside the donor area with decent hair density appear noticeably thicker once you over-harvest. (Trust me, you don’t want this)
- Shaving Required: No-shave FUE (C2G) is more challenging, time-consuming, and often yields few grafts. As such, most FUE procedures require you to shave, which can be a bummer if you need to return to work, or you don’t want people to see the more noticeable scars present in the early recovery stage. (Also, the truth is, most women find it quite inconveniencing having to shave their hair for the procedure)
- Future balding risks: The procedure can lead to more balding than intended, especially in young patients who experience hair loss later. For instance, if hair loss occurs in the already thinner donor region, balding becomes noticeable faster. Conversely, if hair loss happens in the recipient area, you lose the grafted hair.
Groundbreaking Developments for FUE Hair Transplantation
Dr. Cole’s CIT is one of the innovative hair transplant techniques that is changing the way FUE is performed. The upgrade aims to solve the challenges of FUE through more effective motorized tools and an added ACell treatment.
CIT
Although FUE is generally minimalistic, the Cole Isolation Technique is far less invasive yet more accurate. CIT promises an almost scarless hair restoration that allows you to enjoy a natural appearance (even in short hair) without much cost difference.
One of the biggest benefits CIT brought to FUE treatment is the fact that the depth and punch size can be customized based on the donor area. This advanced flexibility minimizes the damage to FUs and leaves stem cells within the donor region.
The key benefits of CIT include:
- Patients recover faster and experience less to no scarring. In fact, most scars are unnoticeable even under magnification if the doctor administers ACell with the procedure.
- CIT allows for better density within the recipient region than regular FUE. Studies indicate that CIT typically has a 97+ success rate. While many FUE clinics hit 90-95%, some only achieve 50%.
- Because stem cells remain within the donor area, CIT allows specialists to stimulate hair growth using methods such as Platelet-Rich Plasma and ACell. For this reason, this is the only method that enables follicles to regenerate within the donor area.
More Effective Tools
Dr. Cole’s innovations, like the Power Cole Isolation Device, made motorized extraction faster than ever. This device can extract well over 2,000 grafts while minimizing graft damage. In fact, this instrument only had a 3.41% transection rate from 85,742 grafts extracted during a study.
Besides this device, Dr. Cole made numerous other tools that are making a huge difference in FUE, such as the counting incision device. This tool allows experts to count incisions in the transplant area more accurately and easily thanks to its audible counting, variable blade acceptance, and LED display.
Another great invention is the graft processing board that either comes with backlighting, external lighting, or both. These boards enable the doctor to see what’s happening during a CIT more easily, making it less likely for them to miscalculate and injure grafts.
Additionally, the doctor can use the Cole instrument punches during the procedure, which allows them to tweak acquisition depth between 0.85 and 1.3 millimeters. These manual or power-driven punches come in various designs, with the most common ones being:
- Classic CII instruments
- Surrounded instruments
- CII Best Value Non-Coated instruments
- CII Best Value TiN-Coated instruments
ACell Treatments
Regenerative hair treatments work best when you combine two or more, which is why Dr. Cole administers ACell to his CIT patients. This FDA-approved treatment stimulates the body’s wound-healing process. During CIT, the doctor places ACell biomaterial in donor and recipient regions, which gets resorbed and replaced with hair follicles and new scalp tissue.
ACell treatments complement CIT in many ways, including:
- Strengthen and thicken weak hair while delaying/preventing further hair loss.
- Ensures you heal faster and feel more comfortable during the process.
- Encourages some regrowth in extraction sites.
- Improves the likelihood of graft survival.
- Betters your natural hair quality.
- Minimizes scarring.
Occasionally, CIT patients experience hypopigmentation (small white dots) in the extraction sites. Infusing ACell into the extraction sites may prevent hypopigmentation.These benefits were apparent during our six-month study comparing yields from different grafts transplanted to donor area strip scars that had ACell. The results were as follows:
| Graft profile | Growth | Yield rate |
|---|---|---|
| Beard hair pre-treated with ACell | 46 out of 50 | 92% |
| Non-pre-treated chest hair | Zero out of six | 0% |
Is CIT + ACell Right for You?
Indeed, Dr. Cole’s revolutionary tools and techniques have opened opportunities for huge breakthroughs in FUE hair restoration. With the ability to adjust the punch size and depth to suit the donor region, CIT provides one of the best solutions for hair restoration that’s most likely to suit you. As it leaves minimal to no scars, CIT FUE suits almost all kinds of hairstyles, short or long.
So…
Would you like to know whether this technique is the best for you?
Our specialists will assess your hair problems thoroughly to find the best-customized remedy for you. Schedule a free ForHair online consultation now, and start your journey to a uniform and more appealing scalp.
