Manual FUE Hair Transplant

How Is Manual FUE Technique Performed?

Manual FUE – Turkey’s successes in aesthetic medical treatments have led Istanbul to be labelled the ‘global hair transplant capital’, as it combines an impressive level of medical expertise with reasonable prices in comparison with other countries. In particular, Turkey has been quick to embrace innovation, providing international patients with a much broader range of treatment options than is true of other countries. Among the most widely-used treatments is FUE, which takes several forms including Micro FUE, Manual FUE and FUE Sapphire. 

What is FUE?

FUE, or ‘Follicular Unit Extraction’, involves the individual extraction of grafts from a patient’s donor area, making this treatment different from the FUT method which is based on extracting a strip of tissue from the patient’s scalp. These grafts are then implanted into channels that have been opened in the patient’s donor area. While Micro FUE involves using a mechanised tool for graft extraction, Manual FUE, as its name suggests, involves using manual force alone.

What is Manual FUE and how does it differ from Micro FUE?

Both Micro and Manual FUE involve using punches ranging in diameter from 0.7 to 1.2mm, but normally being between 0.8 and 1.0mm. With Micro FUE, a mechanised punch is used to assist the process, whereas Manual FUE relies on the manual force of the practitioner.

From the point of view of the patient, the main difference between the two techniques is the length of time that is involved and the number of grafts that can be successfully transplanted. Manual FUE is, by nature, a more time-consuming process than Micro FUE, which correspondingly means that a smaller number of grafts can be transplanted, because limiting time outside of the body is paramount for graft survival. In practical terms, this means that Manual FUE is more suited to working with a relatively small number of grafts, or working with a higher number but in multiple sessions.

Another factor to take into consideration with Manual FUE is the potential for fatigue and therefore the potentially greater incidence of human error. A hair transplant is quite a time-consuming procedure which, even in the best of circumstances, can be physically and psychologically tiring for both patients and practitioners. This also makes Manual FUE more suited to smaller-scale operations involving a more limited number of grafts.

What are the advantages of Manual FUE and when is it used?

An advantage of Manual FUE over Micro FUE is that it allows for a greater level of control over the extraction process, and what some practitioners have described as greater ‘feedback’, in the sense that Manual FUE gives practitioners a greater ‘feel’ for depth. An important consideration in any hair transplant is avoiding graft transection, which is to say accidentally cutting the part of the hair that lies under the skin. Proponents of Manual FUE argue that the more tactile nature of this treatment makes it better given to avoiding graft transection and therefore maximising successful graft survival. However, a skilled team will be capable of extracting grafts in the safest way possible, regardless of the technique used.

In general Manual FUE is a good solution for those requiring a small number of grafts to be transplanted, as it is normally not possible to transplant more than 1500 grafts in a single session using this method. In particular, an advantage of Manual FUE is that it can be used to transplant grafts without shaving, but only within the above limit, so a patient requiring a larger number of grafts without shaving would have to do more than one session.

Manual FUE in Turkey

Turkey has long occupied the global vanguard in the medical tourism industry, and has been much quicker to embrace technological progress than many other countries. With time, Micro FUE and other technology-assisted techniques have become the norm because of their advantages in terms of their time efficiency, reduced labour intensity and better level of comfort for both patients and practitioners. However, Manual FUE can still be a viable option in certain cases.

Manual FUE at SHIFT

SHIFT takes a holistic approach to planning any course of treatment, considering more ‘technical’ factors such as time efficiency and graft survival whilst also being mindful of aesthetic considerations such as the best overall implantation method to favour the hair, skin, and other facial characteristics of the patient. SHIFT will always propose the best course of treatment for the patient based on that person’s own unique needs and requirements, working in partnership to create the very best results.



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Hair Transplant Mentor, 2017, What Is A Manual Punch?, accessed 25 May 2019, 

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