Forty Steps to Harvest a Graft

Abstract

Over the past two decades, the stages or steps of follicular unit excision (FUE) harvesting have been described in the medical literature. This article details and identifies the sequence of steps necessary to distinguish the ideal donor harvesting parameters for each patient. The physician’s knowledge and skills should allow for a personalized (and often modified) approach to the different areas of the patient’s scalp.

Understanding and performing the sequential steps to harvest intact follicular units (FUs) without damage or injury is an important part of the successful completion of the process. Not all doctors follow the same process or steps for harvesting follicles. In fact, the first few FUs harvested should be used to help identify and establish the necessary parameters to obtain the ideal harvested graft later. Naturally, extra effort may be required to determine the correct sequence and technique for each patient.

It also is important to understand that there may be anatomical differences between areas of a patient’s scalp, and it may be necessary to adapt and adjust accordingly. This article describes the 40 steps that we believe are essential for the effective harvesting of uninjured grafts. A single error in any single step may be the difference between success and failure.