Follicular Unit Excision-Linear Ellipse (FUE-LE): A New Way to Add the Linear Ellipse Donor Harvesting Method to Any FUE Practice

Abstract

Many hair restoration practices offer exclusively the Follicular Unit Excision (FUE) method of donor harvesting, excluding the linear ellipse (LE), or “strip,” procedure. In speaking with new surgeons joining the field of hair restoration surgery, the most common reasons for not offering the “older” linear ellipse method of donor harvesting are the linear scar, lack of patient demand, and lack of staff trained to perform graft dissection. However, experienced surgeons who perform both donor harvesting methods understand the merits of each, aware that with appropriate patient education and selection both methods can provide excellent cosmesis for recipient and donor areas, in addition to optimizing a good long-term surgical plan to preserve future donor area harvesting if or as needed. Furthermore, patients with or destined to develop advanced pattern hair loss often have a sufficiently larger recipient area compared to the safe donor area making a single method of donor harvesting likely to limit coverage. These patients are best served by a combination of both methods to achieve the greatest number of follicular units (FUs) harvested with the least visible donor deficit. For this reason, identifying a way for FUE-only clinics to easily add the LE procedure to their practice would be advantageous for patient care. To that end, I present here the technique of using FUE to harvest all follicular units from inside a pre-marked area of a planned linear ellipse—a novel technique called Follicular Unit Excision-Linear Ellipse (FUE-LE).