The FUE technique is minimally invasive. Unlike the FUSS technique, which leaves scars, the FUE technique leaves no trace of the procedure. This is because hollow cylindrical micro-scalpels are used to extract the follicular units. They have a very fine diameter, from 0.6 to 0.9 mm, leaving small holes that heal within a week after the transplant.

No scar forms, as the small wounds produced do not require suturing to heal.

The FUE technique is performed as an outpatient procedure under local anaesthesia, so no hospital admission is required. In the days prior, no specific action or special care is needed.

On the day of the procedure, you may have breakfast, with the only requirement being to avoid coffee or caffeinated drinks.

As part of the preparation, the patient will be given an anxiolytic or relaxant to help them feel more at ease during the procedure.

This will depend on the type of procedure defined with the doctor. Although it is possible to carry out a hair transplant without shaving or with a partial shave, the full shave is the most common option.

Thanks to this technique, the follicles to be extracted from the donor area can be identified more accurately. In all these procedures, part or all of the occipital area of the head is shaved.

However, this area should not be shaved by the patient themselves. The clinic’s specialist technicians will carry out this task prior to entering the treatment room. They know how to do it in a way that allows Dr. Espinosa Custodio to perform his work effectively.

For women or men with very long hair, accepting the shave may be more difficult.

In these cases, a hair graft without shaving can be performed, which allows work on the extraction area without it being noticeable after the procedure.

That said, shaving is preferable and is the standard approach for men with short hair.

The FUE procedure is lengthy and highly labour-intensive, requiring the doctor’s full attention. Dr. Espinosa Custodio performs all procedures over two days. On the first day, 90% of the FUE incisions are made, from 9:00 a.m. until approximately 7:00 p.m. The second day is dedicated to reviewing the graft and completing areas where greater density is needed. This second session runs from 9:00 a.m. until lunchtime.

The main reason for this two-day technique is to guarantee follicle survival. Transplants are usually planned over two consecutive days. If a large number of follicular units are required, a third procedure may be needed one year after the first two.

Once the procedure begins, several phases take place, always guided by Dr. Espinosa Custodio. After preparation in the treatment room, the anaesthesia stage begins. The doctor will apply local anaesthesia and the transplant will officially commence.

The first phase is follicle extraction. Using the FUE technique, Dr. Espinosa Custodio, assisted by the punch and the micromotor, extracts the follicles one by one. The doctor’s team then proceeds to classify and prepare them for grafting.

Once extraction is complete, the doctor proceeds to implant the follicles using implanters, which can be described as small grooved syringes through which the follicles are implanted.

Both the punches and the implanters come in different diameters, ranging from 0.6 to 1 millimetre, depending on the size of the patient’s follicle.

After the FUE procedure, the patient can go home and resume normal daily activities, always taking care to avoid direct contact with the implant area, as the implanted follicles may become dislodged.

During the first few days, the appearance will be of multiple small wounds on the head, so it may be advisable, if possible, to take a few days of rest or work from home. In the first 48 hours, facial swelling may occur due to the local anaesthesia.

After 72 hours the extraction wounds will be closed, and after the first week or ten days the appearance will be virtually normal.

The transplanted hair will shed within a few weeks of the procedure. This is expected and normal, and does not affect the hair follicle, which is the true target of the transplant.

The grafted follicles will begin their normal growth cycle and, between 5 and 6 months, the first results will start to become visible. However, it will not be until 12 to 15 months that the full result will be seen.

In the case of the vertex — commonly known as the crown — the process is slower, and it is from 15 months onwards that it will complete its course.

The FUE technique is currently used in more than 90% of hair transplant patients, as it presents clear advantages over FUSS. It is particularly suitable for people who wish to wear their hair short, avoid scars, or who do not want to undergo a more invasive procedure.

Yes, it leaves a small scar. This is because with this technique a strip is removed from the donor area, which is then sutured. The stitches are removed from 10 days after the procedure.

However, the scar can be concealed with the patient’s longer hair (from 1 or 2 cm), although it will be visible if a shaved or very short haircut is chosen.

The procedure is slightly more invasive than FUE, so the post-operative period also involves a longer recovery process and some additional discomfort. It is also, however, an outpatient procedure performed under local anaesthesia that does not require hospitalisation.

Although it is clearly declining with the emergence and refinement of the FUE technique, it still has its indications and advantages. FUSS makes better use of the donor area, so it may be indicated for patients with a limited donor area or where a significant volume of follicles is required.

It also reduces treatment time and avoids shaving, making the procedure less noticeable.

Dr. Espinosa Custodio considers that there is no better time of year for a hair transplant. The process is similar throughout the year. It is normally scheduled at the patient’s convenience, as it is recommended to have several days of rest — between three and five — to recover calmly and carry out the necessary aftercare.

It is also worth noting that facial oedema may occur after the procedure, which resolves after 3 or 4 days. If the patient wishes to avoid social interaction, those rest days are also advisable for this reason.

There is no perfect technique. There are several types that can be adapted to each patient depending on their condition and characteristics.

For the extraction phase there are 2 techniques: FUE, where the specialist extracts each follicular unit one by one (hair by hair), and FUSS, where a strip of skin is cut and the technicians then extract the follicular units (FU) from it.

For implantation there are also 2 techniques: the classic or forceps technique, a mixed method where the specialist makes the incisions and the technicians place the follicular units; and the implanter (DHI) technique, where the doctor makes the incision and inserts the follicular unit simultaneously.

It is worth noting that, by law, incisions may only be made by a registered doctor. Dr. Espinosa Custodio will examine you and determine which technique is most appropriate for you.

FUE stands for Follicular Unit Extraction — the extraction of follicular units one by one, where each unit can contain between 1 and 6 hairs. The specialist makes incisions using a circular scalpel (called a punch), which can be manual or assisted by a micromotor.

It is a procedure that MUST always be performed by a specialist hair doctor. Nurses and technicians assist the doctor but must never make incisions on the patient.

It consists of extracting follicular units (the hair) and then implanting them into the area where restoration is desired.

As with any medical procedure, there are inherent risks: bleeding, infections, facial oedema, etc. However, if carried out following all health protocols, the risks are minimised. It is a minor outpatient procedure, meaning no hospital admission is required.

Essentially, it involves being careful not to touch or disturb the implanted area and keeping it constantly hydrated.

Our doctors personally explain the aftercare instructions, which are also provided in writing. We also have a 24-hour emergency phone line.

Yes, but only temporarily. There is a phase called shock loss in which the follicular units can shed due to the stress of the process. Depending on the individual, between 20% and 80% may fall out. This phenomenon typically occurs 3–4 weeks after the procedure.

At Dr. Espinosa Custodio’s clinic, the commitment does not end in the operating room. To optimise results and accelerate the process, we include in all our transplants oral medication for the first year, as well as the hair treatments (PRP, Mesotherapy, etc.) required according to each patient’s progress. All of this at no additional cost, with the goal of achieving an excellent final result at 12 months.

No, we transplant the entire follicular unit, so that hair does not regrow. However, the high density remaining in the area will make the loss imperceptible.

In the days following the transplant, scabs begin to appear. This is completely normal. In the recipient area, the hair should not be touched or rubbed during the first few days. In the donor area, daily cleaning will cause the scabs to fall off much more quickly.

Achieving a natural hairline is essential. Single-follicle units are selected for the transition, and the design is always made in accordance with the patient’s facial morphology, following the doctor’s recommendations to ensure facial harmony.
For the hairline, single-follicle units are selected, gradually increasing to two and three, so that the line looks natural and the hairline is well-defined. The design must always be tailored to the patient’s facial structure, which is why it is important to follow the doctor’s recommendations.

One of the reasons for undergoing a hair graft may be a scar on the scalp, whether from an accident or a previous FUSS transplant. A hair graft can indeed be performed over a scar, helping to conceal it. However, an experienced specialist doctor must be chosen to ensure the implant is fully satisfactory.

Hair fibres are used to conceal alopecia. Regarding the transplant, the first consultation with the doctor must be attended without having applied these fibres in the preceding days. If the intention is to use them afterwards, they must not be applied during the first month, and if used continuously, patients should wait 3 months.

Psoriasis is a skin condition that causes rashes and red patches. In principle, there should be no contraindications between a hair transplant and psoriasis, although an experienced specialist doctor must assess the risks and benefits.

It is advisable to wait at least one month before dyeing the hair again. By that time, healing will be complete and the follicles will not be damaged.

Dr. Espinosa Custodio incorporates a genetic test (Trichotest) that helps to better understand the patient’s alopecia. This gives the doctor a more specific guide to help slow down alopecia and fine-tune the medication.

It is possible to do so without shaving. However, this technique should only be performed by a specialist clinic, as not all centres are equipped to do so.

Yes, but the doctor must be informed. It would be ideal to stop smoking in the days before the transplant, as tobacco hinders healing and influences the progression of alopecia.

The preservation and handling of follicles during the extracorporeal phase is vital. The follicle must be kept in solutions such as lactated Ringer’s or Hypothermosol to prevent damage from dehydration or microtraumas.

For cutting hair: In the donor area, 1 month with scissors and 2 months with clippers. In the recipient area, 2–3 months with scissors and 6 months with clippers.

Certain requirements must be met, such as having a sufficient donor area and stabilised alopecia. Meeting these requirements will make you a candidate for a hair transplant.

Transection is irreparable damage to the follicle that prevents its growth. A high transection rate leads to graft failure.

Growth of hair on the crown is slower due to factors such as reduced vascularisation and compression during sleep.

It is common to experience telogen effluvium after childbirth. Around 30% of hair can fall out, but this is a completely temporary process.

Ringworm is a fungal infection that presents in patches and is spread through contact or infected combs.

Folliculitis is inflammation of the follicles. After a graft, it may appear when the hair begins to regrow.

Diffuse alopecia manifests as progressive miniaturisation across the entire scalp and is treated with medication and grafting.

Poliosis is a localised cluster of white or grey hairs (a white streak), unlike scattered grey hairs.

There should be no pain during a hair transplant. Local anaesthesia is used, similar to that used by dentists.

Proper preparation includes following the prescribed medication, completing prior blood tests, and avoiding stimulants such as caffeine and tobacco.

Cicatricial alopecia requires expert assessment. A small test graft may likely be performed beforehand.

The doctor requires a hormonal blood test to check values such as dihydrotestosterone and determine the most appropriate medication.

Rosacea is not dangerous for the graft, although a prior test on the tissue may be required.