FUE Surgical Protocol

The FUE Surgical Protocol at California Hair and Skin Institute applies to all physicians, nurses, technicians, and medical assistants participating in hair restoration procedures.

Patient Preparation

Verify patient identity, informed consent, photography consent, medical history, medications, allergies, treatment plan, graft estimate, and preoperative photographs. Document vital signs including blood pressure, heart rate, respiratory rate, oxygen saturation, and weight.

Hairline Design Standards

The physician personally designs and approves the hairline, considering age, facial symmetry, ethnic characteristics, future hair loss projections, and patient goals. Frontal hairline, temporal points, mid-scalp, and crown zones are marked and documented.

Donor Area Preparation

Clip donor hair as indicated, prepare skin with approved antiseptic solution, and establish a sterile field using sterile drapes and gloves.

Local Anesthesia Protocol

Document all anesthetic agents, concentrations, volumes, administration times, and patient response. Monitor for adverse reactions throughout the procedure.

Tumescence Protocol

Administer tumescence to improve follicular visualization, reduce bleeding, and facilitate extraction. Document solution composition and volume utilized.

FUE Extraction Technique

Utilize approved FUE devices including NeoGraft or equivalent systems. Select punch size based on hair characteristics and donor anatomy. Maintain proper punch alignment and minimize follicular transection. Distribute harvesting evenly to avoid overharvesting and visible donor thinning.

Graft Counting and Classification

Count and classify all grafts as singles, doubles, triples, or quadruples. Record harvested and implanted graft totals in the operative note.

Graft Storage Standards

Maintain graft hydration and store in approved preservation solution at controlled temperature. Minimize out-of-body exposure time.

Recipient Site Creation

Performed by the physician. Design sites for natural appearance, density, angulation, and direction. Utilize singles in the hairline and larger grafts in density zones as appropriate.

Implantation Protocol

The placement team shall maintain hydration, avoid excessive manipulation, preserve follicular integrity, and follow physician-created recipient sites.

Intraoperative Quality Control

The physician assesses graft quality, transection rates, bleeding control, density consistency, and placement quality throughout the procedure.

Procedure Completion Checklist

Verify final graft counts, inspect donor and recipient areas, confirm hemostasis, obtain photographs, review post-operative instructions, prescribe medications, schedule follow-up, and provide emergency contact information.

Operative Note Requirements

Document diagnosis, graft counts, punch size, anesthesia utilized, tumescence utilized, complications, estimated blood loss, surgical staff, and discharge condition.

Quality Assurance

Monitor graft survival, patient satisfaction, complication rates, infection rates, revision rates, and protocol compliance through quarterly chart review and quality assurance meetings.