What is manual FUE?
Manual FUE (Follicular Unit Extraction) is the hair-transplant technique in which the surgeon extracts each follicular unit from the donor area —the nape and sides— one by one, using a sub-millimetre micropunch guided by hand, and reimplants it follicle by follicle into the area of loss: temples, frontal hairline or crown. Its defining feature is that it leaves no linear scar.
Instead of a linear scar, FUE leaves tiny millimetric dots across the donor area that blend in as the hair grows, so you can wear your hair short afterwards. It is your own living tissue, relocated: a follicle taken from the nape keeps its genetic memory and, once implanted, keeps growing for life. It is outpatient surgery under local anaesthesia, usually lasting 4 to 8 hours depending on the number of grafts.
Techniques used by Dr. Arístides Arellano
Within hair transplantation there is no single way to perform an FUE: the right approach depends on your donor area, the number of grafts and whether you need to avoid shaving. Dr. Arístides Arellano combines several tools according to the case:
- Manual FUE with micropunch: follicle-by-follicle extraction controlled by hand, giving the surgeon maximum control over the angle and depth of each extraction. It is the focus of this page and the most requested technique, because it leaves no linear scar.
- Long Hair FUE (Trivellini “Mamba” system): FUE without shaving the donor area, using a programmable multiphase punch. You see the result the same day and can return to work without the procedure being obvious.
- Robot-assisted extraction with ARTAS iX: when the case justifies it, the robotic system with AI-assisted vision selects and extracts each follicle at optimal depth and angle, lowering transection. See the ARTAS iX system.
- FUT / FUSS (strip technique) as an alternative: when the largest number of grafts in a single session is needed, the occipital strip yields more, in exchange for a fine linear scar hidden under the hair. The decision is made at the consultation. Compare all techniques.
How is it performed?
Manual FUE is performed in one outpatient session under local anaesthesia, with the patient awake and comfortable. The frontal hairline is designed first, respecting face shape and age —a line that is too straight or too low is the signature of poor work—. The follicular units are then extracted one by one with a micropunch and kept alive in solution. The recipient sites are opened, defining the angle, direction and density of each hair, and finally single-hair units are implanted in the front row, for a natural edge, with 2- to 4-hair units behind, where they deliver density. It helps to know in advance: between weeks two and six the transplanted hair falls out —this is shock loss, normal and expected— and the result is judged at 12 months.
All surgery carries risk and requires a prior medical assessment. Results may vary according to each patient, their anatomy and their individual healing process.
Who is a good candidate?
- People with androgenetic alopecia (male- or female-pattern baldness) who have a sufficient, stable donor area.
- Those who want to avoid a linear scar and be able to wear their hair short after surgery.
- Patients in good general health with realistic expectations, willing to wait the 12 months the definitive result takes.
- People looking to cover specific zones —temples, hairline, crown, scars— or to restore a beard or eyebrows with a moderate number of grafts per session.
Recommended post-treatment care
After an FUE the grafts are fixed within a few days, but they are treated like glass in the first week: sleep semi-upright, avoid direct sun, intense exercise and scratching, and wash the scalp with the exact technique you are given. To support healing and protect the native hair —which surgery does not— the plan may include PRP, mesotherapy and a medical containment treatment (supervised finasteride/minoxidil). See the full guide: Post-surgical recovery and care.
Before and after
Most patients want to see before-and-after photographs before deciding. Out of respect for each person’s privacy, Dr. Arístides Arellano shows real cases —always with documented consent— during your in-person consultation, where you can review results from patients with a starting point similar to yours. Results may vary from patient to patient.
Approximate price
The reference price starts at approximately $55,000 MXN, depending on the number of follicles to be transplanted and the technique. The price is all-inclusive: it covers use of the operating theatre and facilities, pre-operative laboratory work and the post-surgical recovery treatments. It is not the surgeon’s fee alone. Approximate price — the definitive cost is set at your private consultation with Dr. Arístides Arellano.
About Dr. Arístides Arellano
Dr. Arístides Arellano is a plastic surgeon holding a specialty licence: he practises under a Mexican medical licence (D.G.P. 1125959) and a specialty licence in Plastic & Reconstructive Surgery (0002008), both issued by the Directorate General of Professions (DGP), which reissued his certificate of professional standing in 2025. His career began before Mexico’s present-day specialty-board system existed: he belongs to the founding generation of plastic surgery in Puebla, the second generation of a surgical tradition started in 1971 by Dr. Francisco Arellano Ocampo. Trust is verified, not promised: both licences are public and anyone can look them up in the DGP’s National Registry of Professionals.
Related patient guide
To estimate how many grafts your case might need before the consultation, read How many grafts do I need? A hair-transplant guide, reviewed by Dr. Arístides Arellano.
Trust is verified, not promised. All 210 scanned documents —degree, licences, diplomas, publications and certificates, from 1977 to 2025— are open in Dr. Arístides Arellano’s credential archive, alongside an explanation of the difference between a specialty licence and a board certification.
Recovery · step by step
- Days 1–3Mild swelling of forehead and eyelids; sleep semi-upright. The grafts are already fixed, but treated like glass.
- Days 4–7First wash following the exact instructions given. Mild discomfort, controlled with simple analgesics.
- Days 7–10Crusts fall away. Social life resumes; the recipient area is still pink.
- Weeks 2–6⚠️ SHOCK LOSS: the transplanted hair falls out. Normal and expected. The follicle stays alive under the skin.
- Months 3–4New hair starts to emerge, fine at first; it thickens over the months.
- Months 6–12Visible result at 6 months (≈60% of the hair); definitive at 12 (crown, up to 18).
Frequently asked questions
What is manual FUE?
Manual FUE (Follicular Unit Extraction) is the hair-transplant technique in which the surgeon extracts each follicular unit from the donor area one by one, using a hand-guided micropunch, and reimplants it follicle by follicle into the area of loss. Its main advantage is that it leaves no linear scar, only millimetric dots that blend in as the hair grows.
Does FUE leave a scar?
FUE leaves no linear scar. Instead of a line, it leaves tiny millimetric dots spread across the donor area that blend in as the hair grows, so you can wear your hair short afterwards. That is its main difference from the strip technique (FUT), which does leave a fine linear scar hidden under the hair.
Does manual FUE hurt?
It is performed under local anaesthesia: you feel the initial application and then pressure, not pain. The patient is awake throughout the surgery and can listen to music, eat and rest. Subsequent discomfort is mild and controlled with simple analgesics.
How much does a manual FUE cost in Puebla?
Cost is calculated by the number of follicular units (grafts) your case requires, not by a flat fee: one patient may need 1,200 grafts and another 4,000. It is set at the consultation, after the hair diagnosis, with a written quote and the exact planned graft count.
How long until I see the result of an FUE?
Between weeks two and six the transplanted hair falls out (shock loss), which is normal and expected. New hair begins to emerge around the third or fourth month, there is a visible result at six months, and the definitive result is judged at 12 months; on the crown it can take up to 18. Results may vary from patient to patient.
Which is better, FUE or FUT?
Neither is better in the abstract; they are different. FUE leaves no linear scar and allows short hair, but yields fewer grafts per session. FUT leaves a fine linear scar hidden under the hair and allows the largest number of grafts in one operation, so it remains the best option in extensive baldness. The right technique is chosen at the consultation.
Can FUE be done without shaving my head?
Yes. The Long Hair FUE (Trivellini) system allows extraction and implantation without shaving the donor area, using a programmable multiphase punch. The patient sees the result the same day and can return to work without the procedure being obvious.
Every case is different. Discuss yours in a personal consultation.
Book a consultation on WhatsAppEvery figure published on this site is approximate and is not a quote. Any procedure or treatment first requires a private assessment consultation with Dr. Arístides Arellano —$800 MXN, charged separately— and it is at that consultation that the definitive cost of your case is determined.
Educational content; it does not replace a medical consultation. Results may vary from person to person.