Last Updated on July 15, 2021 by Dr Sanusi Umar MD


FUE hair restoration for men and women of African descent has entered a new era of effectiveness due to advances made possible by Dr.UGraft ™ technology.

Hair loss in black men is distressing. Although most cases are due to male pattern baldness, environmental factors may also come into play and influence the progression of thinning.


Hair Styling Practices That Can Accelerate Male Pattern Baldness in Black Men

Though male pattern baldness has a strong genetic component, environmental factors can affect the rate at which hair loss occurs. Some common examples include: – extensive sun exposure – stress – iron and nutritional deficiencies – side effects from prescription medications – thyroid imbalances. Black men also need to be vigilant about hairstyling practices that worsen their hair loss due to pattern baldness.

This includes:

In genetic baldness, the hair follicle miniaturizes and becomes less able to grow normal, healthy hair as before. Tension due to hairstyling practices can make matters worse.

Hair Restoration For Black Patients Requires Ethnic Considerations

Although commonly available hair transplant methods can produce desirable results on many ethnicities, they are extreme limitations in treating black patients. Strip surgery, for example, will inevitably leave linear scars, which are easily seen through the shortly cropped hairstyles preferred by most men of African origin. Standard FUE (Follicular Unit Excision) hair restoration (performed with all commercially available FUE tools and robotic FUE technology) will produce much higher transection rates within this demographic, leading to poor coverage and growth. It has long been believed that its straight cylinder shape will incur difficulties when attempting to follow the torsion twist of a tight curl to encompass the hair follicle safely.


Cross section of hairs, comparing straight, wavy and curly hair types

Cross-section of hairs, comparing straight, wavy, and curly hair types. Different degrees of hair curliness; Straight for most Caucasian and Asian hair; Wavy for some Caucasian, middle eastern, and mixed heritage; and tightly curled found mostly in people of African descent. Shape plays a key role in the success of hair restoration for black African men.


While this may seem to be a very likely scenario, Dr.U has observed across many patient cases that skin thickness is the leading factor that impedes hair transplant success in black patients, compared to the morphology of the hair shaft and hair follicle.

Thicker skin necessitates a new and different approach for performing hair restoration surgery on black patients.

Dr.U’s insights have culminated in developing a paradigm called Intuitive FUE, forming the logic behind the engineering of his  Dr.UGraft™ technology. Black patients can now anticipate reliable hair transplant growth to overcome the difficulties incurred by thicker skin. Their donor grafts can be safely harvested through the use of the Dr.UGraft ™ Intuitive FUE system. The main components include:

  • Dr.U Punch I (intelligent punch)
  • the Nurture handpiece, which powers the intelligent punch, the Dr.UGraft Revolution console, customizes the punch’s performance according to the skin’s thickness. 

Although Dr.U’s Intuitive FUE system offers the ability to help all black patients, some rare or unique circumstances may require the use of a manual punch. Dr.U has thus designed a patented tool called the Dr.UPunch Curl™ which not only penetrates thicker skin types but is also built to follow the inherent curvature of the hair follicle shape found within this demographic.

Patients of African descent require more specialized approaches to hair transplantation.


Intuitive FUE and Why Skin Thickness is the Primary Cause of Hair Transplant Graft Transection in Black Patients

As an alternative hair transplant paradigm Intuitive FUE attributes graft transection to skin thickness as the main contributor.

Dr.U’s rationale for this ideology is based on his experience across patients of many different ethnic backgrounds. He has discovered a much stronger correlation between skin thickness and graft transection than the previously cited factor of hair curliness.

He noticed that some patients with wavy or more relaxed hair types (e.g., some Caucasians, Asians, Middle Easterners, and individuals of mixed heritage) experience much higher transection rates than black patients with tightly curled Afro-textured hair. In these instances, the use of cylindrical FUE punches on hair follicles with severe curl incurred a much lower transection rate compared to more typical, straight-shaped follicles. As Dr.U found, the main determinant was that the patients with relaxed hair had much thicker skin than the patients of African origin. 

Interestingly, Dr.U discovered additional support for skin thickness as a major contributor to hair transplant graft transection. When performing donor extractions on black patients, he noticed that some scalp regions would display much higher transection rates than other areas. Differences in skin thickness can explain this phenomenon.

Because of this limitation of basic FUE methods and their reliance on rotary punches, hair transplants for curly-haired individuals can pose issues to surgeons. Doctors often deem most patients who possess tightly curled hairs as poor candidates for FUE for this reason. This can come as a major source of disappointment for this major demographic group, especially black men, who often prefer to keep their hair short. This also ranks men of African heritage as the worst candidates for strip surgery. Strip surgery leaves a linear scar that would be difficult to conceal with a short haircut. Still, the limitations of basic FUE often force men with tightly curled hair to resort to this outdated form of hair restoration.

How Thick Skin Contributes To Hair Transplant Graft Transection

In individuals of African origin, the hair follicle is anchored to the surrounding skin tissue through a greater density of anchoring attachments. Basic mechanical rotary FUE hair transplant punches are built to penetrate the skin using a set speed and torque. Yet, these parameters are insufficient for safely harvesting grafts in most black patients due to the tougher quality of their skin. 

A regular FUE punch will experience difficulty penetrating thicker skin. In more extreme cases, it will also have trouble rotating as well. Continued efforts to liberate the graft while the anchoring attachments are still in place increase the risk of tearing the protective sheath surrounding the follicular unit. The graft becomes transected at this point. 

The Dr.UGraft™ Intuitive FUE system offers providers the ability to observe how the punch performs on different skin thickness types to customize the speed and torque settings.

In black patients with very thick skin, the punch may exhibit difficulty penetrating or rotating through. With the Dr.UGraft™ Revolution console, it is possible to increase the punch’s speed and torque to avoid injuring the grafts and minimize transection rates. 

With extremely challenging skin thickness, the Dr.UGraft ™ intelligent punch can be adjusted to perform using the oscillation mode, alternating between clockwise and counterclockwise rotations. 


Thick skin in patients of African descent may require the oscillation mode of the Dr.UGraft Intuitive FUE system.


Examples of Black Patient Hair Transplantation With Intuitive FUE

The Dr.UGraft, Intuitive FUE hair transplant system, can produce successful growth outcomes on all patients of African origin. Here are two examples

Dr.U’s Intuitive FUE Procedure Helps Black Male Patient Overcome Failed Hair Transplant Results

This patient had experienced poor strip and FUE procedures performed at other clinics. He was not able to experience the growth he had expected. Disappointingly, he continued to have a receded hairline and temples, along with an evident strip scar. Due to Dr.U’s specialization in black hair transplantation, he decided to undergo a  Dr.UGraft Intuitive FUE procedure. Here are his before and after photos.

Patient's before and after photos show an improved hairline and temples, following his Intuitive FUE procedure

The patient’s before and after photos show an improved hairline and temples, following his Intuitive FUE procedure *

Before and after photos show patient's strip scar repair results, following his Intuitive FUE hair transplant for black patients

Before and after photos show the patient’s strip scar repair results following his Intuitive FUE hair transplant for black patients *


Intuitive FUE Hair Transplant Surgery Helps Black Patient Conceal Bad Tattoo in Hairline and Temples

This patient attempted to fill in his receded hairline and temples through SMP (scalp micro pigmentation). However, the effect did not produce a result that was natural in appearance or convincing. He decided to rely on a hair transplant procedure to cover these areas with real hair growth instead. Being of African heritage, he required a specialized approach that would help ensure appropriate growth. Using his Intuitive FUE system, Dr.U was able to harvest the necessary graft count, which covered the unwanted scalp tattoo and restored the hairline and temples as well.

Hairline and temple restoration , including SMP coverage using grafts harvested with Dr.U's intelligent punch and Intuitive FUE system

Hairline and temple restoration, including SMP coverage using grafts harvested with Dr.U’s intelligent punch and Intuitive FUE system

Bad Tattoo Repair With Intuitive FUE for Black Patient


Side view of temples and hairline advancement, before and after patient's Dr.UGraft Intuitive FUE procedure

Side view of temples and hairline advancement, before and after patient’s Dr.UGraft Intuitive FUE procedure.



About the Dr.UPUnch Curl For FUE Success In Black Hair

Dr. U recently published a study in which he compared the performance of rotary punches with the new Dr. UPunch Curl in performing FUE in black African hair type. The study, which was published in the Plastic and Reconstructive Surgery Online publication, compared the performance of these tools in 18 patients. In the study, the Dr.UPunch Curl was successful 100% of the time. It was successful in all cases where the rotary punches performed dismally. [1]

Because of the limitations of rotary punches regarding FUE in most black patients, Dr. Umar set about researching new devices and ways of performing FUE in Afro-textured-haired individuals. Indeed, experts often consider this vexing issue the last frontier of FUE hair transplantation. His work culminated in inventing a brand new way of performing FUE, which does not involve any rotary motion. Rather, this new component of the Dr.UGraft method requires only a plunging action to affect. The following schematic demonstrates how the new non-rotary Dr.UPunch Curl invention works. The punch is engineered to navigate the course of the curled hair under the skin without transecting it.


The Dr.UPunch Curl allows for African American hair restoration

Schematic for Dr.UPunch Curl For African Hair FUE


The innovation of the DrUPunch Curl was a breakthrough in FUE hair restoration for black African men

The Dr.UPunch Curl was successful for hair restoration in black African men

FUE Hair Transplant for Black African Men Using Dr. UGraft – Dr.UPunch Curl for All Tightly Curled Hair: The Process

Dr. Umar performes FUE hair restoration in black African men with the DrUPunch Curl

Black male hair restoration: The Dr.UPunch Curl, FUE tool for ALL African American FUE in use by Dr. Umar

The Dr.UPunch Curl has success in extracting even tightly curled hair

Tightly Curled FUE Dr. UGrafts extracted by the Dr.UPunch Curl and used in hair restoration for black African men from a patient who failed conventional FUE tools

Before and After: FUE for hair restoration in black African men

FUE for hair restoration in black African men: Donor soon after surgery and at 1 year after Dr.UPunch Curl extraction of 1600 grafts*

FUE Hair Restoration for Black African Men Before and After Using Dr.UPunch Curl (Case Sample #1)

Dr. Umar used 1600 grafts for black hair restoration

African American hair transplant before after Top view results after 1600 grafts using Dr.UPunch Curl for FUE in hair restoration for black African men*

Hairline restoration in a patient of African descent

Dr.UPunch Curl FUE hair restoration in black African men using 1600 Dr.UGrafts. Before photo shows an area grafted for African American hair restoration by Dr. Umar*

African American hair transplant before after results of the Dr UGraft procedure

FUE Hair Restoration in black African men Using Dr.UGraft – Before and After results of African American hairline restoration*

Video – African American Hair Restoration Using Dr.UGraft 

This case of African American male hair loss treatment is depicted in a self-explanatory video below:

African American hair transplant before and after Dr. U Punch Curl (Case Sample #2)


African American hair transplant Repair before and after Dr U Punch Curl. Patient repaired after a poor FUE outcome from another clinic

African American hair transplant Repair before and after Dr. U Punch Curl. The patient was repaired after a poor FUE outcome from another clinic.

VIDEO: African American Hair Transplant Repair Before and After Dr.UPunch Curl

A patient who had an unsuccessful FUE transplant at another clinic finds hope in Dr.UPunch Curl:

Update October 2018: New Iterations of Dr.U’s FUE Technology for Afro-Textured Hair Transplant Extractions

Dr.U’s devices for successful hair transplant results in black patients have undergone new developments in the direction of healthier, more viable grafts and even greater ease-of-use for surgical providers.

In this video, Dr. U demonstrates how the Intelligent Punch lives up to its name and intelligently navigates the tight curls of afro-textured hair.

The Nurture ™ Handpiece Offers Fluid Delivery for the Dr.Graft Zeus™.

The highly intelligent, self-navigating Dr.UPunch i™ makes the impossible possible through features that enable safe extractions for all types of follicles, including Afro-textured hair. When used with the Dr.UGraft Nurture ™ handpiece attachment, it offers a controlled drip-fluid delivery system that hydrates the grafts as they are being extracted. Wetter, more hydrated grafts are bulkier. They are also more protected from the damaging forces of evaporation, the leading factor of follicular death and poor growth yield.

At the same time, the fluid also lubricates the inner curved surface of the punch, helping the follicle ascend into the punch lumen more easily. Additionally, the lubrication protects the sharp edge of the punch from dulling over time through repeated use.

Dr.UPunch Curl™ Version 2.0 Offers Better Speed and Improved Ease-of-Use

Some African-American patient cases are more challenging due to the likelihood of higher transection rates. However,  they can benefit from Dr.UPunch Curl™, which offers more specialized features for overcoming graft damage and injuries to enable successful growth in the end.

Dr.U has further improved upon the capabilities of this device with his 2.0 version. The newer evolution of the Dr.UPunch Curl ™ includes sharper blades that create smaller incisions for better user-friendliness and improved wound healing results.

Practitioners can now perform extractions on more difficult patient cases with far greater ease, especially when separating grafts from stronger tissue attachments.

The Dr.UPunch i™ paired with the Dr.UGraft Nurture™, along with Dr.UPunch Curl ™, provide surgeons with reliable tools for addressing all difficulty levels of black hair transplant cases.

Frequently Asked Questions – Hair Restoration for Black African Men

Can the Dr.UPunch Curl Afro FUE hair transplant procedure work for all men of African descent?

Typically yes: The Dr.UPunch Curl uses an unconventional non-rotary method of extraction. Unlike conventional rotation-based punches, grafts from even the most tightly wound hair can be extracted successfully by FUE. Patients can thus avoid requiring a strip surgery and the dreaded linear scar that is very unsuitable for black patients who prefer to keep shorter haircuts. This factor makes Dr.UGraft, with its Dr. UPunch Curl component, the best hair transplant method in Afro hair.

If someone has undergone previous black hair restoration procedures unsatisfying results, is he still eligible for a transplant with the Dr.UGraft method?

Yes. Most clinics fail because they lack the proper tools to extract intact survivable hair from African hair types because of their curliness. Dr. Umar invented the first-ever tool for successfully extracting intact hair grafts from all patients with tightly curled hair. This dramatically increases the likelihood that where others have failed, Dr. Umar would succeed with this tool, as well as his vast expertise in performing FUE hair transplants in this demographic.

How much does African American type of hair transplant cost?

The cost of the procedure depends upon the number of grafts required to complete African American hair restoration. In that way, the price of black FUE hair transplants varies from patient to patient. Interested patients should contact Dr. Umar for a free consultation.

Don’t see your question about black hair restoration answered above? Use this button to submit your inquiry to Dr. Umar:


  1. Umar S. Comparative Study of a Novel Tool for Follicular Unit Extraction for Individuals with Afro-textured Hair. Plast Reconstr Surg Glob Open. 2016 Sep 27;4(9):e1069.

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