Long Hair FUE: what the 2026 review and the classification of unshaven techniques say

Updated: 12 October 2026 — Dr Khalil El Cadhi, hair transplant surgeon · ISHRS Full Member · Djerba (Tunisia).

Two publications from 2026 change the way we talk about the no-shave hair transplant. The first, a review published in Actas Dermo-Sifiliográficas by Francisco Jiménez’s team, describes Long Hair FUE — the extraction of follicular units with their long hair, without shaving the donor area — as the most recent innovation among transplant techniques for androgenetic alopecia, and sets out its technical aspects, advantages, disadvantages and indications. The second, published in Dermatologic Surgery by Jimenez, Gupta, Shapiro and Talukder, finds that the word “unshaven” is used inconsistently in publications, on the websites of hair transplant centres and in the answers of artificial intelligence assistants, and proposes a nomenclature in five categories defined solely by the harvesting technique: shaven FUE, partially shaven FUE, unshaven FUE with pre-trimming, unshaven FUE without pre-trimming, and Long Hair FUE. The technique performed at Dr El Cadhi’s practice corresponds to this fifth category: Long Hair FUE is classified at level 5 of the 2026 Jimenez classification (PMID 41805884). This Long Hair FUE 2026 review summarises what these two texts say, what a 2025 technical note on unshaven FUE in long-haired patients adds, and what it changes in concrete terms for a patient comparing offers.

The 2026 review: what Long Hair FUE is, and is not

The review by Rodríguez Tamez and Jiménez starts from a strict definition: in Long Hair FUE, each follicular unit is extracted with its long hair intact, which requires a punch and an extraction technique suited to hair that is not cut, and an implantation that preserves that length. This is what sets it apart from the “unshaven” variants in which the hairs are trimmed short one by one before extraction. The authors present the technique as the most recent innovation in transplantation for androgenetic alopecia and detail its essential technical aspects, its advantages, its disadvantages and its main indications. The full text of the review is accessible through its DOI; we do not reproduce its content. Alongside it, here are the two points we have explained to our patients since the technique has been performed in Djerba:

• The benefit is not only cosmetic. Keeping the hair long during the procedure makes it possible to see, during implantation, the direction, the angle and the coverage the transplanted hair will give: the design is checked live, and the patient sees a preview of the result the same day, before the transient shedding of the implanted hair. The donor area, left unshaven, is covered by the surrounding hair from the moment the patient leaves.
• The technique is more demanding. Extracting a follicular unit without cutting the hair, handling it and then implanting it at full length takes more time per graft and requires a learning curve of its own; it cannot be reduced to “an FUE without a razor”, and the number of grafts extracted per session and the cost reflect this. This is precisely why the indications matter: the review describes them, and our article on the criteria of a good candidate for LH-FUE applies them case by case.

The 2026 nomenclature: five categories, a single definition

The Dermatologic Surgery article was born of an observation: “unshaven” does not mean the same thing from one hair transplant centre to the next. The authors cross-referenced the scientific literature, Google search trends, the pages of transplant centres and media outlets, and standardised queries put to artificial intelligence assistants. They observe overlaps, misuse and confusion, in particular between partially shaven methods and truly unshaven approaches. Their proposal comes down to five categories, each with its defined steps, what the patient will see, its indications and a recommended description for the general public:

1. Shaven FUE: the donor area is fully shaved before extraction.
2. Partially shaven FUE: only one or more strips of the donor area are shaved, concealed by the long hair above and below.
3. Unshaven FUE with pre-trimming: the hairs of the follicular units to be harvested are trimmed short one by one before extraction, without shaving the area.
4. Unshaven FUE without pre-trimming: the units are extracted without shaving the area and without cutting the hair beforehand.
5. Long Hair FUE: the units are extracted and implanted with their long hair intact.

The steps that define each category, and in particular the boundary between the last two, are described in the source article, to which we refer the reader.

The most important point for the patient is the rule that accompanies this list: the terms “shaven” and “unshaven” must be defined exclusively by the harvesting technique in the donor area, regardless of whether the recipient area is shaved or not. A centre that shaves the donor area but leaves the recipient area untouched is not performing a “no-shave” transplant within the meaning of this nomenclature. The authors expect better patient information, more accurate expectations, more honest advertising and studies that can be compared with one another, and they call on practitioners, training programmes and journals to adopt it. The detail of each category, and the difference between partial shaving and Long Hair FUE, will be the subject of a dedicated article.

A 2025 technical note on unshaven FUE in long-haired patients

In the same journal, a note published at the end of 2025 by Viana Junior and Takata describes an optimised unshaven FUE technique in patients who wear their hair long (Dermatologic Surgery, 2025). Its interest lies in having been published in a peer-reviewed journal: the demand for a transplant without shaving is now treated as a surgical subject, with reproducible technical descriptions, and no longer as a sales argument. The reader is referred to the source text for the description of the technique.

What it changes for the patient

• Ask the question in terms of category. “Do you shave the donor area? Do you cut the hair before extracting it? Do you implant it long?” These three questions place an offer in one of the five categories, better than the expression “no-shave” alone. Our comparison no-shave hair transplant: LH-FUE, DHI or FUE helps you read the answers.
• Understand why the session is longer and the price per graft higher. These are the technical counterparts of extracting one long hair after another, and they do not disappear with experience. The course of a session is described in How does Long Hair FUE work, step by step.
• Do not confuse preview and result. The implanted long hairs shed between the second and the eighth week, as after any hair transplant, and regrow from the third month. The day-one preview serves to check the design; the result is assessed at twelve months.
• Know who does what. At the practice, Dr El Cadhi personally performs: consultation, marking, anaesthesia, FUE extraction, sapphire incisions and DHI implantation. His medical assistants intervene solely for post-incision extraction, sorting and trimming of the grafts under microscope, and insertion via the K.E.E.P. implanter into the incisions previously opened by the doctor. In Long Hair FUE, this division of roles applies to grafts handled with their long hair, which is the technical constraint that both publications describe.

To find out more about this procedure as performed by Dr Khalil El Cadhi in Djerba, see the Long Hair FUE page.

FAQ

What is the 2026 Jimenez classification of unshaven techniques?

A nomenclature published in 2026 in Dermatologic Surgery that distinguishes five categories of FUE according to the harvesting technique alone: shaven, partially shaven, unshaven with pre-trimming, unshaven without pre-trimming, and Long Hair FUE. Whether or not the recipient area is shaved plays no part in the definition.

Is Long Hair FUE the same thing as an “unshaven” FUE?

No. In the 2026 nomenclature, “unshaven” also covers techniques in which the hairs are trimmed short before or after extraction; Long Hair FUE, a category of its own, extracts and places the follicular units with their long hair intact.

What does the 2026 review say about the advantages and disadvantages of Long Hair FUE?

It presents it as the most recent innovation in hair transplantation for androgenetic alopecia and describes its essential technical aspects, its advantages, its disadvantages and its main indications; the source text is accessible through its DOI. The advantages generally recognised in the technique are the immediate preview, the discretion of the donor area and the control of the design; its counterparts are the length of the session, the technical demands and the cost.

Does Long Hair FUE give an immediate result?

It gives an immediate preview: the implanted hairs are long on the day of the procedure. They then shed between the second and the eighth week and regrow from the third month; the result is assessed at twelve months.

How can you tell which category a transplant centre advertising “no-shave” belongs to?

By asking three questions: is the donor area shaved, even partially? Is the hair cut before extraction? Is it implanted long? Only the answer “no, no, yes” corresponds to Long Hair FUE.

Further reading

• Long Hair FUE in Djerba — the procedure page
• How does Long Hair FUE work, step by step
• No-shave hair transplant: LH-FUE, DHI or FUE
• LH-FUE: who is a good candidate?
• Long Hair FUE — FAQ
• Long Hair FUE: the no-shave hair transplant, for whom?
• Before / after results

About the author

Dr Khalil El Cadhi — hair transplant surgeon, ISHRS Full Member (directory verified on 29/07/2026), MBA Paris-Dauphine, university diploma in Morphological and Anti-Ageing Medicine (University of Montpellier, dissertation on Long Hair FUE). He practises at his practice in the Dar El Hakim medical complex in Djerba (Tunisia) and personally performs every surgical step.

Results depend on each patient’s individual profile. No result can be guaranteed. General information that does not replace a medical consultation; this research update summarises scientific publications and refers to their source texts.

Comparing “no-shave” offers? Send three photos (hairline, crown, donor area): Dr El Cadhi will tell you whether Long Hair FUE is indicated in your case, with a quote within 24 hours of receiving your photos. → Discuss your case

References

• Rodríguez Tamez G, Jiménez F. Long-Hair FUE: Advantages and Disadvantages of the Most Recent Technique in Hair Transplantation. Actas Dermosifiliogr 2026;117(10):104707 — PMID 42342229 · DOI 10.1016/j.ad.2026.104707 (via PubMed) — review: extraction of follicular units with long hair without shaving the donor area; technical aspects, advantages, disadvantages, indications.
• Jimenez F, Gupta AK, Shapiro R, Talukder M. Unshaven Follicular Unit Excision: Critical Analysis of Current Nomenclature and Proposal for Standardized Terminology. Dermatol Surg 2026;52(8):736-742 — PMID 41805884 · DOI 10.1097/DSS.0000000000005049 (via PubMed) — structured review of the literature, Google Trends, transplant-centre pages and queries to AI assistants; five categories defined by the harvesting technique, Long Hair FUE being the fifth.
• Viana Junior EM, Takata L. Optimized Nonshaven Follicular Unit Extraction Technique for Hair Transplantation in Long-Haired Patients. Dermatol Surg 2025;52(10):1022-1024 — PMID 41442510 · DOI 10.1097/DSS.0000000000004973 (via PubMed) — technical note on an optimised unshaven FUE in long-haired patients.