BACKGROUND: Conventional epilation methods commonly encounter challenges in achieving permanent removal of unwanted facial terminal hair (uFTH), particularly when it is interspersed among normal hairs. OBJECTIVE: To assess the safety and effectiveness of follicular unit excision (FUE) for permanent removal of uFTH. METHODS: The retrospective analysis included 231 patients who underwent FUE hair removal at three medical centers. uFTH in five facial areas was excised and assessed for follicular integrity. Surgical details, complications, in situ hair regrowth, and patient satisfaction were recorded and analyzed. RESULTS: Scattered uFTH was excised using a fine punch (inner diameter, 0.6~0.7 mm) at a rate of 18.0~23.6 units per minute in five facial areas. The procedure yielded a low transection rate of only 6.2% (median), minimizing in situ hair regeneration and facilitating the intact harvesting of hair follicles for transplantation. Most sites exhibited optimal wound healing without visible scarring. The overall complication rate is 26.3%, with folliculitis accounting for 3%. Overall satisfaction was significantly high, reaching 96.6%. CONCLUSION: FUE technique is a precise and effective potential approach for uFTH permanent removal in facial areas. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .