We are going to explain to you our position and philosophy regarding the comparison between FUT (Strip) and FUE Hair transplant procedures. Most doctors are biased while enumerating the differences depending on what procedure they do best. However, this discussion of the debate of FUT Vs FUE Hair transplamt techniques is unbiased.
Tried mentioning the magical phrase “But Doc! I want an FUE!” to a ‘strip alone’ surgeon? Did you feel you had hit upon a raw nerve! Strip hair transplant surgeons form the majority of the practice today but their turf is very fast slipping away as FUE emerges as the technique of the future. The future of hair transplant surgery is bright indeed with minimally invasive hair transplant surgery taking over from the scarring, the pain, the long days of recovery and more importantly poor growth. However, please note that FUE is an equipment intensive and labour intensive technique. Poor quality of instruments and lackadaisical technicians can affect good results.
| No. | FUT Strip Method (Scarring, Stitching Method) | FUE Method (No stitch, No Scar Method) | Which Method Scores | Why? |
| 1 | A strip of skin from the back of the scalp is removed with a surgical knife and usually measures 10 cms x 2 cms in size | Minute 0.65-0.85 mm micro-incisions with miniscule punches take hair randomly (one follicle group is taken out for every 4 follicles) | FUE | FUE is minimally invasive. Watch Video |
| 2 | A long linear scar results. Pain can be present for upto one year since adjacent skin is stitched under tension to bridge the gaping wound. The body at times cannot compensate for this loss. (Try demonstrating on yourself- bend your head till it touches your chest. Now, pinch the skin. You will not feel a fold. Now look up, and a fold instantly appears. This is the fold that is cut off during strip surgery. Imagine how restraining and discomfiting it would feel if you were to touch your chin to your chest now after the strip is removed. | No visible scar SCARLESS | FUE | The surgical scar undergoes a one year long maturation process till when it is tender, intensely itchy and forward bending like doing desk work will cause pain. FUE scatters the pin point incisions and the tension is likewise distributed, not affecting neck function. Itching subsides in 2-3 weeks. |
| 3 | A wide scar may result | No visible scar SCARLESS | FUE | Any hairstyle can be worn after FUE technique. After FUT there is no hairstyle freedom for life |
| 4 | Recovery period is prolonged | The client can return to office work after one night’s rest | FUE | In today’s hectic lifestyles a procedure needs to be minimally invasive with less downtime |
| 5 | Follicles are dissected by technicians | 100% of follicle extraction is done by us | FUE | Quality control is better |
| 6 | Since technicians do 100% of graft cutting, the error margin is higher with greater transection rates The strip contains follicles from all the 3 phases- anagen, telogen and catagen hence an anagen selective procedure cannot be done | Our transection rate is less than many (World average 12%) FUE selects only hair in the anagen phase (fully bloomed follicles) This technique is called ANAGEN SELECTIVE FUE and is an advancement in FUE technique | FUE | The transected follicles in FUT method are lost permanently. This may comprise upto 20% of the follicles at an average center. The less than 1% transected follicles in FUE grow back since their roots are intact under the skin FUE grows better hair. The hair in FUT which are in regression phases have a high chance of going into dormancy after the surgical assault. Hence the density obtained after FUT is less than after the anagen selective procedure of FUE in which only hairs in the anagen phase are selected. |
| 7 | Doctor spends 5% of the time on the patient doing the procedure | Doctor spends upto 80% of the time with the patient and this is reassuring to the anxious patient | FUE | Quality control, OT discipline is ensured and the patient’s anxiety is allayed |
| 8 | Stitches required (An average of 40 stitches are required) | Completely STITCHLESS | FUE | Stitches can mean infection and gives an operated look |
| 9 | Bleeding during the procedure can occur | Bloodless – Blood loss is less than 10 ml which is the amount of blood you give for a blood test | FUE | Patient does not get apprehensive seeing himself bleed |
| 10 | May lead to pluggy appearance | Grafts give a natural look | FUE | Grafts in FUE are precut |
| 11 | A Limit to number of grafts that can be taken during a lifetime | Limitless donor site | FUE | With the advent of body hair transplants at here, hair can be harvested from the shadow area of the beard, chest, underarms, belly and pubic regions |
| 12 | Not fit for those who are prone to develop bad scars (keloids) Do you have a scar at the tip of your shoulder, center of the chest or below your chin which is raised? If yes, please be cautious about FUT | A boon for people with scarring tendency | FUE | ‘Bad Scar formers’ comprise 15% of the population |
| 13 | Damage to deeper tissue– nerve damage, vessel damage and cyst formation is a distinct possibility since the knife cuts down to 7 mm below skin surface | No chance of vital tissue damage since depth control is present. No more than 2 mm of skin is pierced. | FUE | Safety of FUE |
| 14 | 3-6 weeks before you can resume your Gym, swimming, sports, sex, yoga or aerobics | No lifestyle change after FUE | FUE | After FUE there are no restrictions after one week |
| 15 | Client needs to visit for stitch removal and dressing changes (average number of follow up visits is 4) | Follow up visits are not required. Clients stay in touch through Skype/ mail/ phone | FUE | FUE saves loss of hours off work |
| 16 | The term “STRIP” is not an acronym! | FUE is an acronym for Follicular Unit Extraction | FUE | We only hear of FUE Societies and not strip societies or clubs. |
| 17 | Was the Gold standard till 2010 | FUE has emerged a clear winner scientifically amongst practitioners and is the first method of choice amongst clients today | FUE | FUE is the client’s modern day Gold Standard |
| 18 | Every year strip surgeries continue to decline in number | The number of doctors embracing FUE are multiplying manifold with each passing year | FUE | In a paper by Dr Alan Bauman, President of the International FUE Society www.fuesociety.com, it was logically speculated that FUE will be done in most cases by the year 2014 the sounding of the death knell for FUT seems very near (FUT will however continue to be used for advanced baldness in a subset of clients who have a poor growth on the body- this will continue till cloning will take over and hair transplant surgeons shall stop talking of donor sites!) |
| 19 | Srip surgeons prefer it since it is very time and cost effective | FUE requires total commitment of the doctor and his staff since it is labour intensive | FUE | FUE surgeons are usually only hair transplant doctors and do not undertake other procedures while the hair transplant case is underway |
| 20 | FUT scar can be revised only by FUE technique | Does not require revision | FUE | Is the best stand-alone technique |
| 21 | Eyebrow reconstruction results poor | Best results with FUE | FUE | Since FUE selects only single hairs for transplant |
| 22 | High transaction rate of non-pigmented hair (gray hair, blonde hair) | Transection rate is unchanged and remains less than 1% | FUE | FUT is a sight only technique whereas FUE is a feel only technique, hence color of hair affects FUT harvest with higher wastage rate in this patient subset |
| 23 | Pain killers required for upto one week | One day only | FUE | Patient does not feel sick |
| 24 | Shock loss at donor site can occur | No shock loss | FUE | Since FUE is a minimally invasive procedure and Doctors uses titanium pnches |
| 25 | Cheaper | Costly | FUE | The cost is compensated by better technique, better interaction with the doctor and better growth. FUE is costly since it is labour intensive. The doctor is being compensated for extra work |
| 26 | Cannot be used for tight scalps | Eminently useful in tight scalps | FUE | There is no tightness after FUE |
| 27 | Can do upto 2500 grafts in a day. In case the doctor needs to take more grafts, he would have to wait for 6 months. | We have harvested upto 4000 FUE grafts in daily spurts. Usually 2500 are done in a day. However, in case more are required, the doctor need not wait for half a year | FUE | Body hair transplants have changed the philosophy of FUT vs FUE comparisons |
| 28 | The old adge “FUT is for large cases and FUE for small cases” needs to be rephrased | FUE is for large cases, FUT is for short cases | FUE | In view of the limitless donor supply in FUE. However, our method remains an alternative for advanced cases with less body hair. |
| 29 | The strip has been around for over 15 years | FUE has been around for longer. The earlier technique got refined in the past 3 years an is today considered stet of the art | FUE | New techniques meet with resistance from peers. However the discerning client is driving the new trends towards FUE. |
| 30 | Strips works well in most hands | FUE takes over a year to master. Our Teaching program showed that only 1 in 3 doctors who came for FUE training eventually shifted to FUE | FUE | Only full time hair transplant surgeons can master the FUE technique |
| 31 | It is easy to find a doctor doing good FUT work | FUE doctors who give good results are few at present. | FUE | Do your research well. Do not get carried away by tall claims. See the doctor’s peer –reviewed credentials. What societies is he affiliated with and what is his position on these societies. Does he ever attend conferences to update his skills. You can consult www.fuesociety.com and www.ishrs.org for assistance in making a choice regarding the best FUE surgeons in your locality |
