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)
(No stitch, No Scar Method)
|Which Method Scores||Why?|
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 is minimally invasive.
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
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.
A wide scar may result
No visible scar
Any hairstyle can be worn after FUE technique. After FUT there is no hairstyle freedom for life
Recovery period is prolonged
The client can return to office work after one night’s rest
In today’s hectic lifestyles a procedure needs to be minimally invasive with less downtime
Follicles are dissected by technicians
100% of follicle extraction is done by us
Quality control is better
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
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.
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
Quality control, OT discipline is ensured and the patient’s anxiety is allayed
Stitches required (An average of 40 stitches are required)
Stitches can mean infection and gives an operated look
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
Patient does not get apprehensive seeing himself bleed
May lead to pluggy appearance
Grafts give a natural look
Grafts in FUE are precut
A Limit to number of grafts that can be taken during a lifetime
Limitless donor site
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
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
‘Bad Scar formers’ comprise 15% of the population
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.
Safety of FUE
3-6 weeks before you can resume your Gym, swimming, sports, sex, yoga or aerobics
No lifestyle change after FUE
After FUE there are no restrictions after one week
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 saves loss of hours off work
The term “STRIP” is not an acronym!
FUE is an acronym for Follicular Unit Extraction
We only hear of FUE Societies and not strip societies or clubs.
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 is the client’s modern day Gold Standard
Every year strip surgeries continue to decline in number
The number of doctors embracing FUE are multiplying manifold with each passing year
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!)
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 surgeons are usually only hair transplant doctors and do not undertake other procedures while the hair transplant case is underway
FUT scar can be revised only by FUE technique
Does not require revision
Is the best stand-alone technique
Eyebrow reconstruction results poor
Best results with FUE
Since FUE selects only single hairs for transplant
High transaction rate of non-pigmented hair (gray hair, blonde hair)
Transection rate is unchanged and remains less than 1%
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
Pain killers required for upto one week
One day only
Patient does not feel sick
Shock loss at donor site can occur
No shock loss
Since FUE is a minimally invasive procedure and Doctors uses titanium pnches
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
Cannot be used for tight scalps
Eminently useful in tight scalps
There is no tightness after FUE
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
Body hair transplants have changed the philosophy of FUT vs FUE comparisons
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
In view of the limitless donor supply in FUE. However, our method remains an alternative for advanced cases with less body hair.
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
New techniques meet with resistance from peers. However the discerning client is driving the new trends towards FUE.
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
Only full time hair transplant surgeons can master the FUE technique
It is easy to find a doctor doing good FUT work
FUE doctors who give good results are few at present.
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