FUT VS. FUE hair restoration
Why we prefer FUT for most patients
There are two methods of harvesting grafts from the donor area. In the traditional technique, follicular unit transplantation (FUT), also referred to as “strip surgery”, a strip is surgically removed from the back of the scalp and sutured closed. The result is a thin scar in the back of the scalp which is usually easily hidden with average length hair (3 guard or longer). The alternative is FUE, which stands for follicular unit extraction (or excision). Many patients assume that because FUE is the newer technique, it must be better. It is important to understand that there are pros and cons to each technique.
One of the most important issues to consider is the best way to use the donor area. This issue is often overlooked and seldom explained to patients considering FUE. The whole idea of a hair transplant is to take hair from the back and sides of the scalp which is genetically programmed to not go bald, and transplant this hair to the desired area where it will grow permanently. However, this zone is not the entire width of the back and sides; it is a band in the middle referred to as the ‘Safe Donor Area’. Hair follicles above and below this area may be prone to balding later in life. Some patients who underwent large or repeated sessions of FUE have wondered why their grafts seem to get thinner over the years. This is because the further away from the Safe Donor Area that the grafts are taken from, the more DHT sensitivity they will have and therefore may be prone to balding over the years. In contrast, the strip in FUT procedures is taken from the heart of the Safe Donor Area.
Another advantage of FUT is that we do not have to shave the scalp in order to perform the procedure. Most FUT patients can return to work and social activities within 7-10 days with minimal noticeability. The majority of FUE clinics require that the scalp is shaved in order to perform the extractions. There are a small number of clinics offering ‘Unshaved FUE’ but this adds to the expense of the procedure and generally the number of grafts that can be performed in these types of procedures is limited.
One advantage of FUE is that after a week, the sites have healed up and the grafts are securely anchored so full workouts may resume. We ask our FUT patients to gradually return to physical activity in the second week and to be cautious for a couple of months with any motions (e.g. sit ups, presses) where tucking chin to chest my place tension on the incision.
Overall, we feel that the majority of patients are better served with FUT. On the rare occasion where the FUT scar is wider than expected, we can perform a small FUE procedure to put grafts in the scar. We now perform FUE for small fill ins and repair situations. If you have done your research and have decided you prefer FUE, there are many clinics which specialize in this; as always, do your research before selecting which clinic to where to go for your hair transplant.
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