Hair transplants are nothing new but the method used to harvest hair follicles in recent years has come up in many discussions, and there is plenty of misinformation and misunderstandings out there on the subject as well. There is a lot of attention on the methods used to obtain hair follicles for hair transplants and not as much on the results they achieve. With many myths and opinions out there it can make it difficult for individuals to know what a good option is for them.
For some people the terms “FUT” and “FUE” can be confusing. Both techniques are for extracting follicular units from the donor area, and both involve transplantation. Each technique has its advantages and disadvantages.
With the FUE (follicular unit extraction) methods, grafts are removed by drilling very small holes in the scalp and extracting the hair follicles one at a time. This technique can be done manually or by use of robotics. Rather than a single linear scar, the FUE techniques leaves very small circular scars spread out over the back of the head that are not always noticeable even for those who wear short hair. For this reason it is a preferred method if the individual like to wear very short hair or for those who would like to have the option to wear very short hair.
There has been a lot made of FUT (follicular unit transplantation) scarring. The truth is that the typical patient that undergoes this type of surgery will find the linear scaring will never be an issue. It should also be noted that FUE is no without scarring. Depending on the amount of hair transplanted with the FUE method there can hundreds or thousands of small circular scars. When considering between to two methods think about this. The total amount of scar tissue created by a 2000 graft FUE procedure using a 1mm punch is about 16 square centimeters, or 10 square centimeters if a .8 punch is used. The total scaring from a typical FUT procedure for the same number of grafts is only about 4-6 square centimeters. If a second 2,000 graft FUT procedure is done, it may not result in added scar tissue. A second FUE transplant must create an additional 10-16 square centimeters of scar tissue. The total amount of scaring from the back and side of the head can produce a noticeable amount of thinning of hair.
Advantages of FUE method:
- Allows additional donor hair to be obtained in those cases where one or more FUT procedures have resulted in a wide linear scar, multiple linear scars, or a “tight” scalp
- FUT can provide additional donor hair following one or more FUT procedures
- Makes it possible to harvest beard and body hair. Can provide grafts to fill in old donor scars that cannot be excised
- Generally less post-op discomfort (though many FUT patients report “no pain at all” after surgery)
- Earlier return to strenuous activities (though waiting 5-7 days to allow the recipient area to heal is advisable)
Advantages of the FUT method:
- A more productive use of the donor area by the extraction of the maximum number of grafts within the “safe donor area” where the follicles are most likely to be permanent.
- FUT microscopic dissection is more likely to yield intact 3 and 4-hair (and even larger) follicular units. Greater numbers of hairs per follicular unit translates into better density.
- FUT is more efficient, therefore generally enables a surgeon and team to perform larger procedures (3,000 plus grafts) in a single session while remaining entirely within the safe donor area.
- Subsequent procedures are able to remove scar tissue resulting from previous surgeries; repeat FUE procedures can only add more scar tissue.
- It allows for FUE procedures in the future, even if large numbers of grafts have been obtained by the FUT method. The reverse is not always the case due to the greater amount of scar tissue.
- FUT surgery is typically about half the cost of a similar FUE procedure.