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FUE & FUT

P

Philb

Member
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#1
I appreciate some of this many have heard before but at the same time it's important that it is said so apologies if you have and even more so for the length of the post.

FUE or Follicular Unit Extraction is the removal or harvesting of grafts or follicular units made up of either 1,2,3,4 or sometimes 5 hairs per unit. A surgical punch is used to extract the graft from the scalp; this does not require scalpels and is minimally invasive, and can leave invisible scarring to the eye. FUE is technically a harder procedure than FUT/Strip; much more care must be taken when harvesting.

Certain factors will determine how many grafts can be performed with FUE in a day, basic reasons such as popping, poor laxity, excessive bleeding, an impatient patient, changing between punch size, changing punches generally during the procedure will all slow down the procedure and limit the final number. Without understanding such factors as skin to hair orientation knowledge, as well as an understanding of density and FUE donor management is not understood by the doctor transection, growth rates and over harvesting will occur.

The smaller the punch isn't always the better, that said it is generally recognised that below 0.8mm punch is required to leave the minimum donor scarring or white spot. A larger punch, 1.0mm and over may harvest more hair quicker and be easier to use but will potentially cause bigger scarring and transection of peripheral FU. A 0.75-0.8mm punch can harvest large groups of hairs, if a .6 punch is used again the survival rate could be lowered.

FUE may allow the doctor to harvest hair from a larger area to FUT but does mean that more follicular units can be removed. Whereas strip removes an area of hair with the skin, FUE leaves the surrounding tissue/skin and does lower the density. To not over harvest and leave large gaps between the hairs an educated extraction pattern must be adhered to and this will ensure not just for this procedure but in the future the patient has options and a good donor supply to fall back on. This can mean larger procedures, say 3000 plus grafts the person will need a high density in the donor area in the first place, and even then it may not be prudent with FUE to harvest in one procedure due to the multiple healing of the wounds.


FUE and Strip can combine in this case and provide the man with the largest amount of grafts possible without damaging the laxity or the density to the donor area. This may allow even a man with average density and laxity to reach over 8000 grafts over multiple procedures.



I have just posted a large FUE case, 5500 FU over two sessions, the patient now has almost tapped out his FUE donor, maybe a few hundred left but certainly not 1000 plus; and this was with a better than average donor density to start with.

If our 5500 FUE patient after had decided to go FUT in the first place he would have reached 5500 possibly in one session and then possibly able to have a smaller FUT after and still opt for FUE after that. His choice was to go FUE and reach max coverage and density as possible; so here is the trade off.

Of course if you wanted to waste the donor and take 50% then you could match that of FUT but you would leave the donor over harvested and thin and the patient with few options if any for the future.


As we perform both FUT & FUE and have performed large sessions of both it is maybe easier for us to determine what will give more or less. This is not to say one is better than the other but when deciding you have to weigh up your options and what may be best for the future; in my experience large FUE results, 5000 plus are limited and not the norm, regardless if you spread over multiple sessions, few people can achieve this without over harvesting. As most people are looking for restoration that would mean it would not be possible with FUE alone and so it must be understood that FUT may well have to be a consideration. This is important because if you are adamant never to go FUT and have a linear scar then you will also have to realise the limitations to FUE, and possible not have a H/T.

 
timuk

timuk

My member is cooler than NN's
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#2
I agree... very good post and very informative.

Thanks Philb

Tim
 
Bigmac

Bigmac

Administrator
Staff member
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#3
Thanks for the informative post Phil.

Very interesting to read.

Cheers bm.
 
A

Aspinal

Member
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#4
How many drs don`t require you to shave the recipient area when having surgery.

Surgery is my only option now as ive exhausted all other avenues...having my head shaved scares me...this alone puts me off. Is there a list compiled anywhere for my perusal.