FUE vs FUT

[profilehair01]

One of the most important decisions a patient needs to make is which type of hair transplant procedure to have: FUT or FUE.
In Follicular Unit Transplantation, a long, thin sliver of tissue removed from the donor area in the back and sides of the scalp and the individual follicular units are removed from that strip via stereo-microscopic dissection. The wound edges are then closed leaving a single, generally fine scar.
In Follicular Unit Extraction (FUE) hair is harvested through small circular incisions over a considerably larger area of the donor zone leaving tiny, round, white scars.

FUE procedures have grown increasingly popular with the development of new handheld devices, but FUT procedures still provide excellent results and are considered excellent by many doctors.

 

[drkrishanarora]

Thanks for sharing about Hair Transplant Techniques.

 

[Prohairclinic]

FUT procedures still provide excellent results in the hands of experienced drs.
Yes I can agree to that.

However, patients have a choice now, and as a former FUE and FUT patient I would gladly shave down my hair to avoid FUT.

Let's further analyze the picture:
FUE requires a patient to shave the head: BUSTED

No, not true at all. I had the please of meeting a Brazilian dr that transplants 2000-3000 grafts via FUE without shaving at all.

1-3 hair grafts are removed: BUSTED

Yes, this is in fact the majority of the grafts as 4 hair grafts or more are quite rare. But an experienced practitioner will extract those 4 and 5 hair grafts as well, no problem. Let me dig into our archives and try to get some pictures:

Let's add some ingredients.
The largest procedures, in total amount of grafts transplanted on the same patient: FUE (I believe it is over 11000 grafts)

Sorry, but it's been a while since I participated in a classic FUT and FUE head to head compare, hence .....

 

[baldasabadger10]

If someone wanted a one time transplant and opted for a very large surgery which method would be best?

 

[Prohairclinic]

A one time transplant is a myth.
Nobody can predict future hair loss, nor can anyone predict that you will stick with your hairloss regime.

But to answer the question:
You would have to have a combination of both FUE and FUT done. I believe the first day a FUT procedure is used and the following day the area around the scar will be used for FUE harvesting.

 

[reddwarf]

Thanks Profilehair01 for posting the diagram. Do many clinics still do FUT these days then?, all the adverts and all the online media seems to suggest that FUE is the main method used these days.

 

[Mayank82]

Informative one to clear the dobut between FUE Vs FUT. FUE is one of the most favored technique by many hair transplant clinic. You rightly said FUT also provide better results but all depends upon surgeon experience.

 

[Hair Restoration Europe]

The FUT/FUE debate has been going for as long as both techniques were recognised as the only two responsible/ethical donor harvesting techniques available. If performed to a high standard both techniques can deliver natural results and minimal donor area changes. The flipside is, if not performed to a good standard both can deliver poor results and impair the quality of the donor area often beyond repair. It´s possible to see examples of both being poorly executed online.

These techniques only really differ in donor management. While recipient site making and graft placement can vary the practice is largely the same. A hair transplant in the past and today FUT and FUE have traditionally been Doctor performed donor extraction techniques. FUT has not changed in this respect. But in recent years FUE donor harvesting responsibilities have been diluted. With some Clinics/Doctors giving the task to others in the clinic to perform. Other Doctors prefer to maintain their control over FUE harvesting and punch all the grafts themselves still.

While the obvious difference (linear scarring vs white dot scarring) between the techniques is known by most if not all. Often any more information is then either not imparted to the patient in the first place. Or, told but disregarded by the patient because it doesn´t suit their goals maybe. Or summarily dismissed by both as unimportant to the process to go into any detail in the first place. Planning hair restoration is an important aspect. MPB is progressive. The donor area is also affected by the extent of the hair loss pattern. Whist most emphasis is on the hair growth and recipient area the donor also requires careful planning.

FUT donor management relies on several factors, laxity, follicular unit hair density, length of the donor safe zone. Surgical closure techniques and innate skills allow some Doctors to perform larger FUT sessions than others. Whilst maintaining a clean and neat closure line. While the position may vary slightly it is commonly considered to be position approximately midway point with the donor safe zone. Within an area normally no more than 2cm wide. Good healing can allow the original scar to be removed with subsequent procedures to still only leave the one line. Over pushing the limits and or poor healing can lead to stretch back of the scar.

FUE donor is open to debate how small or large it may be. The safe area can be open to discussion and interpretation. Being wider with the only boundary being the border of no hair areas, nape, crown if open etc. In some respects, it is this interpretation of safe that opens a concern regarding FUE. FUE punches are small and made around the head in a random style pattern. Occasionally concentrated over the back of the head. As there is a high concentration of large hair units in this area. It is also easier to harvest compared to the sides. The punches as such are randomly spread but less so by design but simply to extract as many grafts as possible. The impact of this extraction is never obvious at this point. If the extraction is spread from one side to the other. Considering the variations in donor hair density around the scalp. An educated extraction pattern can be performed. Resulting in a balanced removal of hair follicles from the donor area. Balanced in the areas the hair has been taken and importantly what hair has been left and the quality of the remaining hairs.

This debate has been around since the advent of FUE vs FUT. Regarding one of the differences pros and cons to FUT. How many grafts can be removed in one or multiple sessions?

Around 30% of the enquiries we receive are people who have undergone FUE in the past few years. Of these around 80% are concerned their donor area has been over-harvested. When explained why this has occurred some appear genuinely surprised and angry. Others seem to be more accepting of the fact but still unhappy. Maybe more accepting because during their research they had been told this is a consequence but deciding to ignore. In favour of believing the promise of more hair and hoping it wouldn´t happen to them.

Donor management goes far beyond the preference of a linear scar or visible or partially obviously hairless areas or white dot scarring. It can determine whether future hair loss can be treated and to what extent. How many grafts can safely be removed while limiting any visible changes to the existing donor area. There is nothing wrong in preferring one technique opposed to the other. If all the considerations are understood.