Which one is best for maximum yield FUT or FUE?

[Arnold6]

Ok guys I consider myself a newbie to all this hair transplant scenarios. There is a plethora of information online that suggests FUT is better for gaining maximum grafts numbers, especially if you’re a Norwood 5 or above. Some clinics say you’re not a good candidate or that they can only get around 3-4000 grafts max which won’t be enough to provide full coverage. The frontal half is recommended and the crown left bare.
On the other side there is FUE. I’m seeing people with huge numbers, 5000 plus extracted gaining full coverage with the back and sides of their heads looking good. How are some clinics getting 5000 plus graft numbers when other clinics say it is impossible?
I did contact a well known FUT surgeon who suggested he could get the same amount of grafts as FUT by doing FUE. All the contracting information is somewhat confusing.
How has the numbers for FUE increased so dramatically?

 

[Prohairclinic]

First of all, combining both FUE and FUT will mathematically give you the most possible amount of grafts.

But if you only choose FUE or FUT things a bit more complicated.

FUT limits
You may have a great density in your donor area, but if your laxity (the skin tolerance for stretching) is low you will be limited by this fact. Yes, you can perform exercises to enhance laxity, but eventually, this also reaches its limits. Finally, the more FUT you have, the possibilities for scar stretching goes up with each surgery.

FUE limits
Laxity is not an issue since only the grafts are extracted, not the surrounding skin.
Some clinics will perform very large sessions, like 4000-5000 grafts in a single treatment (sometimes spread over multiple days). You must know that donor area shock loss is always possible, especially when performing this type of Giga session.
At our clinic, we limit the procedure to about 3000-3500 as not to overharvest and minimize the chances of donor shock loss.


FUE vs FUT in total amounts
FUE is the clear winner, hands down. There are some (lucky) patients out there that have received well over 10.000 grafts with FUE alone.

 

[HairDr Clinic]

Hi @Arnold6 , this is not a simple question to answer. It´s one of the biggest questions in surgical hair restoration. Over the last ten plus years there have been debates on the pros and cons to FUT and FUE hair transplant techniques. The advent of FUE years ago sparked debate whether it was credible and whether the transection rate was too high compared to FUT. Then it moved onto how many FUE grafts could be extracted in a one day procedure. It was very common that around 500 grafts in a day were extracted in the early days and a two day procedure was frowned upon. Another area was manual compared to motorised and the robotic extraction, including punch size from 0.6 to over 1mm good or bad.

In good hands and performed to a high standard there is no reason to consider one technique is going to give a better yield than the other. But this assumes so many variables. One being graft numbers extracted are within safe parameters for either technique. For example, FUT and FUE relies on the grafts being correctly prepared under magnification and then placed carefully without damaging the bulb the yield could drop.

There are a few aspects to consider. The agreed plan, the number of grafts required and whether the donor area can then safely provide the numbers required in one or multiple procedures. With either technique the donor area characteristics need to be measured as they are constant. Like the hair density around the donor and the approximate hair count per follicular unit. These don´t change so can be measured regardless of the technical ability of the person extracting. With FUE the variables then come down to the agreed size of the safe zone, how high or low can hair be removed around the back and sides of the head. Then the % that can be removed in one or multiple procedures.

You can ask each clinic what protocol they have in place for donor management. How they measure the donor safe zone and what % do they consider can be safely removed without leaving the donor visibly thin, patchy and or over harvested. The number of grafts is finite so different punch tools etc cannot change the numbers only the way they are removed. With FUE the donor surface area remains the same size and structure. As a result every hair follicle removed lowers the amount of hair in that area. The more hair removed will impact on the look of your hair and potentially on the yield.

 

[Arnold6]

Appreciate the informative answers guys, they make a lot of sense. There are so many variations.

 

[SeanFUE]

FUT has better yield in most hands, whereas, FUE has decent yield in few hands. Most if doing hybrid approach, max out FUT first then FUE.

 

[Bigmac]

I did mainly FUT, then I did a couple of small FUE.

 

[MrPierre]

For advance balding, men usually use the strip options first, and then FUE after for maximum yield.

 

[theport]

I think Fue because it is bad to have a scar in Fut technique

 

[Arnold6]

FUT has better yield in most hands, whereas, FUE has decent yield in few hands. Most if doing hybrid approach, max out FUT first then FUE.

That makes a lot of sense. Any preferences on who the best clinics are for maximum yield?

 

[Bigmac]

There are lots of clinics on here in the clinic section. Check them out, take your time while researching.

 

[SeanFUE]

That makes a lot of sense. Any preferences on who the best clinics are for maximum yield?

The clinic that has a doctor that actually puts out the efforts of being s doctor and focuses on you the day of surgery would probably will be a less risky choice. HW is good and so are some others. Meet patients though- real patients and see their results. It will help you out

 

[Arnold6]

Thanks Sean.