Aug 2nd, 2019 - BY Rafael

FUE vs FUT hair transplantation

Hair Transplants

Surgical

The 2 predominant forms of hair transplantation being done today are follicular unit extraction (FUE) and follicular unit transplantation (FUT). In FUE hair transplantation, tiny punches are taken around the hair follicles to extract the hair follicle one at a time. It is a more time consuming procedure for the doctor, especially if the doctor performs all aspects of the treatment such as anaesthetising the area, extracting the hairs and implanting the hairs. In FUT hair transplantation, a large strip of hair is taken and assistants dissect the strip of hair into individual follicular units. The implantation procedure is largely the same, however, a strip can be removed within half an hour while removing hairs via FUE can take 4 hours or more for the same amount of hairs. For this reason, many doctors advertise FUT as a gold standard procedure, when the reality is that it is a time saving procedure that allows some practices to perform several procedures per day.

In this article, I will therefore discuss the arguments for FUT and against FUE and show why they are invalid.

FUT gives better quality grafts – false

One argument that is often made in support of FUT is that it gives better quality grafts. The false reasoning behind this is that FUE cannot predict the course of hairs beneath the surface of the skin and is therefore a blind procedure. This is not true, in FUE a doctor will observe the angle that the hair exits the skin and place the punch accordingly to extract the hairs in a predictable manner. After performing a few test extractions, a doctor can easily achieve a transection rate of less than 10%. This means that less than 10% of hair follicles are damaged in the process of extraction.

The other factor to consider is that when extracting the strip, hair follicles are also damaged along the upper and lower borders of the strip where the skin is cut. When the strip is being cut under the microscope, hair follicles are further damaged as the large strip is cut into smaller and smaller pieces until only hair follicles are left. Many doctors do not accurately count the amount of transections that occur in this process of subdivision done by assistants and it is almost impossible to accurately count the amount of transections that occur in this process. Dissection under the microscope is difficult, and in many ways a “blind” procedure where it can be difficult to see where the hair follicles lie.

In FUE the head is shaved while in FUT it is not – false

Another argument often used in favour of FUT is that the strip can be taken without shaving the head. While FUE can involve shaving the back of the head for maximum amount of grafts taken, advanced FUE can be done in a microstrip technique. This means that hair follicles are taken in small shaved sections from various parts across the back of the head so that when the procedure is finished, the small shaved areas are totally covered by existing hair. For both FUE and FUT the front of the head is ideally shaved to enable more precise implantation. For both procedures, the hair can be implanted without shaving the frontal hairline, however, this is much more time consuming and therefore costly. The other thing to consider is that the sutured strip area is far uglier than the tiny punch holes taken from FUE and so it makes sense that a person would want to cover this. The punch holes from FUE start to become cosmetically more appealing within the first 2 weeks.

FUE leaves the back of the head empty of hair while FUT leaves it in good condition – false

One of the most common arguments used against FUE is that they say excessive extraction of hairs here will leave the back of the head depleted since all the donor hairs are taken. The reality is that if a strip of hair is taken from the back of the head with the FUT technique, and the strip represents all of the healthy hairs, the rest of the hairs on the back of the head will be supposedly less healthy and therefore continue to be lost with balding. A hair taken from the back of the head is a hair taken, and regardless of technique there is a limited donor supply. Over-extracting with any technique will leave the back of the head depleted. At least FUE has the backup of allowing beard to hair and body to hair transplantation to fill the gaps. Please keep in mind that yes, beard and body hair look different. A good hair transplantist will implant these flat and in strategic locations to produce density without looking out of place.

Why go for FUE hair transplantation?