FUE vs FUT. Why do people prefer FUE over FUT more and more?

[californian]

I was doing kind of a research on Google. I found this graph

 

FUE vs. FUT comparison by years - Google

Edited September 22, 2014 by californian

[stinger99]

Simple, fue less invasive , no linear scar, quicker recovery

[KO]

Risk. If an FUT fails you have a linear ear to ear scar. With FUE you can still buzz down, and shorter hair styles look better when you are losing hair IMO.

[chrisdav]

Simple, fue less invasive , no linear scar, quicker recovery

 

Pretty much sums it up.

[FUE2014]

In the hands of a good doctor like Lorenzo, Feriduni, Rahal and Bisanga, you get a result equal to FUT but with less of the drawbacks than FUT. Everything being equal, it's pretty much a win-win. I also think people consider FUE to be a next generation process whereas strip is perhaps more antiquated and carries that reputation of awful ear to ear scars which FUE doesn't have. I think if you were to objectively list the pros and cons of both techniques, FUE would come out on top (and quite comfortably).

[chrisdav]

In the hands of a good doctor like Lorenzo, Feriduni, Rahal and Bisanga, you get a result equal to FUT but with less of the drawbacks than FUT. Everything being equal, it's pretty much a win-win. I also think people consider FUE to be a next generation process whereas strip is perhaps more antiquated and carries that reputation of awful ear to ear scars which FUE doesn't have. I think if you were to objectively list the pros and cons of both techniques, FUE would come out on top (and quite comfortably).

 

 

The top part will be debated forever and ever as people have differing opinions on benefits and drawbacks. However, the main reason we can debate these different talking points is we are fortunate to be given a great source of information that allows us to make a better, more informed final decision.

 

If you took the random guy who did no research, the first question that will be brought up and the decision to be made will be do I want a linear scar are not. Then if the surgeon compares horrific scarring from strip procedures dating back years ago and even right up to this moment now - it will put anyone off. I am not saying that surgeons on here do that but I am talking about selling a hair transplant as a procedure around the world to an individual who has little knowledge about hair restoration. Even though forums are popular, the number of patients coming from forums going to have hair transplants globally is I am guessing a pretty small proportion and hence most will be not fully informed.

 

There is so much information you need to process in my opinion when getting a hair transplant as the problem is not resolved there and then - it is an on going battle.

Edited September 19, 2014 by chrisdav

[lifeisbeautiful]

The reason I woulnt have FUT is because of scar. But some Turkish doctors I have had video consultation with told that FUT is superior in terms of results.

[bismarck]

The FUE vs FUT debate comes down to scarring vs yield. Some points that I think are important not to miss:

 

- You can never completely shave your head with either technique. Keep that in mind, as that seems to be a common misconception (see attached images).

 

- FUE leaves you with small white dots as scars -- best case scenario allows you to shave down to a 1 guard.

 

- FUT leaves you with a linear line as a scar -- allows you to shave down to a 2 guard. The trade off is higher yield.

 

- Your hair shaft caliber, as well as the number of double and triple units you have impacts the punch diameter with FUE, and thus scarring. There is a newer style of punch that balloons out at the base and tapers towards the skin that may help with this as well.

 

- The trade off is lower yield. Even looking at the top FUE guys, there seems to be a ~10% loss of grafts when comparing them to the top FUT guys. I've seen cases where the loss of yield with FUE can drop as low as 30% or even 60% less, even with the so called elites. If you have curly hair, this will likely increase. If you have scattered miniaturization, this may decrease. This is by visual estimate only--there is no good double blinded, randomized clinical study on this that I have seen.

 

- If you are trying to maximize your grafts over time, you lose some ground doing FUE.

 

In terms of research, FUT is more time tested, but not by much. The first article on FUT in the literature that I could find was in 1997, with about ~220 total articles on the technique in peer reviewed publications, with the majority coming from America and some from India and other Asian countries.

 

FUE is a newer surgery, with the first article on it being published in 2002, with only about 50 articles on the technique in the literature, with about half of those being in the last 2 years. Interest has picked up on it recently, but we are still learning a great deal about what is and isn't possible with the technique.

 

By comparison, a time tested procedure like coronary angioplasty has about 44,000 articles. Both are relatively marginal procedures when looking at the entire spectrum of medical research, although FUT seems to be slightly more established.

 

Also, when people are claiming certain yields, etc. it is important to keep in mind that much of this opinion comes from surgeon submitted cases. That's a bit like looking at Facebook pictures to get an accurate representation of what someone's day to day life is like.

 

Patient submitted cases tend to be more honest, although they suffer from patients not submitting follow up, taking poor images, and patients with disappointing results not wanting to publish their cases on the forums (ie. not getting a positive response, not wanting to alienate clinics from whom they hope to get future procedures at a discount, etc.). Sometimes the reason for poor follow up may just be laziness, and have nothing to do with the success or failure of the procedure.

 

Some suggestions:

 

1) Do your research. There is no rush. The procedures will only become more refined with time.

 

2) Look at patient submitted cases for the surgeon you are considering.

 

3) Shave your head, and see if you can live with it.

 

4) Realize that some of the most experienced people on the forums and in the surgical hair community have never had surgery themselves (ie. Spencer Kobren, etc.). Ask yourself why this is the case.

 

5) If someone has had a surgery, and had a good outcome, of course they will support it. If someone works for a clinic, of course they will be positive. By the same token, if someone is unrealistically negative about a procedure in the face of reason, they may have an ulterior motive as well. Use common sense, and look at where someone is coming from before you take their advice at face value.

 

6) Scarring can be unpredictable, as can scar revision.

 

7) Take advantage of the search engine. Look for words like "failed" or "botched" to see "1 star" reviews in addition to "5 star" reviews.

 

In general, the latest procedure is often thought to be the greatest, but neither FUE nor FUT are perfect. Both have their drawbacks and benefits.

 

No matter how much research you do, as soon as you cut the skin with a scalpel, there is an implicit roll of the dice. This is still the wild west. Your choices are half chance. So are everybody else's.

 

But trust me on the sunscreen. :cool:

[KO]

Ha, Spencer Kobren is just a guy whose job is to sell hair transplants....

[Rootz]

You can never completely shave your head with either technique. Keep that in mind, as that seems to be a common misconception (see attached images).

 

- FUE leaves you with small white dots as scars -- best case scenario allows you to shave down to a 1 guard.

 

- FUT leaves you with a linear line as a scar -- allows you to shave down to a 2 guard. The trade off is higher yield.

 

I just want to say in your example pictures the FUE scarring is orders of magnitude less noticeable. I'm pretty sure the average person would not notice anything weird about the FUE guy's head, even if they sat behind him on a train for hours with a clear view of his head. Whereas with the FUT scarred guy, everyone would immediately notice the moment their eyes went near his head.

 

If you go with a top FUE doctor, the scarring will always look as good or better than your example picture. If you go with a top FUT doctor, the scar could very well end up ]worse.

 

I should also add, the FUE guy has the option of doing a medical tattoo on the little white dots to have his scars become completely unnoticeable. The FUT scar is much more difficult to hide with a medical tattoo and would likely never fully blend in. Even doing a FUE into the FUT scar and then a tattoo on top of that would still stand out a bit. Our eyes are trained to pick up and recognize continuous lines, and that's what a FUT scar is.

 

The main reason we (on the forums) recognize anything wrong with the FUE guy's head is because 1) we're looking for it, and 2) we know about HTs in great detail. The average person, even if they happened to notice the dots, wouldn't even know what to think... they wouldn't know what they were looking at. Whereas with the obvious line scar, "Oh were you in an accident? What happened to you?"

 

In terms of comparing FUE to FUT scars it's not even close. It's like comparing a shark bite to an ant bite.

[Loags79]

extract 5000 individual fue grafts from a donor area from the average ht patient and the donor area will look mangey and pretty thin with hair cut down to grade 2. Compared to 5000 taken from fut for the same person and the donor area will appear normal with the same cut.

Fue is not all that.. but neither is fut. Each has its own issues. Choose accordingly based on your goals and hair characteristics.

Edited September 23, 2014 by Loags79

[bismarck]

I've seen FUE scars look a lot worse and FUT scars look a lot better. Those were just middle of the road examples from what I found online. Show me a patient who's been shaved down to the skin with FUE that's unnoticeable. Until then, the scar is relative but inevitable with either procedure.

[1978matt]

extract 5000 individual fue grafts from a donor area from the average ht patient and the donor area will look mangey and pretty thin with hair cut down to grade 2. Compared to 5000 taken from fut for the same person and the donor area will appear normal with the same cut.

Fue is not all that.. but neither is fut. Each has its own issues. Choose accordingly based on your goals and hair characteristics.

 

Good comment.

 

What's not to like I about FUE if you have minimal hair loss.

 

The problem comes when you need a lot of hair. Even with no visible scars the chances are the 'gaps' of missing hair will be pronounced.

 

Like most pastey white guys I looked horrible with a shaved head so buzzing shorter than grade 3 never entered the equation.

[BUSA]

I've seen FUE scars look a lot worse and FUT scars look a lot better. Those were just middle of the road examples from what I found online. Show me a patient who's been shaved down to the skin with FUE that's unnoticeable. Until then, the scar is relative but inevitable with either procedure.

show you an FUE patient shaved down to the skin that doesn't have visible scaring? thats like nearly all cases performed these days by top FUE surgeons.

 

maybe ur looking at old PLUGS or the extreme rare case that a doctor takes way too many grafts from the donor area that was thin to begin with but otherwise there is nearly zero evidence of scaring these days with FUE wen performed by even a decent doctor and not a great one.

 

I guess the same cud be said in some cases for FUT as far choosing the right doctor to close the site properly and not hav a stretched scar but a patient might have the "X" factor and no matter how skilled the surgeon is the scar may stretch over time even if it looked perfect at first.

 

the same cannot be said for FUE. if it looks great the first month after healing it will look great for life.

 

but nonetheless I have NEVER seen bad FUE scaring look worse then a bad FUT scar. and with a round of SMP any visible scaring at all with FUE is pretty much none existent and will make it nearly 100% unnoticeable especially if the hair is grown out to a #1 on the clipper. SMP does wonders for FUT scars as well but not on the same level as FUE imo.

Edited September 23, 2014 by BUSA

[Garageland]

Loags makes a very, very good comment as there have been several cases of large fue sessions where the donor was shaved to around a grade 2 and the donor looked very thin, grown out to a grade 4-5 it looked better. This particular case I am thinking about stated that the patient had 8000 donor grafts as he only did fue I was assuming that to be the case and I couldn't possibly imagine what another 4000 from his donor would leave it looking like.

 

I think it is fair to say the fue in the right hands has come on leaps and bounds from 8-9 years ago when I was considering my repair session and giving the patient choice is no bad thing. I do wonder why fut has to be demonized by some people to the point of them wanting it to become extinct.

 

It seems that some have to always take corners and pick a fight. I have seen terrible fue scarring and very little growth on patients I have seen horrific wide donor scars from fut and very little growth if you choose carefully a surgeon that is at the top of his game this is far less likely to happen.

 

What I do predict is that there will be more and more unhappy fue patients over the coming years. How do I know this well it is obvious there are new clinics opening up everywhere offering fue because that is what the public wants. More patients having fue from unscrupulous clinics will mean more repair work for the good clinics and it's happening already. Mark my words we will see more and more terrible fue work over the coming years from the bad docs just like we have all seen the wide fut scars from the bad docs over the last 20-30 years.

 

Both procedures have their benefits and draw backs and have a place today and for tomorrow.

[Rootz]

I've seen FUE scars look a lot worse and FUT scars look a lot better. Those were just middle of the road examples from what I found online.

 

From a top FUE doc, the FUE scars will not look any worse than the example you gave. Always. From a top FUT doc, the result is more of a variable and can definitely look worse.

 

Show me a patient who's been shaved down to the skin with FUE that's unnoticeable.

 

Well I would classify the FUE example you gave as unnoticeable. Whereas the FUT example you gave is the opposite - very noticeable.

 

Until then, the scar is relative but inevitable with either procedure.

 

The scarring is completely different between them.

[1978matt]

I do wonder why fut has to be demonized by some people to the point of them wanting it to become extinct.

 

 

Yes. God bless FUT. It's the difference between me having 8,000 grafts instead of 5,000.

 

What I do predict is that there will be more and more unhappy fue patients over the coming years. How do I know this well it is obvious there are new clinics opening up everywhere offering fue because that is what the public wants. More patients having fue from unscrupulous clinics will mean more repair work for the good clinics and it's happening already. Mark my words we will see more and more terrible fue work over the coming years from the bad docs just like we have all seen the wide fut scars from the bad docs over the last 20-30 years.

 

Yeah I happen to share your opinion. There is only really 5-7 years of large FUE work and like what happened with plugs the drawbacks have yet to fully materialise.

 

I suspect FUE will continue rising to about a 50% market share, dropping back a little in 10 years when FUT enters a renaissance period. That is unless donor cloning comes to fruition.

[BUSA]

 

I do wonder why fut has to be demonized by some people to the point of them wanting it to become extinct.

 

I think thats mainly in part due to the fact that someone who was devastated by their hair loss chose to seek out a HT surgeon to give them their life back and because of the way the scar has healed they are once again devastated with a disfiguring scar that now requires them to seek out ANOTHER HT doctor to repair them.

 

I'm pretty sure if you were one of them patients that experienced bad FUT scaring you wud feel the same way.

 

of course its not the norm but it does happen and still happens even to this day. the bad FUE scaring is really a non issue these days.

 

doctors like H&W are imo the best or at the top of their game when it comes to FUT and thats far less likely to happen but still possible. GREAT FUE doctors around the world experience ZERO bad scaring these days.

 

in fact, its been quite a few years since I've seen any bad FUE scaring from a top rated FUE doctor. but the same cud be said for a TOP rated FUT doctor too.

[Garageland]

Busa,

 

I agree with the points that you are making but there are so many examples of bad scarring from poor doctors thrown around the forums by some fue only clinics and yes I agree there is always a chance of a scar widening even from a top fut doctor.

 

Most of these people who are demonizing fut have not had a bad strip scar and to the ones that have had a bad strip scar then I feel for them I honestly do and you know why because I have 3 wide strip scars from my old procedures so I understand what is is like.

 

I know just how bad it is to experience my barber cutting my hair too short and partially exposing the scar and people asking me if my haircut was a fashion statement and going bright red and having to state no I had a really bad haircut and trying to change the subject asap.

 

But to compare what I had three times back in the 90's to what I had with H&W and what other top FUT doctors can do today is like chalk and cheese.

 

What I am saying is that without fut the options for most patients greatly reduce.

[BUSA]

fair point. I agree. both procedures have their place.

 

Busa,

 

I agree with the points that you are making but there are so many examples of bad scarring from poor doctors thrown around the forums by some fue only clinics and yes I agree there is always a chance of a scar widening even from a top fut doctor.

 

Most of these people who are demonizing fut have not had a bad strip scar and to the ones that have had a bad strip scar then I feel for them I honestly do and you know why because I have 3 wide strip scars from my old procedures so I understand what is is like.

 

I know just how bad it is to experience my barber cutting my hair too short and partially exposing the scar and people asking me if my haircut was a fashion statement and going bright red and having to state no I had a really bad haircut and trying to change the subject asap.

 

But to compare what I had three times back in the 90's to what I had with H&W and what other top FUT doctors can do today is like chalk and cheese.

 

What I am saying is that without fut the options for most patients greatly reduce.

[bismarck]

show you an FUE patient shaved down to the skin that doesn't have visible scaring? thats like nearly all cases performed these days by top FUE surgeons.

 

The example you showed isn't shaved down to the skin. I mean, literally, shaved down to the skin with razor. I haven't seen that, because it's not possible.

 

To quote one of the more respected surgeons on this site:

 

I think your real issues should be:

 

If you are going to shave bald, why spend the money on a transplant? And, if you are going to shave bald, why have 1200 FUE scars, albeit small, visible to all.

 

The scars may be small, but shaved clean, they are definitely still visible. I'm talking Michael Jordan, not Jason Statham.

 

Well I would classify the FUE example you gave as unnoticeable. Whereas the FUT example you gave is the opposite - very noticeable.

 

The example I posted also wasn't shaved down to the skin. I mean literally, bic razor shaved down to the skin. Like the front of your face when you shave (ie. the type of haircut one would get when your hair loss progresses and you run out of transplant reserve). Show me that you can't see tiny circular scars all over the scalp.

 

I'm pretty sure the average person would not notice anything weird about the FUE guy's head, even if they sat behind him on a train for hours with a clear view of his head.

 

Seriously? The picture I posted is dramatically obvious. It looks like they were sprayed in the back of the head with shotgun pellets. It does not take a trained eye to notice that degree of scarring. I appreciate that it is relatively less, but it is certainly painfully obvious.

 

will make it nearly 100% unnoticeable especially if the hair is grown out to a #1 on the clipper.

 

Yes, good FUE scarring can be disguised by growing to a #1. But not with a clean shave. Good FUT scarring can be disguised by growing out to a #2, but less likely beyond this.

 

But once you have progressive hair loss, the innate desire is to shave your head completely for a Mr. Clean look. What's the point of a #1 vs a #2 shave? You can see the degree of baldness with both. A totally clean shave is not possible with either surgical technique.

 

Both procedures cause scarring, just different kinds. The scarring is more unpredictable with FUT, and the yield more unpredictable with FUE. However, to pretend one is invisible is unrealistic.

 

extract 5000 individual fue grafts from a donor area from the average ht patient and the donor area will look mangey and pretty thin with hair cut down to grade 2. Compared to 5000 taken from fut for the same person and the donor area will appear normal with the same cut. Fue is not all that.. but neither is fut. Each has its own issues. Choose accordingly based on your goals and hair characteristics.

 

Agree with this.

[scar5]

A totally clean shave is not possible with either surgical technique.

.

 

For the most part I could shave to the skin after FUE and the scarring was not evident. It's proof that you can shave if you are lucky with skin and scar tone. One patch is a bit noticable, and not to a 'normal' person due to over harvesting, but that is not so much scar tissue as just empty patches where not enough hair is. Later I had SMP over my entire scalp. Mistake in some respects, because the area scarred by over harvested FUE, previously invisible, is now whiter - the ink having drained from the scarred tissue much faster.

 

It's really sad that the 'experts' told you either technique prevents you from shaving, but FUT stayed in business along time because of that assumption.

Disclaimer - if you have a certain type of skin it may be harder.

 

Some other points I read on this thread.

1) FUT will have a renaissance.

Totally disagree. Why would it? Education is improving and patients are demanding FUE. Strip will continue to go down in importance in countries with a mature HT industry unless ignorance really gets a shot in the arm. Possibly countries new to HT will boost it, but no renaissance. Makes no sense.

 

2) 5000 grafts removed by FUE and buzzed to #2 will look worse than 5000 grafts taken from a strip.

Again wrong. Scar aside, and buckled seams and the misangled hair aside. Good technique and extraction pattern assumed.

If you talke a strip and re-close it you are STRETCHING the scalp hence THINNING the remaining hair. Image stretching your front lawn without adding any grass.

Furthermore, a 5000 strip will take 300-500 telogen (resting phase hairs within the strip which are invisible) so really its a 5400 strip 'cept you get 5000 . FUE does not touch telogen hairs unless they are within an otherwise growing follicle and even then, they should survive as part of the bundle.

 

But key point - I can shave vast areas of my FUE'd scalp with no problem except the wretched strip scars and buckled skin around them. Pity (or lucky) I'm as ugly as a dog!

[Loags79]

You've missed the point completely scar5. The comparison is the best possible result from FUT and FUE.

5000 graft harvest virgin scalp: scarring from BEST result from FUE is a lot better than FUT with grade 1 buzz, compariable at grade 2 and with longer hair virtually the same. At grade 2.. Fue man will h

have thin donor compared to fut man. At grade 1 fue man is good and fut man will wish he did buzz so close. In terms of yield, Fue man will have less yield than fut man. These are facts.

Everyone's donor supply is finite. I'd rather a linear scar with better yield than have a dot scar with lower yield rate. Fue will make my hair mangey cut down to grade 2 back and sides. For me fue of 1200 grafts or less will be ideal and thats what i might consider after my 2nd pass of fut if required.

[Yaz89]

I thought I chip in. If the doctor has honed his skills there is less chance of scarring being visible. Keeping in mind, skin tone and hair style can play a big factor. Being a recent fue patient, I thought I may contribute to this thread. The first two images show my haircut with a grade 2. The last two show with a grade 1.

Edited September 24, 2014 by Yaz89

[scar5]

You've missed the point completely scar5. The comparison is the best possible result from FUT and FUE.

5000 graft harvest virgin scalp: scarring from BEST result from FUE is a lot better than FUT with grade 1 buzz, compariable at grade 2 and with longer hair virtually the same. At grade 2.. Fue man will h

have thin donor compared to fut man. At grade 1 fue man is good and fut man will wish he did buzz so close. In terms of yield, Fue man will have less yield than fut man. These are facts.

Fue will make my hair mangey cut down to grade 2 back and sides.

 

How so? If you stretch the scalp in order to close the wound, you spread out the remaining hair - it is as simple as that. So you now have lower density.

But I agree with you about mangy. I don't know why, I think it is to do with the fact that try as they might, they don't have time to consider how each and everyone of those extracted hairs will impact the natural fall of the hair after extraction.

 

You say you would rather a strip scar than little dots and that FUE is good for 1200 well, that was the standard line that kept strip clinics rich sround 2005 -2010 in the period they had to concede a little ground to FUE. Good luck with that.

 

People say FUE yield in good conditions now matches strip, but I am not convinced and I suspect that all docs know strip yield would be better. I suspect the fat cushion for strip hairs makes them more bouncy, even stalky. But the gap will close to some degree.

 

I wouldn't wish a strip scar on almost any male. For women, I kinda think it might be alright, and I think of the yield issue, the way men incriminate and destroy each other, and the different balding styles women tend to have.

 

For Yap,

Yes, I think so. Indirectly. If the doc uses a small punch then the scarring should be good. But will the yield? That is where the skill comes in. As do the different punch styles. manual/rotary/robotic etc