What is better FUT or FUE ?

[Rashid36]

If you had a choice which is best to go for?

[Melvin- Admin]

I personally don't feel one is better than the other, it really just depends on your situation and goals. If you want to wear your hair long and get the maximum amount of grafts in one sitting choose FUT. If you want to wear your hair short and have less visible scarring choose FUE.

[Bill - Seemiller]

This topic has been long discussed on our discussion forum and I think you will probably see this thread turn into a great debate with time. There are many people who believe that FUE is on the cutting edge and is superior to strip/FUT because it eliminates the linear scar. However, there are others who believe that strip/FUT is superior because growth yield is more consistent and you can typically harvest more follicles for your strip and you can via FUE without compromising the donor area

 

Now here's my opinion…

 

I believe both FUT and FUE, when used in conjunction with one another, starting with FUT, can you hold the best results because it allows doctors to harvest the greatest amount of donor hair fro can you hold the best results because it allows doctors to harvest the greatest amount of donor hair and use it for the balding areas.

 

For instance, if you have advanced baldness and a sufficient donor area, it would be best to get as many strip procedures as you can in order to fill in the bowling areas. Once you are "stripped out" or in other words your donor area the strip is depleted, physicians can then typically harvest another couple thousand grafts via FUE.

 

Some of these FUE grafts can even be used in the strip scar if desired to help camouflage it even more even though existing hair on the sides and back of your head should pretty easily conceal it assuming you keep it at a reasonable length, which can be quite short if preferred.

 

That said, every patient is different and every patient has their own needs and physiology. For some patients, FUE might be the preferred procedure while others may only require strip.

 

I hope this helps.

 

Bill

[bunsenburner]

Well said, Bill. I concur completely.

[Sean]

Both can have their place. In fact, some may regret getting fue and should have stuck with FUT in the first place. But some docs at consultations may say to their patients that their FUT matches their FUE quality and you may end up believing them not knowing the reprecussions that may occur. You get all these gaurantees and assurances and things may change the day of surgery or their may be surprises. But thats why it is very important and prople learn this now, that a sirgeons surgical protocol is very important.

 

For FUE you have to be more cautious of the skill of the surgeon and their protocol as it is a very sensitive procedure. I've seen amazing results for FUE with docs that have a great surgical protocol. If they extract properly, pace your surgery, use the right tools, the right placement, and dont hammer your recipient area,they can do amazing work on you. There is even a doctor, Dr Umar, who can do amazing repairs on thos that had even donor hair depleted or severe cases of damage. He does this all with FUE. So, depending on the doc and their efforts, you can have an outstanding result in FUE. It is a very delicate procedure. Not one that rookies or rookie techs (rookie to FUE) should be extracting. I think it is hoghly unethical for someone to use a paying patient as for testig and learnig purposes without that patient knowing that a tech has little to no experience whatsoever. So, you really have to look through a surgeons surgical protocol.

[Bald36]

Hi Everyone. This is my first post. I'm looking at the options that I am being told about and I really don't know what to believe. On one hand I'm being told that the strip grafts survive better where I'm being told on the other hand that FUE grafts survive almost as well but the difference is imperceivable. I do have some saying that the survival and growth with FUE is better than strip but when I read survival rates of 98% how can FUE be noticeably better across the board? Anyway, I wish there was more video of results so that I could better understand the differences. I've been looking through some of the videos and it helps me learn.

[matt1164]

I think bill gave good advice. I also think you should visit some dr's in person. some people have certain hair characteristics that make fue harder because of the different angles you have to go in.

 

I was seriously considering a fut instead of fue because I would have gotten it done in one pass and been done with the whole transplant issue.

 

but fue was awesome because about 7 or 8 days post op everything pretty much healed up and I went out with out a hat and no one could tell I had anything done. not my co workers, not my family or friends. that was pretty cool.

[Rashid36]

If someone has a large area and they chance a ht with fut and it works out great but if not or they have future hair loss they will have the scar to deal with too.

 

How big would this scar be ?

 

Just by comparison what would the typical graft number difference be between the 2 procedures ?

[Melvin- Admin]

If someone has a large area and they chance a ht with fut and it works out great but if not or they have future hair loss they will have the scar to deal with too.

 

How big would this scar be ?

 

Just by comparison what would the typical graft number difference be between the 2 procedures ?

 

That is the million dollar question, in a perfect world your hairloss does not progress enough to expose the scar. However, it's not guaranteed and can not be guaranteed. This reason alone was enough for me to choose FUE, should I ever progress to a Norwood 7 I will be able to buzz my head possibly shave. However, I did that with an FUT the scar would be visible.

 

How big the scar is depends on many factors like surgical skill and your own physiology, if your skin is elastic and the wound is closed with out tension the scar probably won't stretch, but again there are no guarantees to how you will scar or how big the scar will be.

 

I think again it depends from person to person, some men can only have one large strip due to skin elasticity, others can get multiple. If you're talking best case scenario, amazing donor and elasticity, I think possibly 2K grafts more. If you're talking average like myself, maybe 1,000-1,500. Ive had 4,000 grafts I met with Dr. Gabel, he advised I could do another 1,000 and still have some grafts left for future, I assume my total capacity is about 6,000. Perhaps if i went FUT I might've gotten away with 7,000 or ,8,000 who knows, I was told I have slightly above average elasticity. I don't regret my decision one bit though, in the long run I feel better about my choice should future loss occur. I can also blend in to the crown nicely which makes the contrast a lot less compared to if I had a strip. This is my situation though everyone has different goals and situations and styles.

[n00b]

Hi HTSoon,

 

I have a quick question if you don't mind. You mentioned that Dr.Gabel said that you have 1000+ grafts available. Is it through FUT or FUE?

[Melvin- Admin]

Hi HTSoon,

 

I have a quick question if you don't mind. You mentioned that Dr.Gabel said that you have 1000+ grafts available. Is it through FUT or FUE?

 

That is strictly through FUE, after seeing me and how I style my hair he was in agreement that FUE was the best option for me. I asked about my elasticity just out of curiosity and he said I have slightly above average elasticity.

[Rashid36]

I used to style my hair long for years and liked it. Then over the years of hair loss I kept it short and started to prefer short but if a ht went well and the hair grew well who knows.

 

What i mean is some might like to chage the hair style.

 

I thought fut could give double the grafts of fue but after reading this i think fut might not be worth the risks.

[Melvin- Admin]

I used to style my hair long for years and liked it. Then over the years of hair loss I kept it short and started to prefer short but if a ht went well and the hair grew well who knows.

 

What i mean is some might like to chage the hair style.

 

I thought fut could give double the grafts of fue but after reading this i think fut might not be worth the risks.

 

I think combining the both may get you double the grafts, but strictly comparing FUT to FUE I don't think the difference is that much. The general consensus though is to FUT first then FUE if you're trying to maximize your grafts. I just personally never wanted the linear scar, I know without a doubt that if I would've gone FUT then FUE I'd probably be able to get a lot more grafts than just FUE alone, I knew that but still decided on only FUE.

[harin]

I know this has been discussed and refuted and brought back in the forum before. Essentially in FUT that long strip of tissue (skin with grafts on donor strip) is permanently lost.

 

Given that some percentage of follicles are in telogen phase on the strip which are lost forever, whilst in FUE those follicles are still preserved to the large extent given only grown and active follicles are harvested.

 

Essentially Even though at times FUT may be preferred over FUE the advantages are blown out of proportion by some who hate FUE, and some who refuse to adopt and adapt to the new technology. Again this is my personal feeling and opinion.

[Rashid36]

Another thing in favour of fue, never thought of that!

[Melvin- Admin]

I know this has been discussed and refuted and brought back in the forum before. Essentially in FUT that long strip of tissue (skin with grafts on donor strip) is permanently lost.

 

Given that some percentage of follicles are in telogen phase on the strip which are lost forever, whilst in FUE those follicles are still preserved to the large extent given only grown and active follicles are harvested.

 

Essentially Even though at times FUT may be preferred over FUE the advantages are blown out of proportion by some who hate FUE, and some who refuse to adopt and adapt to the new technology. Again this is my personal feeling and opinion.

 

Good point harin, I never thought about that, I guess that's why after months of having an FUE the donor recovers, I'm guessing most of the follicles in the telogen phase grow back and give the donor a fuller look great point.

[newbie33]

I know this has been discussed and refuted and brought back in the forum before. Essentially in FUT that long strip of tissue (skin with grafts on donor strip) is permanently lost.

 

Given that some percentage of follicles are in telogen phase on the strip which are lost forever, whilst in FUE those follicles are still preserved to the large extent given only grown and active follicles are harvested.

 

What's the significance of that?

[templeloss]

Depends on the doctor. Very fue doctors can achieve FUT like yields via fue consistently, but there are a few out there. I say fue is better. I saw a guy at the airport who had his head shaved. Huge scar at the back of his head and you could see where he had hair up front but was bald behind it. He must have continued to lise after his HT. I felt bad for him.

[Dr Blake Bloxham]

Harin,

 

Interesting thought. And to address what Newbie is asking, I believe Harin is saying that a telogen follicle couldn't be properly transplanted because it would not be cycling and growing hair and therefore couldn't be properly implanted?

 

I've never observed this, and I think it may be for a few reasons:

 

1) Remember that only a small percent of hair follicles (somewhere between 1-10%) are in the telogen phase at any given amount of time. This means even a large strip would only have a small number of follicles in the telogen phase.

 

2) Furthermore, remember that most follicles reside in "follicuar families" or "follicular units" (FU) made up of 2-4 (usually) follicles. This means that the majority of these telogen follicles will be located in groupings with other follicles. Even if one of the two or three follicles in a follicular unit was in telogen, the entire unit would still be transplanted without issue. And the technician would be able to see the telogen follicle in the follicular unit (as they sit a little higher up in the skin) under the microscope, and know it was a multi FU and NOT an FU that should be implanted as a "single" (more on this in a minute). This means the follicle would survive and thrive just fine.

 

3) The only scenario where a telogen follicle could theoretically be "wasted' in a strip (as described above) would be if it was a single hair FU that was in telogen. Because the vast majority of follicles are in anagen and most are actually 2's, 3's, and 4 follicle FUs, this would be a pretty rare occurrence (and likely not statistically significant enough to make much of a difference). What's more, I don't really see any reason why this graft still couldn't be dissected and implanted. It may sit further down in the recipient site, but I don't think it would be deep enough to cause any issues when it woke up and began cycling normally. Especially considering the fact that most transplanted follicles do go into a resting phase quickly after implantation, and they still wake up and cycle hairs that penetrate the surface without issue.

 

Now, just to play devil's advocate a bit ...

 

The trouble with telogen follicles is actually a bigger concern in FUE. Why? The scenario I described above where a 2 follicle FU consisting of 1 follicle in anagen and 1 in telogen is mistaken for a single hair FU and implanted in the hairline. As you pointed out, you can't see true telogen follicles when removing grafts via FUE. Unless a clinic inspects the FUE grafts under a microscope before implantation, it is possible for: a 2 follicle FU with one follicle in anagen and 1 in telogen to appear like a single follicle FU at the surface, be harvested as such, not be inspected before implantation, be placed into the hairline, and then actually grow as a multi-haired graft when the result matures. Unfortunately, I have seen this.

 

Again, an interesting point and good discussion topic!