Why some surgeons/clinics no longer offer FUT?

[Phab]

I have found many clinics that used to offer in the past, do not offer FUT anymore.

These clinics told me that is an old practice, but why is that other surgeons prefer FUT over FUE saying FUT is still best aka "gold standard", so why stop? Anybody knows? It's hard to get a non-biased answer from these clinics so I thought I asked here.

Edited March 18, 2021 by Phab

[kramer79]

Which clinics told you that FUT is an old practice?

[Gatsby]

I think part of the reason is client demand and BS marketing. Many people do not want a strip scar which I find odd as ALL surgery (FUE, etc) leaves noticeable scars. I would rather have surgery performed by a top FUT surgeon than an average FUE surgeon any day of the week (assuming that is right choice of surgery for my hair loss needs). The real choice though should be what surgery is best for the patient as everyone is different. Both FUT and FUE combined may be the best option.

[Silent1234]

A lot of hair transplant clinics simply do not have a surgeon who can perform FUT. It requires a lot of skill hence why many doctors only learn FUE as it is much easier!

[gman849]

Surgeons and clinics that do offer FUT say that it is  more efficient way to harvest grafts. Scar aside the donor area is left in a better position for future harvesting. There is also better survivability rates of grafts using FUT.

[SLA]

14 minutes ago, gman849 said:

Surgeons and clinics that do offer FUT say that it is  more efficient way to harvest grafts. Scar aside the donor area is left in a better position for future harvesting. There is also better survivability rates of grafts using FUT.

Survivability rates with FUT used to be better than FUE, but this is not necessarily the case any longer. Ron Shapiro did a study on graft survivability between the two techniques and actually found that FUE survival was slightly  better. We must remember that it was a small study and more are needed to confirm. Melvin posted a video and another thread of Shapiro talking about the study (see below).

I think new extraction tools have even allowed more protective tissue to be extracted with FUE thereby protecting grafts.

 

 

 

[gman849]

FUE is where its going hopefully it will continue to improve.

[Melvin- Admin]

There’s less demand, staffing becomes harder to find. Technicians now don’t learn how to dissect and sliver grafts. It becomes easier from a business standpoint to just offer FUE. I hope it doesn’t fade out completely. But even H&W perform strip less now.

[Raphael84]

“Newer” doctors who may have “arrived” in the industry in recent years may not feel that it worthwhile to invest and dedicate x amount of years to really learn the intricacies of FUT due to the “dying” demand, which is understandable, and certainly one reason why FUT will continue to phase out each year. Such doctors would prefer to invest this time into improving their craft in FUE. However in doing so, it is fair to say that they will have a different understanding and potential limitations in serving each patients individual needs.

I feel that any doctor who may say that FUT provides better yield, they are speaking about their own experience and in their own hands. Leading FUE surgeons who have been in the industry for a long time and have much experience with FUT and FUE, generally have another view. FUE in the hands of a skilled surgeon produces optimal yield inline with FUT.

Considering the evolution of FUE over the last 5 - 10 years, very few patients now request or are even open to the idea of FUT surgery, with its more invasive nature, longer healing and recovery and of course the linear/strip scarring.

Therefore due to such a shift, the majority of hair restoration clinics have had to evolve with the times, and with the preference and demands of their patients.

Initially when FUE was introduced, it was more expensive than FUT due to the time demands of the doctor who would have had to invest significant time to learn the complexities of punching on patients with different hair characteristics and skin types.

FUE demands that the doctor(at least in reputable clinics) to personally punch each and every graft and to cut each recipient site, meaning a much greater demand on their time in comparison to FUT. Another very important point is that an FUE surgery may require only 3 technicians.

With FUT, the doctor will excise and suture the strip and prepare recipient sites. Depending on the graft count(FUT surgery is generally always a significant graft count), a patient may require 6+ technicians, to dissect, clean and appropriately sort and store grafts before beginning to place. FUT is very technician reliant with more demands time wise on the team over the doctor.

Just as “newer” doctors may not see the value in investing their time into learning to perform FUT, the same applies to technicians/nurses. This means that in general, a smaller percentage of technicians have training and experience in the technicalities of FUT surgery, meaning staffing FUT surgery can be also be a challenge for many clinics.

The reality of this, is that with FUE  “leading” the market over FUT, clinics no longer require the same quantity of technicians as they once did as the vast majority of patients decide to proceed with FUE surgery. When FUT is scheduled, more technicians are required, meaning more expense to be covered, which will be absorbed into the cost of surgery for the patient, oftentimes meaning that FUT may now present a higher price than FUE, and is no longer the more economical option, which in turn results in FUT becoming even less attractive to many.

[Melvin- Admin]

2 minutes ago, Raphael84 said:

“Newer” doctors who may have “arrived” in the industry in recent years may not feel that it worthwhile to invest and dedicate x amount of years to really learn the intricacies of FUT due to the “dying” demand, which is understandable, and certainly one reason why FUT will continue to phase out each year. Such doctors would prefer to invest this time into improving their craft in FUE. However in doing so, it is fair to say that they will have a different understanding and potential limitations in serving each patients individual needs.

I feel that any doctor who may say that FUT provides better yield, they are speaking about their own experience and in their own hands. Leading FUE surgeons who have been in the industry for a long time and have much experience with FUT and FUE, generally have another view. FUE in the hands of a skilled surgeon produces optimal yield inline with FUT.

Considering the evolution of FUE over the last 5 - 10 years, very few patients now request or are even open to the idea of FUT surgery, with its more invasive nature, longer healing and recovery and of course the linear/strip scarring.

Therefore due to such a shift, the majority of hair restoration clinics have had to evolve with the times, and with the preference and demands of their patients.

Initially when FUE was introduced, it was more expensive than FUT due to the time demands of the doctor who would have had to invest significant time to learn the complexities of punching on patients with different hair characteristics and skin types.

FUE demands that the doctor(at least in reputable clinics) to personally punch each and every graft and to cut each recipient site, meaning a much greater demand on their time in comparison to FUT. Another very important point is that an FUE surgery may require only 3 technicians.

With FUT, the doctor will excise and suture the strip and prepare recipient sites. Depending on the graft count(FUT surgery is generally always a significant graft count), a patient may require 6+ technicians, to dissect, clean and appropriately sort and store grafts before beginning to place. FUT is very technician reliant with more demands time wise on the team over the doctor.

Just as “newer” doctors may not see the value in investing their time into learning to perform FUT, the same applies to technicians/nurses. This means that in general, a smaller percentage of technicians have training and experience in the technicalities of FUT surgery, meaning staffing FUT surgery can be also be a challenge for many clinics.

The reality of this, is that with FUE  “leading” the market over FUT, clinics no longer require the same quantity of technicians as they once did as the vast majority of patients decide to proceed with FUE surgery. When FUT is scheduled, more technicians are required, meaning more expense to be covered, which will be absorbed into the cost of surgery for the patient, oftentimes meaning that FUT may now present a higher price than FUE, and is no longer the more economical option, which in turn results in FUT becoming even less attractive to many.

Very well said, the yield is really a non-issue. The only thing that is debatable at this point is whether you should go FUT first or FUE.

[pkipling]

I imagine the FUT vs FUE Debate will never completely go away, but it seems the general consensus here in this forum and amongst most surgeons is that they're both valid procedures and both serve a purpose depending a patient's particular situation and needs. And while there are a few surgeons who still think that FUT is infinitely better than FUE, it's undeniable that FUE has improved drastically over the past 5-10 years and if there is a gap between the two in regards to FUT "being better", that gap has closed significantly at this point, and I don't think it's nearly as cut and dry as maybe some FUT Loyalists would have you believe.

As to why so many surgeons primarily offer FUE these days, I think the biggest component to consider is simply demand. Now that FUE is in many ways comparable to FUT (in the hands of the right surgeon, that is), most guys don't want to deal with a strip scar and many won't even consider it - therefore, the surgeons shift to what is marketable and what the majority of the patients want. And when you have surgeons who are getting solid results with FUE, it's easy to see why so many patients would much rather go that route than having a strip scar in the back of their scalp.

All of that said, I personally think it's important to find a surgeon who is skilled in both methods so that they're making a recommendation based on what is in the best interest of the patient. For some guys, FUT may very well be the best route for them to take, and so it would be important for them to have that option. But if a patient can get just as good results with FUE (or even almost as good), I personally would go that route every time.