FUT VS FUE

[rabbitandthehair]

Have a doctor I like, he has recommended that I get FUT strip method instead of the FUE method.

I need 2000 grafts.

This concerns me because I dont want a linear scar. He advised that FUT method is superior because it allows him to get better quality grafts and get a better graft survival rate.

Is this true? Or is he simply trying to save time on his end?

[Rahal Hair Transplant]

@rabbitandthehair,

EDIT - Read the below post but I did create a second post below because somehow I missed where are you sad that the surgeon claimed FUT was superior to FUE. I am finally disagree and my second post explains why 

—-

My question to you is, did he explain why he suggested you undergo FUT instead of FUE?  As a general rule, I think it’s good to request an exclamation for anything you don’t understand. For example, if you are considering FUE only and the surgeon recommends FUT, and I would advise asking why he feels FUE may not be good for you or why he recommends a procedure for distinct  from what you are considering.

in my opinion, there are two possible reasons why this particular surgeon suggested FUT over FUE.

1. The surgeon is more comfortable performing FUT and as a result, he feels he can get you a better result using this technique.

2. He evaluated your specific situation and determined based on your physiology, available donor area, scalp  elasticity (which really only applies to FUT), area of baldness to cover, or some other variable that he could provide you with The best results using over FUE.

Now it’s rare, but even Dr. Rahal who now only exclusively performs advanced FUE and does it exceptionally well has turn down the occasional patient stating that The patient is not a candidate but if the patient is going to proceed with surgery, that FUT would be the better route.  But like I said, this is exceptionally rare.

as for the first scenario, if the doctor is strictly recommending a few tea because he’s more comfortable with it, I suggest consulting other surgeons and potentially going elsewhere. You always want to see a Doctor Who has your best interest in mind and not interested in doing only what’s easier for them.

I hope this helps

Rahal Hair Transplant 

Edited August 10, 2023 by Rahal Hair Transplant

[LaserCaps]

Great post and one that deals with a lot of misconceptions.  Let's really get into it and chime in if you have something constructive to share.

FUT was the standard not too long ago.  A segment of tissue is removed. The area is then sutured together hair to hair.  This results in a linear scar which can be easily covered with the native hair.  There has to be enough native hair to fall down, shingle, and provide coverage.  No one should be able to notice a thing, not even the day of the procedure.  A year later you look great but now you want to work farther back into the pattern. The doctor would re-exice the original scar so as to keep the area as neat as possible with only one scar.  You could do this many times until the doctor tells you, "there no elasticity left," at which time you can do FUE.  (You could put FUE grafts on the scar to help camouflage if necessary). By considering both procedures, you would have full access to the donor.  This is of particular importance if you have a very advanced pattern and limited donor.  Now the scar.

Scarring has a lot more to do with wound physiology than anything else.  The doctor will use all his knowledge and experience to achieve the best result.  A scar so fine it'd be difficult to detect.  But then consider the other side of the coin.  The patient. 

It's typically suggested a patient avoid weightlifting that affects the neck for 6 months.  No shoulder shrugs, no squats, as this can cause a scar to widen.  It's also recommended you get an orthopedic pillow that conforms to you so as to avoid stretching the neck while you sleep.  Following pre and post op instructions is imperative.  Can you guess how many patients actually read these documents? How about the patient that goes to the gym the day following the procedure? 

FUT will allow for a follicular with a lot of substance and hair.  Consider, a FU can have 1-5 hairs per follicle.  This will typically provide more yield than FUE.  Why?

FUE, Follicular Unit Extraction, can be done in a number of ways.  Robotic - such as ARTAS, Neograft, Smartgraft, etc.  The issue with these, they typically use a larger punch which results in circular type scars.  This defeats the whole purpose of an FUE procedure.  For the "scars" to be undetectable, a punch smaller than .9mm is required.  This is typically achieved with manual systems.  A micro-scar will not be detectable by the eye. The size of the punch is so small, so will the graft.  Not a lot of substance nor hair.  You will typically achieve less coverage compared to FUT.  So, which one should you choose?

If weightlifting is essential to you, do FUE.  If you keep a high and tight haircut in the donor area, do FUE.  If you keep your hair long and can care less about weightlifting, you have the option of doing either one. 

It's important to recognize this is a progressive condition.  If you've shown the propensity to lose, you'll continue losing. It's imperative to consider some sort of regimen to help with retention and enhancement of the native hair.  No one with an advanced pattern has enough donor to allow for full density throughout the head.  

[Rahal Hair Transplant]

@rabbitandthehair,

I don’t know if you modified your first post but I didn’t see his explanation until now. So allow me to respond to that.

In the past, the statement that FUT was superior in terms of growth yield to FUE was true.  This was when surgeons were still perfecting the procedure and learning how to overcome forces such as traction, torsion and tension when extracting the follicle.

These forces still exist due to the blind dissection component to FUE. But with continued practice in performing FUE exclusively by top surgeons such as Dr. Rahal, transection and damage to the follicle during the extraction process is practically nonexistent.

And while the tissue surrounding the follicles is thinner and thus more fragile, historically, it was easier to damage the follicle during the insertion process into the recipient site. However, By using implanter tools which enables skilled technicians and the surgeon to insert the grafts into the tiny incisions without touching them, The possibility of crushing or causing any kind of damage to the grafts during the insertion process is also practically nonexistent.

Long story short, FUE is Actually superior to FUT as a whole because now that growth yield is on par with FUT, The other benefits of FUE outweigh FUT. These include…

* No linear scar

* more minimally invasive

* faster healing times

* ability to wear hair even shorter on the sides and back of scalp

* the ability to cherry pick follicular units for the crucial hairline areas

* The ability to select more single haired FUs or multi haired FUs For certain areas of the scalp as needed.

So I emphatically disagree with what the surgeon told you about FUT being superior.

Best wishes,

Rahal Hair Transplant

Edited August 10, 2023 by Rahal Hair Transplant

[Al - Moderator]

Get another opinion from someone who does both FUE and FUT.

 

[A_4_Archan]

@rabbitandthehair

Imo FUT use to have an upper hand in past but this days it has an upper hand in just one thing that is the total lifetime availability of the number of grafts ...high number of total lifetime grafts can be taken out if you go for FUT...But this advantage comes with lots of drawbacks too...

So in the present time imo FUT should be considered if the baldness level is advanced and the availability of number of donor grafts is doubtful....

In most of the other scenarios FUE will have the upper hand..still i would say its not about which one is superior or inferior but its about which one suits well in the given situation of the patient...so your surgeon is wrong in stating that FUT is superior technique...

You should ask him why do he/she believes that you should go with FUT...What are those reasons for which he/she thinks FUT will be better in your particular case.?

 

[GoliGoliGoli]

The others have already responded well and in-detail, so I'll keep this short: The only reason to opt for FUT is if you have very good scalp laxity as this allows you to harvest more grafts over your lifetime. So if you have good scalp laxity and thing you're going to need every graft you can get, FUT can give you like approximately 1000 more grafts (Don't quote me on that number) if and only if you have good scalp laxity.

[Emiry]

5 hours ago, rabbitandthehair said:

Have a doctor I like, he has recommended that I get FUT strip method instead of the FUE method.

I need 2000 grafts.

This concerns me because I dont want a linear scar. He advised that FUT method is superior because it allows him to get better quality grafts and get a better graft survival rate.

Is this true? Or is he simply trying to save time on his end?

Just BS and the doctor trying to sell you on a dated technique he does.

 

Edited August 10, 2023 by Emiry