Strip excision or "FUE"

[hawk]

Strip excision or "FUE"

What to Do?

 

The ongoing debate - Strip excision or "FUE". What to go for?

[hawk]

Strip excision or "FUE"

What to Do?

 

The ongoing debate - Strip excision or "FUE". What to go for?

[Robert_]

Hawk,

 

Good question. While the "FUE vs. Strip" debate gets beaten to death (there are plenty of dead horses if you do a search) at times, there have been some interesting threads lately that touch on the subject. One that comes to mind:

 

FUE/FIT and "scarless technique" - started by Dr. Paul Rose.

 

To find more, simply look under the "Find" tab to perform a keyword search on "FUE."

 

For more information on FUE, you can also look here.

 

-Robert

[gillenator]

Hawk,

 

Many HT surgeons performing "both" strip harvest and isolated extraction methods commonly know as "FUE" have the same general consensus that a strip harvest in the hands of a "skilled surgeon" who performs ultra-refined microscopic follicular unit grafting techniques will undoubtedly produce the best yield, no other detrimental physiological factors considered.

 

From that start point you and "only" you can define what your current and long-term goals are in hair restoration. For most of us men we consider and subsequently incorporate or add a medicinal regimen like finasteride, minoxidil, etc to attempt to slow down the genetic loss. Since that too is an elective decision you may or may not want to add a medicinal approach. Simply do the research yourself if you have not done so already and then you can make an "informed" decision.

 

In addition there are a number of questions or a number of issues to consider when trying to decide "which one".

 

I encourage you to first consider your age along with your family history of MPB. If you are still fairly young yet are experiencing more advanced levels of genetic hairloss and/or it's in your family history, you undoubtedly will need a fair amount of work in the future "IF" your goal is to acheive the illusion of decent coverage front-to-back. So if you elect to forego the meds, FUE may provide more ultimate donor supply if you continue to loose hair.

 

Most of the individuals I converse with (mostly men), have some real budget concerns especially those who desire a fair amount of coverage. If the "average" FUE price is $8.00 US per graft, 3,000 grafts will cost $24,000!!! You can get a high quality strip procedure done for half that price if not even less say $10,000 or so. And many of the great FUT docs here and in the Coalition can offer affordability like that.

 

More clinical advances are being utilized such as Dr. Rose' new "ledge closure technique" which is on another thread in this forum. In layman terms the suture/closure techniques are advancing to the point where the scar visibility can potentially be "greatly" reduced. Pat just posted a photo displaying a patient with this technique and it speaks for itself. Keep in mind that the patient previewed is obviously also a "good healer".

 

So worst case depending on the variances of healing, the small linear scar from strip excision can also have grafts implanted in the scar. It is always a good idea to do a "test" or "pilot" procedure if there is any question as to how an area might heal. Specifically, if any individual tends to experience raised scars, keloiding, etc in other areas of their bodies, a test procedure would prove insightful.

 

Some younger men who do not have a family history (adopted or other reasons) may want to approach their restoration with FUE especially if their genetic hairloss is minimal at present. And those guys who do have a minor level of genetic hairloss in their family history may desire to "start" their hair restoration with smaller FUE procedures.

 

It did not appear that you were seeking FUE for repair purposes but it certainly would apply to those repair cases lacking donor and/or scalp elasticity.

 

Isolated extraction methods can also be considered for eyelash, eyebrow, and other facial recipient areas.

 

One last comment about scarring. Some would be so bold as to refer to these isolated extraction methods as a "scarless technique" which they are not. Do the homework on this one. When FUE really "hit the streets" in North America several years ago where there were very few cases being done, some were saying "OH you can shave your head with a razor or buzz your head with a number 1 guide and you'll never notice any scarring!" THINK AGAIN. I agree that with some patients especially those with fair densities and more narrow hair to scalp color contrasts, the scarring was "barely" detectable or not as noticable but then again I have seen cases where there was a very moth-eaten appearance.

 

The moth-eaten appearance seemed more evident with patients who had "larger" isolated extraction procedures and also those with wide color contrasts. Obviously these were guys who desired to continue to wear a very short hair style so let that also be a consideration, how one desires to style their hair now and in the future.

 

Hope this has been insightful for all of those with the same question as Hawk and best wishes to you.

[Smoothy]

The debate continues. The way I look at it is like strip is the perfected technique and FUE is the newer less perfected technique that shows promise and is an option for limited donor patients. Right now, in my opinion, FUE can not stand up to strip, but within the next few years will probably be equal with quality, survival, and results as more surgeons experiment with the techniques and perfect it. Just like any other medical advancement.

[arfy]

Some guys do not want to undergo an invasive surgery like Strip Excision just for their hair, and they opt for FUE.

 

As far as which method yields more hair, an FU graft is an FU graft and it doesn't matter how it's harvested if it's healthy. If you transplant an equal number of grafts then the total yield will be the same, when done correctly.

 

As far as the minimal scarring from FUE or the "moth eaten" claim. if someone digs through your hair and examines closely, then they will find evidence of FUE hair transplantation. But the same is true of strip surgery or any other kind of hair transplant.

 

Some of the people who downplay FUE seem to have a vested interest in Strip surgery.

 

FUE is certainly not a perfect solution, but hair transplants in general are flawed and are never as good as what you had "pre hair loss".