We have two excellent methods of harvesting donor hair follicles in hair restoration surgery. With follicular unit transplantation (FUT), more correctly described as the strip harvesting method, a narrow piece of scalp (typically 1cm or wider) is excised from the donor region. Surgical assistants dissect the strip with stereo microscope and result is the production of grafts that contain follicular group of 1-4 hairs. With FUE, the donor grafts are harvested individually with very small circular punches typically < 1 mm in diameter. When harvesting grafts using the FUE method, the physician creates all the grafts each containing follicular groups of 1-4 hairs.
Comparison of Techniques
So follicular unit extraction(FUE) is best choice in following cases-
- A patient wants to have least painful post-operative course.
- The scalp is very inelastic.
- A patient wants to start gym as early as possible.
- A patient wants to keep hair short (buzz cut) which is very popular nowadays, and wants to avoid linear scar.
- A patient has donor healing problem from previous strip surgery.
- Body hair needs to be harvested.
- Finer hair needs to be selected for hairline or eyebrow.
- A patient has a history of keloid or hypertrophic scarring.
- Repairing prior strip scar.
- A patient has low donor density.
Strip is best choice in following cases:
- A large treatment is required.
- A patient who wants most hair possible single day procedure.
- A patient has no plan or desire to keep the hair short and is unconcerned about a linear scar.
- A patient who does not want to shave donor region for the procedure.
- Cost is a major concern.
Finally it is important to note that strip and FUE are complementary techniques. They can be interchanged sequentially over a treatment course depending on the specific requirements of the patient at any given point in time. They can also be used simultaneously in same procedure to facilitate a large harvest. A hair transplant surgeon must know both the techniques.