Hair Restoration Blog

Often times we at US Hair Restoration receive questions about the difference between the FUT Strip Method and the FUE procedure. Some will make claims that one option is superior, while the other is inferior. Both hair transplant techniques are done in US Hair Restoration and have their own adavntages and disadvantages.  Here is a list of reasons supporting both the strengths and weaknesses of the FUT Strip Method and the FUE:

The FUT Strip Method

• Allows the hair transplant surgeon to transplant a larger number of grafts in one session. Most people who have never had a hair transplant surgery can have maximum results in only one procedure.

• Allows the surgeon(s) to process and harvest the grafts under a microscope minimizing the level of damaged hair follicles.

•  Can be achieved at a more rapid speed than the FUE.

• What can be achieved in one FUT strip procedure can take 2-3 FUE surgeries.

• The number of damaged grafts might be greater for certain patients which undergo the FUE procedure because of their unique hair characteristics. People with wavy or   curly hair may have a higher risk of transection than patients with straight hair. A FOX test may be performed on patients with curly hair or wavy hair to determine whether or not they make good candidates for an FUE procedure. A FOX test is a small FUE procedure which helps to determine the level of damage to follicular graft before proceeding with a complete FUE transplantation procedure.

• The FUE requires more tedious labor and the cost for performing an FUE is usually more than a strip hair transplant.

• FUE procedures require a highly skilled operator and create a technical challenge for less experienced technicians who don’t have good hand-eye coordination.

The majority of the patients which receive a hair transplant with the strip method are going to have a linear scar on their donor area.  This scar can be minimized with certain surgical techniques such as the trichophytic closure, but it can never completely be eliminated. FUE hair transplant procedures offer unique advantages for differing patient circumstances.

FUE Procedure

• The scar visibility is slightly noticeable to completely non-existent with the FUE.  It may leave some miniature spots because of a lack of hair in that particular area or de-pigmentation, like a small dot which is lighter when seen close up.

• Hair can be kept short after the Hair Transplant surgery in front and back.  Any types of spots or de-pigmentation are not easily detectable.

• There is minimal pain for most patients and they don’t need pain killers after their hair transplantation.

• The surgeon can get donor hair from different parts of the body which the strip method has limited areas to take from. Areas such as the temples, beard and other body hair is included in this.

• The surgeon can choose the specific type of grafts to harvest.  When a special type of follicular unit is needed, this option is very good because the surgeon can choose the exact number of specific grafts to transplant. This is great for touch up work on the frontal hairline which needs single hair grafts, or for filling an isolated crown balding spot that does not require any singles.

• The contrast between high hair density and bald areas can be decreased by the FUE. Restoring hair in a scar only needs hair added to the scar, and the FUE would help to minimize the contrast between the scar and the surrounding areas more easily.

Despite of all above advantages and disadvantages about the two methods discussing them with a good hair transplant surgeon is a good starting point to find out what it the best option for you.

Q:

Hello,

I wanted to get more information like FUE vs FUSS…I have been doing a lot of reading..How do you know if one is best and using a FOX test??..I like the idea of the FUE but hear manny claims that it is not good..However, I am not a big fan of getting a piece of my sking taken off. There is so much differnet information.. also all the normal questions that come with the procedure….I hope to hear from you.

Thank you for taking the time to read this,

_

A:

Thank you for your question. It is a very good one.

Follicular Unit Extraction (FUE) is a method by which we remove hair follicular units individually as opposed to taking a strip of scalp and dissecting it, extracting the follicular units.

You are absolutely right in the fact that there is a lot of different information online, for and against FUE procedures. The truth is that many hair restoration surgeons and facilities promote one method versus another due to their specific surgical capabilities. FUE, if done right, might be a great solution for some hair loss sufferers – primarily those with minimal hair loss, those who (for any reason) cannot have any type of scarring on their scalp, those who have had problems associated with previous strip procedures, and those with a compromised donor area wherein a strip procedure just isn’t possible.

Having said that, most hair transplant surgeries are still performed utilizing the strip method, for a number of reasons:

Strip hair transplantation allows the surgeon to maximize the quality and viability of the hair follicles. We anticipate a maximum hair follicle transection rate (“transaction rate” referring to hair follicle ‘grafts’ that are cut during surgery, resulting in follicles no longer capable of growing healthy hair) of 1-5%, since the grafts are harvested under 3-D magnification with stereotactic microscopes.

In FUE cases, patients may experience significantly higher hair follicle transection rates of up to 10% or more. A FOX test is performed, primarily, on patients with curly hair to determine whether or not they are candidates for an FUE procedure. (It is basically a small FUE procedure.)

Although mega and giga session hair transplant procedures of 4,000 grafts or more can be performed using the strip method, individual FUE procedures cannot harvest more than 1500 to 2000 grafts. Sessions larger than this will keep hair grafts outside of the body for an extended period of time, potentially jeopardizing their survival.

Today, we have several methods to minimize the visibility of any scarring resulting from a strip procedure.

An FUE procedure is labor intensive, and as such the cost for performing an FUE procedure is significantly greater.

I think it’s best that you be evaluated by a hair transplant surgeon, skilled in both FUE and strip techniques before deciding which procedure is right for you.

Please don’t hesitate contacting us if you have any additional questions.

Thanks,

Q:

My hair loss is ruining both my life and my family’s lives. I go to the XXX school of medicine in XXX and would be flying over to get the procedure done. I wanted to see if we could discuss a large FUE treatment from my body and beard area for transplantation into the balding areas of the scalp to end my hair loss for good.

I look forward to hearing from you,

Cheers

A:

As I have previously stated before here in my blog, body hair can be considered as an alternative method for hair restoration as long as you, the patient, understands that the end result is not going to be comparable with a scalp hair transplant due to smaller final length of hair and short growth phase (Anagen) as opposed to long resting phase (Telogen) that are characteristics of body hair.  In other words, you may only see a portion of transplanted hair follicles in growth phase while the remainder stay in resting phase without maintaining a visible hair shaft.

Beard hair transplantation could also be another option, which is typically closer to scalp hair in many patients and has a longer growth phase (which is why it grows to become longer in comparison to body hair).  However, any of these options have their own pros and cons and patients should be evaluated for each treatment plan based on their needs and only after a complete evaluation by a hair transplant surgeon is performed.

Discount for FUE Transplant – Limited Only for Study Participants

As a leader in hair restoration, US Hair Restoration is now conducting a study on different methods of FUE (Follicular Unit Extraction) hair transplantation in its Southern California offices.  Our main goal of this study is to compare the quality of grafts harvested by the most advanced hair restoration techniques.  Study patients will be entitled to a discount from our standard rates of FUE hair restoration. The study will be going on until the end of July 2010 and the results will be submitted for publication in world-wide medical journals.

Who is a good candidate?

Hair loss patients who does not want to have linear scar on the back of their head might consider this option most probable for their needs.  Also, any candidate should know that the number of grafts available to be harvested in one FUE session might be significantly less than what could be done through a traditional strip method.  Thus, in addition to those who want to avoid scarring, patients who does not need a large number of grafts for their hair restoration may also be relatively better candidates.  FUE could be used for treatment of male patterned hair loss with class III and IV, eyebrow hair transplants, or to restore the linear scar from a previous strip procedure. Applicants can call the US Hair Restoration office at 1 (800) 302-8747 to schedule a consultation with Dr. Mohebi.  If you are still unsure whether or not FUE is the right procedure for you, please read our website and in particular the page on Follicular Unit Extraction.

Why FUE?

Follicular Unit Extraction (FUE) also known as FUE transplant is another version of Follicular Unit Transplant (FUT).  It is a newer method of harvesting follicular units that eliminates the appearance of a linear scar and it is much more comfortable during the post op period of a hair transplant surgery.  Although FUE transplantation may be the answer for many hair loss patients who do not want any scaring on their donor area, it is not the answer for everyone.

Who can use FUE?

The number of available grafts in FUT transplants can be limited.  So, candidates who require a large number of grafts in one session and traditionally may have needed several sessions of (FUT) hair transplantation are now able to acheive the same number of needed grafts through traditional methods of FUE. In order to be approved as a candidate for a FUE hair transplant procedure, one must attend a complimentary in-office consultation with Dr. Parsa Mohebi and have the FOX test performed to show eligibility.  

Automated FUE

The good news is that the efficiency of FUE transplants have increased as newer automated techniques are developed, thus allowing hair transplant surgeons to remove follicular units faster than what was possible in the past.  US Hair Restoration is a center located in Southern California and known for its ability to perform quality FUE procedures in its Encino, Beverly Hills and Orange County offices.  We at US Hair Restoration have added automated FUE methods to our armamentarium of hair restoration techniques.  Automated hair restoration surgery with FUE techniques has increased the number of hair grafts able to be harvested from the donor area and transplanted within one day.

Additionally, we are also offering special promotions for candidates who are interested in participating in our ongoing FUE study that is designed to compare different methods of FUE procedures both qualitatively and quantitatively.  Please do not hesitate to contact US Hair Restoration’s office at 1-888-302-8747 anytime for more information.

Q:

I have heard of FUE transplants with relatively high-quality hair coming from the neck area, and from the beard. It seems like this could dramatically increase the number of grafts available for patients, at least for the hairline and front.  Then, body-hair (chest, back…), which I think are lower quality (but very abundant on me!), could possibly be used for the crown area. I would like to take as few hair from the back of the head as possible, and as much as possible from other areas.
Doctor, what do you think of this plan? Would it be a good strategy to pull from other sources rather then the scalp for donor hairs? What would be the costs involved?

A:

Follicular Unit Extraction (FUE) can remove hair from anywhere in the body as long as you are tested positive for FOX for those areas.  Neck hair is not the best option for hair transplantation because those hairs may fall out at higher ages of some patients. We can use body hair for hairline, and front or even the crown, but you may need multiple surgeries to obtain adequate density from those areas with body hair.  As we discussed before, body hair has a long resting phase in relation to its growth phase.  So you will have more follicles in resting phase (telogen phase) that do not have any visible hair in comparison to the ones in growth phase (anagen phase) that provide you with actual hair and give you coverage. We do FUE transplants in our California hair transplant centers on a regular basis.  FUE procedures are more labor intense and more time consuming so the cost of them are almost double in comparison to regular strip hair transplant procedures.

(more…)

It is about 8:00 Pm and we just finished performing a big FUE procedure and I thought I write this post on “who is a candidate for FUE procedure” before going home.

Recipient and donor area right after a FUE (Follicular Unit Extraction) procedure.

Follicular Unit Extraction or FUE hair transplants is one of the methods of hair transplantation with Follicular Unit Transplant (FUT) technique. The biggest advantage of FUE is that, the linear scar in the donor area on the back is eliminated.

FUE has been around for a few years now. Many people ask about the advantages and disadvantages of FUE when they are considering doing a hair transplant surgery. People always ask; whether or not FUE hair transplant is the right procedure for them. There are many articles on hair transplant techniques including FUE and its different methods that compared FUE with regular techniques of strip hair transplant. Hair transplant surgeon has to consider patient‚Äôs needs when planning for a hair restoration procedure. Many surgeons don‚Äôt do FUE on a regular basis. This needs to be explained to the patient. Unfortunately some doctors talk patients out of this procedure simply due to their inability to perform one. That is the same for mega session surgeries that many people are told that grafts won’t survive if place too densely only because they can not perform one. This might be due to not having enough skilled personnel or any other limitations.

Donor area with small wounds of FUE punches right after FUE procedure

The most important factor that people consider when they consider doing a FUE is elimination of linear scar on the back with FUE hair transplant surgery. It might be because they want to wear their hair short on the back or shave it at some point. FUE by far is the only method that can completely eliminate the linear scar on the donor area. Have more comfortable post-op period is the other reason for choosing FUE.

All patients need to be tested before performing an FUE procedure for their candidacy. At the Los Angeles office of US Hair Restoration, Dr. Mohebi tests all patients who are considering this method for their hair restoration. FUE test (FOX) is easily done in the office with to extra charge to the patients. We perform a mini FUE procedure under local ansthesia to test feasibility of removing intact follicular unit grafts with different FUE technique and see which method is the right one for each patient. If patients are FOX negative then other options should be discussed with them. Even if patient’s are FOX positive, they have to understand that they may have a much better yield and superior final outcome with regular strip technique. For some patients, not having scar on the donor area is more important than having higher density in recipient area and they can live with thinner hair in the recipient area, but they don’t want any line of scar at all. These patients are the best candidates for FUE if they are tested positive for that.

Follicular Unit Extraction (FUE) – Advantages or disadvantages

My patients always ask about advantages and disadvantages of Follicular Unit Extraction so I thought this topic makes a good post for the blog. Before going over these points I have to say, although we at US Hair Restoration offer the most advanced techniques of FUE nationwide, most of our patients are still being transplanted by strip technique and I don’t recommend FUE to everyone and select my FUE patients very meticulously. Here are the main reasons why we do recommend FUE to some people and not to everyone.

Advantages

• FUE does not leave a linear scar, which is great for those who want to wear their hair very short on the back or the ones who may need to shave their head in the future (like actors).
• FUE has a more comfortable healing process with decreased healing time.
• No restrictions in physical activities for those who want to do strenuous exercise right after FUE procedure.
• FUE is a viable alternative for those who have tight scalp that makes strip surgery risky or impossible.
• Follicular unit extraction makes it possible to harvest hair from body, beard or almost everywhere else.
• FUE is very useful when we need limited number of grafts like for restoration of eyebrow hair.

Disadvantages

• The biggest disadvantage of follicular unit extraction is that the maximum follicular unit graft yield is lower than when it is done with strip technique due to higher rate of follicular transection compared to the strip technique.
• Although linear scar is not present after FUE, small punctuate scars will be there that may make future FUE hair transplant surgeries more difficult or impossible.
• Not everyone is a candidate for FUE and patients need to be tested with FOX before proceeding with the surgery.
• FUE procedure takes much longer to perform compared with strip FUT procedure.
• FUE is more laborious thus it cost more compared with strip technique hair transplants.
• In FUE, we have more chance of burying grafts that increases the risk of having folliculitis (tiny inflamed cysts under the skin) on the donor area.