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 do mix martial arts and would like to know, how long will i be out from MMA (wrestling, jujitsu, muay thai, etc…) after strip surgery? also when can I return to regular cardio (running, rowing, sprinting,etc..) and weight lifting?  thank you. I have contacted other doctors too, but they all tell me different answers. the internet says to stay away from MMA at least for 3 months? some doctors tell me I can return to MMA after one month but in wrestling and jujitsu they are always grabbing and pulling down the back of the head in a very fast and hard manner.

A:

It has to do with the technique of hair transplantation.  If you are considering the conventional hair transplant surgery with a strip method, you should not perform any aggressive contact sports for the first month. After that first month, you can resume most of your activities, but you really need to be careful for the first 3 months and avoid some moves such as bending your head forcefully until your donor scar is fully healed, which is 3 months after  your hair transplant.

FUE (Follicular Unit Extraction) has different timelines after hair transplantation.  If receiving a FUE transplant you should be able to resume activities much quicker  because there is not a linear scar on the back of your head and you do not have to avoid bending your head for 3 months after hair transplant.  For more information, you can also read this other blog post in which I have answered another similar question from one of my patients (Physical Activity Limitations After Hair Transplant).

Q:

I was told that a spot has opened up for my hair transplant surgery. I told them to slot me in, but now that I’ve jumped into the deep end I’m a bit nervous. My nerves don’t have to do with what it will look like six months or a year from now, but for the weeks following the surgery.
I need to take the next day to really meditate on this. Although my hair loss does bother me, it’s not as if I’m noticeably bald. So I’m deciding if this is something that makes sense for me.

A:

It is completely normal to have a touch of nervousness prior to this elective surgery. Since it is an elective procedure, it is common to have questions and/or
reservations. We need to remember that it is simply hair and not some life threatening procedure! Many patients have this reluctance and there is never a clear or definitive answer aside from your intuitive feelings.

Your particular situation is for the enhancement and detailing in order to complement what you already currently have. Your hair loss is probably going to progress in the future but again, it depends on when you want to address the issue.

Having experienced seeing many other patients who had similar feelings before their hair restoration procedure, I think you will very happy you did it!! Either way, I support whatever decision you make. US Hair Restoration is always going to be a resource for you with whatever questions or concerns you have regarding hair loss and the treatment options available.

Meditate  on that assurance and clarity will present itself!

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:

I have read some good things about your practice and I am willing to travel. I am in need of 1500 to 2000 graphs placed using FUE. Please let me know the price/graft you have available. I have been quoted 4/graph but was not comfortable with the doctor.

PS. A representative at Bosley is saying FUE is not possible at 1500 to 2000 graphs. Is this true? I am not trusting this notion. Thank you

A:

Thank you for your interest in our quality hair restoration services and for taking the necessary time to contact our office regarding your inquiries. Although I cannot personally evaluate your options or offer you recommended graft numbers without reviewing your past and current medical history, I have taken the time to address your questions below.

- You stated that you are in need of 1500-2000 FUE grafts.
Here at US Hair Restoration, the regular cost for FUE hair transplant services is $8.00 per graft.

*If you have a flexible schedule and willingness to book for your procedure within 7-10 days of the hair transplant then you are eligible to take advantage of our standby option which offers a discount on the total cost of your procedure. The current discount percentage fluctuates, so please call our office for more information on the current seasonal rate.

- You stated that you were not comfortable with the previous clinic you consulted. If you are feeling uncomfortable with the last clinic you consulted for a hair transplant, we urge you to continue consulting doctors until you find the perfect fit. Finding the perfect physician for you will likely not happen over night, but the research to achieve your best possible results is well worth the wait.

- As for a Bosley representative saying that 1500-2000 FUE grafts is not possible, I would not necessarily agree. To be sure, you would need to be evaluated in a consultation for other restricting conditions. Because FUE procedures are so meticulous and time consuming, many doctors do not want to plan for over 1500 FUE grafts to be transplanted in one day. This is not to say that it is impossible to transplant more than 1500 FUE grafts in one day, but 1500 transplanted grafts of FUE will typically take about 8 -12 hours of work for the doctor and technicians. We do not like to push our patients, or surgical team to the limit, so if any patient is wanting more than 1500 FUE grafts we elect to break up the surgery between two or more days of work (up to 1500 FUE grafts per surgery day).

If you would like to schedule a free consultation so that we can discuss your options and graft number recommendations, submit an online consultation form through the main US Hair Restoration website and one of our patient coordinators will respond when they have a free moment. Thank you for your inquiries.

Q:

I am a 23 year old medical student with about 4 years of hair loss history. I have diffuse thinning with very aggressive frontal hairline loss. I would be looking to do 2-3 procedures at 2000 grafts each FUE style from my beard and chest area. But my body hair and beard hair seem to be just fine. I have had all of my bloodwork done to rule out any systemic problems thats causing this odd pattern diffuse hairloss (autoimmune alopecia is also ruled out by 3 dermatologists).

A:

Before proceeding with a hair restoration surgery, we have to properly determine your type of hair loss and candidacy for a hair transplant based on your history and diffuse hair loss.  Many people who have diffuse hair loss including the hair on the sides and back of their scalp may have a condition called Diffuse Unpatterned Alopecia (DUPA).  This condition can be mistaken with hair loss as a result of other systemic medical conditions like iron deficiency or possibly due to thyroid or other hormonal imbalances.  Body hair transplants through FUE harvesting techniques can be considered for those patients who do not have the option of scalp to scalp hair transplant, but it certainly comes as the last option considering the very short growth phase in hair cycle for body hair as opposed to scalp hair. Beard hair may be a better option in some patients, but all individual options need to be considered after a complete evaluation of patient’s supply and demand of hair.

* More information on body hair transplants and its results in contrast to that of scalp hair transplants, please visit Hair Restoration Blog.

Today, many medical specialties are using new technology that involves robots for completing procedures.  Robots can help to minimize human error or increase the speed of procedures.  In hair transplantation, one of the most meticulous procedures in the surgical field, many stages need to be done microscopically using trained and highly specialized surgical technicians for the best results.

The FUE (Follicular Unit Extraction) procedure is one of the newer techniques of harvesting hair.  FUE can help surgeons to avoid leaving a linear scar on the donor area of patients after a hair transplant.  FUE transplantation has been gaining popularity in the last few years, but it is limited in terms of the quality of grafts and the number of follicular units that are able to be harvested in one session.

The reason for these limitations are due to the fact that FUE procedures require very extended labor hours as well as the need of the surgeon and surgical team to constantly work on removing follicular units using high magnification devices.  Due to the above requirements and our standards of quality, we recognize that staying in the same position for long periods may cause fatigue in the surgical team and is a limiting factor in the number of grafts that are able to be harvested in one session.

Robotic surgery seems to be a perfect solution in which machines can do the tedious hard work in removing the follicular units in FUE sessions.  Robots can also miraculously be used for placing the removed follicular units in the recipient areas.  There have been many advanced methods of automated hair restoration procedures developed in the last few years.  There is no doubting that many of the currently available automated techniques will lead to the advanced development of a perfect robotic system to harvest and transplant hair grafts in the near future.

Restoration Robotics is one of the companies who have pioneered robotic hair restoration procedures.  The current machine used is a computer guided system that allows a surgeon to remove FUE grafts with high accuracy and a reasonable speed.  The system still needs to be equipped to a transplanter in the future but even now, it could be considered a great device in the field of hair restoration.  We will follow the advances in the field of robotic hair restoration closely and keep our viewers posted with other techniques or devices that become available in the future.

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.

Hair Care Beverly Hills interview with Dr. Parsa Mohebi

Below is the second interview of Hair Care Beverly Hills with Dr. Parsa Mohebi.  Dr. Mohebi is the medical director of US Hair Restoration hair transplant centers in Southern California with offices in Encino, Beverly Hills, Orange County and San Diego.  Dr. Mohebi is the author of Hair Restoration Blog.  He also responds to the questions of many other resources of hair loss and hair restoration.  Her is his recent interview of him by Hair Care Beverly Hills for BuzyMoms.com.

• If a client has already had a transplant with another hair transplant doctor and is disappointed with the hair restoration results, can the procedure be redone?

Yes, hair transplant repairs are a good portion of our hair transplant surgeries performed in our Southern California offices (located in Beverly Hills, Encino and Orange County). Many people may have unnatural results from previous hair transplants due to the older techniques such as plug surgery, but some may even have problems with recent hair restoration procedures due to technical issues or lack of proper judgment on the part of the hair transplant surgeon. In most situations, the repair is easy and can be done in one or two sessions.

• Is there a minimum age for hair transplant surgery?

It was not unusual that a Hair transplant surgeon discourage a person younger than 24 for a hair restoration surgery.  However, nowadays microscopic techniques being used to evaluate the miniaturization of susceptible hair can assist surgeons in predicting the final pattern of hair loss. By being able to predict each patient’ s final balding stages, we are able to see where the pattern of baldness is heading and based on that recommend hair transplant surgery at an earlier age.

• Won’ t my bare scalp be showing in the back of my head once the donor hair is taken?

If you do not plan on shaving your hair after your hair transplant surgery, your donor wound will never be visible. However, if you plan on shaving your head for any reason, you may choose to have a FUE or Follicular Unit Extraction procedure done rather than the general FUT procedure through removing a strip from the donor area. FUE transplant eliminates the visibility of a linear scar on the back of your head and is the best option for patients who plan on shaving their head or keeping their hair very short in the future.

• Do you provide free consultations?

Yes, the initial consultation with me (Dr. Parsa Mohebi) is always free in any of our Southern California hair transplant offices in Beverly Hills, Encino and Orange County and San Diego.

• What type of information should be brought to the consultation?

Anything related to your hair loss and hair restoration, including family history of hair loss, other medical conditions that may have been attributed to ones hair loss, medical, surgical or even cosmetic changes that you like and may help you have a better result after a hair restoration procedure.

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.