Ok, so what is better FUE or FUT?
I’ve noticed that FUT seems to be a lot cheaper and some sites say that it is actually more consistent and in general seems to give better results, but they also say that it may leave a scar.
05-24-2009, 06:50 AM
Let me begin by stating that if you desire to have surgery but not have a scar, then you are NOT a candidate for ANY surgery.
The myth that FUE is "scarless" surgery is FRAUDULENT and purposefully misleading on the part of several "FUE-only" clinics. When one FUE group tried to advertise that lie in New York I informed the New York state medical board and that group and it's advertisement vaporized instantly. Claiming that surgery is scarless is a blatent violation of law and will result in the revokation of the license of any medical doctor who publicly makes that false claim.
With that said, let's move on.
FUT and FUE are really complimentary forms of HT, not competing methods of which one must make a choice.
If you need a large area covered, then you most likely want to go for FUT because it is the best bang for the buck and gives the most reliable growth yields.
If you absoltuely, positively don't want strip surgery, then FUE is your only alternative.
As our current U.S. president is so (over) fond of saying: "let me be clear", BOTH methods leave scars. FUT will leave a narrow line across the back of your head, whereas FUE will leave little unpigmented dots across the back of your head. The only difference is that the FUE scars are not concentrated together and therefore harder to detect when wearing hair very short.
There is no doubt that FUE procedures are harsher on the grafts than FUT procedures. Because of this the final growth yields tend to be lower for FUE compared to FUT. But BOTH procedures work for the most part.
Here is an animation of an FUE graft being removed using the safest method that I am aware of. We first score down over the graft with a punch-like tool. We then grasp the graft with a forcepts and apply gentle traction. Note the tenting of the remaining tissue at the bottom of the graft as it holds the graft down. Then a tiny needle is inserted to perforate the teathering tissue to allow the graft to come free with minimal traction force instead of just pulling hard to rip the graft free. The hole that is left will seal up on its own and leave a small punctate scar about .9mm to 1mm wide.
Jeffrey Epstein, MD
05-24-2009, 01:57 PM
It has been my experience, over the past year or so as my experience with FUE has dramatically increased- to the point where I am now performing on average 3 to 4 FUE procedures weekly- that FUE has some definite indications, primarily due to the absence of the tell-tale hair transplant scar.
Now, for most individuals who have a strip FUG procedure, this scar is less than 2 mm in width- allowing individuals to cut the hair quite short. However, if the head is shaved, no matter how perfect this scar heals- and no matter even if grafts are subsequently placed into the scar- it will be visible.
This as opposed to FUE, where in my experience, most patients can have essentially an undetectable normal appearing scalp after having as many as 2,400 FUE grafts extracted. Going over this number can, in individuals with great donor density, be done no problem- where as many as 3,500 or so grafts can then be removed from a donor area that contains 20,000 or more follicular units.
So, for whom do I recommend FUE procedures?
1. Patients who are young- typically 24 to 28 or so years old, who may still want to shave their head in the future, but currently are devastated by their hair loss and are seeking to do something about it. In these patients, 1700 to 1800 grafts, placed strategically in the frontal forelock can make a huge difference in appearance- and therefore self-esteem. If in the future they decide not to have any further work done, the transplanted frontal forelock will provide a natural look for life, and there is no detectable donor site scarring. And if more work is in fact desired, these patients can likely have another FUE procedure, or switch over to FUG strip where they know they are never going to shave their head. Because younger patients tend to have a higher incidence of widened scars from strip removal, FUE has a particular advantage.
2. Any patient who cuts his hair very short with a #3 or shorter and is unwilling, if in the case of a slightly widened strip donor site scar that they would be willing to let their hair be a bit longer.
3. Almost any African-American patient, the overwhelming majority who shave their heads and look quite good at that.
4. Patients who have had scarring from prior donor strips who are seeking the maximum number of grafts.
5. Patients who have a donor site scar that they wish to have filled in with grafts.
Of course, there are some other considerations for deciding on FUE vs. FUG/strip, but these are sound guidelines.
Jeffrey Epstein, MD, FACS
Miami and NYC