FUT-vs-FUE

[Dav7]

Just wondering if anybody could provide a brief summary of the advantages and disadvantages of both. Also which surgery would you go with for your own HT, and why?

[Dan26]

Just wondering if anybody could provide a brief summary of the advantages and disadvantages of both. Also which surgery would you go with for your own HT, and why?

FUT does not exist....eliminate this thought from your head!

Yes there are advantages but at this point and time it would be sheer and utter buffoonery to go with an FUT.

Dav7 describe your hairloss man, IMO there are only a very few select cases in which FUT is acceptable nowadays. I will explain once I know your situation.

[Dav7]

Dav7 describe your hairloss man, IMO there are only a very few select cases in which FUT is acceptable nowadays. I will explain once I know your situation.

I am a 27 year old male nearing a NW3 hairline. I realise that FUE is supposedly scar less, however I've also heard that FUT has a much better yield than FUE, so I'm at a loss here as to which choice I should make.

[drybone]

FUT does not exist....eliminate this thought from your head!

Yes there are advantages but at this point and time it would be sheer and utter buffoonery to go with an FUT.

Dav7 describe your hairloss man, IMO there are only a very few select cases in which FUT is acceptable nowadays. I will explain once I know your situation.

I would like to hear the explanation too Dan26. Please list your credentials that allows you to make such an incredible statement such as the above.

[35YrsAfter]

Just wondering if anybody could provide a brief summary of the advantages and disadvantages of both. Also which surgery would you go with for your own HT, and why?

FUT and FUE are not a consistent product like let's say, a Corvette. You buy one in Alaska or Georgia and it's essentially the same car. What you actually get with either procedure type (FUE/Strip) depends heavily on physician skill, donor characteristics and the technology used. Working at Dr. Cole's office, I see a little bit of everything. Unnatural looking recipient areas rank worst in my opinion. Next on the ugly scale is a widened strip scar. There is a debate raging in another forum where an ARTAS Robot donor was posted immediately post-op. It appears that a huge punch was used and I think that result gives FUE a poor representation.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
I am not a doctor and the content of my posts are my opinions, not medical advice.
Please feel free to call or email me with any questions. Ask for Chuck

[topcat]

Assuming one is dealing with someone that is competent in each procedure and not including the whole list of pros and cons of each I would say FUE has an advantage for a first time patient. The reason being is that you can opt for the smallest procedure possible even if it does not result in much of a cosmetic difference. The advantage is gaining an understanding of what you are getting into without having to rely on others and wondering if they are being truthful with you while also giving you the advantage of being able to walk away and not continue if you choose with very little damage if any being done.

The ht industry can almost be described as a room. In that room a big party could be going on with lots of friendly people and if you decide to go in you could have memories that last a life time. But that room could also be a very dark foreboding place with many unsavory characters. It’s much safer to peek into the window and see if you really want to go inside and to me that is what a small session of fue represents.

[greatjob!]

Basically at this point until donor regeneration is a proven consistent reality it comes down to a few patient characteristics.

If you have advanced loss good laxity, average/poor donor density and favorable scarring properties, strip or no procedure is probably your best option. Other situations will lead to fue being your best option.

I won't go into all of the other scenarios because to be honest I don't want to put the effort in, but you can understand that there are a few variables that should be considered when choosing between strip and fue. Namely donor density, scalp laxity, level of loss, possible future loss, history of scarring, ect.

[35YrsAfter]

Basically at this point until donor regeneration is a proven consistent reality it comes down to a few patient characteristics.

If you have advanced loss good laxity, average/poor donor density and favorable scarring properties, strip or no procedure is probably your best option. Other situations will lead to fue being your best option.

I won't go into all of the other scenarios because to be honest I don't want to put the effort in, but you can understand that there are a few variables that should be considered when choosing between strip and fue. Namely donor density, scalp laxity, level of loss, possible future loss, history of scarring, ect.

There are some good candidates for strip surgery. One such candidate is a former co-worker of mine. At 62 years of age, he still had mostly thick black donor hair with a very long stretch of similar caliber donor hair in the back. He was thin and receded in the front and had a bald spot in the back about 8cm in diameter. He didn't care about his hair loss, but if he did, he could have been a reasonably good candidate.

A common but overlooked problem with strip surgery besides scars that widen, is the marrying of dissimilar hair. Notice the image below. By cutting out a strip, the natural hair caliber gradation and hair direction is abruptly terminated. Notice that this is one of the better strip scars. This particular patient can not wear a short haircut because of these two issues.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1045 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
I am not a doctor and the content of my posts are my opinions, not medical advice.
Please feel free to call or email me with any questions. Ask for Chuck

[John P. Cole, MD]

You know what I like? I like that we are discussing something we never used to discuss before without a huge volume of negative information about FUE. In 2002 a handful of doctors began to do FUE on a regular basis. These included Rob Jones, Alan Feller, and John Cole. Now, i'm not going to mention Ray Woods only because he was the originator of the FUE movement and he'd been at it for a long time prior to 2002. In 2003 only Ray Woods and John Cole focused primarily on FUE. That pretty much left Ray Woods and John Cole to promote the FUE movement. Today, FUE prevails over FUT only because these two guys along with their converts refused to back down to all of the pressure to proved strip surgery. Now let us not forget the help out of Asia and Europe. The help is the USA was scant. They were the last to figure it out.

Anyway, how to you promote FUT? Strip scar! Unknown strip scar width! Limitations on hair style due to the strip scar. Similar yield to FUE Worse potential donor area. Fewer potential grafts over time due to the strip scar.

And with FUE? Better aesthetic result with FUE. A larger number of potential grafts because we don't need to conceal the strip scar. Equivalent yield if not better because time out of body is less. More hair per graft since you can cherry pick them. No strip scar, HAH! The doctor cuts the graft rather than the assistant.

[topcat]

Something else to consider is that the industry has not been regulated. If it had the outcome might have been quite different as market demand would not be helping to determine the direction. Heaven help us if those with the deepest pockets would have been making the rules.

Too much regulation gives us something equivalent to chemotherapy and radiation when in fact there could very well be something much better available we just don’t get the choice.

[baldymcgee]

You know what I like? I like that we are discussing something we never used to discuss before without a huge volume of negative information about FUE. In 2002 a handful of doctors began to do FUE on a regular basis. These included Rob Jones, Alan Feller, and John Cole. Now, i'm not going to mention Ray Woods only because he was the originator of the FUE movement and he'd been at it for a long time prior to 2002. In 2003 only Ray Woods and John Cole focused primarily on FUE. That pretty much left Ray Woods and John Cole to promote the FUE movement. Today, FUE prevails over FUT only because these two guys along with their converts refused to back down to all of the pressure to proved strip surgery. Now let us not forget the help out of Asia and Europe. The help is the USA was scant. They were the last to figure it out.

Anyway, how to you promote FUT? Strip scar! Unknown strip scar width! Limitations on hair style due to the strip scar. Similar yield to FUE Worse potential donor area. Fewer potential grafts over time due to the strip scar.

And with FUE? Better aesthetic result with FUE. A larger number of potential grafts because we don't need to conceal the strip scar. Equivalent yield if not better because time out of body is less. More hair per graft since you can cherry pick them. No strip scar, HAH! The doctor cuts the graft rather than the assistant.

I think the *biggest* advantage of strip is the price. Strip tends to cost about half as much as FUE and, for all strip's disadvantages, it will be the "default" choice people make for some time to come.

Speaking for myself, needing something like 4,000 grafts, I would probably have had 2 HTs by now if I could find a trustworthy (that is ISHRS approved) physician who could do FUE for something close to the cost of FUT.