- December 6, 2016
- Posted by: dr.diaa
- Category: hair restoration
For years, follicular unit transplant (FUT) was the major technique for hair restoration surgeries. But in the last decade, the follicular unit extraction (FUE) became the logical alternative to the old technique of strip harvesting or (FUT). The new technique took much time to gain the public acceptance and to become the main hair transplant strategy of the age. Since a revolution in the field of mechanical devices and powered FUE devices has erupted to develop the technique to its current method. A long discussion and controversy start to spark from this time among the supporters of both techniques. Therefore, a hidden war erupts in the market to advertise for each method and to proof their priority.
The donor area in fut vs fue hair transplant
First, the donor area is that part of the scalp that is located in the back and sides. This area is the source of hair follicles that will be placed on the bald areas to restore the old style of the head. The process of hair restoration is a redistribution of hair on the scalp, not a new hair creation. The donor area if the first place to compare between the two methods. The strip harvesting technique produces a scar in the donor area. The appearance of the scar is a serious concern for both the patient and the physician who aim to restore their hair quickly.
The patients who undergo strip harvesting will suffer some scars in the donor area. It depends on the above hair that will conceal the scars, which will not be evident at all. But one of the consequences of these scars is that they may become wide and cause apparent appearance. The widened scars may cause damage to the follicles around the incision because of the dissection of these follicles or as a result of the widening shape.
A physician’s pre-studied plan of the donor area may diminish the scars and hide them thoroughly. This plan should put limiting of the scars in consideration and to avoid tension of the wound. Some physicians use the trichophytic method to close the wound, which will minimize the scars. This closure method may be helpful in improving the final appearance of the strip harvesting. The trichophytic method will help in camouflaging the incisions and will limit any upcoming stretching in the donor. While, some other physicians prefer the layered closure to minimize the widening of the scar.
The advantages of Fut vs Fue hair transplant in harvesting the donor area
The main advantage of the FUE is that it avoid the linear scar of the FUT. You will notice that all the proponents of FUE advertise for the technique as a scarless procedure, which does not produce cutting. To be fair in the comparison between the two techniques, thorough measurements of the incisions should be noticed.
Especially relevant, a linear wound is one of the disadvantages of FUT. Circular or round mini-scars are involved in the FUE technique. If we measured the length of the scars in both methods, we will discover that it is greater in the FUE than in the FUT.
When we calculate the diameter of the circular scars and multiply the 1 mm punch by the number of grafts in the donor area. We may find an answer. For example, 2000 grafts x 3 mm = 6000 mm = 600 cm. Yet, FUT of 2000 grafts produces nearly a strip width of 25 cm. But, the linear scar of the FUT is much apparent than the circular scars of FUE. Second, the depth of the incisions and scars are points of considerations in the comparison. The linear scar is much deeper than those incisions of the FUE. The incisions are shallow and in the surface of the skin. Rather than the scars that are deeper and they are already into the fat.
Graft Survival in FUT vs FUE
The time that the grafts are to survive is a point of consideration in studying FUE versus FUT. The grafts in FUE have a little tissue around them, so they have short survival period. Pulling on the grafts when removing them makes the tissues around the grafts much little than in the FUT. These grafts are subject to dehydration because of the lack of frequent tissues and it is a major cause of reduced graft survival. If the ends of bulbs are far apart, they will be more subject to trauma. The graft survival depends on the skill of the surgeon and on the technique of preserving the grafts.
Transection is a frequent and has a great chance in FUE than in strip harvesting. It means that when the surgeon pulls on the grafts to get them out, it is a great instance of cutting them horizontally. But in strip harvesting, there another kind of damaging the grafts when transplanting them. This kind of damaging is due to making the incisions in the initial stage on the scalp. These kinds of dissection in the FUT are with lower rates than in the FUT. The grafts picked in the strip harvesting are with much tissues surrounding them, which makes the prone to dehydration decreased.
FUT vs FUE grafts placing
The placement of grafts in both FUT and FUE is not much different, and it depends on the technique of placing. But there is much concern about the fragility of the grafts because of little amount of tissues around the grafts in the FUE method. The concern comes out of the subjectivity of these grafts to dehydration and over manipulation. These instances of graft diminishing are in the manual placement of grafts. But in the machine placement process using the pneumatic pressure, there will be less manipulation.
Grafts may be damaged during the placement stage and then become unable to grow and fail. The well known factors that may affect the growth of the grafts are trauma and dehydration. It should be some kind of experience and skill of the surgeon and also technical expertise to best placing the grafts to produce acceptable results.
Surgeon experience and technical expertise
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The skill of the surgeon is a key factor in both strip harvesting and FUE. The alienation of the punch correctly is one of the most important operations. The process is how to find the correct depth and to adjust the punch thoroughly in the correct direction. While, in the FUE the transection is the primary concern, the dissection is that concern related to FUT. The follicular units are less likely to grow if there is any kind of transection. ِAll the reports of surgeons and physicians pertaining to follicular unit transplant refer to that the rate of transection is much higher in FUE than in FUT. So, it is another controversy in how the strip harvesting surgeons close the wounds. All these pre-suggested procedures may avoid the consequences of FUT, but it does not mean that it will diminish this disadvantage of the technique.
The experience of the surgeon will appear in adjusting the punch correctly. As a result, the wavy and curly hair is that kind of hair that is difficult in placing on the scalp. Some surgeons refer to that strip harvesting is suitable for mostly all kinds. Using the blunt punch may be useful and helpful in placing these hard types of hair.
No doubt that FUE is a boring process because the patient and the surgeon will face some kind of tiredness. The full operation may take more than 6 hours, this will limit the number of grafts. The license of the surgeon is a must when seeking the ability of the surgeon to deal with the tedious sense in the operation.
Harvesting grafts per session
In general, the number of grafts in each session of the operation is a basic factor in choosing the method of transplantation. Strip harvesting has the much ability of harvesting much grafts per session than in the FUE technique. The session in strip harvesting is scoring many grafts that may reach more than 3000 grafts. In the FUE the same happens but with much time and effort. The skill of the surgeon is one of the factors to reach the target of the operation. The experience and the sufficient training are also main factors to determine the number of grafts for every session.
Finally, The patient should choose between the less time and fatigue of the strip harvesting and the less scar and wound of the FUE method.
Transplanting body hair with FUE & FUT
Most scientists refer to that transplanting body hair is much effective with FUE than strip harvesting. In contrast, the FUT can do the operation with permanent scars and wound that will never diminish by time. The FUE will be able to do the operation with much effort and tiredness, but with accurate results and fewer scars. The only disadvantage of transplanting body hair with FUE is that the process will leave some hypopigmented dots in the body donor areas. All surgeons prefer the FUE technique to transplant body hair with fewer scars and mainly to achieve maximum results.
The FUE is perhaps one of the most successful techniques in hair transplant history, and it scores that kind of marvelous results. These results are because of the less pain and the short period of recovery of the patients. The skill of the surgeon will control the depth and width of the scars. If a surgeon cut deeply into the scalp, it will be invasive. And, if the surgeon makes the incisions close to each other,they may appear as a scar like a wound. Much as the strip harvesting, if the hair on the linear scar does not grow as expected. Then the wound will be apparent when the hair above is short.
They are not found that good in the strip harvesting. But the FUT is capable of harvesting many grafts in less time and less effort, but the patient can not forget that pain and the long recovery period post-operation. Infection is also a current and recurring factor in the strip harvesting. It may occur much frequent than in the FUE, because of the linear scar in the donor area. Regardless of any complications related to both techniques, the FUE is a real revolution in the field of hair transplant.