Comparison between FUT and FUE
Most recent online information indicates more favor of FUE technique over FUT. But in fact, both techniques have pros and cons. As the hair restoration surgeon, we recommend you to study both side effects from the 2 techniques. Our team is capable to do both techniques fluently, therefore, we have no tendency to be bias on one specific technique. And as the price between 2 techniques is the same, so we cut off the different cost issue. Then the patient should select the best method that match to his or her condition.
The adverse effect or limitations of FUE
1. The shaving of donor area is required.
For the best outcome, we need to shave the donor area for we can harvest the hair graft at best quality. Even we can do the non-shaven FUE [ selective FUE] but actually, the shaving of donor area would give us best vision and to distribute the holes from harvesting evenly. This will bring us best FUE scar outcome. The limitation of being shaved is you might have to cover up the shaven head for 2 weeks. The recovery from FUE is faster because it is less pain than FUT, but, to get back in public may be later than FUT because of this reason.
2. The zone that is used for FUE harvesting may expand beyond the most permanent hair. For FUT, we cut the hair bearing skin where the follicles are long life expectancy, while the FUE graft may come from the outer zone and may not last as long as the follicles from the center.
3. For aggressive harvesting [ eg; high number of graft] , the donor site began to thin out. At some point, the donor is too thin. And by cluster of punch holes from FUE, the remaining follicles may be more affected. FUE may destroy more existing follicles that FUT in the end.
4. Pain from FUE may be less than FUT, but, you may experience the late pain instead. At 2-3 weeks after FUE, there are some reports of late tingling pain at the donor area. It usually occur at night and described as needles poking or itching. We believe that this is from nerves ending. However, this late pain only last 2-3 weeks and completely disappear. During the episode, you may be annoying.
5. Folliculitis. We found the incidence of folliculitis in both recipient and the donor area. It usually happen 1 month after surgery. For FUT, it happen only the recipient site while FUE can show this symptom both recipient and donor area.The treatment is supportive. It usually temporary and self clear once the hair grow fully.
6. FUE procedure is to scoop out the follicles one by one. The raw surface created by FUE, if calculate a summation may equal to full thickness burn. Too aggressive or too many number in one session may introduce large raw surface area. And that lead to extensive damage to donor site. We do not recommend large session, for example; the number beyond 4000 grafts is quite risky. The optimal amount of graft in one session should be calculated and discussed with your physician carefully. The universal acceptance of safe number in one time is 2500-3500 grafts.
[Depend on the density and size of the donor area.]
The photos down here shows the aggressive harvesting from other clinic that destroy the donor area permanently.
7. The limitation of FUE is the number of graft available in one session. FUT may give the better donor survival while giving large amount of graft in one time. FUT may give 5,000-6,000 grafts in one setting without damage to the donor site. Therefore, the one who have advance stage hair loss [ Class 6-7] is more compatible with FUT that FUE.
It is easily said that FUE is optimal to early stage hair loss while advance stage is likely to have better outcome from FUT.
Adverse effect or limitation from FUT
The FUT or strip harvesting is still a standard method in hair transplantation. Even it is now not popular because of medias favor to FUE side. In fact, it is a universal standard. Any doctor who qualified ABHRS [American Board of Hair Restoration Surgery] must be capable to do FUT or strip technique. Somehow, we need to discuss both good and bad from FUE and FUT.
1. Scar formation. Of Course that scar from FUT is long and narrow strip crossing behind the back of donor area. The scar will limit you from wearing real short hair. a few cases may report of hypertrophic scar formation. However, with good skill surgeon and optimal donor selection, the scar is almost as thin as pencil line. With ,Trichophytic donor closure,the scar from FUT can even be obscured nicely.
2. Pain after surgery is more with FUT. The pain score from FUE is averagely at 0-1 from 10 while FUT is 4-5 from 10. The pain is only on the donor area while the recipient is no pain at all. The pain usually last 2-3 days and can be suppressed by common pain pills [ Paracetamol] or Tramadol. Once we remove the stitches, the pain is almost free then. The good anesthetics during the procedure is also the helpful key. We use tumescent anesthetics which can effectively help relief the after pain.
3. For the one who have tough or stony hard scalp, FUT is not a good option. If there is nor skin elasticity, the cut of strip is not possible. So FUE is better option for the one with hard scalp.
4. The grey or white hair. This is quite skeptic, for some instance, the people with grey hair is better going with FUE than FUT. The follicles that grey is really hard to see under microscopes. So, the isolation of white hair follicle is hard because with FUT, we need to see it clear to separate each follicular unit under microscopes. Contraly by doing FUE, we scoop out the follicle by using the feeling, not vision, so FUE may be better in white hair. However, the best answer to the people with white hair is up to when we meet in person. Doctor will thoroughly check and discuss about the best method according to individual hair and skin character.
5. The limitation of FUT is the skill requirement of the surgeon and his or her team. If the doctor does not have a surgical skill as a background, one cannot do FUT with good result. The hair surgeons around the world in current dates favor FUE than FUT because the skill between 2 techniques is different. The one who initial start his/her practice with FUT can adapt the FUE faster. While the one who start practice with FUE usually do not favor to do FUT. However, it does not mean that plastic surgeon or general surgeon would do FUE better. It takes a long road to earn the skill in both FUT and FUE.