There are two different hair transplant methodologies, Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE). Hair transplantation involves surgical transplanting of hair follicles from the donor area of the body to the bald area or area with aesthetic surgical through a small incision formed in skin .

We will provide a comprehensive comparison of two popular no-scalpel hair solutions – Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) – by explaining the important differences between each procedure, highlighting their main advantages and disadvantages, as well as several factors that will help you assess which method would work best for your specific needs.

Introduction to Hair Transplantation

Globally, hair loss affects tens of millions of men and women, as it can have many causes, including hereditary factors, hormonal imbalances, stress, medical disorders and ageing. Though medical therapies (drugs such as Minoxidil or Propecia/Finasteride) that have been studied previously can help to slow down the pace of hair loss, they cannot replace lost hair in areas where the scalp is already free of follicles. For patients who are looking for more enduring results, hair transplantation surgery can help achieve this goal by moving healthy and viable hair follicles from one area of the scalp to another hair-thin area or balding area, thus replacing them where they are needed.

What is FUT (Follicular Unit Transplantation)?

FUT, or the strip method, is one of the oldest hair transplant techniques. It involves removing a piece of scalp skin, usually the back of the head, cutting it up into follicular units under a microscope and then implanting them into the recipient area.

Procedure

  1. Preparation: Clean the scalp. Give either local or general anesthesia to numb the donor and recipient areas.
  2. Strip-removal: This technique involves removing a piece of scalp 1-1.5 cm in width, the length of which depends on the quantity of the grafts.
  3. Dissection: The strip is cut into individual follicular units with custom tools using a microscope.
  4. Implantation: Small incisions are made in the recipient zone. The follicular unit are implanted:
  5. Closure: The donor area is sutured or stapled closed, leaving a linear scar.

What is FUE (Follicular Unit Extraction)?

FUE is a more recent and less invasive method of transplantation than FUT: it involves the individual harvesting of follicular units, making it unnecessary to cut out a strip of tissue from the source area. A scalpel isn’t even necessary; instead, what are called punch tools or dermal punches can be used, especially those with holes that allow the hair follicle to be removed without unduly damaging the rest of the tissue.

Procedure

  1. Prior to dissection: Hair and skin are cleaned in the donor and recipient sites, and local anesthesia is injected.
  2. Follicular Unit Extraction: Each follicular unit is removed individually from the donor area via a punch tool that shapes the excision around a single follicular unit. The punch used is less than 1 mm in diameter.
  3. Implantation: and, as with FUT, small incisions are made in the recipient area and the removed follicular units are inserted and planted into these incisions.
  4. Healing: The donor area is left to heal naturally without the need for sutures.

Key Differences Between FUT and FUE

Although FUT and FUE are both excellent options for hair transplant surgery, they are different in several crucial ways, mostly revolving around scarring, healing time, graft quality, and overall cost.

1. Scarring
FUT: The big limitation of FUT, the classic ‘strip harvest’ method, is that it leaves a linear scar at the donor – ie, harvest – site where the strip of scalp containing the donor follicles was removed. This scar can be hidden when there is enough hair and the style is worn long enough that the donor site is not visible.

FUE: FUE leaves small, round scars at every site the follicles were removed, which are a little easier to see, but are much smaller and distributed evenly over the donor area, so if you plan to go with shorter styles on your hair, or if you are concerned about apparent scarring, FUE is probably the way to go.

2. Donor Area Utilization
FUT: FUT gives better utilisation to the donor area. It generally gives more grafts than FUE (10-15 per cent more), as a strip gives much more follicles from small area than the FUE.

FUE: Yield is sometimes lower with FUE, depending on the patient’s type of hair (finer types often are not ideal) and the density of donor hair (patients with low density won’t get much with FUE even if it’s a fine hair type). On the other hand, the donor area can be larger because the grafts can be harvested from multiple locations.

3. Recovery Time
FUT: The healing time is longer following FUT due to the incision in your donor area that must be sewn up with sutures or staples. You can feel pain, tightness, or numbness in the donor area, and you will have to avoid physical activity for at least two weeks following treatment.

FUE has a quicker recovery time than FUT, largely due to the fact that there are no large incisions and sutures. Patients usually return to normal activities more quickly after an FUE procedure, and discomfort is limited.

4. Procedure Length
FUT: A single strip will provide many more grafts than that seen in FUE, and this often means that FUT can be performed more quickly.

FUE is more time-consuming because each follicular unit must be dissected out by hand, as opposed to having an extraction tool strip away an entire strip of tissue from the back of your head. For this reason, large sessions can take longer.

5. Graft Quality
FUT: Because FUT entails removal of a full strip of tissue, the follicular units are typically well-protected during the dissection under the microscope, which can help to create higher-quality grafts with lower risk of damage.

FUE: With FUE, because the extraction is being done with rapid repetitive movements, graft injury is more of a concern (and will clearly be a greater problem if the surgeon lacks proper experience with the procedure). Good surgeons can obtain excellent results with minimal graft damage.

6. Cost
FUT is cheaper than FUE because it takes less time, requires less expensive equipment and fewer staff.

FUE: FUE can be more expensive because of the extra time it takes to do the procedure and also because of the extra equipment that is needed. In the hands of an experienced and skilled surgeon, FUE can be performed in a single session to achieve the same results as can be obtained with a single FUT session.

7. Ideal Candidates
FUT: Good for large number of grafts and best for young patient with long hair and desire the linear scar, i.e., MVC. Also for a younger patient that cuts his hair short, (large top), and MVC is unacceptable.

FUE: FUE is the better option – especially for patients who want their scarring to be invisible and who have small areas of hair loss to address, or who intend to wear their hair very short. It is also better for patients with small, tight scalps that could move or displace during strip excision.

Advantages and Disadvantages of FUT

Advantages

  • More Hair in One Sitting: FUT grafts tend to be bigger, and so FUT can harvest more of them in any one session. This is useful if the recipient has lots of hair loss.
  • Better quality faired grafts: Because the follicles are protected during strip extraction as well as dissection of the grafts, FUT grafts are less likely to be damaged than those harvested with the FUE method.
  • Cost-effective: FUT is typically cheaper than FUE, so this can be an option for those on a budget.
  • Time Efficient for Larger Areas: FUT can cover larger areas of hair loss in one surgery, saving you the need for multiple surgeries.

Disadvantages

  • Linear Scar: The scar will likely be visible with shorter hairstyles.
  • More Time: Recovery takes longer, and patients may experience more discomfort during recovery.
  • Restricted Donor Area: FUT is limited to the donor strip area, so in cases where the scalp’s elasticity is limited, it might not be desirable.

Advantages and Disadvantages of FUE

Advantages

  • Scarring: A transfer to an area with absolutely no scarring would involve more hair loss on the donor site. FUE causes tiny circular scarring that is entirely or partially hidden if a patient shaves their head very short.
  • Getting back in the game faster: Recovery period is much quicker and pain-free (no stitches or staples).
  • Larger Donor Area: FUE can extract hair follicles from a larger area, which might include the body with some patients, which make it useful for those patients who have less donor hair on the scalp.
  • Natural Look: FUE is good for people who wish to avoid the risk of a visible linear scar.

Disadvantages

  • Higher Cost: Because FUE requires a longer procedure time – up to eight times that of FUT – it is often more expensive. The S.H.A.R.P. device at work.
  • lowered graft yield: Recipient sites are punched one at a time and a large punch may not fit through some tight spots on the head, which can reduce the number of grafts that can be extracted in one session. This makes FUE a poor choice for those with a lot of hair loss.
  • Risks: Higher risk of follicle damage as they are being pulled.

Recovery Process: FUT vs. FUE

Once again it touches on the fact that the recovery period is different in the two procedures, but with a different emphasis on the reason for this: The incisions that necessitate the recovery periods are different from each other, and this is also linked to the differences between the two procedures.

FUT Recovery: The donor area will have staples or stitches — removed between 10-14 days post-procedure. The donor area will be tight and sensitive over the first week, so the patient should avoid any strenuous activities – for example, an itch should not become a scratch. Two weeks after the surgery, physical activity should be restricted in order to minimize the chance of further complications. The recipient area will have white fine scabs around the grafts, which should drop off after 1 week or 2.

FUE Recovery: Much quicker and less uncomfortable since no large incision is made. There are no sutures and the tiny holes where the follicular units were harvested will heal within a few days. Patients who had FUE can return to work and light activities within a week, although strenuous activities should be avoided for at least two weeks.

Which Procedure is Best for You?

Your decision between FUT and FUE will depend on your individual hair loss pattern, the number of grafts you’ll need for your hair transplant, your budget, and your preferences regarding scars and post-operative healing time. Here are some things to consider.

Extent of Hair Loss: If you already have a significant amount of hair loss and need a high number of grafts in a single session, FUT might be a better option because it allows you to get more grafts in one session.

Short Hairstyles: A good rule of thumb is that if your hairstyle will be short (most of the time or all of the time), then go with FUE as the potential scarring will be minimal.

Visible Scarring: If your concern is that the scarring would be visible to the casual observer, then FUE is likely the best choice for you.

Donor area: If you had tight scalp or limited donor source, you will have an advantage with FUE since the procedure can be carried out from a larger area.

Budget: FUT is typically more affordable than other methods, especially if you’re doing a big session.

Since FUT and FUE both consistently provide a good cosmetic result, both are good hair transplantation methods, with each having their advantages and disadvantages. FUT is better at providing a high graft yield, and is better for patients with a lot of hair loss. On the other hand, FUE has less noticeable scarring and is better for patients who want to cut their hair in a shorter hairstyle.

However, the choice between FUT and FUE is a decision to be arrived at only after a thorough evaluation by an experienced hair transplant surgeon who will do a comprehensive analysis of your hair-loss pattern, your donor area, and your cosmetic concerns to ensure that you undergo a procedure that provides you with the best possible outcome.

With either FUT or FUE, you get your hair and your life back with a hair transplant – it can restore your confidence and self-esteem like nothing else.