Follicular Unit Transplantation (Strip FUT)​​​​​​​​​​​

Strip FUT entails removing a strip of your donor hairs from the scalp and closing the area using absorbable and non-absorbable stitches.  The non-absorbable stitches are removed 5-7 days after surgery.  Pain or discomfort is mostly felt at the night of surgery and considerably less until it disappears within a few days. This technique generally leaves behind a white almost undetectable scar several months later.  Wearing your hair long enough to cover the area helps cover the scar and the transplanted area.  You can go back to work after a few days without having people notice you had surgery.  Complications are minor and are manageable. This technique remains to be the gold standard treatment in hair transplantation.  Growth rate of the transplanted grafts is above 90%.  The donor hairs are taken from the “safe zone” or from the area that is not affected by the hormone Dihyrotestosterone (DHT) that causes Male pattern hair loss (MPHL).  The procedure lasts from 6-8+ hours depending on the number of grafts to be transplanted.

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Strip FUT using the Refined Open Technique in Donor Harvesting​

FUE can be done manually, using a motorized hand-held punch, or most recently via robotics.  Only a handful of hair surgeons are adept at doing manual technique especially with the advent of the motorized punches and the robotics. Motorized punches can either be dull or sharp, with the dull punches found to be less traumatizing to the grafts and posing less risk of transection (cutting the grafts).  The hair grafts are punched and extracted individually.  Stitches are not necessary.  The grafts may have less surrounding tissue protecting the bulb (root of the hair) though survival rates still vary from surgeon to surgeon and with debatable results.  In the hands of trained surgeons and his/her team, survival should be expected to be highly satisfactory and may even be comparable to the Strip FUT.  We will need to shave the entire donor area for surgery to be able to spread out the extracted punches and these shaved hairs will regrow quickly enough with the punches also healing as fast (within 3-7 days).  This technique leaves behind multiple circular 1mm white scars diffusely scattered throughout the scalp, which can easily be covered even with shorter hair.  Complications are less compared with Strip FUT.  FUE has become the more popular choice especially among those who prefer less downtime, less pain/discomfort, are wary of cuts and stitches, and do not mind shaving.  Wearing caps, hats, or bandanas can help camouflage the signs of having the procedure.  This lasts 6-10+ hours depending on the number of grafts to be transplanted.

 

Follicular Unit Extraction (FUE)​​​​​​​​​​

FUE can be done manually, using a motorized hand-held punch, or most recently via robotics.  Only a handful of hair surgeons are adept at doing manual technique especially with the advent of the motorized punches and the robotics.  Motorized punches can either be dull or sharp, with the dull punches found to be less traumatizing to the grafts and posing less risk of transection (cutting the grafts).  The hair grafts are punched and extracted individually by the surgeon and his assistant.  Stitches are not necessary.  The grafts may have less surrounding tissue protecting the bulb (root of the hair) though survival rates still vary from surgeon to surgeon and with debatable results.  In the hands of trained surgeons and his/her team, survival should be expected to be highly satisfactory and may even be comparable to the Strip FUT.  We will need to shave the entire donor area for surgery to be able to spread out the extracted punches and these shaved hairs will regrow quickly enough with the punches also healing as fast (within 3-7 days).  This technique leaves behind multiple circular 1mm white scars diffusely scattered throughout the scalp, which can easily be covered even with shorter hair.  Complications are less compared with Strip FUT.  FUE has become the more popular choice especially among those who prefer less downtime, less pain/discomfort, are wary of cuts and stitches, and do not mind shaving.  Wearing caps, hats, or bandanas can help camouflage the signs of having the procedure.  This lasts 6-10+ hours depending on the number of grafts to be transplanted.

 

Combination Strip FUT + FUE​​​​​​​​​​​

Combining these two techniques have been employed for the following:

1.  Initial Strip FUT procedure that requires more grafts and extraction is limited by an already tight scalp

2.  Initial FUE procedure that require more grafts and to avoid going beyond the “safe zone”

3. Acquiring maximum number of grafts in 1 session without regard or preference to the type of scarring