FUT vs. FUE: Which one is best for you?

bald businessman with his head on scalp view from behind with white background

If you are like most men who are ready for a hair transplant, then inevitably the question comes up: Which type of surgery is better for me? This dilemma is not a decision to be glossed over as there are essential individual factors which can make a substantial difference in tipping the scales towards one versus the other. You must educate yourself on both the pros and cons of each procedure and talk to a skilled hair transplant surgeon with experience in both techniques in order to make an informed decision on which is best for you to have the best outcome.

What is FUT?

FUT stands for Follicular Unit Transplantation and involves surgically removing a strip of skin from the back of the scalp. The skin edges are closed with sutures or staples leaving a thin horizontal scar which can be concealed by wearing the hair at a reasonable length in the back. Pre-operatively hair is typically left long in the back so that the sutures or staples won’t be visible after surgery. The current gold standard of FUT surgery would then involve cutting up the strip of skin under microscopes into individual follicular units of between 1-3 hairs each. These grafts would then be placed one by one into small incisions made in the recipient area.

What is FUE?

FUE stands for Follicular Unit Excision (formerly extraction) and involves harvesting individual follicular units/grafts from the scalp using punches. Punches come in many shapes and sizes. Some are handheld and manual, others are handheld and motorized, and others are robotic. It is important to note that they all involve cutting the skin and will all leave scars, despite some misleading advertising claims. The scar formed by FUE is different than that of FUT. FUE will leave numerous small circular scars instead of a linear scar. Traditionally the preparation of the scalp for FUE involves shaving the hair very short though certain physicians are utilizing long hair FUE. Once the grafts are excised from the skin, they are then placed one by one into small incisions made in the recipient area.

Additional Factors to Consider

How old are you? Remember that balding is progressive! If you are in your 20’s and have a hair transplant, then you can almost guarantee the need for another surgery in the future. Preserving the donor area is very important in a young man’s case. Overharvesting of the donor area with FUE can be an issue. If you take too much, the back of the scalp may thin out considerably leaving a moth-eaten look. Donor management with FUT is a different calculation. Often FUT as an initial surgery may be advisable if total lifetime graft needs will be significant and multiple surgeries will be needed. As individuals age, it’s easier to predict the extent of balding that you will have which makes for a more precise calculation of the number of donor grafts needed long term. With this knowledge, it’s easier to decide between FUE and FUT, or in some cases how to time the combination of both methods.

How bald are you? This question is essential. A man who is low on the Norwood scale, i.e. not too bald, and not likely to until considerably into the future, has many good options. A man with advanced baldness, i.e. Norwood class v-vii will require a lot of hair. There is only so much donor hair from the back of the scalp to go around! Let’s talk for a moment about the Safe Donor Area. For reasons not fully understood, there is hair on virtually everyone’s scalp that is resistant to the balding process and is likely to grow for the rest of your life. These hairs generally reside in a narrow segment around the sides and back of the head. Harvesting from this safe donor region means the transplanted hairs will likely grow forever. Large FUE sessions invariably involve harvesting hair from outside of that safe donor area. Again, for advanced baldness, to maximize the number of grafts available you may need a combination of FUT and FUE spaced out over the years and may even need to consider donor body hair.

What is your future hairstyle going to be? With a hair transplant, sometimes compromises have to be made. Are you ok with having the hair a little longer in the back? Then you could be a candidate for FUT. Are you going to wear your hair very short? Then you could be a candidate for FUE.

The Pros and Cons

FUE has its advantages for those who want a very short hairstyle in the back; this is because the small circular scars produced by FUE (if not overharvested) will be less noticeable to the eye than a linear scar produced by FUT when the hair is very short. FUE also does not involve any sutures or staples that must be removed in the days following surgery. Though it is in many ways just as invasive as the FUT procedure, because the skin is not tightened, some report less discomfort the night after the surgery.

FUE disadvantages include a higher transection rate meaning hair is damaged and must be discarded, wasting those potential donor grafts. FUE necessitates smaller session sizes and overall less capacity for harvesting safe donor hair from the scalp. Hair is likely to be taken from higher risk areas of the scalp, so your transplant may not be permanent. Costs may be higher. Most likely you will need to shave the entire scalp for FUE.

FUT has advantages in that we can harvest more safe donor hair. The grafts are better quality with less risk of damage when manipulating them. The transection rate is very low, so very few grafts will be discarded. The hair can be kept long in the back concealing the suture line leaving no noticeable evidence of the hair restoration surgery.

FUT disadvantages are that the hair has to be worn at least a centimetre or two in length in the back to cover up the linear scar formed after surgery. FUT also involves stitches or staples that will need to be removed. Sometimes patients report some discomfort initially due to increased tightness in the back of the scalp.

Prime Hair Clinic offers services to help you get back on track. Our world-class surgical techniques set us apart and our honest, caring, and experienced staff can help you look and feel your best. For all hair restoration services including PRP therapy, scalp micropigmentation, surgical hair transplants as well as medical aesthetic procedures such as Botox and dermaplaning, trust Prime Hair Clinic. Contact us by phone at (403) 259-6798 or by email at [email protected]

 

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