Hair transplantation has become a beacon of hope for all out there who dream of a head full of hair. Both the techniques of FUT and FUE have proven to be equally efficacious in treatment. FUE vs FUT, the question is which to choose.
Technically they differ only in the harvesting of grafts from the donor site.
There is no difference in how grafts are implanted. So the difference is only n one step of hair transplantation. They only differ in terms of the donor area, and the following points.
FUT: Involves single strip method with elliptical excision of donor followed by suturing.
|Shorter operative time||May leave a scar|
|Larger sessions are easier||Longer healing time|
|A repeat FUT/FUE can be done in future||More discomfort|
|Dissection occurs under microscopy|
|Can be followed by FUE if needed but not vise versa|
FUE: Involves extraction of grafts as individual follicular units.
|Minimal recovery time-JUST ONE DAY||More expensive|
|Can sport a short hair style||Long operative period and hence tiring for the patient.|
|Tiny dot like scars over donor areas||Number of grafts extracted per day is limited therefore in extensive baldness may require multiple sessions|
|No requirement of stitches||Once FUE is done, a second FUE/FUT cannot be done in future|
|No need for repeat visit for stitch removal||Shaving / Trimming of the donor -required|
|Shorter healing time||Difficult for larger areas|
Having seen the benefits and limitations of each procedure, now lets take a look at how they fair against each other.
Comparison FUE vs FUT
|Shaving /Trimming of head||not needed||needed|
|Visible scarring with short hair at back||May be present||Tiny dot like scars|
|Pain after the procedure||Minor||None|
|Time required for the procedure||Short||Longer|
|Healing time: donor area||2-3 weeks||Approximately 1 week|
|Healing time: recipient area||Around 2 weeks||10–14 days|
|Amount of time after which patient may return to work||Next day||Usually the next day, BUT SOME DISCMFORT FOR2 WEEKS|
|Transection rate (grafts damaged during extraction)||Varies 1–2%||2-5%|
FUE vs FUT – Which is more successful?
They both are equally effective and efficacious in regrowth and it’s not possible to tell one from another as the technique of implanting the hair follicles at the recipient site are the same for both.
Opting a method also depends on other factors irrespective of the techniques. They are:
- Age of the patient
- Extent of loss of hair over the scalp
- Donor area hair availability
- Attitude of the patient
The surgeon needs to take all facts in to consideration and then decide what is best for the patient. One method does not fit every one. So a patient choose a clinic which can perform all methods.
Things to note:
- In some rare cases when the scalp is very thick or the hairs are fragile, FUE may not be possible and FUT might be inevitable.
- In very large cases, a combination of both methods might be needed to obtain the necessary number of grafts.
- FUT can be repeated very easily. Doing FUT in the first setting leaves another FUT or FUE in the next sitting. With FUE, taking more than 3000 grafts at the same time is risky and the second sitting of FUE may not be possible.
If you have a large area of baldness, there are two options;
- Cover only front up to the highest point of the scalp so that for all social interactions and photographs, you look good from the front. The front would need about 2500-3000 grafts by FUT/FUE to cover roughly the area of the size of the palm (the exact number depends on the quality of donor area which can be determined during personal examination).
- Cover the front as above in the first session; later, if you desire, you can plan the vortex area separately after 6 months. The second session can be FUT or FUE.
How can large hair transplant sessions be done?
Some people wish to cover entire area in one visit; this can be done by a Giga session, which is done by taking hairs by different methods not only from scalp, but also other areas as follows: Large sessions over 4000-8000 grafts can be done as follows:
- FUT 2500-3500 grafts depending on quality of donor hair on back of scalp,
- FUE 2000-3000 grafts depending on quality of donor hair on back of scalp,
- Beard hair 1500 grafts.
Body hair can yield depending on availability. However, this needs stamina and a big budget and therefore is applicable for select patients only.
Please note that this advice is of a general nature. Precise estimation would be possible by personal examination; this advice is given as a guide to help you decide with different options. You may discuss further by emailing on firstname.lastname@example.org or email@example.com.
How to do large sessions of 4500-5000 grafts?
- Session 1: FUT 3000 grafts, followed by 2nd session of FUT after 6 months.
- FUE, 1 session of 2500 grafts from the scalp, and 1500 from the beard.
- FUE, 1500 grafts in the morning, followed by FUT 3500 in the afternoon.
How to do larger sessions over 5000-6000 grafts?
- Two sessions of FUT as above for 5000 grafts, followed by FUE 1500 grafts from the scalp, total 7500 grafts over 6 months.
- Two FUE sessions total about 4000 grafts, 1500 beard grafts and body hair of 2000 grafts.
- FUT 3000 grafts plus FUE scalp 2000 grafts plus 1500 beard grafts plus if necessary, body grafts.
Note: FUE sessions are more expensive than FUT
In our opinion, for Indian situation, for patients with a limited budget, FUT is the best method as it is cheaper, more convenient and gives outstanding results.
Despite this, FUE holds an attraction to many patients who are apprehensive of the FUT method because of “skin being removed”. In such patients, and for those who wish to have short hair, those with adequate financial resources, and limited bald area, FUE can be done, up to about 2000 grafts.
Beyond 2000 grafts, FUT is better- if the patient still wishes to have FUE, FUE will have to be combined with body hair. Body hair in our opinion is inferior to scalp hair and is therefore recommended only when scalp hair is not available.
In our opinion, the real value of these new techniques is that they give more options for the transplant team: The techniques give options for those who have a poor donor and for those who wish to have 3-4-5 sessions. They help us to transplant more grafts; for Eg. By combining FUT, FUE, BHT, it is possible to transplant even beyond 4500 grafts in one session: 2500 by FUT, 1000-1500 by FUE and another 500-750 by BHT, over a period of 3-4 days.
This is particularly applicable for those with large areas of baldness, who wish to complete the surgery in one session, such as those coming from foreign countries. Of course, this would mean a heavy cost, above Rs 3 lakhs.
It should be emphasized that despite all the hype in internet sites, 90% of all hair transplants in the world are done by FUT only. FUE accounts for only 10% of all transplants because of its high cost. This is the case with us also- we have many patients who seek FUE after reading on the internet, and then change their minds to have FUT after knowing full details.
Great things are done by a series of small things brought together.
The decision is best made by answering the following questions:
- Do you have the budget for FUE? If not, go for FUT.
- Are you bothered by a linear scar? If yes, go for FUE.
- Do you want it to be painless? If yes, go for FUE.
- Do you need a large session with more than 2500 grafts? If yes, go for FUT.
- Are you thinking of a second session after? If yes, go for FUT now, and FUE later.
About The Doctor
Dr. Venkataram Mysore was one of the first surgeons to learn this technique in the country. He is an expert in FUT and is one of the most respected Hair Transplant experts in the world. He has edited the first Indian textbook on the subject and is the first and only Indian Dermatologist to be made a fellow of the International Society of Hair Restoration Surgeons.