The basis of a hair transplant is moving healthy hair from what’s called a “donor” area of the scalp and transplanting that hair into another area of the scalp that has permanently lost hair.
Follicular unit extraction (FUE) and single strip harvesting are both ways of extracting (or “harvesting”) follicular units from a donor area of the scalp. These two methods form the basis of “follicular unit transplantation.”
But which is better? Let’s first look more closely at what is follicular unit transplantation.
In the “old days,” i.e., before the early 1990’s, the basis of hair transplants were large skin grafts from the scalp that contained up to 12 to 30 hairs. But grafts of this size resulted in the “pluggy,” patchy unnatural look. Today’s advanced hair transplant techniques rely on harvesting just a few hairs (1-3) at a time from a donor area (called a mirograft). This allows for greater control and precision in the hair transplant operation.
Micrografts typically contained a single follicular unit, and this allowed surgeons to preserve, in the transplanted area, natural anatomical groupings of hair follicles from the donor area. Micrografts, combined with the ability to harvest successfully 1000s of them in one surgical session, paved the way for the natural look hair transplant, which is so common today.
Follicular Unit Extraction vs. Single Strip Harvesting: Which is Better for Hair transplants?
Single strip harvesting is essentially a two-step process of harvesting. First, the surgeon removes a single strip of scalp, and then he or she uses microscopic surgical techniques to dissect and extract individual follicular units. The surgeon must take great care and have great skill, training and a lot of experience to avoid damaging the individual follicular units.
Follicular unit extraction, on the other hand, extracts the follicular units directly from the donor area.
Both techniques of follicular unit extraction produce excellent results.
Follicular unit extraction, however, is less surgically invasive than single strip harvesting. On the other hand, FUE tends to be a much more labor and time intensive process than strip harvesting and therefore more costly
The big advantage of single strip harvesting over FUE is that it can produce the same natural looking hair transplant outcomes as FUE but in less time and at less cost. But single strip harvesting, unlike FUE, will leave a noticeable linear scar in the donor area if the patient wants or needs the hair cut short in that area. FUE is usually undertaken if the patient does not want to have a scar or if a patient’s natural hairstyle involves a very short (buzz) cut in the donor area which would cause the tiny scar from the strip harvesting to be visible.
If FUE has an outcome advantage over single strip harvesting, it is due to new FUE supporting technologies that result in better quality dissected follicular units.
One of the reasons for developing new FUE supporting technologies is that FUE is seriously labor intensive. This increases both the cost and the time compared to strip harvesting. The goal of these new technologies is to make FUE less costly and labor intensive without sacrificing current quality.
The bottom line is that the considerations of which method to use have more to do with cost, whether or not its permissible to have a scar, and certain scalp characteristics that are contraindicated for one of the methods rather than which procedure produces a better outcome. In terms of natural looking hair transplant outcomes — both produce excellent results. Only your doctor, after a thorough examination, can tell you which procedure might be better for you.
© 2012, John Frank, M.D.
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