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FUE vs FUT: Differences, Pros and Cons

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The hair transplant field is dominated by two main techniques: Follicular Unit Transplant (FUT) and Follicular Unit Excision (FUE).

The industry consensus is that FUT is a more time-tested and reliable procedure for harvesting healthy hair, but FUE methods have been brought up to speed in the past several years as a quality alternative with a few distinct advantages.

In this article, we’ll be examining the differences between these popular methods, and comparing the pros and cons of each one.

Key Differences

Before we dive into the differences between these two methods, keep in mind that FUT and FUE are ways by which surgeons harvest hair from the donor area, usually from the back of the head or along the sides of the crown.

Follicles in these locations are chosen because they are generally the densest and strong hairs on the human head, even in cases of severe hairline and crown balding.

FUT is the traditional method used to harvest hair, in which a thin, horizontal strip of tissue is removed from the back of the head with a precise incision. 

This technique allows surgeons to harvest thousands of follicles from an area one time, giving them a huge array of eligible follicles that they can then dissect, treat, and graft to the target areas of the scalp.

Clinics may use a range of unique instruments and structure their surgeries with the help of various staff members, but the overall process is more or less as follows:

  • Surgeons identify a dense, hair-bearing strip of skin on the donor area.
  • A long, horizontal incision is made along the area, separating the skin from the tissue beneath and isolating the targeted strip of skin.
  • The strip is fully removed and placed in a designated staging area, where team members will “sliver” individual follicle units one at a time.
  • Follicles are dissected under high powered stereo microscopes with precise instruments, with the aim of minimizing damage to the units.
  • Units are then individually grafted to the target recipient areas on the scalp, usually along the hairline, around the temples, and at the vertex.

FUT is also known as the “strip surgery” technique, which characterizes the main difference from FUE. The terms FUT and FUSS are used interchangeably in the industry to describe the same method of harvesting.

Many surgeons are more comfortable and confident in performing this technique, and it grants them the ability to secure strong, durable follicles with plenty of healthy hair.

FUE takes a slightly more deliberate and targeted approach to follicle extraction. Here is how the process typically goes:

  • Surgeons scan the donor area for the strongest, densest hairs available, then use a precision punch tool to remove follicle units individually.
  • These units are then examined under a microscope by team members who select the best ones and prepare them for implantation.
  • Just like with FUT, the units are grafted into the target area one by one, with tiny incisions that are allowed to heal around the new follicles.

Once again, FUT and FUE are both methods of extraction. Once the follicle harvesting process is complete, the remainder of the surgery is virtually indistinguishable.

Advantages of FUT

As mentioned, FUT is the tried-and-true harvesting technique for most clinics, and it comes with a few advantages that make it the more common and relied-upon method.

The first advantage comes from the sheer quantity of follicles that can be harvested in a single strip of densely populated skin. With only one strip, surgeons have access to thousands of quality follicle units, and they can be more selective with the ones they choose to transplant.

Unfortunately, FUE does not grant surgeons the same quantity or quality of follicles to work with, and is therefore slightly less reliable in terms of providing lasting results. FUT is known for its low transection rate, meaning the grafts are more likely to grow long and strong in their new locations, offering more coverage and permanence.

Doctors practicing FUT can also leverage the power of a bigger team of surgical professionals during the procedure since the harvested strip can be worked on by several people at a time. In some clinics, a team of four or five assistants can work alongside a leading surgeon to quickly dissect and prepare units for grafting. 

For this reason, it is far more efficient to perform “megasession” transplant procedures using FUT, and some clinics have posted impressive numbers ranging over 4,000 grafts per session. The same cannot be said for FUE.

Clients are not required to shave their heads before FUT surgery, and the cost is typically lower than other procedures. It may also be easier to find a board-certified surgeon willing to perform FUT surgery since FUE is still a relatively new method in many parts of the world. 

Advantages of FUE

While FUT may be the old-school classic hair transplant technique, there are a few key areas in which FUE has the edge.

The first and most prominent upside to FUE surgery is the fact that clients will walk away from the procedure with no horizontal scar on the back of their heads, which is an unfortunate hallmark feature of strip surgery techniques. 

Since follicles are extracted individually from the back of the head during FUE, surgeons can space out their incisions and prevent major clusters of scars. The most experienced hair restoration doctors can effectively harvest strong follicles from the donor area without leaving much of a mark at all, allowing patients to wear their hair closely shaven in modern styles.

With minimal scarring in the donor area, clients will also have an easier time recovering from the hair transplant process as they navigate aftercare in the weeks following surgery.

Unfortunately, the horizontal scar resulting from FUT can be somewhat painful and be a limiting factor during the recovery stage, not to mention the aesthetics of the scar tissue.

While there may be some small, circular scars that result from FUE, they are thought to be far less noticeable than the long, raised scar from the FUT strip.

A final advantage of FUE is that it can be performed following a previous FUT procedure in order to “top up” hair that may have thinned or fallen out in the years after the original surgery. Surgeons may recommend FUE to patients who do not require many grafts to achieve their desired look, making it a more supplementary surgery in many situations.

Surgery Success Factors

Now that we’ve compared the pros and cons of FUT and FUE, it’s important to mention a few important success factors when undergoing and recovering from hair transplant surgery of any kind. 

Whether you choose strip surgery or FUE, it is crucial that you communicate with your surgeon during the consultation stage to set expectations, clarify your desired goals, and be open to taking alternative paths towards achieving them.

With so much information freely available online, too many people have the tendency to self-diagnose and try to determine for themselves what the best course of action may be. In reality, only a certified cosmetic surgeon or hair restoration specialist will have the knowledge and experience to lay out a long-term game plan to combat hair loss.

For instance, many clients may be dead-set on having FUE surgery to restore their hairline and completely cover the balding on the crown of the head. In most cases, this is simply not a realistic outcome for this surgery type, and doctors should provide viable alternatives with a sufficient explanation as to why.

Alternatively, a client could be impressed with the success rates of FUT and request this procedure without knowing about the possibility of FUE. They may only need 1,000 or 2,000 grafts to achieve their desired look, and FUT might not be entirely necessary.

Surgery is also not the be-all-end-all solution in the world of hair restoration, and doctors must provide clients with a well-rounded regimen that combats hair loss from every angle.

This may include natural remedies like oils and scalp massages, prescription medications like Finasteride and Minoxidil, or alternative therapies like laser or red light. 

The lesson here is that your chosen clinic and doctor are often far more vital to a successful surgery than simply picking between FUE and FUT, so do your research and select your team carefully.

Conclusion

Both FUT and FUE can deliver transformative results for patients seeking a more permanent and reliable solution to hair loss. 

You now know the basic pros and cons of each procedure, and have an idea of what to expect at your first consultation. Remember to ask questions, look at all your options, and trust the guidance of your chosen hair loss professional as you embark on this journey. 

Sources:

https://fellermedical.com/fue-vs-fut-hair-transplant-surgery

https://www.themaitlandclinic.com/difference-between-fue-fut-transplants/