FUE Vs Strip: An Unbiased View Part II

I hope my last blog clarified some of your perceptions regarding transplant procedures. Taking this a step further, I will now discuss remaining features of both FUE and strip to help you choose the procedure that is best for you.

FUE Vs Strip contd....

6. SHAVING

 Strip method is almost always done without shaving of the entire donor area. The existing hair in the donor area can usually hide the stitch line well. The recipient area may be trimmed or shave.

 FUE requires shaving of the donor area. However, if small no. of hair are required, one may shave a strip of hair, harvest from it and use existing hair to cover the donor area. This is usually not the case. Shaving is the price, I feel, one should be ready to pay for all other donor site advantages.

7. BODY HAIR TRANSPLANT:

Strip method can not be used for BHT. Total hair supply is restricted to 4000 to 6000 grafts in Indians who have lower density as compared to caucasians. In patients with advanced stages of baldness (Norwood VI/ VII) where more hair is required, it actually delivers less.

FUE can be used to harvest DHT resistant body hair. In this way an almost unlimited supply of hair is available for transplant. Body hair can be used to cover cosmetically unimportant areas, to increase hair density or to give a peach fuzz hairline.

8. FOLLICULAR TRANSECTION RATE

Strip method probably has lower transection rate compared to FUE since it is done under direct visual control. However, graft preparation and follicle isolation is done by technicians of differing experience and skills. While some may be adept, others may have just started learning. It is not possible for surgeon to evaluate each graft, and so practically speaking graft quality may be inferior.

FUE harvest is almost always done by surgeon (rarely by highly trained technician). He can evaluate each graft before handing them over for implantation. In strip surgery 80% job is done by assistants and 20% by surgeon whereas in case of FUE it is vice versa.

9. HAIR QUALITY:

Strip method has no control over the quality of harvested hair. At a given time 10-15% of hairs on the head are in telogen /  exogen phase. In strip technique, what ever is harvested is grafted, whether it is a good anagen follicle or a poor telogen follicle. Moreover, the exact no. of hair harvested is difficult to tell beforehand, and sometimes the surgeon may harvest more or less than the requisite number.

In FUE only good anagen hair are harvested, because every hair is chosen by transplant surgeon. These hair have more chance of robust growth in post operative phase as compared to poor telogen/ exogen hair. Also, the number of hair harvested is exactly the same as no. of hair required.

10. COST AND TIME:

Strip method is relatively faster and cheaper.

FUE usually requires more time. An average surgeon will do 1000-1500 FUEs per day depending upont the expertise of the team. However a single session can go on for 2-3 days or more, depending upon patient requirement.

The cost is usually 2-3 times more than strip method because 1.Disposable items ie; FUE punches are costlier, 2. Majority of work is done by highly skilled cosmetic surgeon, 3. Only a limited no. of grafts can be transplanted in a day so operation theatre charges & maintenance cost goes up.

Remember, no one procedure is better than the other. A good transplant surgeon should be able to offer both the procedures to his patient and should be willing to modify his approach as per patient requirements.