Hair transplant methods – FUE or STRIP?
Over the years there have been several different hair transplant methods. They have been developed and refined over time into now two. These are called FUE (Follicle Unit Extraction) and the STRIP/FUT-method.
The FUE method simply means that individual hair follicles/hair grafts (1-4 of hairs) are harvested separately from the neck and temple and placed on top of the head.
The STRIP method involves a strip of skin containing hair follicles that is usually about 20 cm long and rarely more than 2 cm wide. The hair follicles are removed from the neck with local anaesthetic. The natural grafts are separated out under a microscope and whereupon they are placed on the crown, as with the FUE method.
Under normal conditions, the yield of hairs in the strip method is approximately 2,000 grafts, sometimes considerably more. It corresponds to 5000-7000 hair follicles.
There are a lot of contradictory information about the two current methods, which come from both consumers and clinicians in the industry. This is due to either lack of knowledge about the methods, or the underlying commercial interests. On this page we sort everything out to make it easier for you to make the right decision.
“FUE and STRIP methods only differ in terms of how the implants (hair follicles) are extracted. The insertion process of the extracted implants is identical for both methods”.
What method is better, FUE or STRIP?
So, what is the best method, FUE or STRIP? The question is hard to answer as the both methods have their advantages and disadvantages. Primarily it is about the economic and physical conditions the patient has.
Most people choose STRIP method
Statistically, the absolute majority of all patients that undergo a hair transplant choose the STRIP method. The main reason is the lower cost. However, it important that the choice of method is based on knowledge, risks, benefits, and the total cost of both methods in order to achieve your goals.
STRIP method leaves a scar, but is bothered by few
The STRIP method causes scarring at the back of the head. It is however for the vast majority not a reason to dismiss the method. As long as a skilled surgeon performs the procedure, the result will be rarely a distracting scar. In cases where scars occur, it usually depends on misjudgement in terms of elasticity in the scalp or the patient’s ability to heal. Both of these scenarios are however rare.
Normally, scars associated with STRIP hair transplant are approximately 20 cm long and 1-3 mm wide, which appears as a linear white line at the back of the head. However, the scar is invisible as long as you don’t a very short haircut or shaved hairstyle.
The advantages of the STRIP method is that it allows a large number of qualitative transplant and is the most cost effective method to extract a large number of hair follicles for transplantation.
In most cases, with STRIP method it is possible to collect hair twice from the neck, with a minimum one-year interval, without having any problems with scars and healing process. During the second harvest the scar from the first surgery is removed. In this way, it is possible to harvest an impressive number of hair follicles, and maintain the possibility of an additional FUE hair transplant in the future, if necessary.
The disadvantages are the linear scar, which was described earlier, the postoperative pain for 2-3 days, the soreness that lasts about a week, and sensory changes around the scar in the back of the head and tightness in the scalp that remains in 6-10 weeks.
FUE – no scars and faster recovery but at a higher cost
When it comes to the FUE method, the advantages are that there is no linear scar on the back of the head; the possibility to have a very short or shaved hairstyle, pain after procedure is almost non-existing, and the short-term healing process which is 2-3 days. However, it takes another 10 days for scabs from the transplanted area to fall off, and to look completely normal.
FUE method can also be a simple and practical method when needing only a small amount of hair follicles, for example, to strengthen the lateral sides of the forehead in relatively early stages of male pattern baldness. Another advantage of this method is that it allows the harvest from areas where it is inappropriate to take out a strip of skin. This refers to the temple and areas in the back of the head, which is located at the top and bottom parts.
The disadvantages of FUE hair transplant is that larger areas of the donor zone must be shaved to obtain an equal distribution of extracted grafts, the increased time required for the procedure, or the need for multi-day sessions, as well as the cost, which is almost double or more compared to the STRIP method
FUE may also leave changes in pigmentation, such as small white dots. The risk is, however small when using micro-punch of 0,8 mm and lower to extract grafts, provided that they do not harvest too much in one area. Finally, there is the possibility that the survival rate of grafts harvested with the FUE method is not as high as the STRIP method.
Conclusion – FUE or Strip?
Many surgeons believe that the FUE method is an option for all patients who consider undergoing a hair transplant surgery. However, perhaps primarily for patients, who want a very short haircut, is in need of a quick recovery, has limited flexibility in the scalp and a relatively decent economy.
Advantages and disadvantages of the FUE method for hair transplantation
Below you can see a disposition of the FUE methods main advantages and disadvantages. By studying these you gain an understanding of which of these methods suits you best.
Advantages of the FUE method for hair transplant:
- There is no scarring at the back of the neck, which is good for those who wish to shave or have a short hairstyle
- Shorter healing time in the donor area
- Ideal for repairing/hiding donation scars from previous hair transplantations
- It’s an alternative for those cases when the scalp is too taut to use the STRIP method, or where the central parts of the neck have already been used for previous procedures
- Provides the possibility of harvesting finer hairs from the lower parts of the neck for use around the hair line or eyebrows etc.
- Makes it theoretically possible to also harvest hairs from other parts of the body
Disadvantages of the FUE method for hair transplantation:
- Provides less access to qualitative transplantable hair at one and the same procedure
- Greater difficulty harvesting the entire hair follicle
- The harvested hair follicle groups are more sensitive to damage during insertion since they lack protective epidermis and fat that the STRIP follicles have.
- Hair which has been harvested from the optimal zone of the neck hair is not always permanent. The surgeon may be tempted to wander outside the ”safe” zone in search of a large amount of transplants.
- The volume of hair which can be moved during one surgical procedure is limited which means that an additional procedure is needed in order to achieve the same level of hair covering possible with one STRIP procedure.
- It takes more time and is therefore substantially more costly than the STRIP method