The annual International Society for Hair Transplant (ISHRS) meeting is an opportunity for hair transplant surgeons from all over the world to meet, explore and debate new ideas. Often, the hottest topic is: “Which donor harvesting technique is the best?” The presentations and subsequent debates about strip vs FUE harvesting can get heated, which is fantastic, because it shows how much these talented and successful doctors believe in their technique.
Overall, both techniques have their merits and have a place in the hair transplant world.
Here are a few pros and cons of each technique:
Strip harvesting has been in use for much longer than Follicular Unit Extraction, or FUE in the world of follicular unit grafting. It is a proven method of donor harvest and it has stood the test of time. Strip harvesting is the most efficient way to harvest a large number of grafts in a short period of time. Cases of 4,000-5,000 grafts can be harvested and planted in the same day. However, strip harvesting does require that the surgeon have a team to help prepare and plant the grafts in the recipient area. It takes many new surgeons a long time to start using the strip harvest technique because a larger, well-trained staff is required. The cost to the patient is usually more affordable as the overall cost is usually less than FUE.
One knock against strip harvesting is the linear scar that is left behind. This is the one point that FUE supporters use the most. However, many patients leave their hair long enough to cover the scar. Linear scars can be so thin that they are hard to see even with a short haircut. If you have no interest in a buzz cut then the type of scar isn’t a problem.
FUE harvesting has increased in popularity over the past 10 years. There are many excellent surgeons throughout the world that do a superb job with this technique and get excellent results. The FUE procedure individually removes each follicular unit rather than in a strip. The surgeon can pick and choose which grafts are harvested and there are different methods for removal: manual punch, powered punch or robotic.
There is a large learning curve with the FUE procedure. A beginning surgeon is likely to get very poor growth because of grafts damaged during the harvest. You should check with your surgeon their experience to better understand the risks. Another risk associated with FUE is a surgeon that harvests outside the safe donor area- the “horse shoe ring” in someone who is very bald. This is the area that we know will most likely last even if there is extensive balding. If harvesting occurs outside of this area, it could lead to visible scars when the surrounding hair disappears and failure of transplanted grafts in the future. Since the FUE procedure is still in the early years of use, only time will tell if these problems will arise.
FUE is a much more labor intensive technique because the surgeon removes each individual graft. Therefore, it limits how many grafts are able to be harvested in a day. A larger session may have to be done over several days and the cost per graft is often more expensive with FUE.
Overall, the residual scars from FUE are smaller, rounder scars much different than the linear scar associated with strip harvesting. For example, picture a forest with 1 million trees. If 10,000 trees are removed from different areas the human eye may not be able to notice a difference or scar. However, if 10,000 trees are taken in a straight line, the eye is more likely to notice a difference.
Patients often see ads in airplane magazines and online that use taglines “no visible scars” or “no incision”. These are absolute lies. Sometimes, even scars from FUE procedures would be visible if the patient shaved their head. If you are interested in a FUE procedure, avoid any surgeon making these promises.
Both of these techniques are very good and patients may benefit from each. Sometimes, patients are unable to have any further strip harvesting or FUE, they may need to see surgeon who can perform either procedure. In the future, surgeons will have to master both techniques in order to better serve their patients.
If you are seeking more information about either procedure, contact the physicians at Parsley-Waldman Hair Center. Call us today at (502) 585-5249 to learn more about the treatment methods available.