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Follicular Unit Extraction or Strip for Hair Transplant?

Which of the procedure is better for Hair transplant: Follicular unit extraction or strip hair transplant?

Doctor Answers (15)

FUE vs FUG

+4

Both techniques have advantages and disadvantages.  Below are the pros and cons of each:

Follicular Unit Extraction

pros

  • no linear scar on the back of the head
  • almost limitless donor especially if body hair can be used

cons

  • time intensive sometimes requiring several days to complete  a large case
  • lower individual graft survival rate (75% vs 90%)
  • cost usually 50% higher per graft

Follicular Unit Grafting

pros

  • more time efficient
  • higher individual graft survival

cons

  • linear scar on the back of the head (usually not noticeable)

I don't think this is an issue of one being better or worse than the other technique, but rather a question of which technique is right for individual patient problems.  I feel FUE is best suited to very young patients (teens or early 20's) with an unpredictable future pattern of hair loss, people who want to shave or cut their hair very short, and those who can't tolerate the risk of a scar.  I still think FUG is the treatment of choice and the gold standard against which other techniques should be compared.


Salt Lake City Facial Plastic Surgeon
5.0 out of 5 stars 40 reviews

FUG vs. FUE

+3
For over 10 years, follicular unit grafting (FUG) which is the strip procedure has been the gold standard. Over the past 3 years, follicular unit extraction (FUE) has grown in popularity, and it now constitutes around 20% of the hair procedures I perform.
FUE has one main advantage- the absence of any linear donor site scar, thus permitting the patient to shave his head if desired.
The downsides of the FUE procedure are several: typically a lower percentage of hair regrowth (for most patients an 80 to 85% rate of regrowth vs. 90plus % with FUG; higher cost; difficulty of obtaining a large number of grafts- anything more than 1500 or so requires 2 consecutive days of procedures; and the need to shave the head in the donor area.
However, FUE is still the procedure of choice for young men, men of African American ethnicity, those who have depleted their donor supplies from prior work, and those who wish to have the option of shaving the head.

Jeffrey Epstein, MD, FACS
Miami Facial Plastic Surgeon
4.5 out of 5 stars 49 reviews

Which procedure is best?

+2
Though the results of either FUE/Neograft or strip will be very similar in the graft sites, the donor area will be quite different.  If you like to wear your hair short or would consider doing so in the future, this can be problematic if you have a strip procedure done that results in a long linear scar on the back of the head.  This is one of the main reasons so many men are choosing Neograft/FUE instead of the traditional strip procedure. So if future scarring is a concern, then Neograft could be the procedure for you.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 75 reviews

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FUE or Strip

+1
I don't think there is a "Gold" standard to any hair transplant procedure regarding FUE vs Strip/FUT. There are many factors which determine whether a patient is a better candidate for a Strip vs FUE procedure. For example I may see a patient who is 35 years old, wears his hair short, and has recession of hair in the angles in which he wants to correct. This patient needs 1,000-1,500 grafts. The patient tells me that he absolutely does not want a strip due to the chance of a linear scar in his head. For this patient the "Gold" standard is not strip method, it is FUE method. There are many circumstances which make one procedure better than the other and that is patient dependent. In my mind, Gold standard has to do with the technique and quality of the procedure. With FUE punch sizes smaller than 1.0mm should be used with minimal transection rate, the grafts need to be stored appropriately, sites need to be created to match the grafts, and placement of the grafts needs to be done by experienced staff to minimize trauma to the follicle. This to me is a "Gold" Standard.

Amir Yazdan, MD
Irvine Hair Restoration Surgeon
5.0 out of 5 stars 6 reviews

FUE versus Strip grafts

+1

   Today it is getting harder and harder to find a hair transplant surgeon who does strip donor hair work. Fewer and fewer patients are willing to trade a lifelong scar for a better price. I use a mechanized system to remove the FUE grafts so as to speed the proccess somewhat. I can now make it more affordable to patients. I personally do not do strip graft work anymore because of the problems with the scar and very few requests by prospective patients.

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

FUE versus Strip for Hair Transplant?

+1

It totally depends on the type and quality of donor hair.  The most important event of a hair transplant is not how the donor hair is harvested.  It is really the judgement and artistry of the doctor in inserting and designing a natural hairline.  I think too much has been made about how donor hair is harvested .  If a strip donor site is properly closed a scar can be minimal.  If a FUE procedure is done with too many donor grafts too close together one can be left with a white visible scar. 

Jack Fisher, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 3 reviews

Follicular Unit Extraction or Strip for Hair Transplant?

+1

Both procedures produce excellent results. It basically comes down to personal preference. 

The strip method has been around longer and is the most common method of hair transplantation.

The benefits are you can move more hair per procedure at a lower cost and the outcome is remarkable. The only negative I see is you are left with a linear scar in the donor site, which is typically not recognizable unless you shave your head.

Benefits of FUE's would be in the donor site. Instead of having a linear scar it would leave tiny little "dots." But again these are not visible unless you were to shave your head.

The only negatives with FUE's would be the fact that it takes longer so therefore the cost will be higher.

With the addition of Neograft however, the time factor will not be as much of a factor.

Jon E. Mendelsohn, MD
Cincinnati Facial Plastic Surgeon
4.5 out of 5 stars 35 reviews

Follicular Unit Extraction is possible WITHOUT a linear scar!

+1

Hi there-

There is a great new technique available in a few areas of the country (including our Orlando Plastic Surgery, Skin Care, and Hair Restoration Center) called the Neograft, that allows Follicular Unit Extraction WITHOUT a linear scar on the back of your head.

We are incredibly impressed with the procedure, the easier recovery, and the outcomes. Our patients are incredibly happy.

Find a qualified doctor near you skilled in the Neograft technique. You'll be glad you did.

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

FUE for shorter hair styles

+1

If you anticipate the need to keep an overall shorter hair style, then you want to avoid the linear scar that would necesarily result from Follicular Unit Strip Surgery ( FUSS ). It would make sense to do Follicular Unit Extraction ( FUE ) instead. If you already have a strip scar from prior surgery or never anticipate keeping a short hair cut, then FUSS could be considered. I am of the opinion that FUSS is perhaps too too invasive a method for procedures involving less than 500 grafts.

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
5.0 out of 5 stars 23 reviews

Hair transplant option a matter of opinion

+1

It depends on the bald area that needs coverage. It also depends on the surgeon. Concerning the area, small areas (i.e. patches) may only need a few hundred grafts and obtaining the hair by FUE may be a very reasonable method. If there is a large area of bald scalp that needs coverage then I am of the opinion that obtaining a strip is a better method and yields more grafts. In my hands I can get more viable grafts with a strip method than the FUE method.

Hope this was helpful.

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.