Why did the doctor recommend FUT over FUE?

Question

I am 25 years old and a Norwood 3 - Vertex. My father and paternal grandfather are both Norwood 5. I am looking at getting a HT but prefer wearing my hair short so I thought that FUE, though more expensive, would suit me better. The doctor I consulted said, "You're not considering FUE are you?" This was before he even evaluated my donor zone. I am sure he had his reasons, but can anyone here give me more insight as to why he may have said that?

Sean R. Weiss, MD, FACS · Answer

Some hair restoration professionals are not equipped or skilled to provide FUE to their patients.  Most patients are a candidate for either procedure, but those who wish to wear their hair short may be better suited for FUE to avoid possible obvious linear scaring.  Be sure to consult with an expert who performs both FUE and FUT.

Jae Pak, MD · Answer

There is no way to tell you why your doctor recommend one surgery or the other.  We can all guess but it would be difficult without having examined you or understanding the exact circumstances. It would be best to ask the doctor what the reason was.

Amir Yazdan, MD · Answer

Before even getting to your question, its important to discuss that HT surgery at age 25 is very early.  Your doctor should be discussing medical management before even getting to the topic of FUE vs FUT.Now to answer your question:FUE and FUT/Strip methods of surgery have their pros and cons. Deciding on which method is right for you depends on many factors such as quality of the donor area, personal hair coverage goals, number of grafts needed, and preferred style of hair. The FUT method of surgery usually allows for a higher number of grafts to be extracted and placed, so is often the choice of those needing a high number of grafts to meet their goals. That being said, FUT does leave behind a linear scar that is visible if the hair is worn shorter. If you like to wear your hair shorter, this may not be the method of surgery for you. If you are needing a high number of grafts but prefer the FUE method, you may need to break up the hair transplant into multiple surgeries in order to avoid complications caused by FUE mega-sessions. While this may not sounds ideal, you will have a better outcome after all is said and done. Feel free to browse more information on my site.

Christopher Varona, DO · Answer

I would ask how many of each type of procedure the doctor performs. FUE is a different skill set for the physician than an FUT. Chances are if he doesn't do a lot of FUE procedures, or doesn't do the FUE extraction himself, he may be more comfortable recommending a procedure he has more experience with. I don't know your specific situation but from what you're describing, I would think you'd be a candidate for an FUE as well, especially if your goal is to wear your hair short after surgery.

Michael Vories, MD · Answer

FUE requires much more physician involvement than FUT. Many physicians like FUT because they can perform multiple procedures in a day, with technicians performing most of the work. So my guess is that his recommendation had little to do with you, and more to do with his own schedule.

Kapil Dua, MBBS, MS · Answer

The choice of the surgical technique usually depends on both the surgeons' and patients' characteristics. On the surgeons' side, it will depend on his his skill and experience in a particular technique. And on patients' side on the history of progression of baldness, donor area laxity and hair characteristics, recipient area requirement, etc. etc. In general, most of the patients can go for either of the techniques but if more number of grafts are required, then someone may suggest you Strip for the first time and then FUE, as the combination will definitely give you more grafts in a lifetime than either of the techniques alone.

Karl Hekimian, MD · Answer

Did you ask him why he made that statement?
FUE is often preferable for patients who like the option of keeping hair sort.  However, if it looks like you will progress from a Norwood III to a VI or VII, an FUT may be a better option for you in the long run.  Rather than guess as to your doctor's reasons it's better to ask, and seek another opinion from someone who does both procedures.

Roy Stoller, DO, FAOCO, FAAO · Answer

If your goal is to have the most density, given the family history of extensive hair loss, you will achieve maximum results starting with strip surgery and followed by FUE in the future.  Strip surgery can yield the best and most grafts initially.  After multiple surgeries, as the scalp tightens, patients benefit from FUE procedures which can harvest additional grafts.  If you are most concerned about wearing your hair short and trimmed, go with FUE. You will most likely have less hair density than if you had started with a strip procedure.

David Perez-Meza, MD, FISHRS · Answer

It depends of each case, you need to keep in mind that donor harvesting the grafts is ONLY one of the Six Steps for having a successful hair transplant. The selection of the technique depends of the surgeon training and experience, patient's goals and expectations, the number of grafts, donor availability, budget, etc. Both donor harvesting techniques may leave an unapparent scar: strip=linear scar and punch or FUE=circular scar (sometimes hypo-pigmented). If you eventually are a good candidate for hair transplant I will probably suggest the punch technique that it is more expensive than the strip technique. However, I would like to stable your hair loss first before deciding a hair transplantation. If you are confused about your consultation I always suggest a 2nd opinion too. Great question and good luck.

Robert S. Houser, DO · Answer

Many well established hair transplant surgeons do not believe in FUE. Their are reasons are a little selfish. From the surgeon standpoint, FUE requires much more time for the procedure as well as some specialized equipment and skill. A strip graft can be performed very  quickly and with no special instrumentation. Your points are valid. If you like wearing your hair short, why would you want to have a large scar on the back of your head if it is not necessary? Although I have seen many well done strip procedures with thin scars, that cannot be guaranteed.  Look into the ARTAS robotic transplant system. This allows for an excellent donor site as well as providing excellent graphs for placement in your areas of the thinning. You are on the right track. Good luck!

Why did the doctor recommend FUT over FUE?

Answers (12)

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