What would you recommend; Strip method vs. FUE technique for hair transplant?

I was an engineer working with Dr. Rassman in 1998 (before I became a doctor) .  My work involved a concept of a robot which would use a special optical sighting system to align the hairs for an automated FUE. This work became U.S. Patent 6572625 that we licensed to the ARTAS robot.  Similar technology from our U.S. Patents are used in the NeoGraft.  I perform FUE in my practice with my hybrid FUE instruments, ARTAS, or even NeoGraft.  My point is that I am very familiar with the FUE, ARTAS, NeoGraft, and all forms of harvesting hair follicles.Many doctors push FUE or Neograft or ARTAS claiming "no scar" or "minimally invasive". Many doctors dissuade patients from strip surgery asking "why would you want a big scar".The focus should be on RESULTS. Not how a doctor takes out the grafts. In terms of graft quality between FUE (ARTAS, Neograft) versus Strip, the Strip harvested grafts are generally better (which means better results).  The exceptions are the doctors with unskilled staff, then the ARTAS grafts will be better.From a donor scarring perspective, if you are ever going to shave your head or cut your hair really short, you should probably get the FUE.  That is it.  If a "line scar" scares you, then get the FUE.  Just remember a 4000 graft FUE scar is like having a collective open wound hole the size of a baseball on the back of the head. There is nothing minimally invasive about that. I also perform Scalp MicroPigmentation (SMP) and fix horrible FUE scars routinely.  These is nothing "scarless" about FUE.  I have performed surgery on Dr. Rassman and his family members using the strip technique.  The linear scar on Dr. Rassman is a pencil thin line you probably will have a hard time finding.  The point is, a strip surgery scar is not as terrible as the Internet makes it out to be. The focus should be on Results. A bad hair transplant result from FUE or Strip is like Herpes.  You'll carry it with you for life.

With Follicular Unit Extraction, tiny punches are used. Therefore there is no linear scar. And patients can choose to wear their hair as short as they would like. With strip surgery, hair grafts can only be extracted from the donor safe regions on the lower part of the scalp or the sides. However, this is where hair tends to grow the thickest. Using these follicles may not produce the most natural looking results, particularly in areas like the hairline edge where hair is naturally much finer.Neither method will necessarily produce better growth than the other. Yield will mostly depend on how the follicles were selected and handled. This requires experience and skill on behalf of the surgeon. Therefore, it would be most important to carefully evaluate the past work of doctors you are considering. 

Both strip and FUE methods are good for hair transplantation and yield almost identical results. As a surgeon who performs both procedures I like to individualize the technique for each patient. Most FUE candidates choose the procedure so that they can wear their hair short since the tiny scars are not apparent. If this is not a concern for you, I would go with the strip technique since it can yield more hairs in one session and is less expensive. There is more of a comparison between the technique in the website:

Below are critical questions that you need answers to before moving forward with an FUE clinic.  1) Is your Doctor the person doing the FUE harvesting or is a Physician Assistant or technician doing the harvesting? 2) How long has your surgeon been doing FUE and FUE harvesting? 3) How many FUE cases does your doctor perform monthly?  4) If your doctor does both Strip and FUE, Does your doctor perform more strip cases then FUE cases monthly?

Hi shayda,
As the name suggests, strip harvesting is performed by dissecting a little strip of hair follicles from a donor site. The key difference between the two follicular techniques of hair transplants lies in the process of harvesting follicles.
In FUE, the surgeon harvests individual follicular units containing 1 to 4 hairs from the donor site. While in FUT, a longer linear strip of hairs extracted from the donor site, followed by manual dissection into smaller grafts.
Procedure Comparison
Based on feasibility, harvesting and implanting can be performed in a single session. In both techniques, the patient’s scalp is cleaned with a disinfectant solution.
Patient’s are given a local anesthetic, usually consisting of lidocaine with epinephrine, to numb the area that is going to be treated and to help control the bleeding.
An incision is performed to cut vertically into the scalp to harvest donor hair without hurting the follicular units. Incisions are usually only so deep that harvesting the entire follicular unit is possible.
Healing & Recovery
The treatment areas heal in several days after the procedure. Human scalps have a large number of vessels, thus after the treatment surrounding tissue begins nourishing the transplanted follicles.
In both strip and follicular treatments, you can return to work and almost all daily activities the next day. But strenuous activities and heavy lifting should be avoided until 7 to 12 days have passed or as advised by your surgeon.
Strip or FUE, which is better?
This can depend on some factors. My advice would be to visit a board certified and well experienced hair transplant surgeon in your city for a one-on-one consultation and physical examination. Based on your medical history etc. and the severity of your condition, you and your surgeon can mutually come to a conclusion.
Hope this helps.

Both FUE and strip harvesting are excellent methods of obtaining grafts from the donor area. FUE is good for patients with tight scalps (which may be due to multiple prior strip surgeries) or for those who wear their hair very short (buzz-cut length). Strip harvesting is good for patients who wear their hair a bit longer and have good scalp laxity. Both techniques will produce excellent results if performed by an experienced hair transplant surgeon. With regard to FUE, once the donor hair is extracted, it will not grow at the donor site anymore. Rather, these extracted follicles are being transferred into the recipient site to grow there. In order to prevent the donor area from appearing thinned out, the extractions should be spread out over the entire donor area. Whether FUE or strip is performed to obtain donor hair, the result at the recipient site is the same. Thus, either method is good for adding density at the crown. If the grafts are precisely placed at the recipient area with great care, there should be no damage to existing hair follicles. The surgery is performed under high-power magnification in order to allow precise graft placement at the recipient site. In order to determined if hair transplant surgery is appropriate for you, and to learn more about the various surgical options, a proper physical exam is necessary.

We can not say that Fue method is better than Fut or the opposite. Both methods have advantages and disadvantages .  Fue method can be used for small balding areas . For wide balding areas I prefer to combine Fue and Fut methods in order to be able to extract high amount of grafts and to cover larger portions of balding area . For anybody that has little knowledge of the hair transplant industry, the similarities between the names of FUE and FUT might be misleading. In reality, both are very different forms of treatment and while some individuals will have the luxury of casting a decision based on their own research and personal preference, others will have to let their own circumstances dictate which procedure they utilise. In summarising the procedures, it can be concluded that FUE is certainly the option for those individuals who might consider a shorter hair style in the future, if they are not planning one immediately. FUT on the other hand is a more general form of treatment and is designed for those patients that would rather have better quality hair – even if it means keeping it that bit longer to hide the nasty scarring that can occur with the treatment.All the best 

Good questions Shayda,FUE quality used to be inferior to a traditional strip, but it has improved significantly in the last few years. We do both strip and FUE in our practice, but most women do not feel the need to use a FUE since they are never shaving their head and having a linear scar on the back is not a big issue for them.In terms of density of the recipient area and hair regrowth, but methods can produce the same result.  In FUE grafts are harvested in a scattered fashion so it won't show a pattern at all even if you get a very short hair cut or shave your scalp. ARTAS is a new method of harvesting hair from donor area, but until now it has not been able to minimize the size of its punches to what we can use manually (0.6, 0.7, 0.8).  Those larger punch sizes may cause increased risk of hypo-pigmentation in donor.  Large punch sizes can also damage the neighboring hair in donor area when hair density is very high.

In my practice we offer FUE for hair restoration. This method drastically reduces recovery time, it is much less invasive, and the results are comparable to the strip method because ultimately the harvesting and implantation of the grafts and their survival depends on the expertise and experience of the person performing the procedure.

I wholeheartedly recommend FUE over strip method.  In addition, I recommend FUE with NeoGraft technique and device rather than ARTAS.  The NeoGraft device permits one to do smaller graft extractions, and the risk of post-procedure donor site dyschromia (or funny appearing loss of pigment) is much lower.  I am hearing that with ARTAS, some patients are developing hypopigmentation or pallor at the donor graft sites.  We do not see this with NeoGraft.  I favor FUE for faster, better healing with the same natural result.