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

I needed solid input on which method yields better results, FUE or traditional strip method for more hair and density? Also, in FUE will the donor site regrow hair or there will be bald spot in back of head? For women, which method is best to add density at crown? will transplant damage existing hair follicles since Dr. needs to go in between existing hairs?--I have heard ARTAS is damaging the harvested follicles and not worth going thru...

Doctor Answers 13

Fue vs strip technique for hair transplantation

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Dear Shayda
I have been doing hair transplantation for thirteen years and in the process, I also became the patient more than once. I have had the strip technique done on me and I have performed multitudes of strip techniques on others. I have also had the Artas technique done on me, and I have performed numerous Artas procedures on patients. Here are some reasons I prefer FUE by Artas over the strip method:
1. The healing process for the donor site in the strip method is much longer than the Artas.
2. The donor site pain after the strip procedure lasts about two weeks and can remain tender for about a month. Everytime you bend your neck forward, you will be reminded of the donor site for the first month. In contrast, the donor site of the Artas procedures is much less painful, needs no stitching, and by one month, the sites are hard to find even with the naked eye.
3. About the quality of the grafts, I find the grafts very hardy and healthy when using the Artas.
4. In the strip technique, a large sliver of skin is removed from the back of the scalp. The strip is sliced into individual grafts for placement. In this process, many grafts are damaged, bisected, or otherwise deemed as not usable. These will be discarded. This is a big waist and those follicles are gone for good, and remember you only have a finite number of hair follicles. In contrast, if the Artas transcects any hair follicle, that is done upon punching the scalp, and the top of the follicle will be removed. However, the hair bulb (the areas important for hair regrowth) is still in your scalp and that hair  will regrow. So with Artas, there is less permanent damage to the follicles.
5. About regrowth of the follicles, once hair is removed in total, that hair follicle will not grow in the donor site. However the one millimeter punch used to extract the hairs leaves such a small hole that once healed it is not detectable by the naked eye.
I hope my opinion helped.
best wishes
Omeed Memar

Chicago Dermatologic Surgeon
4.9 out of 5 stars 38 reviews

Why FUT Hair Transplant For One Person, FUE For Another?

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I think that both procedures are excellent, which is why we offer both in our practice. My recommendations are determined by the individual patient. His or her age, desire to wear hair cut very short, athletic activities, donor density and miniaturization, extent of hair loss, and potential future balding are all important aspects in the decision process. In general, if the goal is to get the maximum amount of hair, then one should chose FUT via strip. If keeping one’s hair very short is most important, then one should go with FUE. Of the various FUE techniques, I think that the ARTAS robotic system is best.

Robert M. Bernstein, MD
New York Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

Strip Method vs. FUE

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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.

Victoria Karlinsky, MD
Manhattan General Surgeon
4.7 out of 5 stars 26 reviews

Strip vs. FUE

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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.

FUE vs strip harvesting hair transplantation

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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.

Sahar Nadimi, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Fue or Fut

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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 

Ilker Apaydin, MD
Turkey Plastic Surgeon
4.8 out of 5 stars 33 reviews

FUE for Women - ARTAS Disadvantages

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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.

Parsa Mohebi, MD
Beverly Hills Hair Restoration Surgeon
5.0 out of 5 stars 34 reviews

FUE vs. Strip Method

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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.

Karen Stolman, MD
Sandy Dermatologic Surgeon

Re: Strip Versus FUE for Hair Transplant

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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. 

Sanusi Umar, MD
Redondo Beach Dermatologic Surgeon
4.6 out of 5 stars 33 reviews

The strip will leave scar and FEU not

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The donor site scar can become an issue if you do not heal well or if you decide to have shorter hair. ARTAS damages hair follicle less since robots do not get tired and can perform the same task over and over.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 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.