What is the difference between FUT vs. FUE—pros and cons for coarse (African-American) hair.

Dear evie_lina,Thanks for your question.  FUT, or Follicular Unit Transplant, refers to a linear strip procedure, where a strip of scalp is removed surgically, and the wound that results from the removal is closed with stitches.  This will leave a permanent scar on the back and possibly sides of your scalp.  This can be done on most any person with a good donor area.  Many men, particularly those who like to keep very short hair, don't want a permanent scar on the back of their head, and will opt for an FUE procedure.And FUE procedure, or Follicular Unit Extraction, refers to a procedure where a device is used to remove a single follicle at a time for transplantation.  There are no scalpels used, no stitches used, and no linear scar is left behind in the donor area.  While this may seem like the obvious choice, the singular advantage of an FUE procedure is that no linear scarring is left behind.  With coarse, curly hair, it can be problematic to safely remove follicles from your donor area without damaging them.  This is because just like your hair is curly on the outside of your scalp, it is also curly on the inside of your scalp.  The punches used on every FUE device are straight.  It is sometimes possible to perform FUE on an African American person.  A test procedure is indicated to see if you'll be a candidate for this type of procedure.So the short answer is that with FUT a linear scar is left behind in the donor area, and with FUE the hair is trimmed down and the follicles are removed one at a time.  At our clinic we're proud to be the first in Georgia to offer the ARTAS robotic hair restoration surgery system, but there are many devices.If you're a female, the logic in trying to perform an FUE starts to break down.  Typically with traction alopecia a fairly large amount of hair will need to be transplanted.  If using the FUE method, you'll be required to shave all of your hair on your scalp down to about 1/32nd of an inch (essentially shaved).  Women tend not to like this look, for obvious reasons.  With a dedicated, experienced, and fully-trained board-certified surgeon, you can expect minimal scarring in the donor area with an FUT, allowing you to wear a pony tail or pull your hair up without worry that the scar will show through.  Clearly, a consultation with a dedicated hair restoration surgery clinic is indicated.

Early forms of traction alopecia can respond to topical minoxidil and cessation of grooming practices that exert a pulling force on hair roots, e.g. braiding, heavy weaves, etc. In later situations however, a hair transplant is the most effective solution. Most current technologies would have problems because of the tightly curled nature of the African Hair type resulting in hair graft damage and poor yield. A recent invention called the Dr.UPunch curl which I patented was specifically designed to overcome these challenges. For the first time, we now have a tool that has succeeded in all instances where traditional FUE tools have failed. 
We encourage you to further consult with a physician for any medical advice. I am always available for a free consultation as well.
Read more about this invention using the link below.

FUE does not always work on curly African American hair.  You need to see a doctor for an exam and possibly a limited FUE test (we call it FOX Test).  This is because curly hairs have a higher rate of transection.