If the choice between FUE and FUT hair transplant procedure came down only to the nature of the scar all Patients would choose FUE. Unsurprisingly each technique has resultant characteristics which must be taken into consideration to make an informed choice.
1) Success Rate
The more intricate and time consuming nature of extraction that is required for FUE Surgery means that there is a greater likelihood of follicular transection – damage to the follicle that will prevent successful growth post implantation – during harvesting. Of the follicles that are harvested and implanted via FUE an average of 90% will successfully grow which in comparison to the 97% success typical of FUT follicle populations is three times greater the rejection rate. Visually the aesthetic impact is difficult to notice.
2) Achievable Harvest – Quantity of Grafts Extracted
The choice of hair transplant procedure technique may be heavily dependent on the ‘Donor Density’ or the number of follicles that may be extracted and thereafter implanted
As a rule Patients who require large scale implantation in one sitting must elect FUT as their extraction technique of choice in confidence that a yield of between 2300 and 3000 will be possible in a single sitting. Yields of over 3000 follicles are not unheard of if scalp elasticity is high as the availability of excess scalp tissue material is the determining factor in FUT yield. Conversely a Patient with a small skull and tigh scalp may only achieve a yield of up to 2200 follicles.
Put simply FUE extraction takes longer yet to ensure integrity and optimise successful growth the follicle cannot remain out of the donor site for any longer than a follicle extracted via FUT. The FUE option is viable to Patients who require generally no more than 2200 – 2500 grafts in 1 treatment. Cases towards the end of this scale may require 2 consecutive day sittings.
Patients should exercise extreme caution when dealing with Clinics who promise to extract and implant above 3000 follicles in one treatment, irrespective of whether the proposed treatment is over one day or two.
Whilst technically this is achievable Patients often find that the final result is sub optimal and falls far below their expectation for a number of reasons:
I. Over extraction leads to unsightly scar tissue when insufficient space is left between extraction sites to achieve the expected yield
II. Extraction of follicles from the ‘non permanent’ zone not only means that the transplanted follicles are still susceptible to attack and miniaturisation by DHT but are likely to suffer a premature death due to the trauma of transplant from an area which is not robust enough to withstand harvest.
3) Yield – Quantity Of Grafts Required To Fulfil Treatment Plan
Patients with a healthy and substantial donor site may typically undergo three FUT treatments utilising one site resulting in one scar. Across three treatments it is usually possible to extract and implant between 6000 and 7000 grafts.
Patients electing FUE will generally yield no more than 5000 grafts over multiple treatments if they are to maintain the non scarring visual impact synonymous with FUE. A Patient attempting to harvest more than 5000 follicles via FUE would risk incision scar blending which can often have a worse visual impact than the scar that otherwise would have resulted from
4) Genetics – Predisposition To Balding
If there is evidence of severe balding – a Norwood 6 to 7 – within your family specifically towards the maternal side and if you do not envisage undergoing several procedures there may come a point in the future that you wish to shave your head to reduce the visual impact of aggressive progressive hair loss. At this point any scar from previous FUT treatment would become visible.
Therefore if excessive balding is prevalent in your family you may wish to consider taking medication to slow down the rapidity of miniaturisation. You may also be open to additional procedures to replace existing non permanent hair that will continue to be lost post transplant or micro pigmentation (tattooing) of the scar to minimise its appearance at a later date