Why choose FUT?
FUT strip surgery is performed via elliptical excision of a strip of tissue from the safe donor area by using a single bladed scalpel. Once the strip of tissue has been removed it is “slivered” into smaller sections and the slivers are then dissected into follicular units using stereomicroscope magnification.

The SDA (Safe Donor Area) is a horse-shoe shaped area in the back and sides of the scalp where follicle units are harvested during hair restoration. Follicles located in the SDA are free from androgen receptors and are therefore not targeted by DHT which cause miniaturization of hair follicles that result in hair loss known as Androgenetic Alopecia or male pattern baldness.

The advantages of FUT strip surgery:
– Don’t have to shave scalp hair in donor area, process is less visible
– Can combine with FUE to easily achieve follicle unit numbers required for a particular size transplant, or to achieve the maximum yield without over-stretching the donor area
– Shorter day and cost savings
– Knowing that all the follicle units harvested are taken from the centre (sweet-spot) of the SDA (safe donor area)
– For patients with a limited SDA, eg Norwood VI and Norwood VII patients
– We use a Trichophytic closure technique where the lower edge of the wound is bevelled, allowing the hair to grow “through” the scar and making it virtually undetectable in most cases.

Why choose FUE?
FUE (follicle unit extraction) is the more modern technique in hair restoration where hair follicles are harvested individually one-by-one from the SDA using a mechanical or powered FUE punch. FUE is suitable for patients who don’t like the idea of having a linear scar in the donor area and who don’t mind shaving the donor area or their whole scalp for that matter to have the procedure done. FUE is more favoured amongst younger men, where having short hair is trendy these days.

Some patients simply just have genetically tight scalps and others have tight scalps as a result of previous FUT strip surgery procedures and they do better with FUE harvesting from that perspective.

The post-operative morbidity (down-time) is somewhat lower with FUE compared to FUT strip surgery, because the small skin wounds caused by FUE heal quicker (takes about 7 days), whereas a FUT strip wound takes a bit longer for the “knitting” process to take place and things to settle down (14 days to 21 days).
FUE can mostly be done in combination with FUT strip surgery procedures when more grafts are required after the strip has been removed or as a combination procedure from the start (FUE/FUT combination) for getting the maximum number of grafts by using a balanced harvest that does not over stretch either the FUE or the FUT strip harvest yield and provides excellent preservation of the donor area for the long run.

Sources:
Dr. A Nel , hair restoration practice experience

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