Hair Loss Articles
Strip vs. FUE: What's the Difference?
by Joe Tillman
Date Added: December 13, 2006
Though both Strip Extraction and Follicular Unit Extraction harvest the naturally occurring bundles of hair, or follicular units, the difference between the two surgical techniques is in how the follicular units are harvested.
Strip Surgery
Hair transplant surgery via donor strip removal is simple in concept but not so simple in execution if the goal is for utmost efficiency and minimal trauma. After administering local anaesthesia the doctor removes a strip of hair bearing scalp that can vary from 1cm to 2cm wide and up to 25cm to 30cm long. Three things determine the size of the donor strip to be removed.
- The target number of grafts. Obviously if we want to pull only 1500 grafts the doctor won’t "go big".
- The donor area laxity. What is laxity? It is the amount of movement that your scalp has. In other words, it describes how loose your scalp is. The looser it is then the wider the strip that can be taken without tension.
- The donor area density. This refers to how thick your hair grows in the area to be removed. It is usually measured in the number of bundles of hair growing in a given centimetre squared (cm2).
Once the donor strip is removed it is then closed via sutures or surgical staples. When healed there is a fine line (when performed properly) that is hidden by the hair remaining above and below the area where the strip was taken.
The donor strip is then sectioned off to any number of technicians then dissected via high-powered microscopes to safely remove each naturally occurring bundle. They are then transplanted back into the areas on top of the scalp that are bald or thinning.
Follicular Unit Extraction
FUE on the other hand is different. Instead of removing a strip of tissue the practitioner removes each naturally occurring bundle of hair via a small punch tool that is usually .8mm or .9mm in diameter but the size ultimately depends on the size of the actual hair grouping that is the target. The punch tool can be as large as 1.2mm in diameter. The original claim of this procedure is that is was a no scar procedure in that the patient would be able to literally shave his head and have zero evidence that any procedure had been performed.
As of this writing, roughly four years after it’s initial adoption in North America, this claim has been proven to be untrue. FUE does in fact leave scars on many patients although some practitioners of this technique will disguise this issue by replacing the word "scar" with "hypopigmentation". The literal translation of this term is "absence of pigmentation or skin colour", but there is no denying the fact that this is a tactic used to avoid the negative connotation associated with the word "scar". In addition, FUE can thin the donor area if too many bundles of hair are removed with one FUE clinic admitting that the ceiling for how many grafts that can be removed is roughly 3000.
