Robotic Hair Transplants & Hair Restoration
Flagship: 110 East 55th Street, New York, NY
Add'l Loc: 229 7th Street, Garden City, NY
Call Us: 212-826-2400
Bernstein Medical - Center for Hair Restoration
Hair Restoration Answers

Why Visit a Practice That Specializes in Both FUT and FUE?

Q: Why go to a practice that specializes in both FUT and FUE? — L.P., Bayside, NY

A: This is a great question, but the answer may be counterintuitive in today’s age of specialization. The answer is that you should always go to the practice that offers both. To deliver the best care, hair restoration physicians should have expertise in both Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) techniques and should offer both in their practices. There are at least five good reasons why.

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Hair Restoration Answers

In Hair Transplant Repair, Do You Always Harvest Additional Hair Via FUT or FUE? Which is Better for Repair Procedures, FUT or FUE?

Q: In hair transplant repairs do you always harvest additional hairs to give the hair restoration a better result? Which is better for repair procedures, FUT or FUE? — E.Z. ~ Fairfield, C.T.

A: We do not always harvest additional hair in repair procedures, but we do if possible because it can improve the aesthetic outcome by adding additional density and camouflage. This is called Combined Repair. As for whether we use FUT or FUE in repair procedures, the answer depends on the clinical situation. For example, a loose scalp favors FUT. If the person wants to wear their hair short, that favors FUE. If donor scars from the plugs need to be removed, that favors FUT. If scarring in the donor area needs to be camouflaged rather than removed, that favors FUE.

See Patient ETI’s before/after repair photos
Read about Combined Repair techniques

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Hair Restoration Answers

Is FUE or FUT Better for an MMA Fighter?

Q: I am an MMA fighter and I want to get a hair transplant. How long do I have to be out of commission and which type of procedure should I have, FUE or FUT? — J.A., Columbus, OH

A: With any type of hair transplant it takes 10 days for the transplanted grafts to be permanently fixed in place. The difference between FUE and FUT is in the limitations of activity due to the donor area. With FUE one would need to abstain from MMA for the same 10 days it takes the recipient area to heal (the grappling component of Mixed Martial Arts is the most stressful on the scalp). With FUT, however, one would need at least three months for the linear donor scar to heal before one could resume contact sports like MMA.

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Hair Restoration Answers

What Is Your Opinion on Doctors Performing Only FUT or Only FUE?

Q: It seems that some doctors offer only FUT and others only FUE. What is your opinion on that? — D.E., Portland, M.E.

A: Both FUT and FUE are excellent techniques, but have different indications. To deliver the best care for our patients, hair restoration physicians should have expertise in both procedures, and they should offer both in their practices.

The main advantage of FUT is that it typically (but not always) gives the highest yield of hair. Therefore, when the patient’s primary goal is to achieve maximum fullness, FUT should be performed. There are many well described reasons for this, including the precision of stereo-microscopic dissection and the ability to efficiently harvest from a more select area of the donor zone, but these are beyond the scope of this brief commentary.

The main advantage of FUE is no linear scar. Therefore, when the patient’s primary goal is to be able to wear his hair very short, FUE should be performed. FUE is also indicated when there is an increased risk of a widened scar or when scalp laxity does not permit a strip excision. The patient may sometimes chose FUE simply to avoid the stigma of a linear donor scar.

There are situations in which both procedures are useful in the same patient. For example, FUT may first be used to maximize yield, but then, after several sessions, the scalp may become too tight to continue to perform FUT, or the donor scar may become wider than anticipated. In the former case, the physician can switch to FUE to obtain additional grafts; in the latter case FUE may be used to camouflage the scar of the FUT procedure.

It is tempting to see the world in black and white, and it is easiest to learn and train one’s staff in just one hair transplant technique — but medicine is never so simple. Developments over the past twenty years have given us two excellent hair restoration procedures. We should offer our patients both.

Read about FUE Pros and Cons

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Hair Restoration Answers

How Does Robotic FUE Differ from Other Hair Transplant Procedures?

Q: What is the main difference between hair transplants using the robot versus other procedures? — M.P., Flatiron, NY

A: There are two basic types of hair transplant procedures, Follicular Unit Transplantation (FUT or strip surgery) and Follicular Unit Extraction (FUE). In FUT, donor hair is harvested by removing a long thin strip from the back of the scalp. Individual follicular units are then obtained from this strip using stereo-microscopic dissection. In FUE, individual follicular units are harvested directly from the donor area using a sharp, round cutting instrument. The ARTAS Robotic System performs the follicular unit isolation step of an FUE procedure and can also create recipient sites according to specifications determined by the hair restoration surgeon. In performing each of these steps, the robot uses its image-guided technology to locate the next target and position the cutting instrument, and it does so with precision and speed that cannot be accomplished using manual FUE techniques or instruments.

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Hair Restoration Answers

If I Was Told That I Am Not A Good Candidate For An FUT Procedure Can I Have FUE?

Q: At one time, I was told my donor area was not sufficient for an FUT hair transplant procedure. Does this also mean I’m not qualified for a FUE procedure either? — K.K., Houston, T.X.

A: Great question. You are not giving me quite enough information to answer your question specifically, so I will answer in more general terms. If your donor hair supply was not good enough to do FUT (i.e. you have too little donor hair and too much bald area to cover) then most likely you will not be a candidate for FUE either, since both procedures require, and use up, donor hair. That said, if don’t need that much donor hair, but the nature of your donor area is such that a linear FUT scar might be visible then FUE might be useful.

An example would be the case in which a person has limited hair loss in the front of his scalp, has relatively low donor density, and wants to keep his hair on the short sides. In this case, FUT would not be appropriate as you might see the line scar, but we might be able to harvest enough hair through FUE to make the procedure cosmetically worthwhile. Remember, with low density neither procedure will yield that much hair to be used in the recipient area.

Another example is an Asian whose hair emerges perpendicular from the scalp so that a line incision is difficult to hide, i.e. the hair will not lie naturally over it. A third example is where the patient’s scalp is very tight. In this case, the donor density might be adequate, but it would just be hard to access it using a strip FUT procedure. In this case, FUE would also be appropriate.

From these situations, one can see that the decision to perform FUE vs FUT, or even a hair transplant at all, can be quite nuanced and requires a careful evaluation by a hair restoration surgeon with expertise in both procedures.

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