Strip Excision vs Individual Unit Extraction
There are only two methods to surgically extract follicular grafts from the scalp: F.U.E and F.U.T.
F.U.T. is a general term that means Follicular Unit Transplant. While imprecise, the term is commonly used to describe a technique whereby a strip of scalp is excised from the permanent donor area of the scalp.The wound is closed using small surgical staples. The excised strip is converted to follicular units in a two stage steriomicroscopic dissection process.
F.U.E. is a method that utilizes a very fine manual or motorized punch to individually harvest follicular units from the intact scalp. This technique completely eliminates the use of scalpel from the procedure.
The Donor Zone
The donor zone – these hairs are genetically resistant to hair loss. In FUE, the zone is larger to accommodate individual extractions. In FUT, scalp laxity plays a role in how much hair can be extracted.
FUE Method (Punch Extraction)
Human hairs grown in natural groupings of one to four hairs. In FUE, individual groupings (graft units) are extracted using a surgical punch-tool. The punch tool is positioned over the hair where it emerges from the scalp, then aligned with the direction of the hair growth and inserted, creating a round incision. Whether the incision was created manually or by robotic assistance, the graft unit it extracted by hand.
This method is somewhat challenging because it is difficult to see the graft through the scalp, which makes it tricky to align and position the punch tool and to judge the depth required to excise the graft. The robotic tool uses infra-red light to map out suitable grafts and to precisely position the punch in alignment with the grafts growth vector. When FUE is performed manually, tools with smaller punch diameters can be used so that each graft unit can be more precisely matched. With either method, some transection is expected to occur when the punch cuts through the follicle under the skin. The incidence of transection is higher using FUE than using FUT.
Both manual and robotic-assisted FUE are available, and may be used in combination depending on your particular circumstances.
FUT Method (Strip Extraction)
In Strip Excision, donor hair is harvested by excising a narrow strip of scalp from the donor area. Your surgeon carefully plans the shape and size of the strip to deliver the quantity of grafts required while ensuring a minimal or imperceptible scar. This method has a lower incidence of graft transection because the removed strip can be processed under a brightly-lit, high-powered microscope which allows us to see exactly where the hair is growing under the skin. This clear view allows us to precisely position the scalpel to ensure the integrity of each graft is maintained.
Patients are concerned that strip excision leaves a thin hair transaplant scar where the strip was removed. If the resulting scar is visible, it is easily obscured by short hair growth, and the placement of the scar makes it unnoticeable for most patients. The Trychophytic closure technique allows the incision to heal tightly and with little to no noticeable scarring.
The donor strip is processed under a microscope, allowing the precise extraction of graft units.
Whether grafts are extracted by FUE or FUT, they are processed under stereoscopic dissecting microscopes to prepare each unit for transplant. It is essential that the integrity of these grafts remain undisturbed during the dissection process.
The grafts are planted as units, so if a graft contains three hairs when it is extracted, all three hairs will remain together when it is planted.
Individual graft units ready to be transplanted.
The goal is to produce healthy, viable graft units which can then be planted directly into the recipient area. Both Doctors use the lateral slit technique to carefully place each graft unit. This technique allows us to reproduce the natural growth direction of your hair and to give you the most natural looking results possible.
The amount and density of donor hair available and your restoration goals need to be considered when planning which method of extraction is the most suitable for you. We are happy to help you explore your options and can provide you with a complete assessment free of charge and with no obligation. Send your pictures along with some background information and your goals using our free online consultation form and we’ll provide your assessment, usually within 3 working days.
The Lateral Slit Technique
The position, angle, depth and rotation of the incision define how your transplanted hair will grow. Hasson and Wong use the lateral slit technique to consistently create the most natural looking hair transplant results as you can clearly see in our hair transplant photo gallery.