FUE is not always a good idea
There is a wave of excitement in the world with hair transplant surgery done via follicular extraction or "FUE." I'm excited too - I enjoy doing FUE and a great deal of our procedures are FUE. In fact, about one-half of our procedures this coming week will be FUE and one half will be strip procedures (FUSS).
But FUE always a good idea? No !
Not at all. The main concern about FUE is that it frequently involves removal of hairs from regions in the back of the scalp that might thin out in the future. For some patients FUE and strip are equally good - the patient can go ahead and choose!!! For other patients, FUE is an inferior method - strip is the only method I'll do! For other patients, strip is inferior method and FUE is the only method I'll do!
In many cases, the decision as to whether to have a hair transplant done via the FUE method or via the strip method is not left up to the patient to decide, nor is it left up to the hair transplant surgeon to decide. It is a complex decision that involves discussion of numerous factors.
For 20 % of patients who walk in the door, strip is the only option. For 20 % of patients, FUE is the only option based on the information they provide during the interview. For 60 % of patients, it's up to them!
As an example, let's consider two 29 year old identical twins (TWIN 1, TWIN2) with the same amount of hair loss. These 29 year old male twins have a lot of hair loss at the front of the scalp. I estimate they needs 3000 grafts for a nice result. They have some thinning in the top of the scalp too. They do not want to use minoxidil or finasteride. The dad is fairly bald, and the grandparents are bald. The twins other older brother just had a hair transplant at age 42. Let's pretend for the sake of discussion that we did a hair transplant via FUE for one of the twins and a hair transplant via strip method for the other twin- now let's fast forward from age 29 to age 55 and see how each twin is doing.
What I hope you'll come to understand is that the twin who had a hair transplant via strip method looks similar at age 30 but much, much better age age 55. The twin who had FUE at age 55 likely lost a good proportion of the grafts that were transplanted
TWIN NUMBER. 1: HAIR TRANSPLANT VIA FUE
Fast forwarding 25 years, twin 1 is disappointed. Hair looked good at one year following his transplant and even looked good at 5 years following the transplant. But now 25 years after his transplant, he's disappointed that his brother looks better! Many of the hairs that were transplanted back age age 29 have thinned out- they were taken from areas of the back of the scalp that were destined to undergo balding.
TWIN NUMBER 2 : HAIR TRANSPLANT VIA "STRIP SURGERY"
Fast forwarding 25 years, twin 2 is happy. Hair looked good at one year following his transplant and even looked good at 5 years following the transplant. And now 25 years after his transplant, he's quite tickled that he has better hair than his brother ! TWIN 1 attributes the better hair of TWIN 2 to less stress and a healthier diet - but in reality that has little to do with what we're seeing. The reasons is simple. Twin 2 has better hair because were taken from areas of the back of the scalp that was quite unlikely to undergo balding.
FUE is a wonderful technique. It's just not for everyone.
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Vancouver office at 604.283.9299