To “ef you ee” or to “ef you tee”, what’s the question?


Hair transplant comes up often as topic for debate and I get asked by my friends, as well as acquaintances, “What should I choose? FUE or FUT? What do you think it’s best?”

This topic has been long time the subject of conventions, meetings, congresses, you name it, it’s been done.
So, we’re going to do it again. This is what I tell my friends, a virtual mini crash course in hair transplant:
You could choose FUT provided that:
- you don’t mind that later in life if you want to wear very short hair cut in the back (think of less than 1cm), people will see the scar;
- you don’t mind to have paresthesia for a couple of months, even up to a year;
- you don’t mind having taken out a sizable chunk of skin from the back of your head;
- budget-wise you’re looking for a good deal, FUT is more attractive.

You could choose FUE provided that:
- you are able to put up with the post-op pain, after all both donor and recipient areas look like a battle field;
- you don’t mind to have paresthesia for a couple of weeks, even up several months;
- you choose a skilled surgeon that know what she / he is doing, after all, transections are a hot topic nowadays;
- you don’t get tempted to go into a “mega-session” with more than 3000 in one intervention;
- you have the cash to go for it, as we all know, FUE requires a more labor-intensive effort compared to FUT, almost a double surgery if you think that in FUE one must extract all grafts first, while in FUT the tissue is cut within minutes.

"The dotted line"
Thing is, I see more and more docs and consultants showcasing their successes in FUT (youTube has plenty to offer), but all these videos have one thing in common, they expressly show “Look, no scar visible, not even from up-close (meaning 1 meter)”, combing the 3-4 centimeter long hairs up and down in front of the camera.
The truth is that the scar is there, you just need the right light and be willing to actually see it.

As Dr. Lars Heitmann – once a pro in FUT, turned FUE-er for a decade – explains:

“In FUT the depth of the cut is considerable more sizable than in FUE. Think of 6, 8 even 10 mm deep cuts, depending on the type of skin. Apart from this, the scalpel cuts through peripheral nerves, whereas in FUE we barely get to them. The usual depth for FUE can vary between 3 to 5 mm depending on the type skin and of the native growth angle of the hair follicles”.


In his turn, Dr. Eberson, a passionate FUE-er, pointed out an interesting aspect about FUE, totally worth mentioning:

“It is important to know that even in the case of FUE, especially with large sessions of extractions, say above 3000 grafts per day, the risk of shock loss increases significantly simply due to the fact that the donor area undergoes hypoxia as well as ischemia, for quite some time. The larger the area affected, the higher the risk.”

Wisely spoken.
None of the methods are perfect.
Both FUE as well as FUT leave scars; FUE leaves lots of tiny scars as dots, while FUT leaves a long, continuous scar.
The best is to explain these arguments to the patients and let them make an informed decision.
Besides this, I personally would not recommend mega-session to anyone (my friends included), not to patients, not to operating teams. Let the patient recover and do a flexible treatment plan.

After all, if the result is pleasing and the patient is happy, he or she will most likely wish to come back for the completion of the treatment.

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