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November - 21,2022

Dilemma in advanced baldness – FUE alone or combination of FUE & FUT

Hair transplant is a crucial decision to make and hence you require complete and authentic information before coming to a conclusion or finalising anything. In today’s era of google searches, all information looks like just a click away. But while scrolling through tons of information on hair transplant beware of false traps of misinformation, myths, marketing gimmicks and fleshy results with incomplete truth.

This blogging platform on Satya is our small way to help you provide the most authentic information about some of the most common queries that our patients have come through over the last 20+ years.
In relatively early cases of baldness, the approach will more or less be similar at different places but the real dilemma arises for the patients of higher grade of baldness.

They are hounded by questions like – Should I go for FUE or FUT, or should I start medicine or not, or can I get full coverage or not? In today’s blog we will try to clear your doubts regarding the appropriate hair transplant techniques.
Before moving forward let’s dwell into some basic knowledge. There are broadly two techniques of hair transplant namely, FUE and FUT, with each having its own advantages and limitations.FUE is further popularly marketed as DHT, DHI, DSFT etc.

FUT is the gold standard and time tested technique and fondly known as the “Rolls Royce of hair transplant” in the world of core hair transplant surgeons. FUE, on the other hand, is a relatively younger child which came in picture in around 2008. Though FUE came late, but it soon became almost everyone’s favourite because of the ease in doing so. There are very few hair transplant surgeons who are skilled enough and confident enough to perform FUT. But the important point here is that the incapability of your doctor to do FUT should not be a cause to deprive you of the benefits of FUT.
Your donor is very precious and we urge you to give your donor only in the hands of a surgeon who is equally versed in both the techniques. This will help in you to get your donor judiciously used without any over-depletion.

Firstly you need to have a realistic expectation in case of advanced grade of baldness. You might come across various flashy results claiming to do mega session of 4000-7000 grafts with FUE alone without depleting the donor area. But what is hidden from you is the fact that most of such patients are put on finasteride along with transplant and so 70-80-% of these results are solely a courtesy of medicine.

Let dig a little deeper into the mathematics of transplant.

A FUT strip can easily harvest 2500-3000 grafts in one go. While if we do FUE on the same area as that of the FUT strip, the maximum grafts that we can hope for will be 1/3rd of FUT i.e 800-1000. So adding or combining FUT with FUE gives your doctor the freedom to take out a large number of grafts from the safe donor zone only and at the same time preserving sufficient donor to be used as a second FUT strip, if required in future.

In the same scenario if we harvest a large no of grafts with FUE alone, then the surgeon will have no choice other than using both safe and unsafe(Much higher chances of thinning and fall out) donor zone. Also if we consider the donor aesthetics, FUT will give you a negligible thin scar which can be further completely hidden by hardly 50-100 grafts. But FUE, done in large no, will give you multiple small scars, with thin spaces in between, thereby making your donor look depleted.

In conclusion the selection of techniques should not be based on the available skills of the surgeon, instead it should be based on your grade and progression of baldness, your expectations from the transplant and finally the availability of your donor area. The aim should always be a good coverage and finer aesthetics of both the recipient as well as the donor area. Since and rogenetic alopecia or male pattern baldness or genetic baldness is a progressive condition, so you should aim for a long term planning of your hair restoration and not fall prey to someone looking for one short glory. As Dr. Shaiil famously says, “Hair transplant is a journey not a destination. So plan it right TM

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