Strip and FUE Hair Transplant

Traditional Strip Excision vs FUE Hair Transplantation

- Phase 1: The removal of the hairs from the donor area.
- Phase 2: The preparation of the skin for transplantation.
- Phase 3: The preparation of the transplantation area.
- Phase 4: The implantation of the grafts.

Phase 1: Removal of the hairs from the donor area
Traditional Strip Excision In traditional hair transplantation, strips of skin are removed using a single blade or multi-bladed scalpel.	*FUE Hair* Transplantation In FUE hair transplant, individual hair follicles are removed using a needle one at a time. No scalpel or blade is ever used.

Traditional Strip Excision The donor area is closed using stitches or staples which cause further trauma to the donor site. Return visits are required for suture removal. Patients will be left with a linear scar.	*FUE Hair* Transplantation High magnification of the donor area immediately after the donor hairs extraction. The small wounds which remain do not require stitching and leave no visible scars. Donor site heals faster.

Traditional Strip Excision Typical linear scar from traditional strip excision procedure. The linear scar has a tendency to stretch over time.	*FUE Hair* Transplantation Donor site two weeks after FUE Hair Transplantation. The site heals very fast and scars are less visible.

Phase 1 - Summary In traditional strip excision hair transplantation, the donor area is first anaesthetized using a needle or syringe. As the skin is stretched rather tightly across the scalp, administering anesthetic using a needle can be rather painful. A sharp blade is then used to remove strips of skin from the donor area; this naturally causes significant trauma and bleeding. The area must be stitched to close the wounds and highly visible scar formation is inevitable.	Phase 1 - Summary No blades or scalpels are used in FUE Hair Transplantation. The follicles are removed using topical anesthesia, without needles. The donor follicles to be transplanted (‘grafts’) usually consisting of one or a few hairs and their follicles, are removed using a needle. There is very little bleeding, no need to stitch the wound, and no visible scar formation. After treatment, the small wounds left by the needle can easily be covered by the surrounding hair.

Phase 2: Preparation of the donor hairs for transplantation
Traditional Strip Excision Strips of skin obtained by traditional strip excision hair transplantation techniques. The skin is then dissected into individual hair follicles on a workstation before transplanting to balding area.	*FUE Hair* Transplantation In FUE Hair Transplantation, the grafts usually consist of one or a few hairs and their follicles and they are ready to be transplanted soon after extraction without having to be dissected like traditional strip excision surgery.

Phase 2 - Summary In traditional strip excision hair transplantation, the removed strips of skin are cut and dissected into individual follicles before they are transplanted to the balding area. Sometimes the dissection is performed by technicians instead of the doctors. The doctors will then decide whether to group the individual follicles into larger grafts for transplantation purpose. In order words, a lot of human interventions in the process.	Phase 2 - Summary The process of dissecting or separating the follicles is not necessary under FUE Hair Transplantation. Soon after the donor hairs are extracted by the needle, they are ready to be transplanted to the balding areas. There is no further or unnecessary intervention by the human hands. No artificial groupings of individual follicles or risk of additional transection of the follicles during the dissecting process.

Phase 3: Preparation of the recipient area
Traditional Strip Excision In traditional techniques, punch-holes, slits grafts or round grafts are made in the recipient area. The grafts do not always fit nicely in the holes or slits.	*FUE Hair* Transplantation In FUE Hair Transplantation, micro incisions are made in the recipient area using a needle the same size as the needle used to obtain the grafts from the donor area.

Phase 3 - Summary In traditional strip excision hair transplantation, the recipient area is anaesthetized by needles and incisions are commonly made in one of the following ways: the punch method, where small holes of between 1.0 and 1.5 mm are made using punches; the slit method, where small slits are made using a sharp blade; the laser method, where the holes are made using a laser beam. The grafts do not always fit nicely into the holes under this technique. Sometimes a bandage has to be wrapped around the patient's head after the surgery for 24-48 hours in order to keep the grafts in place.	Phase 3 - Summary In FUE Hair Transplantation, the recipient area is not cut with a knife or punched as in traditional procedure. Only a micro opening the size of a needle tip is required on the recipient site. The surgery is less traumatic for the patient so a small amount of anesthetic will be sufficient. The anesthetic is administered without syringe or needles and hence less pain is inflicted on the patient. A 23 gauge needle (or sometimes 21 gauge), the same size as the one that is used to extract the donor hairs, is used to make micro incisions in the skin where the grafts are then inserted individually. The grafts fit very well into the micro incisions made by the needle. They heal very quickly without leaving a visible scar. The patient is never asked to have bandages wrapped around his head after the surgery.

Phase 4: Implantation of the grafts
Traditional Strip Excision Traditional technique immediately after surgery. The grafts do not always fit exactly into the slits or holes. The recipient site is prepared with more traumatic cutting and hence a potentially a higher chance of scar formation in and unnatural results.	*FUE Hair* Transplantation FUE Hair Transplantation usually use needles to plant the donor follicles. Needles can be as small as gauge 25 which leaves almost no scarring immediately post op.
Traditional Strip Excision Two weeks after traditional surgery. Wound healing takes slightly longer and the scabs have not yet fallen off.	*FUE Hair* Transplantation Two weeks after FUE Hair Transplantation. Scabs completely fell out and redness almost all gone.

Phase 4 - Summary Pros: Strip is more efficient than FUE. Large sessions can be performed more easily. Cost is usually less expensive than FUE, in some cases by over 50% or more. Doctors can obtain more donor follicles using strip technique over any given donor area. It is the preferred technique if the patient wants to max out the donor site. Cons: the procedure is more invasive and more traumatic to the patient. Healing of the donor scar may take longer. Require use of knife, scalpel, and stitches. Patients will be left with a linear strip scar across the back of the head. The strip scar may sometimes stretch over time.	Phase 4 - Summary Pros: minimally invasive and the least traumatic to the patient. No knife, no scalpel, no stitches, no linear scar. Fast healing time. Selective harvesting is possible. Doctors can select the 1, 2, 3, or even 4 hairs grafts in the process depending on the requirements of the patients. The donor scars are more easily camouflaged and blend in with existing hair. With FUE, doctors can also perform Body Hair Transplant BHT using donor from body hair. Cons: generally more expensive than Strip technique, can be twice as expensive or more. Very few doctors perform FUE nowadays. Hard to find a truly qualified FUE surgeon. The technique is difficult to learn and very tedious for the doctor to perform. Not possible to extract the maximum follicles possible from the donor using FUE. Donor scars can sometimes appear as white dots.