FUT graft and FUE grafts

Please see the two photos. The only difference is the FUT grafts have tissue around its follicles and the FUE grafts have no tissue. 

FUE is a blind procedure, the deeper the cutting, the more chance of dissection of the follicles. The standard method is to blindly punch through the skin then use a strong forceps to pull them out. This is the reason why there are no tissues are around the follicle level and the follicle is left exposed with no protection.

Why we don’t offer FUE procedure?

Why we don’t offer FUE procedure?

Because we don’t think it’s your best interest!

Don’t listen to what people tell you! Take sometime, do your study seriously, ask questions, use your own intelligent and make your own decision.

Differences between FUT and FUE:

The only different between FUT and FUE is donor harvesting.

FUT uses blade and FUE uses punch. The recipient site transplant are completely the same.

Different tool used produced different result!

Comparison	FUE	FUT
Is it the latest technique?	no, it is the oldest punch graft but change the size of punch
Tool	punch	blade
Donor harvesting	blind	under direct microscopy vision
Wound treatment	leave open	closed
Scar	thousand of small punch scars	one linear scar
Scar distribution (in same length)	5 to 6 times wider	one line only
Total Scar Size	10 times bigger
Scar long term effect	permanent	permanent
For keloid patient	disaster-hard to treat thousand keloids	easier- only one scar to treat
Quality of graft	defect graft (no tissue around follicle)	intact graft (come with tissue around follicle)
Growth rate of transplantation	61.40%	86%	Read Dr.Beehner's study
Impact to 2nd surgery	huge-scar tissues change the hair direction	minimum- can use different donor area
Length of hair need to cover up the scar	1 cm	2 cm
Hairstyle options such as marine cut	no	yes
Price	Double

Why most surgeons prefer FUE?

  

FUE: need only one technician

FUT: need 3-4 technicians

Some surgeons do everything by themselves without hiring any assistance to save on business costs. It is for their own best interest, not yours.

In addition to the overhead expense, the surgery fee is double for the FUE technique. The incentive using FUE for physicians are simply irresistible. Especially for new physician who’s just starting his practice with only 3 to 5 surgeries a month. It’s difficult to start a business when you need to hire 3 to 4 technicians to assist.

ISHRS Warning

Learn from one hair transplant surgeon’s own experience.

Dr. M Beehner’s Study about FUE and FUT

Below is  Dr. M Beehner’s  (3560 hairs/ follicles) study which was presented at the ISHRS annual meeting on Sep 2015.

Please see the two photos. The only difference is the FUT grafts have tissue around its follicles and the FUE grafts have no tissue. 

FUE is a blind procedure, the deeper the cutting, the more chance of dissection of the follicles. The standard method is to blindly punch through the skin then use a strong forcep to pull them out. This is the reason why there are no tissues are around the follicle level and the follicle is left exposed with no protection.

The impact to survival rate is 10-14 months after surgery- 

FUT 86% survival rate (765/890) vs FUE 61.4% survival rate ( 547/890).

The difference is 24.6 %.

We all know donor hair is limited, our worst nightmare is that we might run out of it someday .
Remaining concerns are, what’s the impact to the transplanted hair quality and the life of it? So far no one has done this study.    

FUE Scars

FUE don’t produce linear scar but create thousand of punch scars. To transplant same amount of hair, the scar of FUE will be 10 time more than FUT because FUE wounds are leaved open, so they will keep the same size but FUT wound are closed and almost of the time it will be reduced to 10% or less.  







More about FUE Scars

Photos taken immediately after FUE surgery

Photos taken immediately after FUE surgery.

For FUE, hair at donor site will be shaved completely for FUE procedure. The punch scars is over the safety zone. There are no way the hypopigmentation scar will be covered by donor hair completely in the future.

Is the latest technique the best technique?

With technology, the saying has always been: the latest, the better; like smart phones and new cars. However, this does not apply with hair transplantation. The human body is a very intricate and complicated system. Pharmaceutical companies invest years, billions of dollars, and multiple phases of clinical tests to develop the newest medications. But even with extensive research, the medications still get recalled occasionally.

Basically, a hair transplant is only a relocation of hair from the back of the head to the desired area. It’s a very easy and simple procedure. However, this makes it difficult to stand out from other clinics. In order to convince potential clients, you have to create something brand new and different. Something that is very convincing and feasible.  For example, laser hair transplants were very popular twenty years ago. At that time, lasers were the the latest invention. It was the best marketing tool which is why doctors spoke so highly of the many laser hair transplant advantages. However, they did not realize that the laser sealed the blood supply as well. When people discovered that laser hair transplants held very poor yield rates and results, a few years had already passed. A lot of donor hair was wasted and a great amount of damage was done. Currently, no one mentions laser hair transplants anymore. Scalp reduction, flap, extension, expansion and ultra slim dense packing claim to transplant more than 3,000 very slim SFU to qualify as being advantageous. However, body hair transplants and eyelash transplants went through that course and all failed. Concurrently, there has been a lot of improvement on hair transplantation. But so far it is still only a relocation of the hair.

The latest techniques on hair transplantation always have a different surgical approach.

A surgical trend like FUE is very convincing and catches the interest of a lot of patients. More importantly is how profitable it is for the doctors. Doctors concentrate on how to produce the perfect grafts but they overlook the more important aspect. How efficient can FUE use the donor area? After the first surgery there will be thousands of punch scars around the donor site. This is worrisome because scar tissues will have a big impact on the hair growth direction. What will be the quality of the grafts by the second surgery? If patients keep losing hair, how will they handle the thousands of scars that will show someday? What is the maximum donor area that can be used? No one currently has the right answer and no one dares to bring up the problems either.

For patients who choose the latest technique for hair transplantation, they are taking a lot of  risks. 

When you want to have the latest hair transplant surgery, you should always be very cautious and use your own judgement. I am sure the FUE technique will be one that will cause major problems in the future.

FUE was called "punch graft" 30 years ago, the only difference is that size of punch is reduced. The scars are smaller but still stay forever. 

Invisible FUE Scar?

There was one young gentleman sitting in front of me on the airport shuttle.

I was looking around, and all of a sudden, I saw thousands of small round bald spots at the back of his head. I realized immediately that they are the recently popular FUE scars.

The size of FUE punch usually range from 0.8 mm to 1 mm. It is assumed the scar would be the same size, but the fact is that the scar always grows bigger than the size of the punch. The more tension of the scalp the bigger the scar. 

People spend 2-3 times the surgery fee and transection rate is much higher just to have the option to have a short hair cut. However, they really don't have option to shave their head. If their barber cuts their hair too short then they will be bothered for weeks before hair grows long enough to cover the scars. At the same time, it is a big problem for their barber too, they don't have any idea how short they can cut without the scars showing. 

Under direct sunshine requires much longer hair to cover then indoors, which is the standard they should perform.  

Attached are two photos which I used an  Iphone to take.The shuttle was very jumpy, hard to focus on.

Compare the Quality of FUE Graft and FUT Graft

FUE grafts are cut blindly using punch, basically are bare grafts, no tissue at button part. No study discuss about regrowth hair rate, quality and life time yet.



FUE Grafts:




FUT grafts are cut under microscopic direct vision, contain a lot of tissue including regrowth elements bulge and sebaceous gland.

FUT Grafts:

Which type of graft do you prefer?

Wine and Hair Transplant

The top news around the world today. ONE GLASS OF WINE A DAY INCREASES
RISK OF BREAST CANCER. It shocked so many people, because not too long ago, they said to drink one glass of wine a day to protect your heart and was published on all medias, That encouraged many people to drink wine every night.
This kind of controversial report it is not the first to happen, and it happens very often. It is
like vitamins, they always have controversial reports.
It happened in hair transplant field too. To try to transplant more and more grafts in certain area, the grafts should be cut smaller and smaller, without doing any study about its impact to the quality of regrowth and hair quality. Especially a lot of FUE grafts and not even a intact graft
( like bare graft)
We all know donor hair is limited if it were wasted, we never be able to undo it.

Compare Different FUE Methods

There are so many name and methods for FUE. I would like to organize them
in this form to make easy comparison.

	punch	motorized	unique point
2 step	sharp	no
3 step	sharp+dull	no
Safe system	dull	yes	*1
Roto core	sharp	yes	*2
Neo graft	sharp	yes	*3
Artas robotic	sharp+ dull	yes	*4

*1,Safe system
The initial rotation speed is only enough to allow the dull punch to penetrate
the skin and slow down the speed when pass deeper to separate the follicular
units from surrounding tissue. This will reduce transection rate of follicles.

*2, Roto core
Automatic rotation when downward pressure is placed. It has debris disposal
window to fasten disposal process and potential harm to the Punch tip.

*3, Neo graft
The device is used to extract follicular units and implant them in the recipient area
via a suction system. It seems a great idea, but has two major problems.
At first, suction has tendency to produce bare grafts. 2nd the contineous flows of air will dry up the delicate follicular units.

*4, Artas robotic
After initial calibration, the robot will work 100% automatic.
The quality of the grafts is excellent and transection rate is about 5-8%.
I would like to say it is the best way to have FUE procedure, if the price is
right.