There are 2 recognised hair transplant techniques in use today, the FUT and FUE techniques. They differ mainly in the donor management and the manner the follicular units are removed from the scalp. The hair loss pattern will determine the number of grafts required to cover the surface area. Each technique has pros and cons and before deciding on the technique to first use it is important to access the long term donor management.
Prior to surgery the donor and recipient area will have their best properties; the donor having the best density, laxity, no scarring and the recipient has also never been touched or impaired. If hair loss has progressed to an advanced state the need for grafts is high to cover the surface area. The larger the surface area the harder it is to treat the entire area in one procedure with either technique.
The options is to treat the area over multiple procedures, starting with the hair line and working back over the frontal third and mid-section and later to treat the crown; this will require maybe 2-5 procedures dependent on technique. Or by utilising the benefits of both FUT and FUE and combine the techniques to maximise the graft numbers in a single procedure; allowing for the potential to reach total coverage and possibly a “home run” result.
FUT the donor area is isolated to a thin strip around the sides and back generally locates around the occipital bone; FUE the donor zone is wider around the sides and back and determined by the potential hair loss pattern. FUT removes the hair in a single strip in an area of high hair density, with a good candidate around 5-6000 grafts can be removed, an average candidate around 4000 in a single procedure.
FUE removes hair from a wider zone outside the FUT area, procedures are generally smaller because of donor management protocols, it is ill-advised in an initial procedure to harvest much more than 3000 grafts, subsequent procedures fewer and fewer.
By combining the two there is the potential to reach in excess of 8000 grafts on a good candidate; on an average candidate that would maybe only achieve 4000 grafts increase the number to 6000. This can make a huge difference in the coverage achieved in a single procedure, with a well-placed hair line can result in total restoration and a full result being achieved in the minimum time frame and least inconvenience.
Combining the techniques can also be of great benefit to repair hair transplant candidates; when the donor area has been impaired by improper previous surgery. Being able to remove a strip and widen the extraction zone at the same time can provide the maximum graft numbers to correct the pattern of hair growth over the recipient area.
To gain the best long term result it must be thought about from the first session, then the optimum and maximum utilisation can be made of the donor area as it is untouched and has the greatest potential. Large Sessions allows the patient to achieve the maximum aesthetic result in the shortest time frame, less down-time away from work and excuses to friends, family and colleagues, as well as it being financially more agreeable to the wallet.
Achieving high numbers is not only about the characteristics of the patient. The Doctor´s & Medical Team must be able to work together efficiently and with high skill to ensure graft survival and patient care is the priority.
When deciding on the technique to best use; remember:
The harvesting method is not a matter of taste but a matter of necessity. Every patient has different characteristics and these should be taken into account when deciding on the best technique that should be employed*