FUT or Strip Method is the main, classic method of hair transplantation. In this case skin strip is cut from the back of head (donor area) and it is further divided into follicle units – grafts, which are transplanted into balding areas (recipient areas).
A graft is a transplant which includes from 1 to 3-4 follicles.
Hair transplantation with STRIP method consists of 4 stages:
- Skin strip cutting fro donor area
This is the main stage which distinguishes STRIP method from FUE (stitchless) method. In this case hair is not shaved. The only area which is shaved is the narrow line on the back of head, which is cut. After that a cosmetic stitch is made on the wound, which is covered with hair and is not visible even right after the surgery.
The surgeon’s experience and skills are very important on this stage. It is essential that he correctly defined the skin strip sizes (length and width), which is to be cut, that is the necessary prerequisite for further formation of invisible scar, as well as performing the plastic incision correctly. We use the plastic method of donor area, which forms a thin, linear scar, which is fully covered with hair after several month from the surgery and it is not noticeable even in case of short haircut. This method of putting stitches is provided by Mario Marzola and it is called Trichophytic Closure.
The scar on the donor area (back of head) after 4 month from hair transplantation surgery with Strip method.
It can only be noticed in case of shaved hair or a very short haircut.
2. Graft preparation is performed under a stereoscopic microscope, with 10-20 times magnification, which significantly improves quality of graft processing and lessens the possibility of follicle damaging. All of these factors are directly reflected in the results of the procedure.
3. Forming micro holes in recipient area
This is a highly important stage as the transplant hair density and direction is formed during it. The depth of the micro holes must exactly correspond the length of the grafts, in order the follicles to be transplanted in the layer of the skin where they can function naturally.
We use microsurgical tools and injections to form micro holes in our clinic, which form a tiny linear incision, 0,8- 1,0 mm in length. This enables us to achieve the maximum density of transplanted hair, which leads to the best cosmetic results.
4. Implanting grafts in balding areas
Special tweezers are used to implant grafts by assistant surgeons.
In case of using implanters, the 3rd and 4th stages are performed simultaneously. Micro holes aren’t formed at that time as the implanter pen stings the skin and places graft into it at the same time.
How to plan hair transplantation?
Well-planned surgery is the necessary prerequisite of high quality transplanted hair. That’s why it is important to make an appointment with a doctor and be consulted. Hair transplantation necessity is identified, donor hair is assessed and exacted number of grafts are calculated during the consultation. In addition to this, forehead line design is negotiated and the most effective and safest method for you is chosen; surgery stages are also defined. A patient should get full information about the possible achievable results in their case. Hair transplantation can only be considered as successfully performed if the results meet the patient’s expectations.
If you cannot visit our clinic, you can have an online consultation.
Hair transplantation surgery doesn’t require special preparation. Prior the surgery patient has to take the following analysis:
- General blood test
- The prothrombin time (PT) test
- Blood glucose test
- Infections test (hepatitis B (HBV) and C (HCV), AIDS, Syphilis).
Patient is not allowed to take alcohol two days prior the surgery.
How is the surgery performed?
Hair transplantation is an ambulatory procedure, its duration depends on the volume of the work to be done and last for 3-6 hours. The manipulation is done under the conditions of local anesthesia, it is absolutely painless, without any side effects, in free mode for the patient: he/she is comfortably placed in an armchair, able to watch desired TV program or a film, talk on the phone, listen to music, etc. Dinner is served to the patient during the break time.
What should we know after hair transplantation?
Patient starts washing hair and gets back to their occupation right the next day of hair transplantation.
In case of Strip method, a bandage can be put on the patient’s donor area (back of head) for one night and hard physical activity can be restricted for two weeks. In case of FUE method bandage is necessarily put on the donor area for one day and the patient can do any sport or physical activity right from the third day after the surgery.
Transplanted hair doesn’t require any special care or further treatment. Due to physiological stability of hair growth, healthy hair starts growing from the follicles in 2-3 month after the transplantation, and after 6 month significant effect is noticeable, maximum result is acjieved after 10-12 months.
It is impossible to distinguish transplanted hairs from the rest; they grow naturally and don’t fall. It can be cut, dyed, styled, etc.
FUE – Stitchless Method
Follicle Unit Extraction or as it’s called FUE method is quite popular and demanding among the patients.
This method is special because grafts are taken separately from the donor area (back of head) with a special, 0.6-0.9 mm diameter, miniature tool – punch.
Nowadays many people consider FUE as the newest technology, though is has 30 years of development history.
In 1988 FUE procedure was first presented to society by a Japanese doctor Masumi Inaba, who used 1mm needle for follicle extraction. This tool was very important to develop FUE method. Later, doctor Woods used the same technique in Australia (1989).
Rosman and Berstein further developed Dr. Inaba’s technique in America. They offered a new approach to this issue, which included extracting follicle units of 1-3 hair ends – grafts (not separately each one) from donor area (back and side parts of head) using a small, 1mm diameter punch.
In 1995 Dr. William Rosman, Robert Bernstein, Voitsekh Shanievski and Alan J. Halperini publish the first publication regarding follicle transplantation.
So, the technique provided by Rosman and Bernstein is used nowadays and it is known as FUE (Follicle Unit Extraction) method.
The only thing that distinguishes FUE from Strip method is donor hair acquiring technique. In that case no incisions or stitches are made on the back of head. That’s why FUE method is also called “stitchless” and “non-surgical” method.
The rest stages of these two methods (FUE and Strip) are identical. Both methods use micro graft transplantation, which include 1-3 hairs and that’s why both result in completely natural aesthetic results.
FUE Transplantation Stages:
- Extracting donor follicle grafts from donor area.
- Forming micro holes on recipient area (in case of using implanter pens, this stage doesn’t exist. Stinging the skin and implanting grafts simultaneously).
- Implanting grafts into balding area.
Advantages of FUE Method:
- No incision is made on donor area (back of head). So there is no discomfort caused by the wound, nor the linear scar (so called “smile”).
- It is possible to transplant hair from the other parts of body (chest, back, limbs).
- Precise calculation of the grafts, consisting of a certain number and structure of hairs.
- Using FUE and Strip methods together (so called combined method) enables us to retain sufficient number of grafts even in case of high quality balding or bad scalp mobility in donor area. The combined method enables us to transplant more than 8000 grafts in frames of one surgery.
- Patient can do sport activities from the third day after the surgery, whereas hard physical activities are restricted for at least 2 weeks in case of Strip method.
It should be mentioned that FUE method doesn’t require profound knowledge of surgical skills and it is comparatively easier to perform that Strip method. That’s why all of the new transplantation specialists start their practice in hair transplantation field with this method. However, it is a misleading approach. FUE method needs surgical skills and, more importantly, experience, in order to avoid damaging grafts during the extraction and to maintain the natural appearance of donor area. Consequently, this results in high viability of the transplanted hair and rational usage of donor hairs, in order to avoid wasting them. You know that donor hair is limited in number and each graft is valuable for the patient.
The doctors of DeaMed have 16 years of experience in hair transplantation field using both _ FUE and Strip methods. In addition to this, they have really successful practice of teaching the doctors from around the world with modern technologies.
More than 5000 grafts can be transplanted using FUE method in frames of one surgery in our clinic.
The combined method of hair transplantation means using both – Strip and FUE methods at the same time in frames of one surgery.
The combined method is recommended in case of high quality balding, when it’s necessary to retain a lot of hairs. It must be mentioned that this way it is possible to retain 40-50% more hairs than in case of use Strip or FUE methods separately.
The combined method is also used in case of lower quality of balding, when there is genetic and clinical possibility of hair loss further progression. In that case we have much more resource of donor hair if hair loss continues in the future.
All of these, mentioned above prove that we can’t consider Strip and FUE methods as competitors. Vice versa, their combination gives us more possibilities to perform hair transplantation with maximum effectiveness and to get good volume of transplanted hair even in case of high quality balding.
Only two methods of hair transplantation are approved by ISHRS (International Society of Hair Restoration Surgery, USA) FUE (Strip) and FUE. There is also known one more robotized hair transplantation (Artas).
FUE (stitchless) method is special because grafts are taken separately from the donor area (back of head) with a special, 0.6-0.9 mm diameter, miniature tool – punch, without any linear incision. That’s why the method was later called “stitchless”, “non-surgical”, etc.
In case of Strip Method a skin strip is extracted from the back of head and then it is separated by follicular units – grafts, which are transplanted in balding areas (recipient area). Hairline scars are hidden by a “trichophytic closure” technique introduced by Mario Marzola, which leaved practically invisible scars on the back of head.
The main difference between these two methods is that in case of Strip method a fine linear scar is left on the back of head, which can be noticed only on shaved scalp or very short (less than 1.0mm) haircut, and in case of FUE there is no linear scar, though a lot of tiny (0.8mm diameter), round scars are left on the back of head, which can also be noticed on shaved head due to the skin features.
According to Bradley Wolf Strip method leaves one scar for all grafts, whereas FUE method forms each scar for each graft.
The idea, to consider FUE method as more advantageous than Strip method only because of the fact that there is no linear scar formed on the back of head, is disputable. In case of Strip method, if a surgeon considers the wound healing conditions, defines the measures of donor area correctly, performs donor area plastics professionally using “trichophytic closure” technique, a very fine linear scar is formed, which can’t be noticed even in case of very short haircut.
During Strip method Graft preparation is performed under a stereoscopic microscope by experienced assistants, with 10-20 times magnification, which significantly improves quality of graft processing and lessens the possibility of follicle damaging. All of these factors are directly reflected in the results of the procedure. And in case of FUE method grafts are retained from the donor area using a tool (0.6-0.9mm diameter punch) after forming a cylindrical incision around a graft. In such conditions the possibility of damaging curly hair is very high.
It must me mentioned that both methods (FUE and Strip) are widely used in the whole world. Both of them have their advantages, features, effects and side effects, it isn’t correct to consider them as opposing methods of each other. Vice versa, their combination gives us more possibilities to perform hair transplantation with maximum effectiveness and to get good volume of transplanted hair even in case of high quality balding.