Which Method to Choose
The gold standard method is follicular unit transplantation –over 95% of worlds transplants are done by this method.
1. Follicular unit Hair transplantation(FUT):
Over years, instruments and techniques have been developed that allow us to achieve truly natural results by transplanting small grafts containing 1-2-3 hairs, very close together. It has been found that hair grows from the scalp in groups of one, two, and three hair follicles called follicular units. Transplantation of these units results in denser and more natural results. This, the so called ‘follicular unit transplantation or FUT ‘is the state of art technique for hair transplantation today. In FUT, a strip of skin with hairs is removed, dissected under microscope to separate follicular units and then transplanted.The removed strip area, is sutured by a special method called trichophytic closure which heals with an imperceptible thin line which is hidden under the hairs.The other major advance in this field is the use of microscope to dissect hairs and avoid transaction of hairs. Also a special method of closing donor strip called trichophytic closure which reduces scar over donor area has also been introduced.
2.Sutureless transplantation or FUE:
More recently a new method called FUE or follicular unit extraction has been introduced. In FUE, each unit is pulled out individually, with tiny 0.8mm -1mm instrument called punch and then transplanted in to bald area, These tiny holes then heal with minute imperceptible scars. For this reason, FUE is also called suture less transplantation. It has also been wrongly advertised as scarless transplantation on internet sites. Once there is some damage in skin , there is always scar , however small and hence scarless transplantation is a wrong and unscientific terminology. It is to be emphasized that FUE method has recieved exaggerated attention and publicity on internet. See table for comparison of the two methods.
Comparison of FUT and FUE
Body Hair transplantation:
Body hair transplantation is generally done only when scalp hair is exhausted. Body hair is not the preferred source when scalp hair is visible for the following reasons:
a) Body hair has to be extracted singly and hence is slow- takes 3-4 days for a 2000 graft session
b) Body hair occurs mostly as single hair units and hence gives less density
c) Body hair diameter is less and so gives less density
d) Long term behavior of body hair is still not known as the technique is new.
e) Body hair may grow long when transplanted on to scalp, but not as long and as thick as scalp hair- so it is inferior to scalp hair
f) Lastly and most importantly, Body hair transplantation is possible only for patients who have good body hair on chest.
Summary:
1. In our opinion , for Indian situation , for patients with limited budget, FUT is the best method as it is cheaper, more convenient and gives outstanding results . The only advantage of FUE is the avoidance of suture. With recent introduction of trichophytic closure , the scar produced is almost imperceptible even after strip excision.
2. Despite this, FUE holds attraction to many patients who are apprehensive of the FUT method because of “ skin being removed” . In such patients, with adequate financial resources, FUE can be done.
3. Body hair in our opinion Is inferior to scalp hair and is therefore recommended only when scalp hair is not available. Again this is a technique receiving a lot of hype and exaggeration on internet sites, and many patients ask for it hoping not to disturb their scalp hair.
It should be emphasized that despite all the hype in internet sites, 95% of all hair transplants in the world are done by FUT only. FUE accounts for only 5% of all transplants because of its high cost. This is the case with us also- we have many patients who seek FUE after reading on internet, and then change their minds to have FUT after knowing full details.