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What Hair Transplant Procedure is Best for Advanced Hair Loss?

6/20/2018 4:45:52 PM

In today’s modern-day hair restoration, hair transplant patients are lucky enough to have two surgical options for restoring their hair. In this article, we will go over the cognitive limitations and physical restrictions and discuss in detail the pros and cons for each procedure.

Follicular Unit Strip Surgery (FUSS):

Hair restoration has evolved from the “corn row” or “barbie doll” hair plugs of the 80’s and early 90’s. Follicular Unit Strip Surgery (FUSS) now use micro surgical blades which enable hair transplant surgeons to make micro incisions and “densely” pack up to 40-60 follicular units per square centimeter. Follicular Unit Strip Surgery (FUSS) or strip surgery, is a surgical technique that involves a surgeon removing donor tissue from the sides and back of the scalp where hair is genetically resistant to the hormone Dihydrotestosterone (DHT), DHT is the main catalyst for androgenic alopecia or genetic hair loss. The donor tissue is then dissected under high magnification and follicular units are put in to their natural groupings of one (1) hair, two (2) hair, three (3) hair and four (4) hair follicular units.

Follicular Unit Excision (FUE):

Follicular Unit Excision, formerly known as Follicular Unit Extraction (FUE) is a minimally invasive procedure that involves a hair transplant surgeon using a small punch between the sizes of .7 and 1mm in circumference.  The hair restoration surgeon uses the small punch to extract each follicular unit one by one. Both the strip excision and FUE procedures create 1, 2, 3, and 4 hair follicular unit grafts that are then transplanted into the balding area in the same manner.

Comparison FUSS to FUE:

The primary difference is the surgical technique used to harvest the follicular unit grafts. However, there are different physical limitations that exist between each procedure that a potential patient must be cognizant of before having surgery. Both hair procedures rely on a finite donor supply thus careful planning must be employed prior to having surgery. Generally, more grafts can be excised using strip surgery because a large donor strip can be removed in one sitting without any obvious signs to the donor site. However, due to the nature of FUE less grafts can be harvested in one sitting for a multitude of factors such as donor density, graft transection, surgical fatigue etc. Conversely, strip surgery relies on scalp elasticity thus the more surgeries an individual has equals a reduction in scalp elasticity until the scalp can no longer support strip surgery.


While both procedures offer ultra-refined follicular unit transplantation, it is recommended for patients with extensive hair loss to maximize their donor supply with strip surgery first, until they no longer have scalp elasticity or “stripped out” and then use FUE to maximize every possible follicular unit in their donor site. As with any surgery, choosing a qualified and skilled surgeon is essential for receiving natural results that will last a lifetime.  Find a prescreened hair restoration surgeon in your area  and schedule a consultation today.

Written By,

Melvin (HTSoon) - Editorial Assistant and Forum Co-Moderator For the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog. To share ideas with other hair loss sufferers visit our new Hair Loss Forum and Social Community.