What is a hair transplant?

A hair transplant is a surgical treatment that reverses hair loss. 

Hair loss occurs when the hair follicles (which are the shafts in the skin that hairs grow through) in the scalp close up or become faulty. As a result, fewer and thinner hairs grow on the top of the head. A hair transplant works by removing healthy hair follicles from one area of the body (known as the ‘donor site’) and transplanting them into the balding areas on the scalp (known as the ‘treatment area’). Over time, the transplanted hair follicles produce new, healthy hairs, which cover the scalp with a full head of natural hair. 

A surgeon can use one of two techniques to extract hair follicles from the donor site: FUT or FUE. 

What is a FUT hair transplant? 

FUT stands for Follicular Unit Transplantation. During a FUT hair transplant, your surgeon will remove a long, thin piece of tissue from the donor site (which is typically the lower-back or sides of the scalp). A local anaesthetic is used at this time to reduce discomfort. 

Once the piece of tissue has been removed, your surgeon will stitch the donor site closed. The stitches will be removed after approximately 10 to 14 days after the surgery. This will leave a thin, linear scar, which can be easily concealed using the surrounding hair.

Then, the surgeon will use a powerful microscope to remove the tiny hair follicles from the extracted piece of tissue (this process is known as stereo-microscopic dissection).

Finally, the extracted hair follicles are inserted into the balding areas of the scalp. Over time, the transplanted follicles will produce healthy new hairs, which will cover the scalp. It takes approximately 12 to 18 months for this final result to become fully visible. 

FUT hair transplants are sometimes called ‘strip surgery’ or ‘the strip method’, because they work by removing a ‘strip’ of tissue from the donor site. 

What is a FUE hair transplant? 

FUE stands for Follicular Unit Extraction. Unlike FUT, this procedure removes each individual hair follicle from the donor site one-by-one, and then transplants them directly into the treatment area. 

At the start of the transplant, your surgeon will shave the donor site. Then a device called a micropunch or a motorised surgical tool is used to extract hair follicles from this region. 

Once a hair follicle is plucked from the donor site, it is immediately transplanted into the balding areas of the head. Each follicle is harvested in a random fashion, to prevent thinning in the donor site. 

As FUE hair transplants do not require a strip of tissue to be removed from the donor site, they do not create a linear scar. Instead, the micropunch creates a small circular scar around each individual hair follicle that is removed – though these can be easily concealed by the surrounding hair. 

As with FUT, new hairs will grow out from the transplanted hair follicles over time, and it takes roughly 12 to 18 months for the final result of the treatment to be fully visible. 

What is the Difference Between FUT and FUE? 

The main difference between FUT and FUE hair transplants is the technique that is used to extract hair follicles from the donor site: FUT transplants remove a strip of tissue and then collect the follicles from this, whilst FUE transplants extract each hair follicle individually and then transplant them into the treatment area directly. 

However, the use of these different techniques results in several other key differences between FUT and FUE, such as: 

• The Time That It Takes to Complete the Procedure

As FUE surgery involves removing each hair follicle one-by-one, whilst FUT surgery only involves the removal of a strip of tissue, it takes longer to complete a FUE hair transplant than a FUT hair transplant. Typically, it takes 1 full day to complete a FUE transplant, though in some cases it can take 2 to 3 days. 

Moreover, FUE hair transplants require clients to spend more time in the clinic than FUT hair transplants. This is because clients must be present as each individual hair follicle is extracted and then re-inserted, but clients do not need to be in the clinic when hair follicles are being removed from an extracted piece of tissue. 

• Scarring 

Both FUE and FUT hair transplants create scars in the scalp. You should be wary of any clinic which claims to offer ‘scarless hair transplants’ or ‘scarless surgery’. These claims will always be dishonest, as it is simply impossible to perform surgery without some scarring. 

The good news, though, is that – when a hair transplant is performed by a skilled and experienced surgeon – the surgery will not leave large, unsightly scars in the scalp. Instead, the scars will be small and easily concealable using the surrounding hair. 

FUE and FUT transplants create different scars on the scalp. FUT surgery leaves a single, linear scar at the site where the strip of tissue was removed from the donor site. The length of this linear scar depends on the size of the piece of tissue that was extracted. 

By contrast, FUE surgery creates a circular scar around each extracted hair follicle. This means that FUE hair transplants create multiple scars, whilst FUT surgery creates a single scar. The number of scars depends on the number of hair follicles that are harvested using the micropunch during the procedure. 

Nevertheless, the circular scars that are created by the FUE process are very small, as each scar is no larger than 1 mm in diameter. Moreover, a skilled surgeon will remove hair follicles sparsely, to prevent a cluster of scars in the same area. This also means that there is enough hair remaining in the donor site to conceal the scars, so that they are essentially invisible. 

• Invasiveness 

FUT is a much more invasive procedure than FUE, because it requires a strip of skin to be removed from the donor site. By contrast, FUE only requires individual hair follicles to be plucked from the donor site, which are very small. 

• The Amount of Hair Follicles that are Harvested 

A greater number of hair follicles can be harvested during FUT surgery than FUE surgery. This is because all of the hair follicles on the strip of skin that is removed during the FUT process can be extracted and transplanted. Meanwhile, FUE surgery only sparsely removes hair follicles from the donor site to ensure that the donor area remains covered in hair, and so that scars can be concealed. 

This means that patients who are experiencing extreme hair loss (such as stage 7 on the Norwood Scale) are likely to be better suited to a FUT transplant than FUE surgery, since more hair follicles will be required to fill the balding area. 

• Cost

The price of a hair transplant varies from patient to patient, as it depends on the extent of the hair loss that the client is suffering from and the number of hair follicles that need to be transplanted. 

Nevertheless, FUE hair transplants are usually more expensive than FUT hair transplants. This is because FUE is a more precise and intricate procedure, as each hair follicle is extracted and re-inserted individually. As a result, FUE surgery takes longer to complete than FUT surgery, which requires more of a surgeon’s time and thus makes it the more expensive treatment. 

• Recovery Time 

Whether FUT or FUE, all patients need to take good care of their scalp after a hair transplant. It takes time for the relocated hair follicles to take root in their new position, and – if you do not follow the aftercare instructions given to you by your surgeon – they could become dislodged, which will prevent the growth of new hair. 

On the whole, however, FUE has a shorter recovery time than FUT. This is because FUT is a more invasive procedure than FUE, and so it takes longer for the wound to heal. 

What are the Advantages of FUE and FUT? 

FUE and FUT have different pros and cons, and the right procedure for you depends on your individual needs. Nevertheless, here is a summary of the advantages of each type of transplant: 

The Advantages of FUT: 

1. It provides better coverage and fullness. The FUT technique harvests more hair follicles than the FUE technique, which means that it is better at treating large bald areas. 
2. It’s faster. FUT hair transplants require patients to spend less time at the clinic. 
3. It’s cheaper. As FUT surgery is a quicker process than FUE surgery, the treatment is usually less expensive. 
4. It only creates a single scar. FUT hair transplants leave a single, linear scar, whilst FUE surgery creates multiple round scars. 

The Advantages of FUE: 

1. It’s less invasive. FUT surgery requires a piece of skin to be removed from the scalp, which is quite an invasive process. By contrast, FUE surgery extracts and re-inserts hair follicles one at a time, making it the more comfortable procedure. 
2. It leaves a lot of hair growing in the donor site. FUE surgery plucks individual hair follicles from the donor site in a sparse and scattered fashion, to avoid large bald patches emerging in this area.
3. It creates very small, concealable scars. The circular scars that are created by the micropunch are very less than 1 mm wide in diameter, and they are easy to hide using the surrounding hair. 
4. The recovery time is faster. As FUE is a less invasive procedure than FUT, patients will be able to recover and return to their normal activities sooner.
5. It is intricate and precise. FUE works by selecting individual hair follicles to extract from the donor site, and then removing them one-by-one. The precision and intricacy of this process produces cleaner, better results. 

FUE and FUT Hair Transplant Timelines:

The timeline below gives patients an idea of what to expect in the run up to and after a FUE or FUT hair transplant:

One Week Before the Surgery:

Both FUE and FUT hair transplants require patients to avoid smoking, drinking alcohol, taking painkillers, supplements or blood thinners in the week preceding their treatment. 

The Day of the Surgery:

Patients must not drink caffeine on the day of the surgery, and should wear loose, baggy clothing which is easy to remove without touching the head. 

Patients having a FUE hair transplant should expect to spend more time in the clinic than those having a FUT transplant, since this procedure is more intricate and precise, and so takes longer to complete. 

One Week after the Surgery:

Scabbing, itchiness, redness and swelling is most intense in the first week after the procedure. Patients must resist the temptation to scratch their scabs, as this could dislodge the transplanted hair follicles and ruin the results of the treatment. 

Patients who had a FUT hair transplant are likely to experience these symptoms around the area from which a strip of skin was taken, whilst patients who had a FUE hair transplant will not experience such localised side effects. 

Two Weeks after the Surgery:

The side effects noted above will have reduced significantly. Scabs will begin to fall off, and shedding (‘shock hair loss’) may begin.

One Month after the Surgery:

At this stage, the side effects of the treatment will have disappeared, but the new hairs will not yet have grown, causing the scalp to look as it did prior to the transplant. The hair in the donor site will have grown back completely, concealing the scars that were made during the treatment.

Three Months after the Surgery:

Some very small, thin hairs will begin to emerge from the transplanted follicles. 

Six Months after the Surgery:

Longer and slightly thicker hair will have emerged from the transplanted follicles. The new hairs will grow at different rates, causing some patchiness – but don’t worry, this will even out with time. 

Nine Months after the Surgery:

The patchiness will have decreased significantly, as new, thick hairs continue to grow.

Twelve to Eighteen Months after the Surgery:

After approximately one year has passed since a FUE or FUT hair transplant, the final result will be visible. Thick, dark hairs will completely cover the recipient areas of the scalp. A follow-up appointment will be scheduled at this time to examine the results and ensure that the client is fully satisfied. 

Is FUE more expensive than FUT?

Yes, FUE is usually more expensive than FUT. This is because FUE hair transplants typically take longer to complete than FUT hair transplants, and so they require more of a surgeon’s time. Moreover, FUE transplants are more intricate and precise than FUT transplants, so they demand a greater level of experience and expertise. 

Who is the right candidate for FUE and FUT?

Whether FUE or FUT, a good candidate for a hair transplant is someone who suffers from hair loss in some areas of the scalp, but not in others. Typically, patients who suffer male pattern or female pattern baldness fit this criteria.

The vast majority of patients are better suited to a FUE hair transplant than a FUT hair transplant. This is because FUE is a more precise and intricate procedure, which leads to a better, more natural-looking result.

However, patients who are suffering from a lot of hair loss (and match stage 7 of the Norwood scale) may be better suited to a FUT hair transplant. This is because the FUT process harvests a larger number of hair follicles than the FUE technique, and more hair follicles are required to fill a large bald area.

If you are unsure which type of transplant is right for you, you can arrange a consultation with one of our specialists online or over the phone and receive advice on the best treatment option for you. 

What are the Side Effects of FUT and FUE?

As we mentioned above, it is impossible to complete a hair transplant without some scarring, and clients should be wary of any clinic that promises ‘scar-free’ surgery. 

FUE and FUT differ in the shape of the scars that they create. FUT creates a single, linear scar, whilst FUE creates multiple, though very small, circular scars. In both cases, the scars can be concealed using the surrounding hair.

Moreover, both FUT and FUE hair transplants can cause swelling, scabbing, itchiness, redness, numbness and ache on the scalp. These symptoms will reduce after one week and disappear after two. During this time, patients can take painkillers, like paracetamol or ibuprofen, to tackle these side effects.

Finally, both FUT and FUE hair transplants cause hair shedding in the first one to three months after the procedure. This phenomenon is known as ‘shock hair loss’, and it occurs because the hairs that were growing out from the transplanted follicles fall out in order to allow new hairs to grow. As a result, it is common for patients to experience patchiness in the first few months following the transplant – but don’t worry, new hair will grow with time. 

Which is more effective – FUE vs FUT?

The effectiveness of the procedure depends on the needs and situation of the client. For example, FUT is the more effective type of transplant in the case of patients who are classed as being at stage 7 of the Norwood scale, since this procedure harvests a larger number of hair follicles.

On the whole, however, FUE is the more effective type of transplant. This is because the FUE process is more exact and meticulous, as well as being less invasive. 

What is the failure rate of FUE?

FUE is the most popular and advanced technique for hair transplants used by clinics today, and its success rate is very high. On average, over 95% of FUE hair transplants succeed (a hair transplant is classed as successful if between 60-70% transplanted hair grafts survive the procedure). 

The success of the procedure depends on the skill and experience of the surgeon, as well as the attention that the patient pays to the pre- and post-surgical care instructions. 

What are the risk factors associated with FUE and FUT hair transplants?

A hair transplant (whether FUE or FUT) is a surgical procedure, which means that there is a risk of infection. However, when the procedure is conducted by an experienced surgeon at a reputable clinic (where clean equipment and hygienic practices are used), this risk is exceptionally low.

Both FUE and FUT transplants also involve the use of anesthetic to reduce discomfort, which carries some small risks, such as the risk of an allergic reaction. 

Both types of hair transplant also come with a very small risk of failure, since it is possible for the transplanted hair follicles to fail to take root in their new location. This is rare, however, and the risk is decreased even further when patients pay keen attention to the post-surgical care instructions that are given to them by their surgeon. 

Can the same person have both a FUT and a FUE hair transplant?

It is highly unusual for a patient to require both a FUE and a FUT hair transplant. However, it is possible to undergo both procedures. 

An example of such an instance would be if a patient has had a FUT hair transplant but is unsatisfied with the result (because the surgery was performed by an inexperienced or unskilled surgeon, perhaps). In this case, the patient could not have another FUT hair transplant, because the scalp is now too tight to remove a second strip of skin from the donor area. However, a FUE hair transplant can be performed to remedy the errors of the FUT transplant (provided that the surgery is now performed by a certified surgeon at a reputable clinic!). 

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Adnan Agic

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