FUE vs Strip Yield

Is it true that FUE can't give good density, ie. is it true that better density can be achieved with strip HT?

Category: FUE / CIT Hair Transplant FAQs

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We do not know where this concern over density has arisen from although it is most probably comes from the physicians who promote strip harvesting (FUG, FUT). The truth is they are scared to death of CIT® and FUE or they should be. Follicular unit extraction (FUE) is now mainstream and they have no choice except to learn CIT® or FUE. If they do not learn these procedures, they will soon have far fewer patients to work on.

If anything, the potential density and the potential total number of grafts available from CIT® are both greater than from strip harvesting. Typically, in a single pass, we are able to achieve densities that are 25% greater than from strip harvesting. This is because the grafts are smaller so we can place more of them into a smaller surface area. In addition, although the CIT® grafts are smaller, they generally contain more hairs per graft than most physicians' staff are capable of producing from graft preparation subsequent to strip harvest removal. Finally, our grafts do not have the same high risk to telogen hairs that are seen from graft preparation after strip harvest. All of these factors- the greater potential number of total grafts, higher single pass density, more hairs per graft, and less risk to telogen hairs - essentially assure a much better density from CIT® than one can obtain from strip harvesting.

There are other factors that contribute to the greater potential density of CIT® hair transplant. With strip, harvesting grafts are allowed to soak in a solution of saline or lactic ringers along with hundreds to thousands of other grafts for prolonged periods of time. A case of 2000 grafts will take at least 4 ½ hours to accomplish, but most patients will require 6 hours and even up to 8 hours for a higher quality procedure. Yes, you can do any strip procedure faster, but you will sacrifice quality and you will have a much higher transaction rate with greater damage to the hair follicles. While these grafts are all soaking in the same solution, they are releasing toxic chemicals that are injurious to one another and to the recipient area. Time out of the body and the exposure to other grafts within the same solution is far less with CIT®. Thus, CIT® grafts have a significant reduction in exposure to these toxic metabolites. This essentially ensures a higher yield from CIT®, although we have not performed scientifically conclusive studies yet. We have found that our CIT® methods often result in a much faster re-growth rate than we saw from strip harvesting. Still, it may take 8 months to 1 year before you have full re-growth. From CIT® you will generally have a higher percentage in the growing phase at any given time.

Peak restoration or temple restoration comes in many different varieties. Basically, it depends on the amount of loss you have or the total surface area that needs treatment. It is safe to say that peak or temple restoration requires a minimum of 400 grafts, but could require up to 1200 grafts. The location of the hairline has an affect on this number. If you are comfortable with a higher hairline, you will require fewer grafts. If you want the lower hairline, you will need more grafts. The hairline extension adds surface area to the recipient area at an exponential rate. A 1 mm extension increases the surface area by 3.14 sq. mm, a 2mm extension adds roughly 12.56 sq. mm, and a 3 mm extension adds about 28.26 sq mm. Small changes can require significantly more grafts. To fill in the frontal area, you may want to add another 100 to 300 grafts. If this area is much weaker, we may require more grafts.

Age is very important to the hair restoration procedure. We find that working on individuals with minimal hair loss in their mid-thirties is a safer bet that we can provide full coverage over the lifetime of our patients. Patients who begin to lose hair in their early 20s will most likely have more excessive hair loss and may not be able to achieve full coverage. Of course, there are many factors governing potential coverage. Density, Diameter, Wave, and many additional factors are important. We look forward to seeing your photos and a hair sample is often times a good thing to send, as well, so that we can assess you hair caliber.


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