Now nearly all world hair transplant surgeons turned to follicular unit hair transplantation (FUT) technique. And the era of transplanting clumps of hairs and giving unnatural “corn’s field “appearance is over. With growing experience of surgeons and sharing of knowledge among them, this field has evolved a lot. The expectations of patients also pushes surgeon to find something more and fulfill the requirement and thus evolving not only surgeon but also the overall techniques and the results. Many surgeons will agree that what they were doing 5 years back they are not following today and thing have changed a lot, rather improved a lot.
Now two techniques are there in the world followed by all surgeons, but with some variations. One technique is FUT- follicular unit transplantation with strip method and other is FUE – follicular unit extraction. FUE is also a FUT, i.e. follicular units are harvested singly and then later procedures; making holes/ slits in the recipient site and doing transplantation / placing are same.
Some surgeons still do some variations or mixing to improve results and customize as per the need of patients. Some variations to list:
VARIATIONS IN HARVESTING FROM DONOR AREA
- FUT with single strip and special care to harvest without damaging any hair bulb and dissecting layer by layer.
- FUE only – single follicular unit harvestation and then routine.
- Combining FUT and FUE – one can get more number of grafts and requires more time and efforts, I suggest to do on separate days so patient and surgery team not existed. And more importantly FUE have the advantage of liberty to surgeon to choose the grafts as per the requirement.
- FUT with multiblade knife- now not advocated, due to more damage to hair bulbs.
VARIATIONS IN SLIT/ HOLE MAKING
- Holes with hypodermic needles
- Slits with premade fixed slit instruments
- Slits with precut blades of different sizes
- Robotic machine hole making
VARIATIONS IN PLACING
- Placing by 2/3 staff with placing forceps.
- Placing with implanter (choi and KNU)
- Special implanter syringe was available previously
With all the evolution of techniques and science, good results are going to come.
One of my patients asked me “FUE is new and FUT technique is old so I want to do FUE only”. It is not like THE NEW IS ALWAYS BETTER; But both techniques suits different people and has advantages and disadvantages, that I will discuss in my next article.
