Dr. pal

Hair transplant is a permanent one time solution for hair loss. Nowadays due to better understanding of anatomy surgeons are doing follicular unit transplantation. There are major two methods for harvesting the hair from donor sites: fut and fue.
There is a continuous discussion in hair transplant surgeons about which method is best for hair transplant for scalp baldness.

My views on this subject are as follows. 
1. Fut gives a single linear scar. This scar is visible only if you shave completely. But if you are going for ht we believe that the person is not going to stay bald anyway. So scar is never visible.
2. Fut gives a linear scar. With help of trichophytic closure, hair grow through scar also. So nobody can see your scar. 
3. Fut gives linear single scar that if not happy with can be transplanted with few graft to hide it. Even scalp micropigmentation may help to improve the quality of the scar.
4. If done by good surgeon the fut scar is barely visible. As marketed against. It does not pain. It does not cause any problems later. There are no need to remove sutures. Stiches does not hurt you. It does not get infected. 
5. The linear scar gives you 2500 to 3000 follicles in single stage. It leaves you with natural density in other donor area, that can be used for 2nd sitting of ht later in life. 
6. After 1st fut session you can get done second session of ht by either again fut or fue. Fut scar can be removed in second stage. So leaves only one scar at the end. Fue even can be done after 1st session of fut with good yield of hair.
7. It can be used with fue for megasessions 
8. It is always in permanent zone. The hair from fut never fall.
9. Over all scar on scalp is less, gives good amount of hair follicles, with future chance of second session from same donor area as the donor site density never get reduced.
10. Fut can also be done in cases of 1st session of fue 
11. In fut hair other than an agent phase can also be used for transplant.

While FUE.
1. If used as first stage will use most of the donor area 
2. As fue uses large area of scalp, over all scalp scarring is more.
3. In contrary to belief fue scars also are visible if you shave.
4. It causes permanent reduction of donor site. The same area cannot be used again. So it is very difficult for young boys to get second sitting in case of 1st sitting with fue. 
5. There are multiple small circular scar that numbers around 3 to 4000. It causes pulling of existing hair roots. This makes the second session by fue all the more difficult with increased transaction rates.
6. Fue uses larger area of scalp. So there are more chances of harvest from non permanent zone and those hair may fall in future.
7. Fut graft are surrounded by supporting structures while fue grafts are unsupported, very thin near hair root level. So chances of drying or damage wile implanting may be more compared to fut.
8. Fue grafts contain skin element on top. So if not implanted deep. Chances of epidermal cyst, cobblestone appearance and decreased density are more possible in fue.
9. In fue there are chances of buried follicles and also transaction. So at time of harvest it is a follicle loss. While in fut theoretically all follicles can be used for implanting.
10. Fue can be done by two or three persons only. While fut a team may work for follicles dissection. So time for surgery is more in fue. 
11. As the time taken is more. Charge per follicle is also more for fue in most of the clinics. 
12 second fue in same area will leave you with more scars.
13. Chances of shock loss are more in fue than fut.

Advantages of FUE.
1. It does not depend on the team
2. It does not produce linear scar so can be marketed as no scar technique, which is a myth.
3. It can in combination with fut give large amount of hair follicles 
4. It can be used for donor sites other than scalp. Namely beard, chest hair and other body hair where cut and suturing not possible 
5. It is good for small needs like. Eyebrows, eyelashes, moustache and scar revision.
6. Theoretically all active follicles in an agent phase are taken so hair growth with fue come little early than fut. 
7. For white hair FUT is difficult while fue is more helpful.

So over all both are the method for harvesting hair from permanent donor zone. It does not effect the result much. The result depends on direction and density of transplanted hair. Patients and specifically young ones have to understand the importance of fut method. They must ask the transplant doctors about which method he or she is offering. Patients should choose those who offer both methods as they can get better yield.

Fue is marketed as no scar no stiches no pain method. This is totally wrong. This gives permanent 3 to 4000 circular scars, leaves you with reduced donor density and therefore very much decreased possibility of second session.

Plastic surgeons usually offer both methods while dermatologist and other transplant doctors offer only fue. Patients must be aware of advantages and disadvantages of both methods.