“POTENTIAL” FUE DISADVANTAGES
As seen above there may are some real indications for the use of FUE. However it is important to point out that there are some potential disadvantages also. There is much controversy over the significance of these disadvantages. Once again physicians who do only FUT tend to emphasize these disadvantages while those that do only FUE tend to minimize them. When FUE was in its infancy these problems were common & significant. However over time the procedure has improved with new equipment and innovations and the results have become much better.
- Graft Tran-section:
When FUE first began incidence and degree of graft transection was very high. However, with improved techniques and experience transection rate can be less than 2%-5%which is similar to strip FUE. However the potential for high transection still exists for some patients with difficult hair characteristics like very curly hair and mushy skin.
- Fragile Grafts:
The grafts from FUE are thinner and stripped of more tissue than Strip FUT and are therefore more fragile and susceptible to decrease yield. However with more gentle ways of handling grafts plus better bio enhancement storage solutions the yield between FUE and FUT is narrowing.
- Potential Decrease In The Total Amount of Grafts Available When Compared to FUT:
This is one of the more highly debated controversial issues and the final answer is yet to be determined. In theory, the inability to fully access the mid-portion of the permanent zone limits the total amount of hair that can be accessed through FUE. At this time most surgeons generally believed that one can ultimately (over the life time of the patient) harvest more grafts with strip surgery than with FUE. If this turns out to be true it represents a significant disadvantage for FUE, since a limited donor supply is the main factor that prevents us from achieving the density we would like in many patients. This problem may not be apparent to patients that need lower amounts of grafts or are earlier in their hair loss journey. But it may be a ticking time bomb in the future. It is probably not a problem for patients who will need less than 4000-5000 grafts top accomplish their goals. But for patients that need more than this it is potentially a problem. To compensate for the inability to harvest all the hair from the permanent zone, many FUE surgeon harvest hair from the upper and lower margins of the original donor area and risk the hair being of poor quality or being non-permanent. The good news is that new paradigms for FUE graft harvesting plus the use of bio enhancement products like Acell & PRP to stimulate new hair from the donor area has slowly increased the number of grafts obtainable from FUE. At the time of this writing this subject is very controversial but most physicians believe that one can get more grafts with Exclusive use of Strip FUT (6000-9000 grafts) than Exclusive use of FUE (4000-5000 grafts). In my opinion the potential for getting the most grafts out of a patient exist when using both techniques together. As stated earlier it is important to be good at both techniques. In some patients exclusive FUE is best; In others exclusive FUT is best; and in many a combination may be the best approach to get the maximum number of grafts.
Although FUE does not produce a linear scar, it does cause thousands of tiny punch scars and in some patients a “moth eaten” scar pattern can occur ,especially in patient who have had a larger numbers of extraction. Patients need to be told about this possibility and that, although they can wear there hair short, they may not be able to shave their heads.
POTENTIAL SCARRING IN FUE
MULTIPLE WHITE DOTS OR A MOTH EATEN LOOK CAN OCCUR IN SOME PATIENTS
Appearance at 1 cm length
Another down side is that in order to do FUE the entire donor area has to be shaved. This is problem for a significant number of women. Most women and a significant number of men simply cannot tolerate this type of look socially.
- Graft Tran-section:
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“Thank you very much for your attention. I am very happy with the results of the surgery. After 3 months only I already have full hair coverage in all the affected areas and don’t need to use the hair clips like I used to do for many years. Please give my beast regards to Dr. Shapiro and the team...”Read More