Surgical hair restoration or hair transplant, while it comes in two basic techniques, always involve transferring bald-resistant hair follicles from the back and side of the scalp to the crown and front hairline.
Over the past 10 years, the follicular unit graft or FUG has been the gold standard practice despite the growing popularity and media hype surrounding a relatively new technique called the follicular unit extraction or FUE.
In FUG, doctors collect a strip of scalp behind the head before they dissect each hair follicle one at a time under a microscope. The graft is then planted into tiny incisions in the balding spots or areas that need coverage.
On the other hand, the relatively new technique FUE involves the use of a small round puncher to harvest hair grafts one at a time and plant them into the areas where hair is thinning out.
Proponents of FUE always highlight the technique’s ability to harvest hair grafts without creating long incisions, which can lead to scar, at the back of the scalp. While there is some truth behind it, there are still notable advantages that make FUG still the gold standard approach.
Despite the use of long incisions to collect a strip of scalp, a well-executed FUG leads to a very thin scar, about 1-2mm wide, that is easily covered by the surrounding hair. Simply put, visible scarring is rarely a problem.
In terms of better coverage and higher survival rate of hair grafts, the FUG is superior over FUE, 90-95 percent vs. 75-80 percent.
The higher graft survival rate in FUG is attributed to its shorter time procedure, meaning the hair follicles are less exposed to the “elements.” Meanwhile, in the FUE the grafts are outside the body for a longer period of time, leading to a lower regrowth rate.
The amount of coverage in FUG is also superior because it allows doctors to collect as many as 3,000 grafts, versus 500 grafts in FUE.
Because FUE is more time consuming and it often involves multiple procedures to achieve the desired result, its cost can be 50 percent higher than FUG which is a much simpler and more effective hair transplant technique.
But even with a well-executed FUG, patients should also do their part to further increase the graft survival rate and avoid the wide scar in the donor site; this typically involves proper care and washing of the hair to remove scabs, and avoiding strenuous activities and heavy lifting for at least two weeks after surgery.