FUE Hair Transplant vs. FUT

Older man, head full of hair

There are several hair transplant methods doctors in Los Angeles can perform. The “strip” method or FUT (follicular unit transplantation) is the most commonly performed method. The FUE (follicular unit extraction) method, a minimally invasive method of hair transplantation introduced in the late 90’s, and this automated method is the newest most advanced method of hair transplantation available today.

Before and After Photos

The “strip” method or FUT is a surgically invasive procedure. With the “strip” method, the hair at the back of scalp is cut short. That section of scalp is surgically excised. The wound created by the incision is then stitched up or stapled together. Next, the excised portion of the scalp is divided up and placed under several microscopes where technicians using sharp blades separate grafts into units of one to four hairs. While the technicians are separating the grafts, the physician creates the hairline and recipient sites using a needle or a specific blade. Once the recipient sites are created, the grafts are then placed into the sites using forceps. The grafts with a single hair are placed in the front for a more natural hairline. The rest are placed behind to give the recipient area density.

Dr. Neavin performs FUE Hair Transplantation exclusively.

From a surgical standpoint, an FUE surgery is a very safe, minimally invasive, relatively minor procedure. It can also be done to female patients. With the FUE method there is no need to excise a piece of the scalp because the follicles are removed directly from the donor area using a tiny 1 mm punch (punch sizes vary) and forceps. The punch is manually rotated to make a small circular incision in the skin around the follicular unit (hair follicles), which is then removed directly from the scalp using forceps. After the appropriate number of units has been removed, technicians separate the grafts into units of one to four hairs and these grafts are implanted much the same way as the “strip” method. With the FUE method there is little bleeding and fewer complications than with the “strip” method. The procedure is performed with local anesthetic and no intravenous or intra-muscular sedation is required.

The benefits of the FUE method is minimal discomfort, no scalpel incision, no sutures, no linear scar, little to no risk of complications, quick recovery time, fewer activity limitations and a more natural looking result than traditional strip methods (patients can wear their hair short without an unsightly scar).

This procedure is the most beneficial for the patient; however the majority of hair restoration doctors do not offer the FUE procedure because there are some nuisances associated with it. First, doing it manually is very tedious and time consuming, making the procedure too costly for most patients. Next, it is difficult to learn the procedure and unless the doctor becomes very skilled there is a risk for a high transection (damage) rate of the follicles. Finally, forceps are used in a manual FUE to extract and implant the follicles which can easily traumatize the follicles as well. As a result most doctors are not willing to spend the time to learn this procedure and they continue to do the easier, more invasive, faster “strip” method.

Finally, with the NeoGraft technology the patient receives the benefits of the FUE procedure and the physician benefits from the advancements of the technique made easier and with more efficient repeatable results.

With NeoGraft most patients can be candidates for an FUE hair transplant. Given the choice most hair restoration patients would prefer the less minimally invasive procedure over having the more invasive “strip” surgery. Even though many patients are good candidates for a NeoGraft, if they are not seen by a doctor that specializes in FUE or with the NeoGraft automated FUE device, they may not be given advice which is in their best interest.

The hair restoration patient also needs to understand how important choosing the right surgeon remains. Final hairline design results are dependent upon the skill and artistic abilities of the surgeon performing the procedure. Hair transplant procedures encompass both cosmetic and reconstructive surgery. These artistic skills and abilities can often be qualified by researching the results of other surgical and reconstructive procedures these surgeons do on the face and head.

It’s important to do your homework and pick a surgeon that is uniquely qualified to handle your hair restoration needs.

The NeoGraft Automated FUE is also a useful procedure to fix visible linear scars from previous “strip” surgeries. FUE can be used to ‘fill in’ or camouflage those old scars by transplanting new follicles into the area.

Hair Transplant Surgeries


How does hair transplantation work?

Hair follicles are taken (harvested) from an area called the donor area and implanted into the bald or thinning area called the recipient site. For men, the balding pattern is predictable. The follicles that are programmed to die from male pattern hair loss are not harvested because it is the follicle, not the actual geographical area itself, that causes follicle death and baldness. Because the pattern of hair loss is predictable in men, the strategy is to take hair follicles from a “protected” area, such as the back and sides of the head for implantation. When a hair follicle is taken from a protected area and put in a bald or balding spot on the head, the follicle with preserve its properties and grow without any threat of dying from genetics to which the other hairs in that balding area succumbed.

For women, the strategy is a little different. As women age, their hair thins and their hairline recedes. While a receding hairline in women is more subtle than in men, it still imparts an aged look to the face. A higher hairline means a bigger forehead. A bigger forehead registers in our minds as “older”. Look at photos of young women in magazines and billboards. The forehead is generally smaller, and the proportions of the face are more harmonious. When a forehead lengthens as a result from hair loss, the upper third of the face is no longer in proportion to the mid and lower third of the face.

Hair transplantation in women aim to restore balance in the upper third of the face and to increase density in the front of the scalp. Hair is generally taken in the same regions as they are harvested in men, and the technique is the same.

What are the main benefits of FUE over the “strip” surgery?

It is well accepted that FUE transplants heal faster and more comfortably than linear incision harvest techniques using a scalpel and requiring stitches. With FUE, once healing is complete, the patient has the option of wearing a very short haircut without the worry of a tell-tale linear scar. Without the need for stitches, downtime is shorter with fewer activity restrictions immediately after the procedure.

What is an “FUE” hair transplant?

“F.U.E.” or “Follicular-Unit Extraction” is an advanced, minimally-invasive hair transplant method which allows for the harvesting of individual follicles from the donor area without a scalpel incision or the necessary stitches, and therefore leaves no linear scar.

How long does a hair transplantation procedure take?

The factors that go into hair transplantation duration include the number of grafts of the procedure, the amount of technicians working on the transplantation, and the skill and experience of the surgeon and technicians. Speed does not always correlate with experience.

Some very sloppy hair transplantation procedures can be performed rather swiftly. In experienced hands, rough estimates range from 3 hours to 12 hours, depending on grafting volume. 1,000 grafts may take 3-4 hours, and 3600 grafts may take 12 hours. This, of course includes lunch and bathroom breaks. Generally, in cases that exceed 1200 grafts, 2 technicians are involved to increase efficiency.

Will I need more than one grafting session?

Most hair transplantations are performed in one sitting. Time is generally the limitation, not hair. We have performed up to 4,000 grafts in one day. Such a large volume of grafts entails two technicians and about 10 hours. If more grafts are needed, then a second grafting can be performed no earlier than 6 months from the first procedure.

Will hair transplantation results look completely natural?

This is one of the most common questions patients ask. The reason is that historically, hair transplantation got a bad name because the techniques were poor. Plug looks and big scars were the rule for a very long time. With Neograft, automated follicular extraction, natural looking hairlines are finally achievable in the right hands. Hair transplantation, like any other procedure, relies on planning and execution. Planning the transplant is critical in achieving natural looking results. For instance, hairlines should “match” the face. Density patterns should mimic the expected density taking into account adjacent hair density and predictable future thinning.

Execution of the transplantation will determine graft survival and also impact the aesthetics. Very experienced technicians such as the ones available through NeoGraft understand and appreciate hair growth figurations. That is, hairs don’t always grow directly perpendicular to the scalp. If they did, natural parts in hair would exist. When implanting hairs in a thin area, the angle of follicle insertion should match and be parallel to the surrounding hairs. In areas of complete baldness, there is no neighboring hairs to match. Experienced surgeons and technicians that understand hair growth will implant follicles to grow in a natural pattern.

Are the final transplanted ‘results’ any different with FUE/NeoGraft than those achieved with the “strip” surgery?

Results are similar. FUE procedures, by default, yield grafts that contain mainly one, two, three, or four follicles called “follicular units. “Strip” harvests, which are microscopically dissected by a team into grafts of one, two or three follicles, would also yield similar ‘follicular-unit’ grafts. Provided that in each case the grafts are implanted with care, artistry and precision into the recipient area, the final transplanted results with FUE would be similar, if not identical, to those of an accomplished surgeon performing the “strip” harvest. The difference is not in the area of hair growth, but how the donor area is harvested either by a strip of scalp or by small individual graft extractions.

How many grafts/hairs will I need?

Estimates of the preferable number of grafts for any specific desire can generally be estimated with photos. However, in person examination always results in a more accurate estimate. As a rule, a music CD surface area on the scalp represents about 2000 grafts.

There are factors to consider when estimating density. Contrast between hair and scalp color will require slightly more grafts to improve density then same color hair and scalp. For instance, a white man with black hair will require more grafts to give the same “look” of hair density than a black man with black hair.

Does the hair transplant procedure hurt?

This is a trick question. The actually hair harvesting and transplanting doesn’t hurt at all. However, this is because the area is anesthetized prior to starting. The process of numbing the scalp involves injections with very small needles. Patients usually take an oral narcotic and
sedative before proceeding. Thus, some pinching from injections is associated with the start of the procedure, but it is very tolerable.

After the procedure, a sunburn like sensation may occur for a couple days in some people where the hair was harvested. However, this discomfort pales in comparison to the older strip method that involved large incisions across the back of the head.

What is the recovery and healing time?

With NeoGraft automated follicular extraction there are no incisions. This in itself cuts down on down time compared to the older, strip method for hair transplantation. No incision means less pain and no need for staples or stitch removal. Generally, one can expect some itchiness or sunburn like sensation to the area where hair was harvested. This typically resolves in a couple of days. In larger grafting sessions, some swelling may develop around the forehead and eyes for a couple of days.

This swelling is mainly from the fluid that was injected to keep your scalp numb throughout the procedure. In the area where hair was grafted, some crusting will occur and flake off within a week. Because there are no incisions, healing is really immediate. Some hair will start to grow within weeks, but many go into a stage of “sleep” and will not wake up to start growing in several months

Can I run out of hair for grafting?

Yes, there are certain limitations with hair transplantation. However, most men and women have enough hair in the back of their head to accommodate a very area. If more hair is required to increase density, hair can be obtained from the body. Body hair is a bit different in its properties than hair on the head. However, when combined with scalp hair the results look very natural.

Can you take hair from my body?

Yes, but body hair is not preferred to scalp hair. The properties of the body hair will be transplanted within the follicle. Body hair can be more curly or finer depending in the harvest site. While body hair is certainly an option for grafting, it is typically used only when there is insufficient scalp hair.

Can I get an infection from hair transplantation?

Because the scalp is exceptionally vascular, infections are thankfully rare. In addition, there are no incisions with NeoGraft FUE. The procedure will penetrate the skin, but only to a very superficial layer. If infection does occur, they are easily managed with antibiotics.

If you take hair from the back of my head won’t I get a bald spot?

This is a fantastic question. The answer is no. Only every 3rd or 4th hair will be harvested from the back of the scalp. A reduction of 25% of hair density will not be visually noticeable. In addition, over 6 months to a year, the “hole” where the follicle was harvested will contract, or shrink, improving the density from the donor site. A repeat grafting session can be performed

Is FUE/NeoGraft suitable for both men and women?

Yes. Because FUE/NeoGraft is a minimally-invasive procedure, it is a viable option for both men and women looking to restore their own living and growing hair with transplantation.

Do I have to get a total ‘buzz cut’ to have an FUE/NeoGraft procedure?

No, not if your wear your hair long. If your donor hair is long enough, harvesting using the FUE/NeoGraft can be done by shaving small areas which can be covered by your other, existing hair. If you wear your hair short, it helps to shave it close for maximum yield. It looks more natural sooner as the transplanted grafts are short as well.

When will my new hair start to grow after NeoGraft hair transplantation?

Some hairs will grow by 3 to 6 months after transplantation. This is because hairs will go into a sleep stage. When hairs do begin to grow back, they start off growing thinner. By one year the hair should develop a thickness similar to the surrounding native hair. While everyone is different, 6 months to 9 months is a safe estimate for significant hair growth. This is an important fact to digest since many people want and expect immediate results.

Are the results permanent?

In experienced hands, yes. The hairs chosen for transplantation are taken from bald-resistant areas. These follicles, and not the scalp to where they will be implanted, provide the protection from dying. This is known as donor dominance, meaning the hair follicles retain their original genetic programming and should grow the rest of your life. If the follicles were taken from an area that is susceptible to hair loss related to male pattern balding, then the hairs would certainly die as the follicles are not genetically destined to grow throughout your lifetime. Thus, the harvesting is just as important as the transplanting.

Am I a good candidate for a procedure using FUE/NeoGraft?

The best way to determine whether you are a candidate for hair transplant using FUE/NeoGraft is a one-on-one consultation with Dr. Neavin.

How Long After Facelift Can I Have Hair Transplant?

How Long After Facelift Can I Have Hair Transplant?

While it is possible to do a hair transplantation during a facelift, there are some limitations to consider. For one, facelift surgery can be a long operation. So is hair transplantations. It is difficult to perform big hair restorations combined facelift surgery in a safe amount of time. While one can save time by getting more assistants, the work on a head can be distracting.

Likewise, surgery on the face can cause motion to the face and head and distract a grafting team. The role for NeoGraft combined with face lift really is for brow grafting or hairline lowering. Higher brows from hair transplantation and a smaller forehead as a result of hairline lowering is a very powerful rejuvenating procedure.

What should I do or what should I avoid to make sure the grafts “stick” and stay in the transplanted region?

By 10 days the follicles should be integrated into the scalp. After the procedure, you will simply “baby” the area. No head gear, etc. No pools or ocean. No direct shower stream onto head. These things will be discussed in more depth during your consultation, but most is common sense. It’s a rather low maintenance after care.

Is there any kind of guarantee the grafts (or at least a certain percentage) will stick and grow? Have you ever heard of any of the transplanted grafts not growing at all?

Your follicles will be extracted in a very atraumatic fashion to preserve graft integrity with very experienced hands. We aim for and expect a 95% take rate.

Once the grafts start growing will they be as strong and thick as my other follicles?

The grafts WILL be as strong. However, the first cycle of growth will produce finer hairs. Second cycle at about a year or so will be normal. This is, of course, assuming we are using the scalp hair (hair on the head). It is true that hairs can be harvested from the body, but these hairs will maintain their native properties. Body hair can be used when all other head hair has been exhausted. It is not the primary donor site.