▶ Previous Artlcle : #9-1. Donor Harvesting Technique: FUS(S) VS. FUE
FUE
There is no risk of complications such as major arterial bleeding or incomplete suture of the incision site, making it available for doctors with no experience in FUSS.
The procedure requires only a few devices, such as punch, punch holder and forceps.
The sutures do not need to be removed.
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Having to harvest hair follicles by follicular unit, it is difficult to harvest a large number of them at once and transplantation outcome is less satisfactory than FUSS.
Doctors should harvest hair follicles by themselves, which is time consuming and physically demanding. Patients also have to endure a long time of procedure.
Donor site should be shaved, making it noticeable for a while afterwards.
The procedure is much more expensive.
FUE may not be indicated for some hair follicles depending on their condition.
Having to harvest hair follicles for a long time, doctors may lose their concentration, which may increase the possibility of damaging hair follicles. A long learning curve is required to be skilled in the technique.
Hair follicles are harvested directly with the use of a 1-1.2 mm punch, which increases transection rate compared with FUSS (Figure 3).
Figure 3.
Harvested hair follicles should be tidied by technicians, but FUE requires fewer staff members and therefore less labor cost than FUSS.
Doctors should perform the hair follicle harvesting as well as the transplantation by themselves. As the procedure time is prolonged, doctors may lose their concentration.
Hundreds or thousands of hypopigmented spots, just as linear scar, may develop and become noticeable on the scalp in people like Koreans. The overall area of scar is much greater than with FUSS.
Post-procedural pain is smaller than with FUSS, but paresthesia occurs relatively frequently.
Patients feel less worried from not having to undergo direct incision of the scalp.
FUSS is no longer available on the tightened scalp due to repeated procedures, in which case FUE can be an alternative.
FUE can be a better option when only a small number of hair follicles are needed. Based on the characteristics of FUSS and FUE, FUE may not be applicable to the following cases:
Patients for whom a donor site scar is not a problem
Younger patients who are expected to have hair loss (Norwood type 3-4) in the future
Patients who want large amount of hair follicles transplanted at once with a limited budget for surgery
Patients whose donor site density is very low
Patients who do not want to shave their hair for donor harvesting
Conclusion
FUE has become more popular and commercialized recently because of less scar, less complicated technique, and high profitability at a lower cost of setting. It is also true that FUE device manufacturers have done a lot of commercials to promote the sales of expensive devices. However, most hair transplantation experts still think that FUSS is superior in outcome and more preferable than FUE. Currently, FUE is adopted selectively for indications only deemed beneficial.
-To be continued-
