Which hair transplantation method is best for you?

Selecting the best hair transplantation method can be a daunting task. What are the parameters that you need to look at to choose the best hair transplantation method? In this article, we explain the thinking that goes into selecting a method for you. Bottom line is - the best method for you is the one that you and your surgeon agree on.

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Which is the best hair transplantation method? 

 

This is the most frequently asked question both among patients and professionals. All consultations usually end in a quizzical look and the words “so which method is the best?” We always recommend the transplantation method best suited to our patients. But, through several years of experience with FUT (which we’ve been using since 1998) and FUE (since 2003) we’ve found that the answer is not universal. 

 

Furthermore, our experience with BHT (since 2006) and LHT (since 2011) has shown that no single method dominates the others. Each of the methods has advantages and disadvantages that come with indications and contraindications.

 

You see, we think that the question “Which is the best hair transplantation method?” is an incorrect one. We believe that each case is unique and needs to be approached with a different mindset. Every hair transplantation operation method has its advantages, disadvantages and, most importantly, the right timing. In order to choose which method is best for you, we have to consider and weigh each option in accordance to your needs. 

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FUE, FUT, LHT: which transplantation method is the best? 

 

There are three methods that we generally apply at the Tsilosani Hair Transplantation Institute. The FUT method, the FUE method and the LHT method. We have extensive knowledge of and experience with all three of them. Dr. Tsilosani has conducted thousands of operations, with each one of these hair transplantation methods. Each one has resulted in success, specifically because he considers individual cases and the benefits for the client before conducting the transplantation. 

 

So what are the advantages, disadvantages of each and when is each hair transplantation method the best for you? Let’s break down the FUT, FUE, and LHT method and find out. 

 

FUT - Follicular Unit Transplantation method

The FUT method, also known as the strip method, is the first method we started using at the Tsilosani Hair Transplantation Institute. It is also the earliest available method for the hair transplantation procedure. As a result, the procedure has been perfected and rehearsed to a fine performance. Here are some of the advantages of the method.

Hair transplantation before and after
Advantages of the FUT method: 

 

  • Speed - The FUT (Strip) method allows an experienced surgical team to harvest and transplant large amounts of grafts faster. A normal FUT procedure lasts only 3 to 4 hours, compared to longer lasting FUE and BHT methods.

  • Higher number of grafts - The FUT method allows a surgical team to transplant a higher number of grafts in a single session compared to FUE surgery. This is the result of the FUT method allowing for efficient harvesting from the donor area. 

  • Efficient use of donor area - Elaborating from the previous point. If the density in the donor area is the same as the rest of the scalp, the FUT method allows for a more efficient use of it. Harvesting hair from the nape area is easier with this method. It is also possible to harvest higher numbers of grafts with several FUT sessions. 

  • Low transection rates - Transection is the accidental cutting of the hair bulb in the grant during transplantation. The FUT method mitigates this issue, especially when using modern tools such as we do. The open donor technique, stereomicroscopic graft preparation and other methods allow to minimize transection rates. What is more, the harvesting and further processing of donor tissue by an experienced surgeon such as Dr. Tsilosani and a team of surgical assistants bring the transection rate below 3% (meaning that in every 100 hair roots only 3 of them are transected). 

  • High survival rate - The FUT graft method is well researched. Most researchers agree that the survival rate of hairs is much higher with this method (nearly 100%). According to them the FUE procedure bears more risk of trauma to the grafts during the harvesting and implantation processes. Especially without proper preparation and use of modern methods. Dr. Akaki Tsilosani’s 2004 research “Survival Rate of FOX grafts” was the first paper in the world to show that FUT and FUE grafts have the same survival rate, if the procedures are conducted with proper preparation. Still, we are inclined to notify you of the general consensus on the two hair transplantation methods. 

  • Lower cost - The FUT hair transplantation method generally tends to imply more workload on the surgical assistant, rather than the surgeon themselves. This results in the procedure having a lower cost. 

FUT scar 6 months after operation
Disadvantages of the FUT method:
  • Scarring - The biggest disadvantage of the FUT method is a linear scar which appears from where the donor strip is harvested. Though, thanks to Dr. Tsilosani’s experience, cleanup procedure and trichophytic-based wound closure methods, the scar is barely noticeable. The scar only becomes noticeable if the eye is trained to look for it - and only when hair is cut extremely short. 

  • Recovery - The FUT method also comes with certain discomfort after the operation. Numbness, mild pain, and a sense of stretching in the nape area are prevalent, but do not last long. Additionally, it is recommended to not exercise for 2 to 3 weeks after the procedure. 

FUE - Follicular Unit Excision method

The FUE procedure has been practiced at the Akaki Tsilosani Hair Transplantation Institute since 2003. Dr. Akaki Tsilosani MD has conducted extensive research on this procedure and has achieved results directly comparable to the FUT procedure. His extensive knowledge and experience with the procedure makes him one of the best surgeons in the FUE procedure. The FUE method is minimally invasive. The individual grafts are removed directly from the donor area, without any kind of cutting, slitting or suturing. This makes the experience less traumatic compared to the FUT procedure. Let’s look at some of the advantages of the FUE method: 

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Advantages of the FUE method:
  • No linear scarring - This is one of the greatest advantages of the FUE method. There is no large scar that results from the method. Only smaller, individual micro scars and depigmentation remain after the procedure, which are barely detectable. Even in the case of a short haircut or a shaved head, this scarring remains invisible.

  • Less invasive - The FUE method, as mentioned above, is less invasive than the FUT method. There is less postoperative discomfort after an FUE surgery. There is less numbness, less pain, and the time to get back to strenuous exercise is also lower. 

  • Alternative harvest areas - If the nape area of the scalp (the back of the head) has low hair density, it is possible to use other areas of the body for donor hair. Using the BHT (body hair transplantation) method, it is possible to harvest grafts from the beard, chest, torso, legs and pubic area. This procedure results in a natural look thanks to the correct use of the technique and strategic planning of the transplant. 

  • Higher density grafts - The FUE procedure has grafts consisting of higher density follicles. The surgeon always targets multi hair follicular units, each containing 3-4 hair roots, to maximize density. Dr. J. Cole’s research papers show that the hair to graft ratio in an FUE procedure conducted by an experienced doctor is close to 3. The FUT method is limited to 2 on average.

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Disadvantages of the FUE method:
  • Longer duration - Due to the need to harvest and transplant individual grafts, the FUE method procedure takes longer. The variance in time can be anywhere from 1 to 3 hours, as compared to an FUT procedure.

  • Lower number of grafts - The FUE method allows the harvesting of a lower number of grafts than the FUT method due to time and donor area constraints. Higher rates are possible for the FUE technique in case of a wider donor area with a high density of grafts.

  • Higher transection rates - The FUE technique requires the harvesting of individual grafts. This results in a higher risk of transection and, as a result, a higher rate of it. Follicles that suffer from the transection rate as a result of the FUE method are several times more numerous compared to the FUT method. In the worst case scenarios the transaction rate can be 10-15% and more. Fortunately, with correct tools, an experienced surgeon and a qualified team the transection rate can be lowered and brought closer to that of an FUT method operation. 

  • Requirement for higher qualification - Due to the nature of the procedure, FUE grafts are exposed to more trauma. Unlike an FUT procedure, they are not surrounded by protective tissue. As a result, delicate treatment by assistants is of utmost importance. Otherwise, the procedure might have a lower survival rate. Thankfully, this can be mitigated by a surgeon as experience as Dr. Akaki Tsilosani and his highly experienced team. 

  • Higher costs - FUE surgeries depend mostly on the surgeon’s work. The price of the procedure reflects this, and thus is higher than that of FUT surgeries. If an FUE surgery is being conducted solely by assistants, it is considered to be a violation of international medical law. The low price of such a procedure would reflect that. 

LHT - Long Hair Transplantation method

 

The Long Hair Transplantation method is a modified Follicular Unit Transplantation method. The modification was invented for the advantages it brings, namely the biggest advantage being the transplantation of hairs that are 2-8 centimeters long, instead of the usual 2 millimeters. 

 

When thinking about the LHT method, it is important to remember that it comes with all the advantages and disadvantages of the FUT method. Yet, it is not limited to just those. Here is a breakdown of what the LHT method brings.

Hai transplantation before and after
Advantages of the LHT method
  • Easier procedure - FUE and FUT procedures do not allow surgeons to preview and perfectly understand the results the hair transplantation procedure will result in. Doctors have to rely on their experience in order to predict what will happen 3 months later, instead of seeing how the hair will look right away. The LHT procedure eliminates this problem, allowing the doctor to see the result as they conduct the operation. They can make decisions about the aesthetics of the procedure on the go, as the result is immediately visible. This produces a more natural result by allowing a precise distribution of hair, estimating angulation and density.

  • Previewing the result - The LHT method also allows the person getting the procedure done to instantly preview the final result. In many ways, the time right after the procedure is the most exciting for many individuals, as it is a source of a lot of positive emotion.

  • No cosmetic postoperative traces - The LHT hair transplantation method leaves no immediate, obvious postoperative traces. Patients who underwent the procedure are able to proceed with their day without bandages, scabs or swellings, with a nice comb. Some of our clients are even able to go to work and social events, without anyone noticing that they just underwent a hair transplantation procedure. 

  • Precise prediction - The LHT method allows for a more precise prediction of what percentage of the hair will regrow, and the density in the transplanted areas for each individual case. The procedure also allows the interactive determination of the ideal density for the patient. 

  • Involvement - If the patient wishes, they can participate in the procedure for the optimal desired outcome. 

Disadvantages of the LHT method
  • Scarring - The LHT method retains the FUT method’s disadvantage. After the procedure, a scar may appear on the back of the head. The Akaki Tsilosani Hair Transplantation Clinic uses the Trichophytic Closure technique in order to minimize the scar. Thanks to this modern technique, combined with the latest technology, we are able to make the scar almost invisible to the naked eye, especially in the case of a non-shaved hairstyle. 

  • Complexity requires professionalism - The LHT method requires the surgeon and the team conducting it to be experienced and highly professional. The procedure is much more labor consuming than the FUT and FUE procedures. Thus the surgery should only be conducted by highly trusted teams, such as the team at the Akaki Tsilosani Hair Transplantation Institute. 

  • High cost - the complexity of the operation and the labour intensive nature of it results in a higher cost than with the normal FUT procedure. 

So which hair transplantation method is best for you?

 

It is hard to determine ahead of time which hair transplantation method is best for you. The best way to find out is to consult the doctor themselves and tell them of your expectations, the issues you are facing and other details that might be important. But, there are of course several qualifiers that determine whether you are fit for a certain procedure or not. Here is a quick breakdown of which hair transplantation method you should (or should not) choose, depending on preexisting qualifiers. 

 

Do NOT opt for the FUT method for your hair transplant if:

  • You have a tendency to develop Keloid scars. It is recommended that you look into the FUE method. 

  • You prefer to have a short hair style or a shaved head.

The FUT method is best when:

  • You have a high density donor area at your nape.

  • You have a preference for long hairstyles.

  • You suffer from high rates of male pattern baldness and want a longer hairstyle.

  • You have limited funds.

Do not opt for the FUE method for your hair transplant if:

  • You prefer to have a long hair style. In this case, it is recommended that you look into the FUT method first.

  • You have a high density donor area at the nape of your head. 

  • You have limited funds.

The FUE method is best when:

  • You do not have a high density donor area at the nape of your head.

  • You prefer your donor area to be elsewhere on the body.

  • You prefer to not have a linear scar on the back of your head.

Do not opt for the LHT method for your hair transplant if:

  • You have a tendency to develop Keloid scars. It is recommended that you look into the FUE method. 

  • You have a low density donor area at the nape of your head.

  • You have limited funds.

The LHT method is best when:

  • You have funds available.

  • You have a high density donor area at the nape of your head.

  • You would prefer a short postoperative period, with no noticeable cosmetic aftereffects such as bandages, blood or swelling. 

  • You would like to participate in defining the final result of your hair transplantation operation. 

  • Would like to have a longer hairstyle immediately after the operation.

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