We have all seen the pluggy "barbie doll" and "corn row" hair transplants of the past. Today, patients are lucky enough to be able to choose from two ultra-refined surgical techniques. However, there are limitations and restrictions associated with each surgical technique. In this article, we will go over the limitations and physical restrictions associated with hair restoration procedures and how to mitigate and reduce these limitations.
Follicular Unit Strip Surgery (FUSS) Limitations and Restrictions
FUSS or strip surgery is performed by removing a strip of donor tissue from the back and sides of the scalp which are genetically resistant to dihydrotestosterone (DHT), the main catalyst for androgenic alopecia (genetic hair loss). Strip surgery relies on the elasticity of a patients scalp, because every time a strip of donor tissue is removed, the patients scalp becomes tighter and loses elasticity. Thus, reducing the amount of surgeies a patient could have without severely compromising the scalp. The term "stripped out" refers to the patients scalp which can no longer withstand any further donor tissue removal.
Follicular Unit Extraction (formerly known as Follicular Unit Extraction FUE) Limitations and Restrictions
FUE is a minimally invasive procedure that involves a hair transplant surgeon removing follicular units one bu one from the patients donor site with a small punch between the sizes of 0.7 and 1mm in circumfrence. Generally, due to the nature of FUE, fewer grafts can be extracted per surgical session in comparison to FUSS because of its inherent limitations which include - graft transection, surgical fatigue, donor density and graft quality. Prospective patients must be cognizant of these limitations before committing to surgery.
Why Combining Both FUSS and FUE Reduces Limitations and Produces More Hair
By combining both FUSS and FUE, the surgeon is able to extract more hair from the donor site of the patient than any one procedure could alone. Additionally, by combining both surgical techniques the donor density and scalp elasticity is easily mitigated thus, producing more hair for the patient. In the old days, a patient would be "stripped out" and would no longer be considered a hair transplant candidate. However, now that both surgical techinques have become ultra-refined a hair restoration physician can now extract more hair from a patient who's already been "stripped out" by finishing off with FUE. This mitigates the limitations associated with both surgical techniques and provides the patient with a denser fuller head of hair.