Hellenicaesthetics

FUT Strip Hair Transplant

FUT (Follicular Unit Transplantation), also known as the strip method, is now considered an outdated approach to treating alopecia. In recent years, its use has significantly declined with the rise in popularity of the more advanced and minimally invasive FUE (Follicular Unit Extraction) technique.

The shift toward FUE is due to its numerous advantages. Unlike FUT, FUE does not involve removing a strip of scalp tissue. Instead, individual hair follicles are extracted directly from the donor area, allowing for a more natural-looking result. Patients experience minimal discomfort, a faster recovery period, and—most importantly—no linear scarring.

In contrast, FUT is associated with a more challenging post-operative experience, including potential pain and a noticeable scar on the back of the scalp. Given these differences, FUE has become the preferred choice for both patients and hair restoration specialists worldwide.

Contact
FUT – STRIP TECHNIQUE

Post-operative side effects

One of the main drawbacks of the FUT (Strip) technique is the formation of permanent, often malformed scars in the donor area, which can be accompanied by chronic numbness (hypesthesia) or even the development of painful neuromas at the site of the scar. Studies show that approximately 5–10% of patients who undergo FUT-Strip procedures report persistent pain in the scarred area, while 20–25% experience long-term hypesthesia. These complication rates tend to rise significantly in cases where patients undergo multiple FUT procedures or reoperations. Another significant limitation of the FUT method is the trauma inflicted on hair follicles during strip harvesting, which can compromise their survival and reduce the effectiveness of the transplant.

Additionally, the creation of deep sockets in the recipient area contributes to increased post-operative bleeding, swelling, and pain. The use of large grafts in this technique often results in an unnatural appearance, producing a “pluggy” or doll-like effect that lacks the refined aesthetic of modern techniques like FUE.

FUE use for FUT – Strip technique restoration

Today, a significant number of individuals who have previously undergone hair transplantation using the FUT (Strip) method seek help from specialized plastic surgeons to correct or minimize the visible scarring left behind by the procedure. At Advanced Hair Clinics, approximately 35–40% of patients opting for FUE (Follicular Unit Extraction) have a history of prior FUT transplants and are seeking either to enhance hair density or to improve the natural appearance of the hairline.

Additionally, in about 15–20% of these cases, specific treatment is required to correct poorly healed or conspicuous scars resulting from the earlier FUT procedure. These recurring issues with aesthetics and post-operative complications have contributed to the steady global decline in the use of the FUT-Strip method in favor of more advanced techniques like FUE.

FAQs

Frequently Asked Questions

Stages of a FUT (Strip) Hair Transplant Procedure

The FUT (Follicular Unit Transplantation) or Strip technique involves a series of defined surgical steps. Below are the main stages followed during a typical FUT transplant session:

  1. Design and Planning of the Strip
    The procedure begins with the careful design of the donor strip, which is usually harvested from the occipital region of the scalp (the back of the head). The strip typically ranges from 1 to 2 cm in width, extending from one outer ear (pinna) to the other. This width is selected to minimize tension during wound closure and to reduce the risk of creating a deformed or hypertrophic scar.
  2. Local Anesthesia
    A local anesthetic—usually a combination of lidocaine and adrenaline—is administered along the planned strip area to ensure the patient’s comfort and reduce bleeding during the procedure.
  3. Strip Removal (Excision)
    The strip is excised by making an incision that reaches the subcutaneous fat. Special care is taken to avoid cutting too deeply, as this could damage sensory nerves, leading to complications such as postoperative hyperesthesia (increased sensitivity) or the formation of painful neuromas. Precise and meticulous hemostasis is essential at this stage, as the scalp is rich in blood vessels. Failure to control bleeding properly may result in hematoma formation or even wound dehiscence (separation).
  4. Donor Area Closure
    Once the strip is removed, the donor site is sutured in layers. Absorbable sutures are used for the deeper layers, while nylon or endodermic continuous sutures are used for the outer skin layer. A more advanced technique known as trichophytic closure is often employed to promote hair growth through the scar, making it less visible and more cosmetically acceptable.
  5. Graft Dissection and Preparation
    The harvested strip is handed over to the surgical team for dissection. It is cut into smaller sections to isolate grafts. A key disadvantage of the FUT method is that many clinics prepare minigrafts containing 5–10 hairs, which are too bulky and unnatural-looking, especially when implanted at the front hairline. Ideally, micrografts with 1–4 hairs should be prepared, as they better mimic the natural structure of hair follicles. However, this requires precision and is not commonly practiced.
  6. Implantation of Hair Follicles
    In most FUT procedures, the implantation is done using an older method. Incisions or “reception sites” are created with a scalpel or needle, into which the grafts are inserted using forceps. This traditional approach tends to cause more bleeding and leads to increased postoperative swelling and scarring in both donor and recipient areas.
What Results Can You Expect After a FUT (Strip) Hair Transplant?

The outcome of a FUT (Follicular Unit Transplantation) Strip hair transplant largely depends on the experience and expertise of the surgical team. When performed by skilled professionals, the procedure can deliver impressive results in terms of hair density, especially in areas like the crown and mid-scalp. However, achieving a natural-looking hairline remains a significant challenge with the FUT method.

This limitation arises because FUT typically yields larger grafts, which consist of multiple hairs. These grafts often lack the refined, single-hair structure that is naturally present at the front hairline, resulting in a less natural appearance compared to what is achievable with the FUE (Follicular Unit Extraction) technique.

Moreover, because androgenetic alopecia is a progressive condition, patients often require additional hair transplant sessions in the future. If a previous FUT procedure has been performed, planning a second session can be complex. Surgeons may need to create a second, parallel incision (a "double-cut") or extend the original scar, which can further compromise the cosmetic outcome and make scar management more difficult.