There’s a lot of debate about whether to choose FUE or strip surgery (FUSS, FUT). In fact there are some instances where using both of these methods in one visit has value.
I’d like to talk a little about FUE + FUSS (Strip Surgery, FUT) combined procedures and where it could be used.
There’s a lot of debate about whether to choose FUE or strip surgery and that’s another topic. In fact, I think that discussions are more or less irrelevant and both techniques have their value.
But there are some instances where using both of these methods in one visit has value. We can summarize these situations as:
Patients who have limited donor area due to advanced hair loss or limited donor availability due to multiple previous surgeries where a single technique does not offer enough improvement.
Patients who have good donor but very advanced hair loss. So there’s a lot of donor availability but there’s also a huge area to cover and the limitations of a single technique in one visit do not allow for a significant coverage.
In these cases we could actually do a Strip (FUT, FUSS) + FUE combined procedure.
Let’s give a few examples to this:
Let’s say a patient had one or two strip surgeries prior, so he has a strip scar. Therefore if you do only strip (FUSS, FUT) again you’re going to get a limited number of grafts, 1500 or maybe 2000 grafts. If you do only FUE, the previous strip has limited donor area, it’s narrowed and also you have to leave some areas around the scar untouched, so it’s camouflaged. So again you’re somewhat limited to let’s say 2000-2500 grafts.
But let’s say you do a combined procedure so you do the strip you get 2000 grafts and then we do FUE and you get another 2000 grafts. So suddenly you’re able to do a huge procedure after multiple ones in one visit. I don’t mean that all this has to be done in one session, it’s frequently a good idea to do it in two separate days so that the grafts are not under too much risk and the operation time is not too long.
Let’s say there’s a patient who had previous FUE, so his donor area is diffusedly scarred and we know that if we try to do FUE again on an operated patient, donor variability is significantly reduced due to the fibrosis that’s all over the area. The scarring may look good to the eye but when it comes to a second surgery, it becomes very difficult to get good grafts. So then again, a combined procedure can come in and you can get get nice 2000-2500 or 3000 grafts, then you can do some FUE and then suddenly you’re talking about 4000-5000 good grafts. So again it works. Also with previous strip scars you can remove the scar you can get few grafts from it but then you add FUE so it again you do a decent sized hair transplant while improving the previous scar.
So, using the two techniques at the same time has some advantages in these difficult situations.