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A comparison between strip harvesting and FUE hair transplants – Part 3

We conclude our three-part series, “Strip Harvesting versus FUE” in discussing a number of remaining issues between the two procedures.

In strip harvesting doctors take strips of hair-bearing tissue from part of the head and place them elsewhere, while with FUE – follicular unit extraction, doctors take follicular units of one to four hairs instead of entire strips, and transplant them elsewhere on the head. 

Technical Expertise

A somewhat different skill set is required for FUE harvesting. The surgeon must be able to align the small punch correctly, find the right depth and adjust the punch to account for changes in direction of the hair. The primary concern with FUE is the rate of damage. If the hairs in a follicular unit are damaged they are less likely to grow. The reports from physicians performing FUE indicate the rate of damage is higher than with strip harvesting.

FUE can be a tedious process and both patient and physician may experience fatigue. This can limit the amount of grafts that can be harvested in a single session.

The learning curve for FUE can be slow for physicians who are used to excisions with scalpels and unaccustomed to the use of punches. Working at a shorter focal distance can be tiresome and lead to neck problems.


The cost of FUE is usually significantly more than that for strip harvesting on a per graft basis. The costs may exceed double the price of strip harvesting.

Body Hair

FUE can be very useful for harvesting body hair. In such situations the majority of follicular units are single hairs.

Small number of grafts

When small numbers of grafts are needed, FUE may be an excellent choice. Using the technique where narrow rows of trimmed hair are used, it would be relatively easy to camouflage the work and avoid creating a linear scar.

FUE into scars

FUE can be used to try to camouflage linear donor scars. This is considered by many hair restoration surgeons to be another excellent use of the technique. Some surgeons have suggested that a combination of strip harvesting and FUE is the optimal use of the techniques.


Some surgeons who prefer FUE feel that their patients experience less pain and there is a shorter recovery time. There is little data to support this view.

Bleeding occurs with both techniques, but more significant bleeding occurs with strip harvesting. That said, bleeding is not considered a problem with strip harvesting.


Strip harvesting and FUE are both acceptable techniques for harvesting donor grafts. Each technique has advantages and disadvantages. On a cost-benefit ratio, strip harvesting would seem to provide the most cost effective procedure. FUE is well suited for patients who insist on not having a linear scar. It may be an excellent choice for young patients seeking small procedures. FUE may be the ideal choice for harvesting trunk, leg and arm hair, and it is an excellent way to camouflage strip scars.

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