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Strip Excision (SE) Surgery

The gold standard for hair transplantation surgery revolves around donor harvest based upon removal of a strip of tissue from the donor area. It is often mislabeled as the “FUT” method (in reality “FUT” stands for “follicular unit transplantation”- this describes the overall use of grafting/transplantation using only follicular units), when in fact, Strip Excision (“SE”) more accurately describes this surgical step.

Despite the popularity of using the FUE method as a primary means of obtaining donor hair by a great number of practices over the last 7 years, Dr Carman has remained committed to using grafts created from the strip excision harvest as a primary means of conducting high quality, long lasting hair transplant surgery.
Graft for graft, strip excision (SE) harvested grafts are consistently of a higher quality than FUE grafts in general. This ensures consistent results across all patient presentations.

In terms of the overall, long-term effects of SE (“FUT”) vs FUE harvest on the donor area, the quality and density (measured in hair mass) of the donor hair remains essentially unchanged when utilizing SE (“FUT”) donor harvest. In other words, the quality and appearance of the donor hair remains unchanged. This is in contrast to the generalized decreased density (measured in hair mass) which occurs with the FUE method, which thins hair the donor area, a process which worsens with each subsequent procedure.

Strip Excision (SE) then, is a surgical hair transplant technique wherein the grafts used for the procedure are harvested in a linear strip taken from the donor area. To this day, this method of donor harvesting represents the “Gold Standard” for obtaining donor hair. The harvested tissue is then dissected under direct visualization utilizing high powered microscopes, to create the high quality, individual follicular units.

The advantages of SE (“FUT”) are as follows:

  • Consistent high quality, life-long lasting grafts.
  • No generalized loss of hair mass in donor area (No donor “thinning”).
  • Most efficient use of potential donor hair.
  • Shorter recovery time (No shaving of donor area).

Disadvantages of an SE (“FUT”) are as follows:

  • Linear scar seen when head shaved.

The SE (“FUT”) Hair Transplant Procedure

A SE (“FUT”) harvested procedure can be broken down into 3 distinct sub-procedures.

  1. Strip Excision:
    During the excision phase, the follicular units are harvested from the donor region in a linear strip of tissue, which traditionally is located on the back and the sides of the scalp. The hair is kept at it’s normal (long) length (no shaving). After removal of the strip, the tissue edges are brought together with traditional plastic surgery closure techniques, leaving a fine 2 mm linear scar.
  2. Site Creation phase:
    The second part of a SE (“FUT”) procedure is creating the places in the recipient area to insert the follicular units for transplant. The follicular units must be set into the scalp at exactly the right depth, angle, location and density in order to achieve a completely natural and aesthetically satisfying appearance. In addition, this needs to be done without damaging the patient’s pre-existing hair.
  3. Graft Placement Phase:
    Grafts created from the strip are placed in the recipient area. This part of the procedure may last for 3 to 4 hours or more, dependent on the number of follicular units that are extracted for your individual procedure.

Recovery After A SE (“FUT”) Procedure

The recovery time for SE (“FUT”) vs FUE is really is related more so to the appearance of the back of the patient’s head; the hair is shaved very close in FUE, not at all in SE. Thus, from a donor perspective, the recovery in terms of appearance in SE (“FUT”) donor harvest procedures is instantaneous. No one can tell any surgery was done as the preexisting hair completely covers incision site. Sutures are removed 7- 10 days after the procedure.

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