In cases where there are not enough follicles to extract individually, then extracting a Strip of follicles will be the only option to consider. While the surgeon stitches the incision, the transplant team will be separating the follicles from the Strip.
A FUT (Strip) Hair Transplant procedure consists of 2 parts:
1. Extraction (removing the follicles from the donor area as a Strip) - this part is different from the FUE method, where the extraction of the follicles is performed one by one
2. Implantation (inserting the follicles at the balding area one by one) - this part is exactly the same as in the FUE method, where the follicles are also being implanted one by one
The extraction is performed while you are lying face down and it can take up to one hour. Local anaesthetic is injected into the donor area (back of the head) and then a strip of skin is removed. While the doctor is stitching the area, the assistants are dividing the strip of hairs into individual follicles. After the stitches will have been dissolved, a fine pale scar will be left, which is easily covered by your own hair as long as it isn’t too short.
After having a short break, the procedure continues, this time with you lying face up because this is when we begin to implant the extracted follicles in your balding areas. Depending on the size of your procedure, the implantation can last from 1 to 3 hours.
Although the procedure is painless, you might occasionally feel uncomfortable because you will be lying down for so long. Thus, you might have a couple more breaks to stretch your legs, go to the bathroom or to eat or drink, etc.
Both the donor and the recipient areas are being anaesthetised with a very thin needle that prevents you from feeling any pain during the whole procedure. The anaesthetic does sting a little at the beginning but is quite bearable and goes numb very quickly.
The Strip of follicles is extracted from the middle-portion of the back of the head, becasue that area is largely immune to DiHydroTestosterone (DHT), which is the ‘killer’ hormone found on the top of your head. The transplanted hair follicles will keep their own color, texture, growth rate, and curl after the procedure and will continue to grow naturally and for ever. The reason that the transplanted follicles will continue to grow for the rest of your life (at the recipient balding area), is because they inherit (from the donor area) the genetic trait of resistance to the hair-killing hormone DHT.
Each extraction method has its pros and cons. There are many factors to be considered in order to determine which method better suits your individual case. Although the individual extraction is more preferable, since it is non-invasive and scar-free, it requires longer hours and the number of follicles we can extract in one session is limited and not always guaranteed.
There are cases where someone is not suitable for neither of the 2 methods and cases where someone should have a combination of both methods, in order to be able to extract the highest possible number of donor hairs.
Though both extraction methods eventually could allow the same number of hairs to be extracted, there is one major difference; during a Strip extraction session we can extract far more hairs than during an individual extraction session. That is why, it is likely that 2 individual extraction sessions might be necessary, if we need to cover a very big area. These sessions can be performed either during 2 consecutive days or within 6-9 months.