# Hair Transplants > Women's Hair Transplants >  Strip method vs FUE?   So confused!

## Rae

I am a 43yr old female with diffused thinning on the top front of my head, I am confused at what method would be best. My thinning has remained the same for the last 4 or so years, I don't see it getting worse, yet.  I was ready to make an appointment for the FUE method getting 1000 grafts but after reading a few posts I am really nervous about what the results may be and I don't want to do something out of desperation that may end up disastrous.

Is it a little more tricky with diffused thinning?
Can I end up worse that before?

Help!

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## Tracy C

Rae,

Have you seen a doctor about your hair loss yet?  If not, make sure you see a doctor who specializes in treating hair loss - and make sure he or she is a member of the IAHRS.  Here is a link to help you find one.

http://www.iahrs.org/member/

Also, have you tried managing your hair loss with medications or possibly low level laser therapy yet?  If not, you should talk about these options with the doctor you choose.  Surgery should be considered a last resort, especially for women.  With that said, you need to make sure you are a good candidate for hair transplant surgery.  The doctor you choose will help you.

I wish you the best.   :Smile:

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## mattj

Transplanting to areas of diffuse thinning is definitely considered trickier, but doesn't present a massive challenge and will be routine for most surgeons. However, it does depend on just how thin the hair is. If your hair density hasn't dropped that far below what it once was then yes, you do risk making things worse with HT surgery, as planting follicles too close to the existing 'native' hair can cause damage to that hair, leading to it being lost. Basically, the advice a surgeon would give you on whether you are a candidate or not would depend on what he or she sees when examining you.

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## Rae

Thanks for the post, Tracy..

This is definitely last resort, I have done all of the things you mentioned and feel that I am done with the temporary methods that have cost me thousands.  It's very frustrating for a woman to deal with hair loss, it has totally wrecked my self esteem and my social life.

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## Rae

Thanks for the info, Matt..

I have been told I am a candidate for HT, I was interested in Neograft because it is done without cutting.  What you are saying is what worries me, my follicles are still sort of close together which makes me nervous.  I have a spot in the front where my hair parts to the side that is very noticeable, I was thinking of doing just that area to see how it works out. Would that be a wise thing to do?

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## Tracy C

> It's very frustrating for a woman to deal with hair loss, it has totally wrecked my self esteem and my social life.


 It is devastating.  You need to be stronger than you ever thought you could be.  It is much more diffucult to determine if a woman is a good candidate for hair transplant surgery.  You need to be very careful about the doctor you choose.  The doctor may need to monitor your hair for a while to determine if you have a stable zone.

Did you choose a doctor who is an IAHRS member?

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## Tracy C

> I have done all of the things you mentioned and feel that I am done with the temporary methods that have cost me thousands.


 Rae,

Can you tell me everything you have tried up to this point - and for how long?  Please be as specific as you can.

Prior to having my surgery, I had not spent thousands even though I treated it for two years prior to surgery - and continue those treatments after surgery.  So your statement makes me wonder.

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## Rae

> Rae,
> 
> Can you tell me everything you have tried up to this point - and for how long?  Please be as specific as you can.
> 
> Prior to having my surgery, I had not spent thousands even though I treated it for two years prior to surgery - and continue those treatments after surgery.  So your statement makes me wonder.


 Tracy, can you post an email so I can send you the details?

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## Tracy C

Rae,

I do not know how to share my e-mail address with you privately.

Can you look at my "statistics" page and tell me if you can read any of the conversations I have had with other members?  If you can't, then I know I can give you my e-mail address that way.

I am doing a friend request for you right now just in case we can have some privacy that way.

If a mod reads this and wants to help, please feel free to send my e-mail address to Rae.

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## Tracy C

It looks like we cannot do private messages here.  I am looking in the women's hair loss project forum to see if we can do private messages over there.

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## Rae

Just created this email address to post here, send me an email.

rae_info@yahoo.com

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## Jeffrey Epstein, MD

In my vast experience treating hair loss in women, the FUE technique is inferior to that of strip, both in terms of how the donor area is handled, as well as the results that can be achieved in the areas of thinning.  Yes, if done improperly, you can look worse than before.  I say you meet with a highly respected hair transplant surgeon who can give you reliable and trustworthy advice.  I am also happy to evaluate any photos you send to me.  Best of luck.

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## John P. Cole, MD

Work up your hair loss properly.  Confirm a diagnosis that will respond to surgical solutions.  As recommended, try non-surgical solutions first.  

i think treating hair loss in females can be difficult simply because the hair loss is progressive over time.  As you continue to loose hair, you need more grafts.  From the perspective of treating anyone with hair loss, it is always easier to please someone who has already lost their hair than it is to please someone who is in the process of loosing hair.  

With women it can be frustrating simply because you are probably going to loose more hair over time and need more transplants.  Over time as you add more hair to the top, you move more and more from the back.  Hopefully your donor area will be able to keep up with your hair loss over time, but there is no guarantee of this.  Still my experience with women over time is that they will be very happy getting a regular top up procedure.  It just seems to make women feel better even when there is very little left to graft from a donor area.  It's surprising how even 100 grafts can brighten the day of many women.  

I think most females are generally comfortable doing a strip procedure, but some are not.  Doing an FUE procedure on a female can be tricky simply because you need to keep the hair long.  Not all physicians are comfortable doing this.  Make sure your physician is comfortable leaving the hair long and has experience doing this sort of FUE procedure.  It can be very time consuming.  

There are many physicians who feel their FUE results are not as good as their strip results.  i would certainly steer clear of these physicians for FUE.  For FUE you need to choose someone who feels their FUE results are at least equal if not superior to their strip results.  Why anyone who feels their FUE results are not as good as their strip results would even offer FUE is beyond me.  I've discovered that many physicians who say their FUE results are not as good as their strip results do not perform the surgery in their office.  They allow non-physicians to do the surgery.  

The neograft is a relatively new piece of equipment.  Just make sure that the physician who is using it has a good bit of experience with it and that they have plenty of results.  There are also many physicians who allow laymen to cut the grafts with the neograft.  It may be that the laymen are better than the physician, but I think this can be a dangerous situation.  Just do your homework.  

Now the skinny comparing FUE to strip procedures.  There are several studies that show FUE results are just as good as strip results.  As with any procedure, you can occasionally get results from either strip or FUE that do not meet the expectations of the physician or the patient.  It's hard to blame the procedure when this happens provided that it was done well.  FUE grafts should be cut by the physician and in my experience FUE grafts offer patients far more hair with each graft than you can get doing a strip procedure.  What this means is that with FUE you can get better coverage from fewer grafts provided the procedure is done properly.  

I've done over 8000 strip procedures and well over 3500 FUE procedures.  In my personal experience FUE produces a superior result to strip procedures.  Of course in my office, i do my own surgery rather than delegating it to someone else.  

Having said all this, i think you can reach a degree of happiness from either a strip or FUE.  First, make sure you have a condition that is responsive to hair transplant surgery.

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## angelina22

You could go for FUE treatment that will be quite good one they give an good result.

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## megan88

I have been doing hair transplantation for thirteen years and in the process, I also became the patient more than once. I have had the strip technique done on me and I have performed multitudes of strip techniques on others. I have also had the Artas technique done on me, and I have performed numerous Artas procedures on patients. Here are some reasons I prefer FUE by Artas over the strip method:
1. The healing process for the donor site in the strip method is much longer than the Artas.
2. The donor site pain after the strip procedure lasts about two weeks and can remain tender for about a month. Everytime you bend your neck forward, you will be reminded of the donor site for the first month. In contrast, the donor site of the Artas procedures is much less painful, needs no stitching, and by one month, the sites are hard to find even with the naked eye.
3. About the quality of the grafts, I find the grafts very hardy and healthy when using the Artas.
4. In the strip technique, a large sliver of skin is removed from the back of the scalp. The strip is sliced into individual grafts for placement. In this process, many grafts are damaged, bisected, or otherwise deemed as not usable. These will be discarded. This is a big waist and those follicles are gone for good, and remember you only have a finite number of hair follicles. In contrast, if the Artas transcects any hair follicle, that is done upon punching the scalp, and the top of the follicle will be removed. However, the hair bulb (the areas important for hair regrowth) is still in your scalp and that hair  will regrow. So with Artas, there is less permanent damage to the follicles.
5. About regrowth of the follicles, once hair is removed in total, that hair follicle will not grow in the donor site. However the one millimeter punch used to extract the hairs leaves such a small hole that once healed it is not detectable by the naked eye.
I hope my opinion helped.
best wishes

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## Jeffrey Epstein, MD

Over the past 2 years, after specializing in surgical hair restoration since 1994 - the majority of the time performing follicular unit grafting-  FUE has now become the most frequent hair restoration procedure we perform.  What is important is not what device is used to extract the device, for they all have their role, but the quality of the grafts, then how the recipient sites are then created which is the key aesthetic step.  In our office, we use our own custom-designed drill with 0.8 and 0.9mm punches, achieving the most viable best grafts.

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## JoeTillman

I agree with Dr. Epstein's latest post above.




> 1. The healing process for the donor site in the strip method is much longer than the Artas.


 Or FUE in general. ARTAS is irrelevant.




> 2. The donor site pain after the strip procedure lasts about two weeks and can remain tender for about a month. Everytime you bend your neck forward, you will be reminded of the donor site for the first month. In contrast, the donor site of the Artas procedures is much less painful, needs no stitching, and by one month, the sites are hard to find even with the naked eye.


 Or FUE in general. ARTAS is irrelevant.




> 3. About the quality of the grafts, I find the grafts very hardy and healthy when using the Artas.


 But compared to strip? 




> 4. In the strip technique, a large sliver of skin is removed from the back of the scalp. The strip is sliced into individual grafts for placement. In this process, many grafts are damaged, bisected, or otherwise deemed as not usable. These will be discarded. This is a big waist and those follicles are gone for good, and remember you only have a finite number of hair follicles.


 You're doing it wrong.




> In contrast, if the Artas transcects any hair follicle, that is done upon punching the scalp, and the top of the follicle will be removed. However, the hair bulb (the areas important for hair regrowth) is still in your scalp and that hair will regrow. So with Artas, there is less permanent damage to the follicles.


 Unmitigated bullsh*t. I hope you don't tell your patients this. 




> However the one millimeter punch used to extract the hairs leaves such a small hole that once healed it is not detectable by the naked eye.


 You can't guarantee this as there are too many factors to consider. 

It is this type of blanket misinformation that leads to uninformed patients being unhappy. If you wish to promote ARTAS do so on the merits it possesses that separate it from other forms of FUE, not FUSS.

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## John P. Cole, MD

There a a vast difference between those who actually perform a procedure and those who either don't perform procedures or they depend on others to perform the procedure.  It's like feeling your graft implantation is good when you have never really done it yourself or feeling that the grafts you dissect from strips are good when you have never dissected the grafts from strips.  I think that rarely performing these procedures leaves you in no better position to have an opinion.  

Artas has major flaws.  I do not think it should be used by anyone at this point.  The reasons are simple.  The transection rate is high.  Approximately 26% of the grafts go missing and no one can explain where they go.  The procedure is quite slow.  Too many grafts are harvested right next to one another leaving empty holes.  The machine creates large wounds and we don't always need large wounds to extract healthy grafts.  The machine harvests too deep making more invasive.  The machine has a difficult time extracting from the sides of the scalp and the nape of the neck.  

Many physicians charge for the graft attempts rather than the number of grafts placed with the Artas.  Make sure you know what they are going to do prior to sitting in the chair.  

I know you cannot expect all cases to do well with only one or two punches.  I actually do my surgeries.  That's why I know what I'm talking about.

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## megan88

The main difference between the FUE hair transplantation and strip surgery is in the way donor-hair is obtained. Generally FUE hair transplant gives greater customer satisfaction as well as recovery. So I will definitely go with FUE hair transplant.
If you decided to go with FUE then back look of your head looks like a Natural and in case of strip surgery it looks like a Scarring. However FUE surgery is much more expensive than the strip surgery.

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