If you have seen the media blitz by certain practices that perform follicular unit extraction (FUE) procedures claiming that they leave less scarring than strip extraction, you are not alone. FUE is a technique used to harvest hair follicles using a small round punch. The wound from the punch is about one millimeter, but it is left to heal without primary closing. This results in thousands of small white scars.

 

Unfortunately, false claims like these can create confusion among patients and then disappointment when the patient results don't match expectations. Dr. Bernardino Arocha of Arocha Hair Restoration is always worried when patients have unrealistic expectations. When he saw other hair transplant practices making matters worse, he decided to take action.

 

Dr. Arocha is speaking out in hopes of getting accurate information into the hands of patients. Not only do FUE procedures typically result in widespread scarring throughout the back of a patient’s scalp, the total scarring is many times greater than the scar from a strip procedure performed by a skilled, experienced hair transplant surgeon.

 

In the video below, Dr. Arocha explains what patients should really expect and compares the scarring from FUE procedures to the scarring from traditional strip extraction. 

 

 

 

Dr. Arocha’s calculation assumes a 1 mm diameter punch, which is the most common size used. The radius of that punch is .5 mm.

 

Pi (π) is important in the calculation, since the scar from the punch is circular. The area of the scar for each FUE punch can be found using the equation π x r².

 

In this case the radius is .5, so the calculation becomes π x .5² or 3.14 x .25 mm.

 

As a result, we know the total scar area for each FUE punch totals approximately .785 sq. mm.

 

To find the total scarred area of an FUE procedure, multiply .785 times the number of punches. For a 3,500 follicle procedure, the total scarred area would be 3,500 x .785.

 

The total is 2,747.5 sq. mm. or approximately 27.5 sq. cm.

 

Dr. Arocha compared that to the scar from a strip procedure that yields the same number of follicles. He would usually extract a 20 cm (2,000 mm) strip across the back of the scalp and work to minimize the scarring using a two layer closing. The deep layer minimizes surface tension. The superficial layer gently brings the surface margins together, allowing the healing of the wound with minimal tension. The third step, is the beveling of the lower wound edge, which causes the hair to grow through the scar, making it only faintly visible.

 

The total scar area can be calculated by multiplying the length of the scar (20 cm) by the width of the scar (.1 cm to .2 cm).

 

Therefore, the total scar area from the strip method is just two to four sq. cm. compared to the total scar area from the FUE method of 27.5 sq. cm.