Will The Strip Technique Become Obsolete Soon?

Dr. Rassman,

Good day sir. Big fan of the blog and all the information you provide. I will keep it short and sweet.

With all the advancements in FUE harvesting, do you think the strip method will become obsolete in the not too distant future?

Thanks and have a good day!

I really believe there will always be a place for hair transplantation with the strip technique. Follicular unit extraction (FUE) is not always the perfect or a preferred surgery, as many people seem to think. Grafts extracted using FUE are not the same as grafts cut under the microscope, and the growth and success is definitely different no matter how good the surgeon is. I speak from experience, as I was the first to publish about the FUE technique in 2002. Shortly after that publication, surgeons all over the world quickly jumped on the bandwagon to adopt it in their practices with varying results. Over the years, I have seen FUE promoted and sold to naive patients as a “better” surgery than the strip, but this is mostly marketing hype and leads to misinformation.

The two techniques (FUE and strip) both have their own unique place in hair transplant surgeries. For example, if you have a Norwood Class 4-6 balding pattern, a strip method of 3000 to 4000 grafts would be a perfect surgery to achieve a full look in ONE shot with a relatively lower cost than the FUE surgery. The strip scar wouldn’t be noticed by anyone unless you decided to shave your head (and if you were going to do that, why even have the surgery). Plus, I would almost never advise a Norwood 6 patient to have the FUE surgery, because there’s a higher incidence of transected hairs in the grafts from that technique. This would be a liability to someone who can’t afford to lose a single hair! Now on the other hand, if you are a Norwood 2 or 3 and wanting your front corners filled in, an FUE surgery may be perfect — especially if the hair is worn buzz-cut short.

Even if the ACell auto-cloning technology proves itself, the strip surgery may still remain the ‘workhorse’ of transplant surgeries. We may be doing combination of all the techniques combined.