Amelia Grant

Follicular unit transplantation (FUT) is the oldest method for extracting hair follicles from the scalp to treat alopecia or baldness. FUT originated in the early days of hair restoration surgery in the 1960s and has remained mostly unchanged since then. Historically, the only technology available for harvesting hair follicles was a surgical blade or scalpel.

It gained popularity since it was affordable, simple to learn, and did not require any formal or ongoing training for doctors or personnel. While it was feasible to harvest a high number of hair transplant follicles in a single session, several complications arose, some of which were difficult, if not impossible, to resolve.

Wound Healing and Scarring in FUT

A basic aspect of surgery is that closing a wound under strain leaves a visible and extensive scar. For example, if you remove a section of the scalp to acquire hair transplants, the resulting defect is often closed under stress. This is due to the fact that most persons who have hair restoration surgery do not have extra scalp laxity or looseness unless they are elderly. 

This implies that removing a half-inch-wide strip of scalp will typically result in a scar that will eventually heal to be half-inch broad. This is especially true for the scalp, which is closed under tension over a stiff and immovable item beneath - the skull. 

Aside from unexpected scars, the disadvantages of FUT transplant or strip surgery include persistent discomfort and lasting scalp numbness. Thinning of hair around the linear scar is also prevalent.

Hair Transplant Advancements

Fortunately, medical research has improved throughout the decades, leading in FUE (follicular unit extraction). Manual techniques were eventually superseded by more complex instruments designed to harvest individual hair follicles with a little punch, frequently less than a millimeter in diameter. The surrounding scalp remained intact.

FUE was less intrusive than prior strip procedures, allowing patients to recover significantly more quickly and with less scalp numbness and pain. The microscopic holes left by removing the hair follicles were allowed to heal without the need for sutures. There was no apparent linear scar, allowing patients to keep their hair short.

Why Is FUT Still Used?

The issue remains. Why are so many hair restoration practices still offering FUT in 2025? There are certainly more advanced and better ways for hair restoration than the FUT or strip process.  Practices that commit to these new FUE technologies invest much in equipment and supplies, whether they use Artas, Neograft, or Smart Graft.

Physicians spend a significant amount of time and effort certifying, educating, and training themselves and their staff. Many physicians who are not trained as surgeons may be overwhelmed by the intricacy of these technologies and are hesitant to incorporate them into their clinics.

During their residency programs, physicians in the "core specialties" of dermatology, face plastic surgery, and plastic surgery are educated in a variety of technologies, including lasers, endoscopic equipment, and even these newer FUE machines. New technology is familiar to such clinicians and represents a natural progression of their procedures.

The bottom line

The FUT or strip method is still popular since the financial load on a hair restoration operation is minimal. It's a straightforward strategy that doesn't require any formal staff training. Many of the most prominent hair restoration "franchises" still see FUT as the most cost-effective and financially profitable treatment. Patients may be persuaded to undertake a strip surgery since it is typically less expensive than modern FUE machines.

However, many of the issues connected with strip surgery, including visible scars, necessitate people paying even more money to conceal them. Sometimes these FUT scars cannot be concealed because the donor location lacks enough hair follicles to implant into the scars.