Strip harvesting’s rationale is to harvest all the donor hair is the area selected. If we choose hairs from the safest donor area, then we can be more confident that the hair transplant surgery results will last. This makes it a proficient harvest of the safest area.
Now consider FUE’s (follicular unit extraction) harvesting rationale, where the technique only uses partial removal of hair from the donor area. Only 25-35% of the available hairs are harvested, as over-harvesting leads to a variation in the density of the donor area compared to the rest of the hair. In extensively balding areas this becomes a concern but is unlikely to be a problem in small cases.
How do we deal with this potential issue? In my opinion, considerably bald, young patients should be urged to sustain long-term medication to limit future possible hair loss.
I do not believe that choice of strip harvesting or FUE changes any contra-indications to transplantation, but it may impact relative contra-indications to surgery. Consider a young man, developing extensive balding, who also has thinning from the nape of the neck. The restriction of existing donor area will reduce the number of ‘safe’ donor grafts that could be extracted by FUE whereas; a greater number of grafts could be taken from the safe donor area by strip harvesting (FUT). In this instance, more grafts could be achieved by strip harvesting than FUE.