The FUE and FUT procedures share the same goal and the same graft placement technique. They differ only in how grafts are extracted from the donor area. This guide walks through each step of both procedures side by side so you know exactly what to expect on surgery day.
Step 1: Pre-Operative Consultation
Both FUE and FUT begin with a thorough consultation, usually completed in person the day before or the morning of surgery.
What Happens for Both Methods
The surgeon evaluates your donor density, measures the area of hair loss, and discusses your goals. Blood work results are reviewed. The surgeon draws the new hairline design on your scalp using a marker, and you approve the plan before anything begins.
This step is identical regardless of which method you choose. The hairline design, graft count estimate, and placement plan do not change based on extraction technique.
Step 2: Preparing the Donor Area
This is where the two methods start to diverge.
FUE Donor Preparation
The donor area (back and sides of the head) is shaved to approximately 1mm in length. This is necessary because the surgeon needs a clear view of each follicular unit to guide the punch tool accurately. Some clinics offer partial shaving (shaving only the extraction zone), and unshaven FUE is available but takes significantly longer and costs more.
FUT Donor Preparation
The surgeon does not shave the entire donor area. Only a narrow horizontal strip at the back of the head is trimmed. The hair above and below the strip is left long enough to cover the incision line immediately after surgery. This is a significant advantage for patients who want to conceal the procedure quickly.
Step 3: Anesthesia
For Both Methods
Local anesthesia is injected into the donor area and the recipient area. The injections sting for 30 to 60 seconds, but once the anesthesia takes effect, you feel no pain during the procedure. Some clinics offer needle-free jet injectors or sedation options for patients with needle anxiety.
FUT patients receive additional anesthesia along the entire strip line. FUE patients receive broader coverage across the extraction zone. The total anesthesia time is similar for both methods.
Step 4: Graft Extraction
This is the fundamental difference between FUE and FUT.
FUE Extraction
The surgeon uses a micro-punch tool (0.7 to 1.0mm diameter) to score around each follicular unit. The punch cuts the tissue around the graft, and the surgeon lifts it out with fine forceps. Each graft is placed into a chilled holding solution (typically Hypothermosol or saline) to stay viable.
Key details of FUE extraction:
- Speed: An experienced surgeon extracts 500 to 800 grafts per hour
- Graft quality: Depends heavily on surgeon skill and punch sharpness
- Donor wounds: Tiny circular holes (0.7 to 1.0mm) that heal in 5 to 7 days
- Maximum per session: Up to 5,000 grafts
- Time required: 3 to 6 hours for extraction alone
The surgeon must distribute extractions evenly across the donor zone to avoid creating visible thin patches. This requires experience and careful planning.
FUT Extraction
The surgeon makes two parallel incisions to remove an elliptical strip of scalp tissue. The strip is typically 1 to 1.5cm wide and 15 to 30cm long. The wound is closed with sutures or staples using a trichophytic closure technique, which encourages hair to grow through the scar line.
While the surgeon closes the donor wound and begins creating recipient sites, a dissection team works under stereomicroscopes to separate the strip into individual follicular units.
Key details of FUT extraction:
- Speed: Strip removal takes 30 to 60 minutes; dissection takes 2 to 4 hours
- Graft quality: High quality because grafts are dissected with protective tissue intact
- Donor wound: A single linear scar, typically 1 to 2mm wide after healing
- Maximum per session: Up to 4,000 grafts
- Time required: 30 to 60 minutes for strip removal
The parallel workflow is FUT's efficiency advantage. While one team dissects, the surgeon can begin placing grafts.
Step 5: Recipient Site Creation
Identical for Both Methods
The surgeon creates tiny incisions (recipient sites) in the balding areas using custom-cut blades or sapphire micro-blades. Each site is made at a specific angle (typically 30 to 45 degrees), depth, and direction to mimic natural hair growth patterns.
Recipient site creation determines the naturalness of your results. The angle, density, and distribution of sites matter more than the extraction method. A skilled surgeon creates 40 to 60 sites per square centimeter for natural-looking density.
This step takes 1 to 2 hours depending on the number of grafts being placed.
Step 6: Graft Placement
Identical for Both Methods
Trained technicians or the surgeon use fine forceps to insert each follicular unit into a recipient site. Each graft must be oriented correctly and seated at the right depth. Grafts that are too shallow may pop out; grafts that are too deep may grow at unnatural angles.
Placement is meticulous work. A team can place 500 to 1,000 grafts per hour. For a 3,000-graft session, placement takes 3 to 6 hours.
During placement, grafts are categorized by size:
- Single-hair grafts: Placed at the hairline for a natural, soft edge
- Two-hair grafts: Placed behind the hairline for moderate density
- Three- and four-hair grafts: Placed in the midscalp and crown for maximum density
Step 7: Post-Procedure Wrap-Up
FUE Post-Procedure
The donor area is cleaned and lightly dressed. No bandaging is necessary in most cases. The tiny punch wounds begin clotting immediately. You receive a care kit with saline spray, antibiotics, and pain medication. The clinic reviews post-operative instructions, and a driver takes you home or back to your hotel.
FUT Post-Procedure
The donor area is bandaged to protect the sutured incision. The bandage stays on for 1 to 2 days. You receive the same medications and post-op instructions as FUE patients, plus specific guidance on caring for the suture line. Sutures or staples are removed at 10 to 14 days.
Procedure Timeline Comparison
| Step | FUE Duration | FUT Duration |
|---|---|---|
| Consultation and prep | 30-60 min | 30-60 min |
| Anesthesia | 15-30 min | 15-30 min |
| Graft extraction | 3-6 hours | 30-60 min |
| Donor closure | Not needed | 30-45 min |
| Recipient site creation | 1-2 hours | 1-2 hours |
| Graft placement | 3-6 hours | 3-6 hours |
| Total | 6-10 hours | 4-6 hours |
What Stays the Same
The quality of your results depends on recipient site creation and graft placement, both of which are identical between the two methods. The extraction technique affects your donor area appearance and recovery experience, but it does not change how your transplanted hair grows.
Read the FUE vs FUT overview for a broader comparison. For what happens after surgery, see our FUE vs FUT recovery comparison.
Plan Your Procedure
Get a free AI-powered hair loss assessment and personalized procedure plan at myhairline.ai.