Many surgeons and â€œHT theoristsâ€ (wow, what a goofy term!), have speculated about this. I believe there are too many variables and patient-to-patient variations to precisely calculate the approach that will result in maximal graft production.
Strip harvests produce linear scarring and hair angle distortion around the scar. They can reduce the surface area of the donor region as well as reduce the follicular density below the scar.
FIT harvests will only reduce follicular donor density. The advantage is that this reduction is evenly spread out through the entire region.
Donor hair is not an endless supply as you know. You can conceptualize the â€œtraditionalâ€ donor as a wide band around the back of the scalp, roughly 6cm by 30cm (emphasis on roughly). Depending on the patient, 1/3 to 1/2 of this area will need to be surgically excised to produce 6000 strip grafts. To reiterate, this will result in linear scarring, hair angle distortion in the donor, surface area reduction, and density reduction. It is true that we can do FIT in a stripped-out donor, but clearly the harvest will not be as plentiful as in non-stripped donor.
If you are concerned about scarring, you should do FIT. This leaves the door open for future FIT or strip work if needed. If you start with strip, you immediately closed the door on the non-strip scarring benefits of FIT. If you are not concerned with linear scarring, FIT is still a good option as is a Strip/FIT hybrid approach. Keep in mind, however that FIT grafts will produce a better calculated density versus strip grafts.