A tale of 2 heads part 2—1400 FUE by Dr. Lindsey McLean VA

This fellow, and the other fellow described in “part 1”, are interesting in that they have the same problem—frontal hair loss, and chose to deal with it differently. Both heard exactly the same talk about the trade offs of FUE vs Strip in terms of scarring risk, success or consistency of results, time and effort, and cost. I’ve blogged on all of these before and in general I feel that if you’ll just keep your hair a half inch long or more, and that if you need or may need a lot of hair….strip is the way to go. However, if you are planning on very short hair, FUE is the better option no matter how good the scar turns out. Plus, FUE definitely stresses the hair root more during extraction than just careful dissection out of a strip. And I believe that inconsistently affects FUE results more than the fairly consistent results with strip.

Additionally these 2 guys have the added issue of being black. This alters things 2 ways. First, they are at higher risk of hypertrophic scarring than whites…which would tend to push things toward FUE. And second, their hair roots are really curved, making them harder to FUE out than straight haired individuals…which would tend to push things toward strip.

Shown are periop pics on days 1 and 2(it took 2 days of work-hairline day one, the rest day 2), pics emailed to me at about a week, and app 2 month pics that the patient emailed me. He lives very far away and I don’t expect to see him in person any time soon. I have encouraged him to send lots of pics and call with any problems as there is a finite window of about 3 months to deal with scar problems.
Dr. Lindsey McLean VA

Very interesting predicament. I'd be inclined to say FUE if the surgeon feels confident in extracting the hair but as you've outlined each has its advantages and disadvantages.

While black people have less FU available for transplantation they also get better coverage per FU so that kind of balances that out. The lower hair to scalp contrast and issue of scarring I think makes it seem like FUE might be the way to go but there's always the extraction and yield issues I guess.

I would say that most black men favour tight haircuts so again the preference of hairstyle could definitely be a big factor.

Excellent points FDR. Only the less consistent results with FUE and the increased difficulty in removing a cork screw as compared to a toothpick (follicles) counters this. All needs to be discussed preop and weighed by the potential patient.

Good post.

Dr. Lindsey McLean VA