4000 Grafts, FUT or FUE

[Dav7]

Just wondering if anybody could advise me on which of the techniques to go for if I need 4,000 grafts?

[fred970]

Fue.

[Dav7]

Fue.

Why FUE and not FUT if you don't mind me asking?

[fred970]

Why? This:



Also, the fact that FUT is providing 0 benefit compared to FUE, besides the reduced cost and operating time.

Some will talk about greater yield with FUT, but it really depends on the skill of the surgeon. Successful FUE megasessions are common now.

[Dav7]

Why? This:



Also, the fact that FUT is providing 0 benefit compared to FUE, besides the reduced cost and operating time.

Some will talk about greater yield with FUT, but it really depends on the skill of the surgeon. Successful FUE megasessions are common now.

But wouldn't FUE not be for smaller procedures such as say 1000 - 2,000 as opposed to bigger procedures where FUT can come in handy? Also the linear scar is not an issue because I never shave my head. And anyways with FUE you still get scaring, just in a different way.

[fred970]

Nope, I thought that before and it made me really sad. But it was nonsense written online by people who had no idea about what they were talking about, things like: "FUE is suitable for only 2% of hair loss sufferers who have minor loss". FALSE!

FUE for more than 3000 grafts is common nowadays. NW6 have been turned into NW2-ish with FUE only more than once.

Different scarring? You're right, but I'll take this kind of "scarring" to the FUT scar any day:

[gillenator]

There are more good FUE surgeons out there including the ones in Europe. Note that I did not say "plenty" of them. There are several more choices today then there were even three years ago and back.

The real issue is how short you want to wear your hair and also the competence of the surgeon as Dav7 stated. There is bad FUHT and bad FUE. And BTW, that has to be one of the worst strip scars to show as an example but I guess he was making his point of view. Obviously not all strip scars look like that. Regardless, this scar result would be extremely difficult and complex to repair.

If you ever think that you want to or "will" want to wear a short hair style, then FUE is your choice hands down.

If you choose a skilled FUE surgeon, yield will not be an issue...

[Jazz1]

I would go FUE.

[35YrsAfter]

I would go FUE.

We did an over 4,000 graft procedure just a few days ago. Some patients are more challenging, so when you get into those numbers, it's best to plan on 2 surgery days. A top surgeon is critical whether you chose strip or FUE. Natural placement and minimal scarring is not a given with either procedure. In other words, hair restoration by technique is not like a product you buy off the shelf where the box label accurately describes the contents.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

[ryan555]

Is it not the case that FUT can provide considerably more grafts over the long run, especially when combined with FUE? I am always confused when guys with severe hair loss do not account for this, especially when they're young and may need the absolute maximum number of grafts as their loss progresses. Also, when did the hysteria over the strip scar begin? If you go to a good surgeon you're not going to end up with a terrible scar. Also, why get a HT if the ultimate goal is to shave your head?

[35YrsAfter]

If you go to a good surgeon you're not going to end up with a terrible scar.

The reality is, going to a top strip surgeon will minimize the possibility of getting a terrible scar. Dr. Cole has performed over 8,000 strip surgeries and transitioned to FUE in 2002 because some guys, even the best strip candidates get a widened scar even when the surgery proceeds flawlessly. Jetfan11 for example got a widened strip scar and according to a post he made, his scalp laxity was/is excellent.

The next question is... What constitutes a terrible scar? Here at Dr. Cole's office I see guys in for transplants with long hair that have strip scars 7mm wide. I usually ask them if they would like Dr. Cole to place some grafts into the scar while they're here. Sometimes they say no because they don't care at all about the scar as it's well hidden under the hair. Other times men are traumatized over a 3-4mm wide scar.

Also, why get a HT if the ultimate goal is to shave your head?

Good question. On a shaved head, usually both FUE extraction sites and the very best strip scars will become visible to varying degrees. A shaved head shows every little bump and imperfection in crystal clear detail. The best strip scars jump right out at you though. When ACell and PRP are administered, we often but not always see shaved donors that simply have some spaces between the follicular units. No white dots. A wide strip scar will not allow even a modestly short haircut. For instance one man consulted with us because he wanted to lose his hairpiece. His hair on top wasn't overly thin but he couldn't hide his strip scar, so he turned to a piece. This was a reputable doctor and the scar most likely wasn't the doctor's fault. This guy's first surgery resulted in an excellent scar. It was the second strip that created the problem. Multiple strip procedures increase the chance of ending up with widened scars.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
The contents of my posts are my opinions and not medical advice

[ryan555]

The reality is, going to a top strip surgeon will minimize the possibility of getting a terrible scar. Dr. Cole has performed over 8,000 strip surgeries and transitioned to FUE in 2002 because some guys, even the best strip candidates get a widened scar even when the surgery proceeds flawlessly. Jetfan11 for example got a widened strip scar and according to a post he made, his scalp laxity was/is excellent.

The next question is... What constitutes a terrible scar? Here at Dr. Cole's office I see guys in for transplants with long hair that have strip scars 7mm wide. I usually ask them if they would like Dr. Cole to place some grafts into the scar while they're here. Sometimes they say no because they don't care at all about the scar as it's well hidden under the hair. Other times men are traumatized over a 3-4mm wide scar.



Good question. On a shaved head, usually both FUE extraction sites and the very best strip scars will become visible to varying degrees. A shaved head shows every little bump and imperfection in crystal clear detail. The best strip scars jump right out at you though. When ACell and PRP are administered, we often but not always see shaved donors that simply have some spaces between the follicular units. No white dots. A wide strip scar will not allow even a modestly short haircut. For instance one man consulted with us because he wanted to lose his hairpiece. His hair on top wasn't overly thin but he couldn't hide his strip scar, so he turned to a piece. This was a reputable doctor and the scar most likely wasn't the doctor's fault. This guy's first surgery resulted in an excellent scar. It was the second strip that created the problem. Multiple strip procedures increase the chance of ending up with widened scars.

35YrsAfter also posts as CITNews and works at Dr. Cole's office
forhair.com
Cole Hair Transplant
1070 Powers Place
Alpharetta, Georgia 30009
Phone 678-566-1011
email 35YrsAfter at chuck@forhair.com
The contents of my posts are my opinions and not medical advice
Please feel free to call or email me with any questions. Ask for Chuck

But which method allows for the most grafts over a lifetime?

[ryan555]

Also, it's worth noting that you can have a doctor FUE grafts into a strip scar and it can make a huge difference. I had a pretty bad strip scar from a terrible surgeon and Dr Cole put some grafts in there. Now it's hardly noticeable now, even when my hair is really short.

[35YrsAfter]

But which method allows for the most grafts over a lifetime?

Depends on a lot of things. I once worked with a man in his sixties who had thinning in front and a bald spot in back around 3 1/2" in diameter that was high up. He had thick, consistent caliber donor hair and a "run" of hair in the back area about 5" vertical. He may be a good candidate for strip. But if he were to get a widened scar, he hates enough to have repaired, grafts would be wasted, placed into that scar. Donor grafts are always put to better use in thinning areas on top.

Hopefully new and more effective treatments will reduce the need for huge numbers of grafts that can adversely impact the appearance of the back and sides of our heads.

Chuck

[ryan555]

Depends on a lot of things. I once worked with a man in his sixties who had thinning in front and a bald spot in back around 3 1/2" in diameter that was high up. He had thick, consistent caliber donor hair and a "run" of hair in the back area about 5" vertical. He may be a good candidate for strip. But if he were to get a widened scar, he hates enough to have repaired, grafts would be wasted, placed into that scar. Donor grafts are always put to better use in thinning areas on top.

Hopefully new and more effective treatments will reduce the need for huge numbers of grafts that can adversely impact the appearance of the back and sides of our heads.

Chuck

Chuck,

I appreciate the response but that doesn't really answer the question. I've been told my some great docs - Feller, Shapiro, Bernstein, etc - that one can extract considerably more grafts over one's lifetime via strip than via FUE. It could be a few thousand more by all accounts. I find it odd that all these young guys are so set on FUE when they may end up with a small island of hair at the front of their heads and a slick bald mid section and crown with no grafts left in the bank. Certainly, you could never have achieved some of the transformative results like Spex and Jotronic without using some FUT. Also, to think that one can "deplete" their donor using FUE and then shave their head is naive. Even in the hands of a master like Dr Cole, there is likely to be scarring from FUE that will be noticeable after they've had 4,000+ grafts taken.

As a guy who jumped into the whole HT thing way prematurely with the attitude "I just want to enjoy my hair while I'm young," I wish to god I could go back and make a more mature decision. These guys who are distraught about their hair loss at 25 are not going to magically stop caring when they're 35 or even 55. We have to live with our decisions forever and planning for the most possible grafts should be at the center of that.