Strip and FUE at the same surgery

[Tsakalos]

lets say that u need some grafts to accomplish ur goals. the number of grafts needed due to limitations from previous surgeries can only be taken by combining FUT and FUE. and lets say that the patient doesnt want to wait and wants to be done as soon as possible and the docs plan is to do them both at the same session. it doesnt matter if it is repair or not,

Safe or not ?
Wise decision or not ?

the photo shows a repair patient who did this with Dr. christian bisanga.



if i were in his position and had those goals i whould probably have done the same

[Dr. Glenn Charles]

Doing FUT and FUE in the same procedure is reasonable on certain patients.
It can definetly allow the doctor to obtain more follicular units in one session.
A patient having had prior work/repair case would not exclude them from having both of these techniques performed in a single procedure. It really depends on what kind of remaining donor hair the patient has and what their expectations are.

[gillenator]

There are a number of reasons why a patient would elect to have both FUHT and FUE in the same session. Another one may be that the patient lives outside of Europe and had to fly a great distance and wanted as much work done as safely possible.

The thing that stood out to me is the massive scarring from previous FUE. Those punches must have been quite large in diameter to produce that much and pronounced shotgun donor appearance to no offense to the patient.

Possibly there are some healing issues, but I doubt it IMHO.

I have seen countless pics with this type of FUE scarring, moreso several years ago before surgeons like Dr. Bisanga became much more efficient and thereby were able to do the same extracting methods but with smaller punches as we can clearly see in the new extraction sites in the photo.

My guess is that once his epidermis completely heals, the new extraction sites will hardly be noticed at all. Nice work.

[Tsakalos]

the old holes dont look like bad fue extractions to me, but punch graft extractions. they are like shotgun holes arent they ?

[gillenator]

the old holes dont look like bad fue extractions to me, but punch graft extractions. they are like shotgun holes arent they ?

That very well could be open donor scarring.

[the B spot]

I am in favor of using the dual approach for the proper patient.

The exciting part of this is we can throttle back on the width of the strip and take a strip that yields say 3500 grafts, then do another 1500-2000 FUE grafts to get to 5000-5500 grafts--without ever putting the patient at risk for a less than optimal scar.

We have had some very in-depth discussions about this approach and we are still looking for the right patient.

I believe a patient with very little native hair (NW5/6) but with average to above average donor density with average laxity would be an excellent candidate for this approach.

The idea is to be able to hit a target "number" of grafts and not be limited by the drawbacks to each procedure.

FUE seems to have a threshold of extractions for each individual which will limit the amount of grafts that can be extracted.

Strip is limited by laxity and donor density within a given area.

By combining both---in theory you gain the positives of both, but reduce the risks or drawbacks of both---in effect a perfect approach for the right candidate.

My opinion of course,
Jason