4000 Grafts, FUT or FUE

[ryan555]

Also, there are great new options in dealing with a linear scar, including FUE and SMP. If one could obtain, say, an extra 2,000 or 3,000 grafts via FUT than with FUE and then get SMP to help camouflage the scar, wouldn't that be worth it? Maybe you can only buzz the back to a 3 instead of a 2, but you're getting thousands more grafts in exchange. Isn't that worth it???

[35YrsAfter]

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.

My thinking on this is, no matter which method is used to remove the hair, if it's 700 grafts or 9,000 grafts, you still have 700, or 9,000 less follicular units in that donor area. ACell and PRP does swing the probability of a fuller donor in favor of FUE. Hopefully those numbers will continue to improve. With strip, there is stretching and the distance between follicular groups increases and the appearance of density of course decreases. I'm not a strip expert, but I know of a debate in a forum some time ago regarding stretching and donor fringe area/height reduction. In other words, a Norwood 6 who has, say 8,000 grafts taken could end up with slightly less "fringe" area/height. I believe that there is more stretching than fringe area shrinking.

Chuck

[gillenator]

Both Ryan and 35yearsafter make some valid points.

I think that beard grafts into scars have lots of potential, and I wish the patients that used beard donor would show their results like NEGuy. We rarely hear back from them...

The more I research and the more examples that I see both in FUE and FUHT have brought me to the conclusion that competence is essential in both arenas, and more than any other factor is the key to a good result.

It is not until you have seen enough bad work from each method that one realizes this point.

Yes, incompetent FUHT work can minimize the future harvest of grafts in the occipital zone because of the width of the scar, damage on either side, and the lower densities. And I still feel very strongly that anyone who desires to buzz their scalp should choose FUE.

But I have also seen some donor areas harvested by FUE which left so much collateral damage to the neighboring FUs to the point that very little FUs were left to harvest. In those cases just about every one of these men had the work done by someone learning the manual extraction technique. And why would any individual let someone learning FUE do such large sessions on them?

The real challenge is how does a surgeon learn manual FUE the proper way? They do so by engaging with a competent experienced FUE master in an internship program.

Actually any form of cosmetic surgery "requires" an internship except the surgical hair restoration field because it is unregulated.

[topcat]

Chuck what I don’t get about this Acell is that if the product actually did cause hair to regenerate then I would think that the company would pursue that additional indication. Are they pursuing this indication?

It’s also illegal for the product to be promoted off label so I suppose that is why the company knows not to promote it………….doesn’t mean it can’t be used off label just can’t be promoted. Of course this is for very good reasons.