FUE or FUT dilemma

[chrisis]

Thanks for the feedback Jotronic!

We took the donor strip higher up (still in the safe zone) for 2970 grafts and he can easily pull off the "high and tight" look with a #1 guard on the lower perimeter with the length tapered out longer toward the top. It works quite well on the right patient.

This might be an option for me then. I'll add this to my list of questions for my consultations, i.e. whether I can have take my donor taken further up to allow me a little more flexibility with styling.

It's really hard to see the scar in your patient's pictures. I think I could deal with something like that. I'm being won around to FUT.

Here's how I have my hair just after a hair cut:


Funnily enough, it's a photo taken on a night out with friends who've become accustomed to fixing my hair when it falls out of place

I have worn my hair slightly longer in the past (see below), but I stopped this when it became more and more difficult to style the front.



Thanks for your input once again!

[chrisdav]

I think the picture shown by Jotronic emphasises how good the Trichophytic Closure is now.

You do still get scarring from fue, just a different type.

No one can predict exactly how hair loss will progress and the the usual indicators such as family/relatives, current miniaturisation on the scalp, age and rate of loss etc are the best guides we currently have.

Some people loss a bit in their twenties, then keep the rest for their life.

Others can have no hair loss, then all of sudden, all fall out in their mid 30's.

Jotronic is in a better position to comment on that than I am.

I know every one has a different opinion but in my honest opinion, until fue has as consistent yield as strip for every type of patient being suitable for hair transplantation, then strip is the best way and once you have maxed out your strip, use fue and even body hair after.

If my scalp was a virgin scalp, I would still strip over fue every time.

I personally would not want to pay a larger amount of money, only for the transplant not to yield correctly as the inconsistency has not been completely eradicated.

I then would have wasted a percentage of my finite donor supply, which could have been growing in my head, leaving me with less hair to gain the coverage I previously desired.

You need to make every graft count; as surgeons are rationing out the limited supply we are given.

If needs be fue into the scar if it was a major issue.

Hair transplants work best when they are grown to a certain length and not when they are kept very short.

If hair is cut short, cutting the hair on the sides and back reduces the contrast in density between the back-sides and the thinning top.

You only have to look at Spex hair, the pictures of him when he has short hair on top (grade 4 from memory) in comparison to when he has his hair long.

His transplanted hair at a good length looks the same as my native hair when I met him but when it is shorter, it appears thinner and this is logical as surgeons create the illusion of density by placing the grafts in the correct position, at the correct angles using less grafts per cm^2 on the scalp.

I am using this as an example from Shapiro.
They are one of the best clinics around without doubt who perform both procedures, but also are honest, ethical and will not tell you what you want to hear, but what is best for you and your future.

http://www.shapiromedical.com/procedure/follicular_unit_extraction_fue/

[chrisis]

Thanks for your thoughts, chrisdav.

I'm being won around to FUT. I feel my hands are tied regardless - financially speaking, but in the last few days I've been on an emotional rollercoaster and at one point considering calling the whole thing off.

I'm going to research FUT techniques and scarring some more and attend my upcoming consultations. Ideally if I opted to proceed, I'd like surgery done some time in the summer. I feel impatient but want to make sure I do my homework too and make the best decision.

I'm intrigued by the photos Jotronic posted of the patient who opted for a higher scar in the donor area, and will ask Dr Feller and Dr Rahal their thoughts on that possibility.

[chrisdav]

I am sure there are other forum members who will make valid reasons for fue Chrisis and they may well be correct, that is just my personal opinion.

Just keep doing your research, have a consultation with the 5 best clinics you feel are the best to perform your surgery and who you personally feel are best to help you achieve your goal not just now, but if your hair loss did progress as you age.

Have some online consultations and a couple at least in person, face to face.

The internet is a great source of information and you can look at lots of before and afters, videos and testimonials on their websites and the forums.

The forums are of great help and good surgeons will post work of a good to high level consistently.

Try to meet some patients from the respective clinics.

All the surgeons you have mentioned are very good, Feller, Rahal, Hasson & Wong,Shapiro and there others also you should consider.

I am not saying rule fue out, as it is very good in the right hands.

If you want your hair cut short in a certain way, then maybe you should have fue but if your hairloss does progress as you age, I can assure you at the age of 40, you will change your hair style.

You have to make the decision at the end of the day.

In my case, I had small strip and fue from a bad clinics when I was younger, so Dr Feller cut my old strip scar out, so there was no point me having fue.

I like my hair longer as I look better with longer hair, so yield was my main interest to me.

Hair transplants do suit different styles at different lengths.

For example you may see a lot of before and after pictures with the hair combed across, allowing the hair to layer over the top, improving the look of the hair.

[chrisis]

Yeah, it's a complex topic. Ultimately the sword falls on each individual's decision which they must make weighing up so many different facts and opinions.

I also feel I should at least wait for the results of Replicel's trial. Even if it was extremely positive however, it would be several years before we saw a treatment. I'm not sure I am prepared to wait even 2 years. 1 year I'd consider, but they'd never get it through the clinical trial stages in that time.

My name's down as a volunteer to trial it which would be perfect, assuming it worked! Help science, sort my hair, and at no cost. I can dream.

[chrisis]

Where were you looking to go to? A lot of your decision also depends on the surgeon. For instance, Rahal charges a preposterous amount of money for his hair transplants. So obviously, going there may seem like a non-option.

Have you considered maybe Dr Keser from Turkey? I've seen his work on various forums and it looks really good, plus he isn't that dear.

But definitely avoid getting an FUT. You are likely to get a big scar, which mostly (in my opinion) depends on your genetics. So sure, MAYBE it won't be bad. But maybe it will. Ultimately you don't want to be replacing one problem with another. Get a good FUE and in five years time you will be thanking yourself I'm sure. Wheras if you went for FUT you will probably ask yourself "Oh, why didn't I just spend the extra 1-2k and do it properly the first time!".

My 2c....

I'm thinking of going to either Dr Feller or Dr Rahal. I haven't seen much of Dr Keser's work to be honest. It's important for me to choose a doctor who has a big portfolio of successful transplants, with focus on achieving a natural and youthful hairline. I've researched extensively and Dr Feller and Dr Rahal stand out. There may be other great doctors, but either they aren't as well known or they aren't marketing their work very well on the forums.

The difference between FUE and FUT is not 1-2k, or I'd not have even asked this question. FUE is almost double FUT. In terms of affordability, FUE is out of my reach. It's FUT or nothing for me. It seems if I can't deal with the scar then I can't have surgery at all.

[rugger31]

Hey mate have looked at Ferudini or Basinga in Belguim I have been quoted top 9000 euros for 2000 grafts via FUE which works out at around £7000 thats the same price as Rahal or Feller is money was no issue I would go with Rahal for FUE but is over £11,000 for the same numebr of grafts.

[Jotronic]

Chrisis,

I actually like your hair better in the pic where it is slightly longer. It reminds me of a celeb that came in for a consultation a few weeks ago and it's very hip. Based on what I see in your photos I think that your expectations can be met but this is only based on your photos.

The style I referred to also reminds me of the patient below. His hair is more coarse than yours but the style is similar. His sides are considerably shorter than the back and while the donor incision does not run nearly as far into the sides as a 4500 session the sides were still utilized but there is no evidence of a procedure. Also note that while the design of the hairline is pretty aggressive it still has enough recession to allow for a natural appearance as he ages.

[chrisis]

Thanks Jotronic. Must admit I'm curious who the celebrity was, but I'm guessing you can't say?

And yeah I did like my hair longer at the back at the time, however the idea of needing to always keep it long to hide a (potentially) hideous scar scares me. I've thought about getting tattoos in the past, but I have the same issue with permanence so never got round to having one done.