FUE or FUT dilemma

[Gandolf]

Yup. And there are those who regret it or look like glorified comb overs
Your call
It;s your head
At 28 Im guessing you will have future hair loss right to the crown
Be prepared to either live with it or continue for more hT's
Rememmer it's not a full dense head of hair
It's an illusion
Good luck on whatever ever you choose, though .

It's only a "glorified comb over" if you are completely bald on top and it becomes an issue of supply and demand. There are many, many people who experience hairloss significant enough to affect their appearance, but still have more than enough to work with to fix the problem areas.

[chrisis]

Also, even if my balding did progress, a good HT (2500 grafts) will buy me time. I think most of us would assume there will be better solutions within 5-10 years.

My balding is very slow with no sign of loss at the crown (touch wood). My grandfather on my Mum's side didn't lose hair at the crown either.

[Folly]

I think if you are an NW2-NW3, then recreating your hairline with a HT is an ideal solution. With the hairlines produced by docs like Feller and Rahal, you can pretty much go back to your original head of hair (pre MPB) with 2000-3000 grafts. When you drift into NW4++, then i think the patient needs to understand what can be achieved with a HT. But for an NW2 - NW3, i think a HT is great, assuming their hair loss is progressing slowly or completely stopped.

(touch wood).

You able to do that yet mate ? Sorry, bad joke. The sides from propecia gone yet? I've cut down to 0.25mg daily. I seem to go through weekly patches with my libido. Some weeks it's ok (nowhere near what it was, but enough that i can live with it) and other times like now, it's non existant !!

[chrisis]

But for an NW2 - NW3, i think a HT is great, assuming their hair loss is progressing slowly or completely stopped.

Yeah, by that definition I'd be a good candidate.

You able to do that yet mate ? Sorry, bad joke. The sides from propecia gone yet? I've cut down to 0.25mg daily. I seem to go through weekly patches with my libido. Some weeks it's ok (nowhere near what it was, but enough that i can live with it) and other times like now, it's non existant !!

Haha. Still got side effects sadly. My libido isn't too bad now, but my dick still feels a bit like it's lost sensitivity and orgasms aren't as enjoyable. Hopefully it'll go back to normal.

It's horrible having no libido. I don't think people realise the effect it has on the male psyche unless they've been through it.

[Jotronic]

Your concerns and observations appear to be logical and I can see the conflict you are dealing with. However, as you said the results from surgical hair restoration are indeed supposed to allow you to have more styling options. You stated that your fear with FUT is that you won't be able to have your hair cut shorter than a #2 or #3 and you currently enjoy a #1 cut.

The problem is that I don't know of a single FUE clinic that would guarantee you that there would be zero visible evidence of surgery at a #1 guard and any that do, well, you'd have to question their motives and abilities. Yes, they can obviously guarantee no strip scar but your goal is to be able to continue your current hair style and not have any visible effects. No one can guarantee this.

The patient below had the same concern that you do in that he had somewhat mild loss in the form of temple and hairline recession but he wanted to maintain his options. 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.





There is also the option of just not doing anything and that is always a great idea but make no mistake, if you do have a procedure, regardless of which type, there will be compromises of some sort. You just have to figure out if you can accept them.

[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/proced...xtraction_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.