I was considering today if I want to go forward with a ht soon. Then I thought that if I ended up becoming one of the unlucky ones years down the road with a huge bald crown that cannot be filled densely if I had the procedure done FUE I could simply buzz down my head.

So I was wondering (apart from the cost) what are the other risks/downsides with FUE compared to strip?

(i) is it true the yield is lower than strip? if so, then how much lower?

(ii) in the first picture in the link below, is it normal to get donor this high on the sides of the head via FUE:

http://www.hairlosshelp.com/websites/galleryview.cfm?id=shuffle|gallery1.cfm

I thought this was outside of the safe zone? I ask because this is where my hair is the thickest and it REALLY accentuates the thinning areas. I even have the barber run the thinning -sheers through this area so as to make my thinning top less obvious. So, I thought it would kill two birds with one stone by thinning that area out by extracting additional donors from it and re-distributing them atop my head. Any thoughts?

(iii) can you shave down the entire donor area (as in bic it) and have absolutely no visible scar with FUE?

(iv) if one did do strip and wanted to fill in the scar with FUE for the same reasons given above, roughly how many grafts would it take and is it possible?

NG2GB,

I recommend reading the following dialogue between myself and Dr. Feller: What are the benefits, risks, and potential problems with FUE/FIT?

Bill

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To learn about how I restored my hair, view my my hair loss website.

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I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

I read it. Would still like additional input as my questions are not answered.

Thats an interesting and informative link, I didnt know it existed, answers alot of questions I had about FUE.

Unfortunately (for me, anyway) it sounds as if this procedure does not work well unless two things are working in the patients favor, one of them being a virgin scalp, the other being doctor skill.

NG2GB,

To answer your questions specifically.

(i) The risk for lower yield is much greater with FUE than strip. But it's not necessarily fair to make that a surefire statement.

(ii) In my opinion, hair was taken outside of the universal safe zone. I know often times physicians make decisions based on a patient's characteristics, age, and family history of hair loss. So even though hair may have been extracted outside of the universal safe zone, if the liklihood that a patient won't lose hair in that area is high, a physician with patient's consent may take hair from that area in order to increase graft/hair count. I recognize that this is highly debatable and there are varying views on this. Form your own.

(iii). Don't count on it. FUE is NOT a scarless procedure

(iv). Can't answer this with numbers unless a specific case is given. It depends on the length and width of the scar for starters. On an average strip scar however, I'd suggest a good 500-800 grafts will probably make a good difference assuming high hair growth yield. But as you have seen, there is greater risk of transection and damaging the hair follicle with FUE. Combine that with trying to grow it inside of scar tissue, there are additional risks. I'm not saying it's not potentially an effective means to camoflauge the scar. I'm only stating that there are many hurdles to be overcome.

Wylie,

I'm glad the above article has helped you.

Bill

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To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Can I call you "not"?,

I think Bill did a good job addressing your specific questions. We are pretty much in agreement with our opinion on FUE.
I've seen many fue cases being done in person and have seen results from fue. First off, when viewing fue technique in action, I've seen a lot of transections. It takes way more time to extract then what doctors claim. Then going outside the safe zone -- what's that about? It's considered outside the safe zone for a reason-there's likelihood that you may someday lose those hairs. Secondly, "scar less" is very subjective. I think I saw one patient where it was really unnoticeable, but then they only received 500 grafts. He needed very minimal work in the hairline.

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I would like to take the opportunity to answer your questions taking into account OUR experience, obviously we can not account for other peoples experience.

1. If you are asking about maximum amount of grafts harvestable : strip is limited by laxity, FUE is limited only by the patient accepting thinning donor area. Technically it is possible to harvest many more grafts using FUE, I doubt anyone could question this. At this point we believe that FUE produces about the same amount of grafts when compared with strip surgery, on average 4000-5000 grafts.

2. Looks maybe a little high on the crown, the sides seem ok.

3. No, FUE may not leave visible scars, but at a certain point missing hairs will become visible as white dot like areas. But even this will be MUCH less visible at bic lenght then even the best scar or tricho scar

4. You wont know how the scar will turn out until 6 or more months after the session. I have no crystal ball, but personally I would not count on FUE scar filling to make the scar invisible at bic level. I have seen FUE scars filled with no result, most results are good in 'softening the scar', rarely the scar is invisible after FUE'ing them.

Again these are our opinions that are based on our experience doing FUE on a DAILY basis.

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Consultant-co owner Prohairclinic (FUE only) in Belgium, Dr. De Reys.

Bart,

I appreciate your posting your experience on this thread from an all FUE clinic's point of view.

I have a couple points based on what you said and want to see if you agree with me.

Technically you are correct however, what you are leaving out is that harvesting more grafts via FUE will most likely leave the average patient looking like swiss cheese. Therefore I would suggest that one could extract on average just about as many grafts with Strip as with FUE. I believe we agree on this point as per your last statement.

FUE may NOT leave obvious scars, but I'm not sure I would go as far as to say that it doesn't leave visible scars. That would be like calling a procedure "scarless" which isn't true. I think it is safe to say that at best, FUE scarring may be less obvious at skin level than than a typica strip scar. However, I have seen some bad strip and FUE scarring cases. In the hands of a proven quality hair restoration physician, these risks are minimized.

Bill

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Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

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Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Bill, Janna, Bvretti,

thanks for the responses. I was just thinking that if I ended up with a big ass crown that could not be filled later during my Alzheimer filled golden twilight years in which I will be hobbling involuntarily having gasteroal passes then if I had done FUE I could at least shave it down to a #1 or #2 clipper with no really visible scar when compared to having a smiley face "have a nice day" sign on the back of my head...

I guess at least the people walking behind me will be happy and having a nice day even if they are holding their noses.


When you guys say that it takes docs a much longer time to perform the surgery, then that means that it might just take 4-5 days of going in rather than one with strip, right?

I think the biggest detterent with FUE is the lower yield. Who wants to take that risk? I only have so many donors which will enable me to live up to my name...


Janna,

no! You have to spell out my name with each letter...

A poor yield is what scares me the most as well; however, it seems like various docs (Dr. Feller in the U.S., Bart's clinic to a greater extent) can do ~1000+ feeling very comfortable in a single session -- especially if you take the FOX test (I think it's called) and are a good to great candidate.

If say you desired/needed a 2k procedure, and your doctor feels very comfortable performing 1k in a single session....is there anything bad about going in for a 1k procedure, then a week or two later going in for another 1k procedure? Or 3 days of this if you need 3k, etc.

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*A Follicles Dying Wish To Clinics*

1 top-down, 1 portrait, 1 side-shot, 1 hairline....4 photos. No flash.

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