olmert

There is a specific reason I ask this, and it is not because I deny that there a pro's and con's to both FUT and FUE. I don't think it is a weighing of these pro's and con's that are guiding people's choices, but rather complete misunderstanding. I've presented the premise that I want to maximize the number of donor grafts. I've heard the claim here that doing a combination of FUT's and FUE's will give you more grafts than doing strictly a series of FUE's. In other words, those wishing to maximize donor grafts, cannot do FUE's alone, but must do FUT's too. I've posted to ask why this would be so. I received nothing but the most retarded answers, basically people claiming 1 + 1 = 3. They usually add in qualifying language and essentially say "In my opinion, 1 plus 1 can equal 3 in some circumstances, but you need a really good doctor, and I can't stress this enough." It is obvious such people are not reading my question carefully enough. Such people also often say "the reason you can get more grafts with an FUT/FUE combination instead of a series of FUE's is that with FUT you get all the hair on the strip, whereas for FUE you only cherry pick a few grafts over the donor area." Only someone who does not understand my question could spout this nonsense. Assume you start out with a donor region of 2.5 inches that contains 10,000 grafts. You have two options. Option 1. Cut with FUT a half inch strip in the middle, which gives 2000 grafts. Allow the remaining 2 inches to stretch out to cover the missing half inch. Now the donor region remains 2.5 inches, but only 8000 grafts cover it. Option 2. Cherry pick with FUE 2000 grafts throughout the entire 2.5 inch region. Now the donor region remains 2.5 inches, with 8000 grafts covering it. So why are people making the claim that an FUT/FUE combo will give you more grafts, than doing a series of FUE's? Do not answer that it is because FUT takes every graft from the strip, while FUE cherry picks. That just will tell me you did not read carefully enough.

Is KO saying that with FUT the skin is stretched uniformly, but with FUE the hair is plucked in a non-uniform way, so the FUT donor region looks more natural than an FUE donor region?

1. I don't understand dr. karadeniz' excess skin argument. I don't see how it could be a way FUT could give grafts without decreasing donor density. If skin is bunched up - or in excess - I would thinking the bunching causes an appearance of greater hair density If you reduce the bunching — that is the skin excess — you will reduce hair density, I should think. 2. The neck stretching argument might be a way FUT gives grafts without decreasing donor density. Under this theory the hair line over your neck is raised up a bit. But how much is this hair line really raised? I thought almost all the skin stretching takes place within an inch of the scar. No? 3. I really wish I could get an answer to this: Why can’t you do FUE before FUT, and FUE harvest from areas no where near the FUT donor region?

Say the FUT cut out a half inch strip, giving 2000 grafts. Say the skin one inch below and above the strip stretched out to cover the missing strip. At the end of the day you have an area 2.5 inches wide with 2000 fewer grafts. Why couldn't you have done FUE on this same 2.5 inch area and taken the same 2000 grafts? Glocktop says you cannot use FUE to take 2000 grafts out of a half inch area. But you can use FUE to take 2000 grafts out of the 2.5 inch area, In sum, why can't a series of FUE's get the same number of grafts as an FUT/FUE combination?

I've googled a little about glidability. I could not find any belief that glidability allows you to take donor grafts without affecting donor density. As a matter of math, this seems impossible. The surface area determined by your skull remains constant. If you take grafts from the donor region, you have to reduce donor density. (The only way around this is to reduce the surface area of the donor region, which is impossible, as your skull does not get shrunk.) More fundamentally, I am very interested in knowing why the FUE doc can simply harvest exclusively from regions no where near the FUT donor area. This seems to be a way to allow FUE before FUT. Anyone have any data on this?

My question is not that. With FUT you are cutting out a strip of scalp, and then stretching the remaining scalp. With FUE you are cherry picking grafts. So I would think you could have five FUE surgeries, and cherry pick the entire donor area, and in the end get just as many grafts as if you had done a combination of FUE and FUT. But I understand you can get more grafts with the combination of FUE's and FUT's, rather than just getting a series of FUE's. Why can you get more grafts with a combination of FUE's and FUT's instead of getting only a bunch of FUE's?

MusoInOz writes: "If you were to now skip from FUT to FUE and require a larger session, there is no doubt the Dr would harvest from this section and sides." Can't I tell the FUE doc that I will get FUT later, and ask him not to harvest from the FUT area?

I don't understand why they can't pull as much hair out using FUE alone.

You can always use more hair. They can never move as many as you lost. You will look better the more you move. Even with 6000 grafts, you won't have as much hair as you used to. It is subjective how many are enough.

What is the advantage to stripping out before going FUE? I thought they can do FUE on areas far away from the strip, and then do FUT later. As for the first FUT, I went to a doctor who normally does not do more than 2450. He is recommended here, but he is not a mega session doc. The doctor did not want to put hair in the front. He told me I am going to continue receding in the front, and it could look bad to recede around the transplants. He did fill the receding hair line on the sides. The argument made sense to me at the time, but now looking back, I think grafts are wasted on any place except the front hair line. The front hair line is what you see. On top, I can put Couvre make up to hide the balding. I can't do that in the front.

The last picture is me from 2012 before the FUT. It has a date on it.

OK. Here are my pics. Doesn't look to me that the 2450 graft FUT did much, btw. http://www.hairrestorationnetwork.com/eve/177322-should-i-get-fue-before-fut-fut-first.html

OK. Here are my pics from now. I had one FUT, 2450 grafts. Nothing was placed in the front, except for the receding corners. 43 years old. I have average density. My goal is maximum grafts. I understand that to do this I have to get FUE and FUT. Which one first? The last picture is marked 2012 and is from before the FUT. The other pictures are current.

My only goal is the get the most grafts possible. Can I do this with FUE alone, or will I need a combination of FUE/FUT surgeries? If so, does it matter whether I get the FUE or FUT first?

Frizz is basically a curliness. https://www.google.com/?gws_rd=ssl#q=frizz+bald+look I saw in my doctor's office Ion Oil Free Glosser, which is an anti frizz product. And I was wondering does Frizz make you look more bald? I would think it might make you look less bald by curling things up.

1. If Spanker is right that doctor charges do not vary much with what the doctor is making (and presumably on the doctor’s skill), but rather vary with factors unlikely to affect the result (for example, location, performing two procedures at once), then a patient would be throwing out money to go to the expensive doctors instead of say the cheap doctors in India with satisfied patients. And we are talking big money by not picking doctors like Bhatti and Madhu (like $20K versus $4K). 2. I use the term “economic profit” because for purposes of this analysis, the doctor’s opportunity cost for his current practice is to have a practice similar to the typical doctor, with the typical doctor’s accounting profit. Graduate economic classes are generally more about math than economics.

1. How do you know FUE doctors make more?. Even if FUE doctors need less technician time, they also must give more doctor time per graft. I've read people claiming on this forum (without citation) that some doctors who do both FUE/FUT push FUT because it is more profitable for them, owing to less doctor time per graft. 2.By "premium" I am not referring to what the consumer profits or loses. I refer to what economists call "economic profit" of the doctor: this is to say the particular doctor's hourly wage minus the average doctor's hourly wage. The better doctors often have economic profit. And of course everyone has some natural inclination toward equality and bristles a bit at someone charging, such that he makes more than the average doctor, even if the doctor still provides a better value to the patient. Unlike the doctor, the patient usually isn't in the 1%, and it reminds the patient that the doctor is not entirely motivated by the patient's interest. BTW, I predict that FUT prices for H & W, and others is going to go down, or at least not keep up with inflation. This is because more patients are choosing FUE over FUT, and the total number of transplants is staying constant. So the FUT doctors are going to have empty slots and will have to compete with each other to fill the slots. Also more FUT doctors will offer FUE, which will be a little awkward, after pointing out the disadvantages of FUE for years. They will say point to the change in technology.

So if my hair loss will ultimately make me a norwood V-A or VI, if my goal is to max out the number of grafts, and if I have average density with only 7500 donors, my best bet is to get FUT 2 or 3 times, and then get one final FUE? And no matter how much FUE technology will advance, this goal of maximum grafts is served better with FUT than with FUE alone?

What about the average person, someone with average laxity/density and every thing else? Which technique gives you more lifetime donors for such person? Why do you suggest FUE after FUT? Are you saying you normally will reach your FUT maximum and then still be able to get some more donors with FUE?

Most doctors can take more grafts through FUT (over FUE) in one session. (Even this is becoming less true with Bhatti doing two day FUE sessions of 5K grafts.) Anyway, what makes you say you can get more total lifetime grafts with FUT than what you can get in multiple FUE sessions?

FUT is dead and has at most 10 years left. The only candidates for FUT will be those who don't care about a scar, and there aren't enough of those people. When an industry is young, there is more opportunity for a provider to stand out. In the beginning, plumbing was a real skill. The best plumber gave you substantially more value than the average plumber and could charge a premium. As the industry matured, there were fewer opportunities for the best plumber to stand out. The best practices permeate and become known to the worst provider. The best become less and less distinguishable from the average. So today, the best plumber and even the best diamond cutter can't give you a much better product than an average one and cannot charge much of a premium. Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices. FUE is also more mature, and just starting to become mainstream option and take over market share from FUT. So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor. To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss. But Dr. Hasson and all FUT experts are in a tougher situation than they were a few years ago. This even Jotronic will concede. And the FUE experts like Umar are in a better situation than they used to be in. As time goes by, things will get tougher for Hasson and easier for Umar. The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's. Ultimately, the same process will happen to Umar once cloning starts. You might ask why Hasson does not simply go FUE. It is because his expertise is all in FUT, and he can make more by sticking with it than by learning FUE from scratch.

Jotronic does not understand the nature of industry, which has nothing in particular to do with hair transplants. When an industry is young, there is more opportunity for a provider to stand out. In the beginning, plumbing was a real skill. The best plumber gave you substantially more value than the average plumber and could charge a premium. As an industry matures, there were fewer opportunities for the best plumber to stand out. The best practices permeate and become known to the worst provider. The best become less and less distinguishable from the average. So today, the best plumber and even the best diamond cutter can't give you a much better product than an average one and cannot charge much of a premium. Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices. FUE is also more mature, and just starting to become mainstream option and take over market share from FUT. So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor. To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss. But Dr. Hasson and all FUT experts are in a tougher situation than they were a few years ago. This even Jotronic will concede. And the FUE experts like Umar are in a better situation than they used to be in. As time goes by, things will get tougher for Hasson and easier for Umar. The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's. Ultimately, the same process will happen to Umar once cloning starts. You might ask why Hasson does not simply go FUE. It is because his expertise is all in FUT, and he can make more by sticking with it than by learning FUE from scratch.

I foresee a day when no one does FUT anymore. If the best FUE docs currently get FUT level yield, then eventually all FUE docs will get FUT level yield. And these second tier FUE docs will charge Dr. Bhatti level FUE prices, which isn't much more than FUT. With price and yield barely favoring FUT, there will be almost no reason to do it anymore. None of the remaining reasons for FUT, including doing more grafts at once, will justify the scar, tightness, and greater trauma from FUT. Cloning might become an option, but it will be expensive in the beginning, so FUE will remain competing with it. Either way, FUT is out. This doesn't mean every one who already got FUT made a mistake. Yield used to be worse with FUE, even with with the best docs. And not everyone was better off waiting for technology to improve to its current state. Also, the higher FUE cost might not have been justified for everyone.

Mickey85, so you think you will get an inferior result with Bhatti? He is really the only cheap FUE guy. I foresee a day when no one does FUT anymore. If the best FUE docs get FUT level yield, then eventually all FUE docs will get FUT level yield. And they will charge Bhatti level FUE prices, which isn't much more than FUT. With price and yield barely favoring FUT, there will be almost no reason to do it anymore.

Boy, I haven't been active here in two years. Back then everyone said you are guaranteed a lower yield with FUE. That was the main reason to go FUT. How far things have changed. Now the top FUE docs get the same yield as FUT docs. If you had infinite money, FUE would be better for most people. But it seems to me, if you can't afford the top FUE docs and if you go with a mid-level FUE doc (even one recommended here), you will get a lower yield than you would have gotten with FUT.