Hair4Days

5 minutes ago, aaron1234 said:

I think a lot of clinics recommend FUE because they feel the patients will not want/need maximum lifetime grafts, probably one or two surgeries at the most, so why not avoid the strip scar altogether.  But I do feel strongly that the FUT+FUE=Max Lifetime Grafts approach needs to be explained to new patients regardless.

I think it depends on how much coverage the patient can realistically get if they opt for 2 fue sessions. Personally, If i was able to frame the face with a dense frontal third, moderate density in the mid scalp and have it flair off into the crown with lighter coverage in the back then I’d without a doubt avoid the strip scar. I think that comes down to the Math though. Measuring the balding pattern and then calculating donor capacity. At that point you can literally map out how many grafts per square cm can go where 

12 hours ago, Curious25 said:

A patients suitability for FUE or FUT is dependent on the characteristics that they present with . . not their NW status. 

A NW6 with thick calibre hair, and a donor density of higher than 80FUcm2 would arguably be a better FUE candidate than a NW 3 with fine hair, and donor densities of 60FUcm2. 

 

That makes sense. But In regards to maximizing yield..Would the same hypothetical  nw 6 with 80 fucm2 get front to back coverage with fue alone.  Some would argue he’s better off with strip first. But h&w is recommending fue to this patient who posted his photos and is a clear future Norwood 6. 

H&W seem to think fue can be done in advanced nw patients. I was suggested fue as well, but they did include in the email that combining fut and fue yields a bit more grafts so it’s up to you 

I think you’ll have enough donor for a thick front half, then less density as it flares back toward the crown. In a worst scenario a lightly covered crown. Which is fine and better then being bald. You also have a good beard which can be a good source. Your sides don’t look like they’re gonna drop that low. The crown may 

The only reason to worry about stabilizing what you currently have is to prolong a second surgery so soon. The better advice would be to see what’s possible with surgery alone if you go completely bald up top. Then you don’t need to stress about committing to medication for life and dealing with any side effects. Expect to be fully bald, even if you won’t. Ask the doctors if your donor would allow for coverage from hairline to crown it you progressed to a Norwood 6. If they’re optimistic then you’re good. Medication or not 

Update ?

I’m glad dr bloxham is actively taking the necessary steps to make sure you’re happy. In my opinion, He’s one of the best communicators in the industry. I’ve met with him twice in Person and have nothing but good to say about him and his results. 
 

My question and concern is, you already underwent an initial strip surgery, another 1500 strip surgery in the same recipient zone will put you at 2 strips just in the hairline. His game plan is typically to use 1 strip for the frontal half, second strip for mid scalp and into crown. If you lose more going forward, did he say you’re only option is fue? A third strip? Did he mention you could do fue in December to save your second strip for a bigger surgery ?

I use topical fin from Wesley. You need a password to obtain access to his online store which i got post consult. Zero side effects btw

14 hours ago, AB2000 said:

 

OP - if you chose to use fin then realize that eventually it's effects will wear out and you will wind up at your natural hair loss pattern.  Fin will just delay that point of time.  If you do any surgery make sure you plan it as if your balding hair is all going to go away, and start designing from that point.

Perfectly said. Don’t rely on a pill for the remainder of life. Plan as if you won’t be on it forever

He packed those grafts in nicely, even throughout your areas that weren’t that thin.. something i thought wasn’t advised to avoid shock loss. Excellent progress nonetheless. 

4 minutes ago, Melvin-Moderator said:

If you plan on shaving, don’t get an HT

nobody plans on getting a poor result either. It happens 

So i know with any type of surgery, scarring is unavoidable. For anyone who has gotten FUE, do you honestly believe you always have that insurance policy of shaving your head or do you think you give that option up when you opt for a hair transplant in general?

3 hours ago, Zoomster said:

You're Incredibly lucky to have such scalpy type texture from your beard.

You're in a very good position re another procedure ..easy 2K grafts under jawline / chin ...I bet they will utilise the inner sideburns too ..

You'll be closing that sunroof very soon M 💂‍♂️

2k grafts under the jaw is a game changer. That makes up for grafts they say you “lose” by not combining fut / fue.

16 hours ago, j1mmy said:

What SLA said. Beard hair looks like..... beard hair on your head. Might work for some, most probably not. Add in survival rates, density, it is an adjunct for few at best. Perhaps Indian patients at an Indian clinic have more compatible matches. My course dark ginger beard is decent, but will look pretty amusing blended in with my sandy blonde straight hair. 

Yeah i was going to add the disadvantage of dealing with two colors. You see a lot of beards that are a completely different shade then the scalp hair. I’d assume these patients are not candidates 

4 hours ago, SLA said:

I think another great example is Eugenix work with @Zoomster in which 7,000 total grafts were extracted (5,600 scalp and 1,400 beard). He was slick bald NW6+ with average donor at best. Check out his 15 month results on page 19.

 

His results came out amazing for where he began. I wonder why more doctors don’t go the Fue + beard grafts route. If you can grab another 1000 grafts from the beard it makes up for the extra you could get with combining fut and fue.

1 hour ago, Melvin-Moderator said:

I’ve shared it with you quite a few times. We’ve even exchanged conversations on PM two years ago about the same topic. At some point, you have to decide for yourself. 
 

best wishes,

My apologies for not recalling a conversation we had 2 years ago.
 

i just re-read what we touched on. No further explanation on this topic needed brother.  

2 hours ago, deeznuts said:

I feel like fue is probably happening either way. From what I've read, the ideal approach to higher NWs would be FUE + FUT. So this would be FUE vs FUE + FUT. 

Would I incorporate FUT as a NW6? Probably yeah, repairing a NW6 is expensive I'd imagine so if it means cutting costs while eating a bit of discomfort then yeah I'm down. Better than cutting costs in other ways I'd imagine

Well yeah, i think we can all agree when it comes to maximizing your lifetime yield there’s more people in favor of combining both methods.. but i was curious how successful a patient could be with fue alone as a Norwood 6. To avoid a strip scar 

20 minutes ago, Melvin-Moderator said:

Yes, and I did

Could you share how your crown looks as is? Why did you chose fue as a nw6?

Could anyone make a case for choosing FUE over FUT in an nw 6? I know on the Norwood scale the crown dips down which eats into total donor reserves, but would you still do fue over a strip? 

You may just be with the wrong person unfortunately 

49 minutes ago, Hairtroubles said:

Hey man, based on my pics, do you suggest FUT for me or FUE, what would benefit me most, also, do you have a list of clinics in Europe?

I would say Fut because you have hairline and crown loss which is indication of a somewhat advanced pattern. They say starting with strip and then going to FUE maximizes your donor yield. You’ll get the most grafts that way. I have no idea of any solid clinics in Europe. I feel like there’s only a handful of good doctors in the world. A majority of them in the US with the exception of Dr Hasson. 

3 hours ago, j1mmy said:

You might find such a result that looks satisfactory I agree, perhaps with the right hair caliber, colour, over 3.0 hairs/graft.

Let's assume the frontal third of a person is is 70-90cm^2. 2500 grafts standing alone gives you a density of 27-35g/cm^2.

It is not unusual to aim for 45-50^2 as a "nice coverage", and Konior has suggested 50-70g/cm^2 provides "the best coverage".

That's certainly more than 2500. Maybe the NW7 after being bald for 30 years is happy with 30g/cm, not the young guy who is struggling when his hair loss is at 60g/cm right now.

When grafting a zone of that size 70-90 sq cm using 2500-3000 grafts, they don’t evenly distributed the grafts. You’d prioritize the front with 50-60 grafts/ sq cm which allows for perfect styling, and then it decreases as you move back. 

As per your Konior reference, he’s told me directly a 40 graft per sq cm restoration would satisfy 95% of men. 

a young man with 60g/cm right now shouldn’t even be talking about a HT. You can’t even tell your thinning at that point. Once you fall to like 15-20 grafts/sq cm where it’s pretty damn thin you should do a Ht to avoid native hair shock loss 
 

10 minutes ago, j1mmy said:

The point is that surgery can give you coverage NOW, sure. My opinion is that 6000 (+2000) grafts gives thin coverage to a NW7.  That's assuming all three procedures and £30,000 went to good use, with no permanent shock loss to the native hair . So let's say he is 35 years old at that point, is he going to be happy with less coverage than he has now, after three years of the last 10 recovering from surgery? That's not to mention that miniaturization in the donor hairs is real depending on the person, affecting your future transplanted hairs.

An action plan based on "keeping ahead" of your loss is an optimistic one, and may lead many people to a dead end, with no donor left, and unsatisfactory coverage. Some people have achieved it, but it is a dangerous game you are playing, and all too easy to look at the people that got there by accident, repairing previous surgeries and hair loss until they ran out of donor with decent coverage, not because they planned it that way all along.

If you densely graft 2500 grafts in your frontal third, those transplants will stand alone and look good without native hairs. You need to know how many grafts per sq cm gives the illusion of density. You’ll obviously favor the front. Anyone that’s progressing towards a nw 6-7 should know they’re compromising density towards the back, which should be fine considering the circumstances 

17 minutes ago, Hairtroubles said:

James given you are like me and do not want to take a pill for the rest of your life, what is your game plan, what did you do if you already had a transplant, can we put together a plan for myself?

Genuinely, I do not want to be on Fin, but I want to save my hair, I am starting to see this puts me in a terrible situation.  I am saving up money for the transplants, so genuinely, please can you help me out here?

So you’re in the same boat as me basically. I’m in my late 20s with difffused hairloss throughout the top with recession in the hairline. I’m not taking finasteride. I was told by multiple Ht surgeons that surgery alone can give you the coverage you need so why would i take fin? I’ll just get a second or 3rd surgery. You will typically start with your frontal third, rebuild your hairline and feather into your mid scalp. That’ll keep you looking great for years until the back half starts to bald out. Then you do another 2500 graft case to knock out the back half. After two surgeries you’ll likely use 5000-6000 grafts with major improvement. The average patient has this in their donor supply. Then if you’re able to grab another 2k fue grafts you can fill in any weaker zones. Knowing that this strategy is possible for you  is the only thing you should care about. Why would anyone want to get a surgery on their frontal third and then rely on a pill to keep the back half? What if you decide you can’t tolerate finasteride anymore? What if it loses its potency? You’re then stuck in the same boat, genetics take over and you lose the hair you were destined to lose in the first place. In my opinion Dr Bloxham is the best as planning for the future and not relying on medication for young patients. Starting conservative with your hairline allows you to get the full coverage you’ll need when all is said and done. Highly recommend consulting with him 

2 hours ago, TommyLucchese said:

 

Having said that - with your overactive mind maybe you should look into a wig or "hair system" or just let nature take its course? If taking fin briefly gave you all that trouble, imagine the stress of booking and going through with a surgery, and the year of slowly waiting as it grows in.

It doesn’t seem that he would have the same anxiety with getting a transplant. He’s expressing fear and doubt in a prescription drug that could harm his body temporarily or permanent. This is health related anxiety and is classified as a disorder by itself. The act of pursuing a HT would create more excitement than fear. This is strictly about Fin and the potential it has to ruin your sex life long term