SLA

Wow...nicely said @TorontoMan! Yes, we are very lucky to live in these times and definitely not to be taken for granted.

Thanks for sharing....looks right on track! Keep us posted!!!

True @Melvin-Moderator. I am pretty sure Shapiro actually said not to exceed 4k FUE grafts (rather than 3k). Josephitis was clear in saying he felt that lifetime there are ~3k grafts available trough both methods.

I am not saying that. If you do FUE 1st the FUT strip will inevitably have less yield, but those grafts that are missing from the strip have already been extracted via FUE and placed in the recipient area. So you are getting all the grafts from the FUT strip, but some had already been extracted and implanted 1st via FUE.

You can have FUE 1st, but that being said, if you do FUT afterwards there will be fewer hairs in the strip because some were already extracted from that area via FUE. What I believe one needs to be mindful of is extracting too many grafts via FUE 1st as the donor area will thinner and one will not have any residual hair to hide a strip scar. In the webinar with Ron Shapiro, he made a comment about not exceeding 4k grafts with FUE if one wanted to do FUT afterwards. 4k is probably an estimate and depends on the individual and donor region.

Nice results!

Excellent results! Very natural and a big difference.

Best of luck in your future HT decisions @ravit

Keep us posted on your journey...wishing you much growth!

Still way early...hang in there!

I feel your frustration @olmert. It would be great if we could narrow down on an absolute regarding this issue and the best we have to go on is the Shapiro study. Does one study prove an absolute? No. Could the methodology have been off? For sure- my wife is a neuroscientist and knows all about methodological issue with studies. Has this study been replicated? Was it double blind? No. Could it be biased? Maybe. Could they not have taken all things into account? Sure Some FUE doctors claim doctors who perform FUT as favoring this technique because it takes WAY less time for the surgeon to perform. Could this be true? Perhaps. Could FUE doctors claiming FUE alone can yield more grafts than the combined FUT/FUE be biased? For sure! As I mentioned above, you can read the article I posted in the FUE forum titled, 'The Case for FUE' and re-read the 9 FUE counterarguments I detailed earlier in this post and you will have to come to your own conclusions. What would prove more of an absolute for me is for there to be several studies performed to test this hypothesis which all point to the same conclusion. Until then, you will just have to go with this and trust your gut.

It seems like common sense @Melvin-Moderatorhowever, for the reasons laid out above, not all doctors seem to agree and their points seem like they could have validity, no?

My bad....I didn't realize 'coalition' and 'recommended' were two different categories.

Sure.... Dr. Arika Bansal (Eugenix)- She is a coalition doctor on this site who left FUT. Saw it in an interview with Joe Tillman and through a virtual consultation with me. She also sent me the photos of donor thinning below an FUT scar as referenced above John P Cole- The inventor of the Cole punch used worldwide. He left FUT over 15 years ago and claims to have performed more than 8k FUT procedures. I emailed him and he specifically said someone with advanced hair loss should not consider FUT. I posted an article in the FUE forum titled 'The Case for FUE' in which he details his argument Dr. Bhatti- You can go to the Darling Buds website to learn more about his stance. He used to be a coalition surgeon on this site. Dr. Vories- A coalition doctor on this site. I had an email dialogue about this specific question through his representative John Casper. Again, please note I am not arguing either position as I don't have the knowledge to do this :).

I do not know percentages. I think at this point, most reputable North American surgeons who perform both techniques would probably recommend FUT for advanced or destined to be advanced hair loss and doing as many FUTs as you can before switching over to FUE so I think there are probably more in the FUT/FUE camp. I think Hasson and Wong says you can get 1-2k grafts which could be up to 20% more with FUT/FUE combo.

So I think the logic is that with FUT you are actually removing the entire strip of skin and can transplant ALL of the hair follicles rather than with FUE in which you are extracting only 1 of every 4 hairs or so from that same region. So in theory, if you do a series of FUT in which you are removing strip after strip of skin and transplanting ALL of those follicles followed by FUE to get even more follicle you can get more grafts. HOWEVER, not all surgeons agree with this. Some of these arguments are coming from very reputable surgeons who used to perform FUT and left that behind. Through my research, the counter arguments range as follows: 1. If you do an FUT, you need to leave hair to hide the linear scar, so you wouldn't be able to extract as much with FUE in subsequent procedures 2. FUT alters the direction of hair growth making it more difficult to extract afterwards with FUE 3. When you perform FUT, the skin stretches which causes a downward displacement of the crown expanding the area of baldness, so the extra follicles you might obtain from an FUT strip is negated by the expanded area of baldness in the crown you must now cover 4. You inevitably transect follicle when you cut the FUT strip 5. When FUT is performed, hair in the growth and telogen phase is often not found and/or hard to extract and is discarded or transected, but with FUE, you can select hairs 6. If a follicle is transected while dissecting the strip, it is unusable, but if transected with FUE it can remain in vivo for future use 7. You can always get more GRAFTS with FUT as there is subdivision which takes place when dissecting. For instance one grouping with 4 hairs can be divided into 2 groups of 2 8. FUT transplants can create more donor thinning below the strip scar making those follicle unextractable (or more difficult to extract) by FUE. A top surgeon well respected on this forum sent me photos of this from actual patients 9. Hairs not in proper phase may not survive the dissection Please note, I am NOT advocating for either side of the argument, but rather just educating on what I learned. I don't what the true answer is and would love to see further studies and debates from surgeons on both sides of the table. Hope this helps :)!

Wow...only 2,000 grafts? Very impressive

Looking on point! Can't wait to see your progress in the coming months!

The article you likely read posted above https://www.ishrs-htforum.org/content/28/5/179 was not the study of total number of lifetime grafts, but rather which technique had a better survival rate. This article https://www.ishrs-htforum.org/content/htfi/29/5/local/front-matter.pdf is a 1-page synopsis on the lifetime graft potential, however, it does not provide detail of the study.

Best of luck @ravit! Looking forward to seeing your progress.

Even though the results the first time were not perfect, it was a major improvement from where you started. The touch up should make it golden!

Good points. It would be great if Dr. Sethi would respond to your thoughtful questions.

Fantastic @ziker. Thanks for the robust answer and keep us posted!

Hi @AndreaYou are probably now close to 1 year post hair transplant at Eugenix. How is everything going?

Here are a few additional questions if you don't mind answering, @ziker How many grafts have been transplanted in your 1st three transplants? All via FUT or FUE as well? How many beard grafts have you used so far? Thank you!