If you start with FUE?

[Spanker]

If I am getting a small proceedure not...say 700 grafts FUE....and one day the bottom falls out and I become a NW 6 (I do not think that is likely to happen as I am almost 32 and there is no sign of such pattern)....but say that happens...and I need a large session....if you start with FUE does that reduce the total amount of grafts you will eventually be able to get?

 

I talked to SMG and Matt said that you can only get 4 to 5 K grafts total FUE and if you just go strip you can get 8 k plus Strip.....so my question is....

 

If you get 4 or 5K grafts fue.....can you still get the next 3k or so strip if you really need them?

 

My question is, no matter what order you do it in.....is the TOTAL number of grafts going to be pretty much the same?

 

I hope you can understand the question....I am trying to get an idea for what I want my master plan to be.

[uselessgomez]

This is a great question and I'd love to know the answer myself!

 

I bet it varies a lot based on the extraction pattern and healing characteristics.

 

In the ideal situation, the donor extractions would be really neat and taken in irregular patterns so that if you later had a strip procedure which stretched the skin and thinned the donor hair density, it wouldn't leave gaps of bare skin or an unsightly donor area. Maybe the extraction pattern factor would be more favorable in this situation if the donor that were harvested came from a larger area instead of a smaller, more concentrated area?

 

If you're one of the unlucky ones who gets the visible white dots (hypopigmentation) maybe the stretching of the skin from a strip procedure would make the FUE dots more visible?

 

At any rate, less than a thousand grafts isn't going to cover much area. That's a pretty small procedure that I doubt will leave your donor area wrecked, especially in the hands of a good surgeon who uses reasonably small extaction tools.

 

Have you had your scalp looked at under magnification to see if there's areas of miniaturization that you might not be aware of?

 

I would love to read the opinion of a surgeon on this question.

[mahhong]

I could be wrong here but essentially I don't think it matters all that much. I have heard that, generally speaking, it would seem the best way to go to yield maximum grafts is to go the strip route until that method is depleted and then consult to see if FUE is a further option.

 

Whether or not you could get 3k in strip after 4-5k FUE I couldn't say, but my thinking would be it's easier to gauge FUT first and then look at potential FUE rather than the other way around. That having been said there must obviously be cases of FUE followed by FUT so clearly there is the potential to go that route. Also, whilst of course FUE can be used to do an entire hair transplant, it would be my thinking that FUT is generally better in terms of getting bulk and density whilst FUE is generally better for refining hairlines, adding detail and essentially "polishing" up your hair (I use the the word generally since clearly this isn't a hard and fast rule).

 

Hopefully a doctor or experienced consultant can answer in more detail but my inkling would be it's overall easier to do a major procedure(s) followed by a minor one than the other way around. I'm sure both routes can be undertaken by a competent doctor, and of course 700-1000 grafts FUE is relatively small so it's unlikely, as the previous poster said, to 'ruin' your donor area in terms of grafts left.

 

So, those are my thoughts! Strip yields greater quantities of hair and usually a better yield, which is why it's overall still the most popular way of doing things. Because it's also the most invasive in some ways it would seem to me better to "get that out of the way" and then see what you're left for FUE rather than FUE all the way and then start thinking about if you can also take a strip out of there. But so much of it depends on your hair characteristics and genetic history. If NW6 is prevalent in your family in the last few generations then you're safer to assume more aggressive hairloss and go from there, just out of precaution. If both you and your doctor, however, really feel confident your pattern is fairly well defined or your hairloss isn't going to be severe then planning smaller procedures with more refined goals might be applicable. As the above poster suggested, checking for miniaturization might be a good idea because defining a hairloss pattern is hard to do at the best of time it would seem (although I myself am trying to get to the bottom of how well it can be established).

 

Anyway, bottom line is your hairloss pattern will play a big part in whether it's worth having 700 grafts FUE or whether it's better to wait and have bigger procedures, maybe via FUT, with bigger goals in mind. Although it's possible to "patch up" thinning hair I think it's best to be pessimistic and aim for dealing with the potential bigger problems - in the short term that may mean immediate hairloss can't be dealt with, but in the longer term you're using your donor hair to the best of its abilities. Again, though, your doctor is the only person qualified enough to really make a call with you on what route is the best to go for.

[Spanker]

No I have not had it put under magnification but have shaved my head to a #1 and have not seen any minituration besides a bit in the temple region. My hair is black and course and I would think it would show up well. I have a vast array of MPB and non-MPB in my family so it is hard to tell what genetics will bring.

[Sparky]

I know someone who has taken the fue route first, and at his procedure the doctor drew a line around an area no to extract fue from, just incase he wants to do strip in the future.

 

4-5k only depends on your density, if your density is high then you might be able to do 7-8k fue, i've seen it done successfully.

[uselessgomez]

No I have not had it put under magnification but have shaved my head to a #1 and have not seen any miniaturization besides a bit in the temple region. My hair is black and course and I would think it would show up well. I have a vast array of MPB and non-MPB in my family so it is hard to tell what genetics will bring.

 

From my understanding, miniaturization isn't noticable to the naked eye until you lose about half of the hair in that area. Then it starts to appear thin. So there's a great benefit in having a good surgeon look at your scalp through magnifation to see if there's any miniaturization in areas of your scalp that you cannot yet see. That way you can help "plan for the worst" in case the bottom does fall out.

 

I'm still willing to bet that MOST but not all people who go with FUE who are disappointed with the yield/results still look ok with their head shaved or buzzed down. It's noticable to guys like us because we are looking for it, but to an untrained eye I don't think it stands out. This is just in case FUE doesn't work out and you want to abort the entire thing and try to move on. Which is a possibilty.

[Spanker]

I think that is true about 50% with a "normal" hair style....but I do not think that is with a buzzed head.

 

I would think with the naked eye you could see a 10% or less change in hair on course buzzed black hair....but I could be wrong.

 

My noggin is lumps and jacked you never know.....

 

 

Has anyone thought about the Joe Dirt thing???

[Dr. William Lindsey]

I have posted several times that I think that FUE is potentially over-recommended. For me, its perfect for someone who is not likely to go "real bald" and who needs a smaller case(s) and who is a poor scar candidate or is extremely worried about the scarline.

 

That said, we have a few guys in the process of getting a series of FUEs to get up to 3000 grafts, all so that they can wear a very close haircut.

 

For guys like you who need a smallish case, like a fellow we did last week, I tell him that he can always keep doing more FUE's if he needs little tuneups, but he could switch to a strip if he needs to down the road. I suspect that after a few FUEs tht strip yeild will have a little scar tissue in it, but that it will stillyield a nice quantitiy of grafts if needed.

 

Dr. Lindsey McLean VA

[Sparky]

i've had about 2k fue taken, I could shave with clippers and no guard and you wouldnt see where they were taken from.

[TC17]

The number of available grafts shouldn't change much, if it all, regardless if whether you start with FUE or start with strip.

 

Why any young patient with a virgin scalp would choose strip over FUE is beyond me. I happen to think that strip is like a VCR, and we're in 1999.

[uselessgomez]

Dr. Lindsey,

 

What would you define as a smallish case?

[Sparky]

Yeah I consider strip as a VCR, but my strip surgeries were bad. FUE is Blueray!

[kathie47]

haha. great posts. i thing fue definitely has its advantages.