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AnthonySC

Shaving before FUT? Why?

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Why is shaving encouraged by some surgeons before a strip surgery?

 

I suppose it makes for easier graft placement as everything is easier to visualize. Can the same results via strip be obtained without shaving?

 

I'm asking this because there is no way I could go back to work in a condition like this and even if I took some vacation time...I would still have to see friends and relatives.

 

Hasson and Wong are in my area, but I often see patients shaving their heads prior to strip. I am considering them in the future, because of there consistent results, but I don't think I could go through with the shaving thing. Again, can you get the same results without shaving?

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Dr Gabel is in the NW area. I know he doesn't require shaving. Biggest arguement in favor of shaving is so the surgeon doesn't transect existing follicles. It Also makes it easier on the surgeon when placing 4000 grafts without having to go aroung existing hair.


Newhairplease!!

Dr Rahal in January 19, 2012:)

4808 FUT grafts- 941 singles, 2809 doubles, 1031 triples, 27 quads

 

My Hairloss Website

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i consulted with 5 docs (all among the top reviewed) and all of them require shaving of the recipient area, to minimize transection of existing hair. They don't require you to shave the donor area, but most people look kinda silly shaving just the recipient and leaving the donor long. If you don't want to shave, some docs in the U.S. don't require shaving, and they'll tell you the cons of not shaving so you can decide for yourself.

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Thanks for posting doc in NW area. Distance is not too much of an issue within NA anyways. But when you have H&W within 20 minutes from your home you have to definiteley consider them.

 

Never even considered the transection issue, but it seems like a valid point. I think I could shave if I had an FUE, but not with FUT unless I was living in a cave for a month....it looks very Frankensteinesque from the back. Might be able to handle shaving just recipient area as I have little loss and straight hair.

 

I have little issue with FUT just the shaving. If however, the transection rate is dramatically reduced by shaving I suppose I should still consider it. I know Dr. Cooley doesn't require shaving too.

Edited by AnthonySC

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From Dr. Hasson regarding the reasons for shaving. For me, this has been the most persuasive pro-shaving argument I've read.

 

"All,

 

I originally typed this post in response to Bezane and his question to Pat regarding recipient site shaving. I feel that this is a very important issue and deserved it's own thread.

 

Bezane,

 

The question you ask about shaving is a good one and one that I would like to address.

 

When you ask if it is necessary to shave the pre-existing hair before surgery- the answer is- "it depends".

 

Depends on what? It depends on the quality of the result that you are looking for. Some patients (and doctors) will be satisfied with a less than optimal result while others will want to achieve the very best result possible. For this long term gain a patient may have to endure some inconvenience including buzzing of the recipient area.

 

There are multiple technical factors that come into play during the creation of recipient sites and the subsequent graft placement. These include:

 

1.) When thinning areas are shaved down the "thinning process" takes on a different meaning. With the use of magnification it will be seen that some follicular bundles are absent (and there are wider spaces between remaining bundles) and that some bundles are significantly miniaturized. It will then be possible to place new recipient sites in the place of absent bundles and alongside miniaturized bundles to recreate the density. This can also be done in a uniform manner so that if the pre-existing hair eventually disappears, due to progression of hairloss, the transplant can still look reasonably natural. If the recipient site is not shaved the surgeon must part through the hair again and again looking for any empty spaces and trying to fill the spaces as best as possible. This is not really as exact a process but much more hit or miss.

 

2.) The hair exits the scalp at an exact angle. The only way to precisely match that angle is to buzz the recipient hair down (in a way similar to how ALL doctors need to shave the donor hair when taking out the donor strip).

 

3.) Transection of existing hair below the skin surface is possible if the incisions are not made exactly parallel to the surrounding bundles. We often see this as a "halo" type effect when performing repair procedures.

 

4.) When inserting grafts the technicians can easily identify the recipient sites and ensure that all sites are filled. This can be achieved with no trauma to the pre-existing hair.

 

5.) When hair is buzzed no manipulation of the pre-existing hair is required at all. When the hair is not shaved it needs to be combed through (hundreds of times) by the physician who makes the recipients sites and again by the technician who places the grafts into the sites. This repetitive trauma of combing through the hair again and again will result in "hair shock", a shedding of the existing hair. When this hair falls out in 2 to 3 weeks there will be a 2 to 3 month wait before it returns. Whereas if the hair were buzzed it would grow from day one 1 and keep growing. A number 3 buzz cut often will look good at 10 to 14 days post operatively and blend in with the recipient site well.

 

Bezane, all these factors are relatively unimportant if you are trying to place to 2 or 3 hundred grafts into recipient sites however if you wish to have the ultra refined type of result that Pat Hennessey advocates, the difference will be night and day.

 

I apologize if what I've said in any way contradicts what others have told you but I feel you should hear this from the doctors who basically developed the process you know as "ultra refined follicular grafting".

 

I have attached photos of a patient who has undergone a mega (mega mega) session into a large area of thinning scalp- before and ten days after surgery. Hopefully my reasoning will be self explanatory.

 

Sincerely,

 

Victor Hasson MD"

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A hairtransplant is a life long investment,the inconvenience of a hairtransplant with a shaved head lasts a month or 6 weeks,its pretty obvious what the sensible thing to do is.

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@aaron1234: thanks for your informative post

 

@ mars: If most of the top doctors have the same opinion as doctor Hasson then yes it might make sense. But if the transection rate is neglible and transplant quality is not compromised very much by not shaving I would say its not worth it. It really depends on your individual situation.

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Dr. Hasson's post says for optimal, ultra refined results, shaving the head and not shaving it is night and day.

 

 

The truth is, many excellent doctors don't require shaving and achieve excellent results. Take Dr. Scott Alexander for example, he has many before and after pics that show incredible final results, and most were not shaved right before surgery. I'm sure there are many other examples.

 

It seems to me that if shaving was a requirement for tip top results, then all coalition doctors would do it, but they don't.

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I've done a ton of thinking about this since I am scheduled for mine next month. I've talked to all the Drs I interviewed and they all said the same thing - it's best to shave the recipient area. It makes complete sense on all levels. But like all things, it comes down to personal choice.

 

I found that all Drs were willing to consider doing it without shaving, even those top Drs on here that others say "require" you to shave. The Drs are trying to meet your needs, and although many have strong preferences and medical opinions, in the end, they all seem to respect that you ultimately have to feel confident going into this (remember, this is elective surgery). I felt that half of the Drs. seemed mildly perturbed by my insistence on not shaving, but also were open to doing it. The other half said that they do it all the time without shaving (yes folliclehero, Dr Alexander was one of them - I really appreciated his response, he was super respectful of wanting to conceal the procedure and return to work unnoticed).

 

All in all, I felt respected by all of them even though a few of them might have been irritated - I understand where they're coming from. And I think they understood where I am coming from. Overall, I learned a lot in the process of my research.

 

My suggestion is what others have suggested - if you can do it, and feel comfortable doing it, shaving the recipient area is the way to go. If you can't, then most Drs will still perform their surgery w/o shaving. And imho, based on my research and observations, the results aren't noticeably different. What is definitely different is that Drs can't do the megasessions that they can do with the recipient area shaved. It also takes more time.

 

So again, it comes to your own needs and personal preferences. Good luck in your research!

Edited by wildflowerwildflower

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I wonder if there is a thread somewhere dedicated to HT patients' photos who have not shaved their recipient area? That would be useful for our research since this is quite a common question.

 

 

There are definitely other articles, but just a thread with photos of guys who didn't shave? that would be cool.

 

I didn't shave, but only had 1300 grafts placed. What's weird is that I would have. It's definitely harder work for the techs and the doc, because they have to move the existing hairs around (I didn't know that then). But the results are the same I believe. If transection were really an issue, docs would require shaving.

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Hi All

 

Im due to have surgery on the 1st March, so Im very interested in this thread. Can you confirm that cutting down to a grade 3 would be sufficient and classed as a buzz cut. Im happy to do this but wouldbt want a completely shaved look.

 

I did read Dr Hassongs post which mentions a grade 3 , but just want to be sure.

 

As of yet Im still undecided on FUT or FUE


HT No1 : Nobel clinic, Gatwick 500 grafts - Terrible result, left with bumpy skin

 

HT No2 : Marwan Saifi 1680 grafts. Great result

 

HT No3 - Marwan Saifi 1250 grafts. Another good result.

 

HT No4 - Hakan Doganay 2134 grafts. Result TBA

 

Total 5134 grafts.

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The truth is, many excellent doctors don't require shaving and achieve excellent results. Take Dr. Scott Alexander for example, he has many before and after pics that show incredible final results, and most were not shaved right before surgery. I'm sure there are many other examples.

 

 

 

Yeah this is what I was wondering about. Its nice to have options.

 

@ Buzz2:I was also wondering what clipper level you would have to shave down to as well. If it was like a 1 I don't think I would want to do that either.

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With shaving you lose the benefit of being able to hide your surgery. That's a big negative for people who must return to work in a place that doesn't allow hats.

 

The positive benefits are otherwise all in your favor. Zero or near zero transection if you still have some hair in the surgery zone, denser packing, and a shorter surgery meaning the grafts are out of the body for a shorter time which gives them a better chance for survival.


Finasteride 1.25 mg. daily

Avodart 0.5 mg. daily

Spironolactone 50 mg twice daily

5 mg. oral Minoxidil twice daily

Biotin 1000 mcg daily

Multi Vitamin daily

 

Damn, with all the stuff you put in your hair are you like a negative NW1? :D

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Those are all good points RC. I've actually had a unique situation, my final 3 choices were Drs Rahal, Konior, and Gabel. Dr Gabel was the only one who didn't require a shave. I can certainly understand not wanting to shave, I'm just planning on wearing a hat for a while!


Newhairplease!!

Dr Rahal in January 19, 2012:)

4808 FUT grafts- 941 singles, 2809 doubles, 1031 triples, 27 quads

 

My Hairloss Website

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Thanks for the offer of the Escort, but not really much to do with Hair Restoration !!


HT No1 : Nobel clinic, Gatwick 500 grafts - Terrible result, left with bumpy skin

 

HT No2 : Marwan Saifi 1680 grafts. Great result

 

HT No3 - Marwan Saifi 1250 grafts. Another good result.

 

HT No4 - Hakan Doganay 2134 grafts. Result TBA

 

Total 5134 grafts.

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