FUE into FUT Scar

[lukeyb1687]

Hi all!

 

I was wondering if anyone has any pictures of FUE into a FUT scar with short hair.

 

I want to see if the scar can be covered well if you then decide to shave your head down to a 1 or 2?

 

Thanks!

[sr0d]

I was curious about the same thing. I wear my hair relatively short and my hair is fine so FUE in the scar is definitely somehting I want to explore as well.

[sunny007]

Hi,

 

Is it good to have FUE for around 2000 grafts transplant ?

 

Will it provide good result?

 

Thanks,

Sunny

[N-6]

I like the idea but not sure if results are consistent. Scars have less blood flow than other parts of scalp and blood flow is needed for growth. Therefore, yield is an issue with FUE into scar. I'm curious about micropigmentation or tattoo into scar to preserve precious donor hair for future loss.

[lukeyb1687]

Yeah I was wondering about the scar tissue accepting the new hair follicles. Does anyone have any pictures of this procedure?

[RecedingTide]

The use of vascular endothelial growth factor could help with grafting scalp hairs into a strip scar by FUE. There's some examples out there of FUE into strip scars. A recent Dr. Feriduni scar repair comes to mind. Google it.

[sr0d]

I googled this and at first it just came up with a number of oncology studies, however after probing a bit I was surprised to find many references to minoxidil. Maybe I'm missing something here but are you saying that simply using minoxidil in the scar tissue will help stimulate growth in that area?

[RecedingTide]

No not minoxidil. Yes VEGF is involved in tumour growth. The malignant growth tricks the body to produce VEGF in and around the tumour so that it can develop blood vessels and grow. VEGF isn't actually bad. It's a growth factor that simply acts to help grow new blood vessels. It can be isolated, like PRP, and used in scar tissue to help revascularise it to an extent. Though it's probably not widely used yet it may have some very useful implications for trying to restore some blood flow to a strip scar when implanting FUE grafts thereby increasing the yield of the transplanted grafts in the scar. I believe Dr. Greco has been investigating VEGF along with other growth factors, PRP, Acell, etc.

 

Sorry for the confusion. I meant to google Dr. Feriduni FUE into scar repair. I've seen one fantastic case where it looks like the hair in the donor has been clipped down to a 1 or maybe a 2 and the scar is pretty much gone. Hope that helps.

[gillenator]

Blood flow to the scar tissue is the number one issue in my opinion for regrowth. That's why removing as much of it first with a revision is really essential in most cases that I have seen.

 

Take note that it does not necessarily take a high number of FUE grafts into the area to camouflauge the area. In Spexx case, the strip scar was not nearly as long ear-to-ear as we are used to seeing.

 

And at the same time, he really got a nice result. He also heals really well.

[lukeyb1687]

Wow Spex that's a fantastic cover!!

 

I am trying to work out my best options for being an actor. If I get a strip I will have a higher yeild for grafts comapred to FUE. However if I was to get FUE I would have the option to shave my head to a 1 if I required it and not have to worry about the scar showing...hmmm I think I have made my decision on saving for FUE. Although your result looks amazing!

 

Thanks for everyone who's submitted their thoughts and comments.

 

I was worried about blood flow and growth into a scar too.

[scar5]

If you don't already have a strip scar, don't even think of getting one and later filling it with FUE and expect to get the 'best of both worlds'. Doesn't work.

 

I had a strip scar filled with thigh hair once and it looked pretty damned good, but no way in the world did it give the consistent texture of an even spread of hair. The scar was still visible.

 

But if I held my head to the light, at the 'correct' angle, the scar dissappeared. Don't let the pics fool you.

 

Add in the fact that coloration of the scar can also mess up the picture.

 

Strip scars are unpredictable, yet relatively more predictable in the right hands.

FUE yield is same. But poor to fair FUE yield with a good extraction pattern, can be buzzed. A strip means you have to grow.

 

But..if you are an actor, don't you have the perfect legitimate excuse for wearing a piece? Even for the folio of mug shots you create for agents? Dunno where you get them though.

[lukeyb1687]

@scar5-

 

Very true regarding the not getting the best fo both worlds. I think that my decision has been made to save up for FUE!

 

Haha I wish I was ok with a hair piece, the main problem is that starting out as an actor it doesn't help. They're willing to use them on big stars but when it comes to an unknown they want to take you for who you are right now. So if I get my FUE in a couple of years, then I can see if it will help for my career.

 

Recently got cast for a TV pilot, but I know it would benefit my character to have a full head of hair, as I will have to have my hair styled to cover up temple recession.

[gillenator]

I just got a PM from a patient who is 8 months post-op with strip.

 

Some docs are recommending FUE into his scar right now which is at present 2mm wide and 25 cm long. It also sounds like he will need lots more work but does not see any more work done for now anyway.

 

A couple of things since this thread is similiar in concern.

 

First and foremost guys, look at family history in MPB on "both sides" maternal and paternal. If, and I repeat "IF" there are advanced classes of hairloss in the men, meaning Norwood class 5-7, it is my opinion to stay away from FUE for now.

 

Why you ask? Well the first reason is obvious, yield is still far more proven with strip. Second, having that much work with FUE (5,000 plus extractions) will in many cases show motheaten dot scarring in the donor zone if buzzed down to a number 1 and yes even in many cases a number 2 will show FUE scarring. I base this on observations of endless pics that I have seen across the board. The punches being used .75 mm to .80 mm have made a big difference in visual scarring IMHO.

 

Thank goodness more and more docs are becoming more extraction proficient and as a result, punch sizes are not as large. However FUE extractions can still do the collateral damage that strip excisions do not. And the higher the donor density, the more potential for damage to the neighboring FUs in the extraction zone. In other words, higher densities distinctly show that each natural occuring FU are much closer togethor than patients with thinner donor zones. Therefore, the degree of manual control (extraction mastering) becomes more and more paramount and where robotic extractions can greatly help to reduce the rate of transection.

 

I still find that many younger guys base their goals (strip or FUE) on their current state of hairloss forgetting/neglecting the potential of hairloss over their lifetimes. They forget that MPB is "progressive". They say to themselves, "All I need is a few thousand FUE grafts and I'm good to go". WRONG!!!:eek:

 

If however on the other hand, the extent of genetic hairloss (MPB) is not extensive, meaning the men on either side of family history is below class 5, then FUE can certanily be a better appraoach "IF" the buzzed look is imminent for your future hair styles. It will cost you far more over your lifetime and let's face it, cost is a big factor for most of us.

 

And ceratinly patients vary including how well they heal, formation of scar tissue in the healing process,whether or not they are using effective hairloss meds in slowing the rate of progression, the degree of hair caliber, etc, etc, etc.

 

Things to think about before commiting to FUE or strip. At best we can camouflauge the visual effects of HT surgery but we can never completely reverse the visual effects of the surgery. This includes FUE into larger strip scars.

Edited January 27, 2012 by gillenator

[HARIRI]

I agree with gillenator. FUE isn't recommended for a person with extensive balding. Even Dr. Feller once mentioned Strip is superior than FUE when it comes to yielding and future plans. Strip is bad when you have it done with a crap doctor who doesn't know the ABC in closure techniques. Top notch Doc like Rahal, feller, H&W and SMG have the ability to create a pencil thin scar that wont be visible unless you go 0 or 1 or 2 buzz cut. FUE is a marketing tool in my opinion especially when its suggested for patients whom have NW5 or NW6 genetic history. In example, SPEX is the a rep of two docs whom are famous in FUE but admits with full honesty that Strip yields better and more efficient.

Edited January 27, 2012 by HARIRI

[lukeyb1687]

I agree for extensive loss it's not the best however for the option of me being able to shave my head it is a good choice compared to strip.

 

My hair loss is not too extenisve...yet.

 

Luckily my grandfather and dad have a full set of hair, my mum's dad is a NW6 though. I will be saving up over the next 2 years hoepfully and will asses my loss then.

 

I have scheduled an appointment to Dr Harris to get his opinion on what would be best for my hair loss stratergy.

[Capelli11]

I agree with Hariri...and also think you should talk to as many doctors as possible. I too wanted FUE at first for the scar and all the normal reasons but upon talking to a lot of doctors they all pretty much recommended FUT because of my loss...and more importantly my future potential loss...that is key...not what you have today but the future loss because you don't want to do FUE now and then have extensive loss and have to do FUT to get better coverage and yield which would totally defeat the reason you got FUE in the first place. Also factor in the costs of FUE...not just for this session but if you go the FUE route...you will prob stay that route and that could be verrrry expensive. Do your research and talk with doctors for their professional opinion as it may sway you.

[N-6]

Good points guys about FUE. It is not the same yield as strip and results in waste of precious donor. Another point about FUE is that doctors cannot reliably predict hairloss in a younger patient. Therefore, when a large FUE session is performed ina younger patient, 20s or 30s, there's the very real chance that to get lets say 2500 plus grafts, the doctor is required to harvest from outside the traditional safe zone. If the patient progresses to a 6 or 7, the transplanted hairs could ultimately fall out. It might look like the safe zone when you're 25 but at 45, the picture could be very different.

[scar5]

ta ta..

 

DISCALIMER - I too have queries about overharvesting FUE and poor yield. This post is MERELY to show why docs recommend strip!!

 

I too wanted FUE at first ... but upon talking to a lot of doctors they all pretty much recommended FUT because of my loss....

 

..even Dr. Feller bla bla... (someone else adds)

 

Guys, of course they will recommend FUT!! Guys, come on! ALL docs recommend strip if they do it, and if they are set up for it.

 

Put yourself in THEIR shoes for a moment.

 

It's 9AM at the Happy Hair Clinic and under the big sign that says, 'Welcome 'cause we do both' (FUE and FUT)' sits Dr. Feelgood sipping on his morning coffee. His eyes drop to peruse the morning's consults.

 

Mnn..let's see now.. Billy Balding, 27, NW3, wants FUE, Dad is bald, hates the idea of a scar, wants to be a NW2 and a widow's peak. Mnn, well, we've seen this guy 10 times this week already. Here we go again. Are you ready, Roger Rep? You got so damn good at dealing with this, that guy's eyes 'gonna be poppin when when we show him the pics of 'Mr Moth' alongside those stellar strips where we pull the grown out hair back at the scar seam and it seems invisible. He will be so impressed he wont think about what it looks like shaven. And his ears are gonna be ringing why him, and just him is not suited to FUE... and that FUE suits SMALL jobs.

 

Who is to say, he won't lose more hair!! and need more grafts! He won't even wanna think about buzzing when he gets the growth form our strip!

 

In the back room wait four cutters. The four most reliable and genuinely conscientious types you could image. They cut those strips up in no time, with hardly any transection and a smile

 

Dr. Feelgood gets up and a small creak in his back reminds him of playing with the kids last night. Damn sure no way in the world am I leaning over that guys head to today for eight hours drilling out 1500 measily grafts, while my cutters sit idle in the back room. I suppose I could ask them to doing cleaning.

 

He ambles into the consult room where Roger Rep had already been softening Billy for the blow. Forgets glasses. Eyes getting strained lately, since he did that damn FUE two weeks ago, damn it.

 

'Hey Billy'

'Doc, I can't tell you how much I've waited for this. I did my research and I want FUE, cause who knows, I might wanna opt out of the HT route when I'm older, you know'

Roger and Doc exchange a knowing glance and warm smiles.

'Billy...oh.. Billy, we understand how you feel. We've been in this business since ...a damn long time..but in your case, we are going to recommend a 3500 strip, with a trico closure. You'll be done in no time and be a lot a happier sooner with the solid and rapid growth strip affords. Let me check that laxity now'

Eh,,yes, let's see. I think we can even do 3800 Roger'

'Nice one Doc', chips in Roger before adding, Doc, Billy is concerned about the scar.

"Well of course he is. Everyone is but we get some pretty damn fine scars, show Billy, Roger. Billy, trust me, with hair, you won't even think about it" And the money and time you will save...FUE is over rated!! Yield is poor. It suits little jobs, that's all.

Billy looks anguished and asks, 'But if it's good for small, why isn't it good for big? What about all the hairs in that are in resting phase within the strip? How about...Billy in desperation now, throws out a dozen questions. Some of them ridiculous, some valid. In the end, the doc and Rog just have to reassure him by answering the easiest.

An hour later. Doc is back in his room having taken out the strip, checking his mail. Back out to do the recipient sites for another 40 minutes. Done..

Billy has signed the disclaimers and is a drug induced delirium as the cutters are busy.

Later, Billy posts. I wanted FUE, but in the end I chose FUT and I am glad. Guys, FUE is hype!!

 

End.

 

The message is simple.

Strip (call it FUT to make it sound better) , is economical for the clinic.

Strip exposes the clinic to less risk

Strip is easier on the doctor's hands, eyes and mind

Strip is simple

Strip puts the onus on the patient to 'recover' properly and buys the clinic 'time'. (The patient of FUE is expecting FAST recovery!)

Strip distributes the technical burden more evenly among the staff of the clinic

Strip is faster for all

 

 

Please, don't take this as an endorsement for FUE, just wanted to illustrate the process and mindbending that goes on in my humble opinion.

I have plenty of doubts about all HT including FUE, especially yield and that included the condition of the follicles that regrow

And I am not anti- HT either. Hair is freakin great and everyone is happy to see it grow back.

[aaron1234]

Great (& hilarious) post scar5. I can understand why you think clinics push FUT over FUE.

 

As you said:

The message is simple.

Strip (call it FUT to make it sound better) , is economical for the clinic.

Strip exposes the clinic to less risk

Strip is easier on the doctor's hands, eyes and mind

Strip is simple

Strip puts the onus on the patient to 'recover' properly and buys the clinic 'time'. (The patient of FUE is expecting FAST recovery!)

Strip distributes the technical burden more evenly among the staff of the clinic

Strip is faster for all

 

I know you were being sarcastic but I think all of those reasons are legitimate ones for clinics. I get your point though that some clinics may push strip for their own interests rather than the patients.

[RecedingTide]

Strip is certainly the best option for most but the guys with no significant loss in their family history, or the ones that have exceptional donor density or even the ones who are not as concerned about the crown may be best served by FUE.

 

I know much has been said about the numbers available by FUE but I know for a fact there's two doctors out there who have done 10,000+ FUE over multiple procedures for many patients (one is IAHRS approved, the other guy is on some the ISHRS and the ESHRS(? think that's the European one)). Both docs are in Europe where everyone wants FUE. I've seen a video of one guy with 10,700 FUE with his hair buzzed to a 1 and it is immaculate but then again he clearly had exemplary physiology to heal that well. He was a norwood 6 too and had very dense donor.

 

Strip probably still shades it for most patients but I think Acell is helping to close the gap. It certainly appears SMG is getting really robust growth with it.

[scar5]

Strip is certainly the best option for most but the guys with no significant loss in their family history.

 

So you can predict hairloss based on family history?

Certainly?

 

Just sayin..

 

FUE has issues with robust graft survival and careless extraction.

 

I agree that strip gives you profound and satisfying short-term returns.

[Tjavs]

I know much has been said about the numbers available by FUE but I know for a fact there's two doctors out there who have done 10,000+ FUE over multiple procedures for many patients (one is IAHRS approved, the other guy is on some the ISHRS and the ESHRS(? think that's the European one)). Both docs are in Europe where everyone wants FUE. I've seen a video of one guy with 10,700 FUE with his hair buzzed to a 1 and it is immaculate but then again he clearly had exemplary physiology to heal that well. He was a norwood 6 too and had very dense donor.

 

 

I would be very interested in knowing who these 2 doctors are, as I'm considering FUE myself.

[RecedingTide]

I would be very interested in knowing who these 2 doctors are, as I'm considering FUE myself.

 

The vast majority of us have nothing like that number available by FUE.

[gillenator]

I absolutely agree although I truly wish we all could potentially harvest that much from our donor zones. And it is very important for patients to remember that we are all different and the reality is that very VERY few individuals can harvest those upper end numbers.

 

In addition, what appears to be the "safe zone" in our younger adult years can and will change as we age. One will never know for sure until the future how much of the harvest was in fact terminal hair when the limits are pushed that high.

 

Time tells all things...

[N-6]

Excellent points Gillenator . . . I think time mega session FUEs garner way too much hype and time will tell whether these procedures are successful