Going for FUE - need your advice

[aim4hair]

It has been a while since i wrote here. I have been thinking about my hair situation and i think im ready to do something about it. The only thing which was holding me back is taking meds because of the possible side effects which i don't even wanna risk.

I have been shaving my head with clipper for years and i think it looks OK on me, the only thing which is really bothering me is the hairline as it's almost gone (my hair is kind of ok from the middle section backward).

So i beleive my best option would be to go for FUE to fix the front part and have a reasonable hairline (not so dense) and then even if i dont take meds and start loosing more hair from the existing ones, i can buzz my hair and would still look better than now because of the hairline (even if the area from the middle backward started to bald) it wont really bother me with a buzzed hair since the hairline will frame my face and the area behind it wont be that noticible with grade 1.

I am 30 years old and i have been shaving my head since i was 24. What do you guys think about the approach im heading to ? Does it make any sense.. Please let me know your openion.

[aim4hair]

Thanks for the reply Spex. Actually i have been doing that for the last 5 years but the hairline is really bothering me and i think about it all the times.

I am not saying that i will keep shaving my head after the FUE. in fact i would like to grow my har and enjoy the feeling of having hair. But my point was if down the road i kept losing hair i can either go for other HTs or buzz it and i would still have my face framed. I am a bit concerned about the FUE scars but i have seen many results where scars are not visible on grade 1. I beleive even if some of the FUE scars are showing still most people will not really think you had an HT and will not pay much attention to them (not like the strip scar) .

As for the clinic it would be either dr. Keser or dr. Umar. As i beleive the tool they use is very small which leads to minimal scars.

[Sean]

Aim4hair, what's your level of hairloss on the Norwood scale right now? I think I can understand your goals. You want to kind of grow with the hair restoration process. Like have a solid front and work done so you can grow it out now. Then use your reserves to keep up with possible further recession when you need to. If you run out of enough donor to have adequate coverage, then at least you will have some sort of outline showing hair when you do buzz. Kind of like http://www.hairrestorationnetwork.com/eve/165487-5000-fue-dr-de-reys.html ? This way in the end you have the ultimate flexibility to buzz later if you don't have enough donor to cover the rest? Right? It seems like a plan but you would have to plan it very carefully.

 

With the FUE scars, I guess it depends on the lowest size punch used that can effectively give you yield without compromising the graft. Probably has to do with the type of hair you have, whether it is straight or a little thicker or curly etc. Obviously, bigger punches may be needed in FUE with different hair characteristics like that.

 

I have seen a couple of FUE results nowadays, including my own, where it is very hard to see any form of scarring. Like scarring may be very very minimal if any, but is it noticeable to the eye, I don't think it is? Unless you take a very close close inspection and maybe you might see something, I don't know. But so far, no one has been able to tell on my donor. I can't check it myself, but have had family check it and no one said they see/notice anything at all. I am 8 months post op. I had a variation between .8 and .9mm punches used. Now if I do a Michael Jordan like shave, then maybe there could be something visible, but I wouldn't do that in the first place to test that theory. If you give your self a buzz to a clip one or close to the skin, you should be able to get away with it safely based on the punches that were used on you as well as the skill of the doctor doing it. In general, how would you rate your healing with scars? That can also probably help you forecast this. If you had a small cut on your finger/hands how long did it take to heal and if you see it heal how bad is the scar etc. These things may help you too.

 

I think those docs you mentioned do some great work. Dr. Keser is pretty good at this FUE yield from what his consultants and patients put up, especially when it comes to hairlines. Dr. Umar is great too, and I think he is a big player when it comes to adding some serious density by expanding your donor reserves/options.

 

Good luck with everything.

[chrisdav]

If there is any patients you can meet from the potential clinics you might use who has had a similar procedure to what you want, I would suggest that.

 

It may give you a rough idea of what the recipient and donor area potentially might look like.

 

Any scarring with hair below a 1 grade will be evident on either procedure, more so with strip.

 

Myself and Sean's hair is thicker and a longer length, so scarring is not evident with either procedure and it is not really a valid example for what you want.

 

Put some pictures up of your hair currently.

[mattj]

Some doctors make extractions from the face (beard hair) and from what I've seen the scarring can be undetectable.

 

I'm not dismissing the idea of FUE-to-buzz, but you'd be better off trying to prevent further hairloss by giving yourself a trial on Propecia.

[aim4hair]

Thanks all for your feedback.

as per the info collected (Dr. Keser uses punch sizes as small as 0.7mm to 0.9mm, and also Dr. Umar uses punches less than 0.9mm.

As for meds, i know some people who suffered terrible side effects using propecia an they had to quit for like a year to kina get back to normal (according to them).

I really believe that everything we take in our body would have a side effect, if not now, maybe in the future. and i know that if i start with propecia, i should stick with it FOREVER which kinda scares me (even if it does not affect my sex drive now, it might slow it down in the future before it was supposed to slow down without the med) and that's something i really don't wanna mess with.

would rogain foam be enough?? i somehow feel more comfy applying this since it's an external thing.

I have contacted different doctors online and each gave me a different answer. one told me that for now i need 2500 graft to have a decent front coverage and then i should use rogain for my crown.

another doctor told me that i need 3000 graft for now and maybe up to 8000 in the near future and was convincing me to go for FUT instead of FUE to have a good coverage. otherwise FUE will not give me a good coverage. he also proposed a very conservative hairline which i did not like at all..

I am reasonable and im not looking for aggressive hairline. as a matter of fact i have always had a wide forehead and i don't mind it all all, so i don't care much about lowering the hairline but the one he proposed i didn't like at all. I have attached the photo for your comments. He proposed 2 hairlines (the red and white line) and i really don't like them both.

do you guys think i can have a better hairline (im not asking to lower it, im just concerned about the design of it).

 

 

Thanks again..

[chrisdav]

If your aim is only to frame the face and you're not worried about the rest of the hair on your head, then you could perhaps aim for a hairline you like but if you intended on rebuilding your hair all over on the top, then hairline would need to be conservative I would say with the level of your hair loss to gain better coverage as it is a numbers game at the end of the day.

 

How do you want it?

[aim4hair]

I was thinking maybe something like that (the black shadow at the beggining)

 

..

[PupDaddy]

Hi aim4hair,

 

What you're really talking about here is completely recreating your frontal third, with a hairline as it might have been in your glory days. The hairline you say you want (the front of the shadow, spanning side to side, with essentially no recession) is actually quite aggressive. Jotronic (Hasson & Wong) has posted here about the surprisingly large numbers of grafts needed for each mm/cm of hairline advancement. If your consulting docs have estimated 2,500 - 3,000 FUE's with a significantly more conservative hairline, those docs might well tell you to double that estimate for the hairline you want. Having said that, there are a number of FUE docs who post results on this board that could probably get you a nice result for your stated objectives with 2,500 - 3,000 grafts, but with a hairline in between the ones drawn in and your shadowed "ideal."

 

Another possibility to consider is Dr. Carlos Wesley, who was recently recommended on this board, who says on his web site that, in addition to strip and FUE, he will soon be offering what he calls "scarless surgery." Based on the vague description, it is supposed to offer the benefits of FUE but with better yield (minimizes transection) and without punctate scars. Scarless Hair Transplantation by Carlos K. Wesley, MD Maybe it will be worth waiting for.

 

PupDaddy

Edited May 23, 2012 by PupDaddy
typo

[aim4hair]

Hi Pupdaddy,

I think you right, we should be able to work something out between the proposed hairline and the shadowed one. I just thought that the proposed one was way too much conservative.

 

The scareless HT sounds too good to be true. If this will really work and will leave no scars at all as promoted! then nothing will hold me back from getting an HT right away even if i decide not to take meds knowing that i will have the option to shave my head to 0 grade with no scars showing at all. But do you think this thing will really work ?

I hope it does because this will make a revolution in the HT world just as the FUE did when it first came out.

[aim4hair]

Yeah i still dont't get it but i hope this thing really works.

The only thing that gives me hope about this is that this surgery was advertised by dr. Wesely who has a great reputation and he's one of the recommended drs in here, so i don't think he would risk ruining his credibility by advertising something like that unless he really has faith in it.

[PupDaddy]

I suppose the technique that Dr. Wesley is working on could be similar to Dr. Gho's (Hair Science Institute) that HARIRI brought to our attention. Dr. Wesley's site says he is working on the technique with colleagues from Yale Medical School, so it sounds as though it could be cutting edge. I guess we'll have to wait and see whether it's anything like Dr. Gho's method (extracting stem cells from the FU donor bulb while leaving enough of the bulb and stem cells intact to permit regeneration of the FU), but something along those lines would satisfy the criteria that Dr. Wesley lists on his site. It will certainly be interesting to see what he's come up with. He says on his site that he could start offering HT's using this scarless extraction technique as soon as this calendar year, so we shall see.

 

PupDaddy

[PupDaddy]

No FUE surgery is scarless,

 

True, but Dr. Wesley claims that the extraction method he is working on is not FUE as we know it and will eliminate scarring completely (including punch/punctate scarring associated with FUE). Whether or not it is similar to Dr. Gho's "Hair Stemcell" extraction method, which is presently in use at his clinics, remains to be seen, but it does appear that technology has rapidly evolved to a point that might permit the "scarless" HT surgery that Dr. Wesley promises. The proof will be in the pudding, of course. I don't want to hijack this thread or engage in speculation, so maybe a new thread could be started once Dr. Wesley announces that he is offering the new technique.

[PupDaddy]

By the way, aim4hair,

 

Another technology to consider regarding FUE is the new ARTAS robotic extractor system developed in collaboration with Dr. James Harris, another recommended doc on this site. You can read about it on his site. It is supposed to make possible dead center, motorized punching out of the FU at the precise angle of the FU's exit, for less transection and damage. It looks to be quite the elaborate and sophisticated contraption, resembling a dentist's chair with lots of computerized gadgetry. Dr. Robert Bernstein, another recommended doc on this site, is reported to now be using an ARTAS in his practice as well. Dr. Harris invented the handheld Powered SAFE Scribe for FUE, which, I believe, is the tool that Dr. Rahal has been using for his FUE procedures. As I understand it, ARTAS employs Dr. Harris' Powered SAFE Scribe for punching the FU's but maps and guides it robotically. Pretty cool.

 

Just some more info for you.

[aim4hair]

Thank pupdaddy.

I went to a local ht dr. here who only do FUT. he told me that i have a very good donor area and that can handle 4 FUT surgeries. My question is would the same thing apply for FUE ? Like can you have a good donor for FUT that is not that good for FUE ?

Or i can take this doctor's word and consider my donor very good for FUE as well ?

[PupDaddy]

Thank pupdaddy.

I went to a local ht dr. here who only do FUT. he told me that i have a very good donor area and that can handle 4 FUT surgeries. My question is would the same thing apply for FUE ? Like can you have a good donor for FUT that is not that good for FUE ?

Or i can take this doctor's word and consider my donor very good for FUE as well ?

 

There are subsets of people who are good candidates for FUT who are not good candidates for FUE. One such group are people with curly hair because the bulb is not necessarily directly beneath the point where the hairs exit the scalp, which can result in unacceptable transection rates. Other people have, for lack of a better term, "mushy" scalp characteristics or other scalp tensile characteristics that can make it difficult to punch/incise the FU and/or extract (pull) the graft out after it has been incised. Sometimes the doc won't be able to determine whether a patient has these non-FUE characteristics until he tries to incise and extract a few FU's, at which point the patient will have the option to stop the procedure or continue with a strip procedure.

 

Hope that helps.

 

PD

[lorenzo]

True, but Dr. Wesley claims that the extraction method he is working on is not FUE as we know it and will eliminate scarring completely (including punch/punctate scarring associated with FUE). Whether or not it is similar to Dr. Gho's "Hair Stemcell" extraction method, which is presently in use at his clinics, remains to be seen, but it does appear that technology has rapidly evolved to a point that might permit the "scarless" HT surgery that Dr. Wesley promises. The proof will be in the pudding, of course. I don't want to hijack this thread or engage in speculation, so maybe a new thread could be started once Dr. Wesley announces that he is offering the new technique

 

I beleive I am familar with the technique that Dr. Welsey is working on. Its it works it will be great. I personally never get my hopes up with any new technique until I have seen results. Hair multipication has been talked about for over 15 years and nothing so far. Although this technique has nothing to do with that and you will still be limited by your donor. I hope it does work out,

[aim4hair]

I was thinking if i went to 2500-3000 FUE for now and then i lost my native and decided to buzz it grade 0.

Even if the FUE scars show on the back (which most ppl will not think of HTs when they see them) i might still look better with a (decent front area and hairline with fue scars) than with (no hairline and bad front area without fue scars at all (no HT option).

 

What do you guys think ?