Help on FUE Transplant

[Sanjay876]

Hi,

I want to get a Hair Transplant done, I am really thankful to see all these information and happy to have found this before having my Transplant done. I have spoke to few doctors and want to have FUE method done. Following are the reasons.

1. No Linear scar as FUT, though I understand there is still a scar of 1-2mm all over.

2. Quicker recovery time, so that I can get back to my activities sooner.

 

I believe I am in Vertex 3 of Norwood Scale & following are my goals.

1. Reduce my receding frontal hairline.

2. Improve density in my primal hair (frontal hair, where there is lesser density)

3. I have attached the pics of my present and expected with dotted line. Please note that even before my hair started falling, I had a longer temple.

4. Though I have a little baldness on my crown, I want to do HT on the front alone now.

 

Now below are my questions/ confusions.

1. What would be the number of grafts/ follicular units required for my goals? Pics attached.

2. Can it be done in one sitting? If so how much time should it take on an average. The reason I am asking this is I heard one surgeon say that its possible for him to do around 2000 units in 1 sitting (7-8 hrs in total). However heard the other one say its not possible for more than 1000 units in 1 sitting.

3. Other than cost, what other details should I know in terms of technique should I know about the FUE procedure used by the Surgeon.

(ex. based on what I read in the forums. punch size used should be 1-2mm; planting of grafts on the front line should be done by the Surgeon himself;)

 

It would be really great if anyone can help me with the answers. I would really appreciate your help in this regard.

 

Please let me know if you need any other clarifications.

[Spanker]

2 mm seems a little big. I think .8 to 1.1 is most common

[England]

Hi Sanjay876

 

1 - Obviously I'm not a surgeon but as a layman's estimate it looks like you need around 2,000 grafts. This largely depends on the density the surgeon recommends. I would recommend you get at least 3 consultations done online and compare the recommendations.

 

2 - Many clinics can do this in one sitting. I recently had 2,550 FUE in one sitting.

 

3 - Punch size should ideally be 1mm or less to minimise scarring. The surgeon should be responsible for the overall operation but often it is far better for your graft survival and result if the technicians perform a lot of the work. For example, typically the technicians perform the extractions of the grafts (in teams), then the surgeon performs the incisions, and finally the technicians place the grafts into the incisions. This is beneficial for many reasons: a) The grafts are out of the head for less time, increasing survival rate. b) The technicians are very specialized in extractions and so can do it at least as well as many surgeons c) If the surgeon had to do every extraction himself he could suffer from fatigue and that could affect the result and d) the direction of the incisions by the surgeon, if done properly, can allow placement of the grafts in only one way so the technicians can't change the direction of the hairs.

 

In terms of the technique used by the surgeon, rather than saying that one technique is better than another (manual vs motorized) etc, I would say just look at lots and lots of their final results and meet some of their patients, decide which results you prefer. What is very important is that you understand the process before you go into the operating room, as much to reduce your stress levels as anything..

 

Best of luck.

[1978matt]

Some other things to consider:

 

- How much additional hairloss are you likely to experience? (family history)

- What is your long term game plan? Just to tackle the front and then come back in 3 or 4 years to do the crown?

- Are you on meds?

 

I'd definately be careful about which doc you choose for FUE. Some use motorised tools, others manual ones with varying degrees of success.

[HARIRI]

I agree with SPEX. Im against large FUE sessions. If he is representing one of the best FUE surgeons in the industry and he still believes that FUT yields better then that really means that FUT is superior than FUE when it comes to growth success rate. I would advise you to do FUT with a very great surgeon to get a very thin scar and then use FUE to do some filling.

 

1978matt, Smart questions to be asked. I guess manual one is much better and gives quality results. Motorized mostly used to reduce the fatigue of the surgeon and allow him to have multiple surgeries in one day as it extracts double numbers of grafts in same period however I feel its somehow commercial plus I dont like to be drilled lol. Most top FUE doctors in the industry these days use manual FUE tool including Jose Lorenzo, Feriduni, Bisanga and Keser.

[England]

It's important to note that my top 3 FUE surgeons, worldwide, regularly perform large (~3,000) FUE sessions and have the portfolio of excellent results to back it up. They would certainly not agree that they don't recommend FUE surgeries of this size, at all. They are also, arguably, far more experienced when it comes to FUE surgery than other doctors who perform mostly (or more) FUT, and certainly they are more knowledgeable than any of the posters on this site.

 

Sean has already posted his results from his 3,000 FUE which have been compared to strip favourably, and Ben had a similarly large session which is showing excellent progress too. After having had consultations with multiple top FUE surgeons I saw hundreds of cases showing the same or similar results.

 

It is worth noting that ALL surgeons, strip or otherwise, will state that their technicians perform a critical role in the operations and are just as important as the surgeon - it's a team effort wherever you go and whichever surgery you opt for. I believe that for legal reasons in some countries, technicians are limited in what they can actually do so some clinics are simply incapable of performing surgeries over 1,000 grafts - it doesn't mean they don't work.

[RCWest]

I'm with Spex. I'd go for 3000-3500. It's going to cost you at least twice what strip surgery costs, and it will take more time to perform. Keep in mind though that if you hammer your donor area with a large FUE session then it makes for smaller strip surgery harvests. Most people who need a lot of hair max out their strip procedures first, then get whatever else they can by FUE.

[chrisdav]

I wouldn't use Ben results so far as a benchmark of fue surgery.

 

He is at 7-8 months and not fully through the 12-18 month process, so it is not a confirmed outcome.

 

His progress so far is average but time will tell.

[England]

Keep in mind though that if you hammer your donor area with a large FUE session then it makes for smaller strip surgery harvests.

 

It's also true that if you hammer your donor area with large strips it makes for smaller FUE harvests.

 

There are advantages and disadvantages to both.

 

@Chris - I clearly said excellent progress so far, the fact he has many more months of improvement only strengthens my point. I also referred to hundreds of other case studies.

[Sean]

The big advantage in going for FUE is to avoid the strip scar so it would not make sense in going for a strip after a large FUE since that defeats the purpose in going for FUE in the first place.

 

People can obtain large graft count from FUE, just look as the Bisanga rep who has had over 7000 FUE grafts. I saw him in person a few weeks ago and its impressive.

 

 

MPBsucks, if you mean "Stephen", then I agree. I believe his graft count is now 8400 grafts and he is about to hit a year mark from his last procedure if I am not mistaken. I think his restoration looks really cool given his starting point and to where he is today. I think the grafts went a long way for him. He usually keeps his hair short. I don't know if he has ever thought about growing it out a little bit now or if he has actually posted pics up showing longer hair on the forums. He keeps it buzz cut style but I wouldn't think hair loss was something that was affecting him. Even after all those grafts extracted from his scalp donor and his beard donor, I wouldn't be able to detect any signs of any surgical intervention he has had.

[England]

Yeah Sean,

 

I met with Stephen too, saw and touched his hair first hand. He's very lucky to be able to pull off that buzz style - he's a good guy too.

 

As you say there are no marks at all or any indication that he's had surgery. Fantastic show piece.

[Sean]

Yeah Sean,

 

I met with Stephen too, saw and touched his hair first hand. He's very lucky to be able to pull off that buzz style - he's a good guy too.

 

As you say there are no marks at all or any indication that he's had surgery. Fantastic show piece.

 

 

England, That's awesome you know first hand how his hair his. He definitely played his cards right. Considering his goals and the fact he was a Norwood 6 restoration, this was a very well laid out plan towards success. The doctor did great work. It did take more than one procedure, but he got to where he wanted to be and that is what matters.

 

 

MPBsucks, I agree. I think the doc does decent work. He gets my vote too.

[Sean]

Sanjay876, as I mentioned it before, but definitely evaluate all doctors and the results. Take a look at the photos, videos, and if you can, meet people in person. Try to look at people that have a similar hairloss pattern to you, had around the same number of grafts you were quoted, & have similar hair texture/color so this can give you a better idea as to how things may look for you. Make a long term plan and if you feel FUE is what you want, get an evaluation to see if you are a candidate for it. With the right planning/strategy, in the hands of the right doctor, I don't see why it can't work for you. Good Luck with everything.

[Kesso]

Hi Sanjay,

 

I was wondering if you could see a 3D render of your grafts before your surgery, if that would interest you. I am a digital modeler and have done many sculpts for people. I have a lot of experience in doing digital hair and think people would see the value in it.

 

Anyhow, I am able to control/grow the exact number of hairs (it's thickness, wavy, curly, density, length) and show you what it looks like on your 3D scan as it grows. That way, you'll have a better idea of what the grafts will look like before your surgery.

 

The renders are photo-realistic and very precise with the hairs grown. I think the 3D renders will help you better visualize the results and the growth progression. If you have any interest, please respond.

[raulbrammin]

Doing a 3d visual is the worst thing you can ever do... its never realistic..... it makes you look so good that if the ht is bad you will get suicidal.

 

I know how a reputed cosmetic surgeon showed my aunt her face in 3d post a facelift and her expectations were so high it was unbelievable.

Too bad because the facelift was not breathtaking and it made her get a nervous breakdown.

[Kesso]

hi raul,

 

I think it really depends on the type of surgery performed. I agree with you that a 3D scan is not necessary for a face lift. I would not recommend that. However, for certain Cosmetic Surgeries such as rhinoplasty and any bone-augmentations, it is quite helpful, especially for the doctors planning.

 

3D Renders have never been done for the Hair Transplant industry because of the difficulty in rendering realistic hair, not to mention having control over it's properties.

 

However, recent advancements in software have allowed hairs to be grown with tremendous control. I have been doing professional 3D portrait sculptures for several years now. I realized I can show people different hair styles and came to this forum because my bald uncle wanted to do a HT. I 3D scanned him and showed him what the grafts will look like (5000hairs). The doctors he saw were very impressed with the realism. The great thing about 3D visuals for hair vs facelift is that you aren't altering his face. You are simply specifying the number of hairs and its properties. As such, you won't get a more realistic preview. For example, if you have a 95% growth rate, I can show what 4750 hairs will look like instead of 5000.

 

I think before you make a judgment, you should see an example for yourself. Otherwise, I would agree with you.

[raulbrammin]

Hi kesso,

 

I just cited my personal opinion. I have seen how 3ds work on facial transplants and I would imagine it cant be ascertained how a persons HT would go because you wouldnt know how the doctor does the hairline, or how he would plug hair and how much in which area. Plus how many grafts fall off permanently, how much regrows back etc.

 

With due respect, I appreciate your work yet continue to have my reservations about it .

 

God Bless !

[Kesso]

Hi Raul,

 

Thanks for the response. Per your concerns about the where to do the hairline and how much hair in the area:

 

1) the hairs would be added based on the doctor's drawing of the hairline.

2) the number of hairs and density would be based on the doctor's estimates (i can control the density too)

 

I would do the render based on the specifications of the doctor. (I'm planning on working with HT centers to offer their patients) -- Just looking for some feedback here

 

Of course grafts will fall out and some may not regrow; I think that's an inherent risk that people understand.

 

Now the great part about this is that I can show you what it would like if only 90-95% grew back. I am able to control pretty much every aspect of the hair which is why I want to show people what's possible now.

 

My whole take on this is that with the control over the hairs, you can't find a more realistic render of the grafts.

The best part is I am able to show how different number of grafts will look so you're happy with the doctors suggestions.

 

Up till now, no one has been able to do hair. I think you would be pleasantly surprised by my abilities (more the software, but hey…i'll take some credit too…lol).