Skin elasticity issues for Strip surgeory. ANy one please help.

[dactum]

I am 35 aged, INDIAN, settled in Hyderabad is planning to do a HT as soon as possible.

 

I had a consultation with most famous HT surgeons of Hyderabad including Dr. Madhu.

 

Please see the attachment to see my current scalp condition. As you can

judge, i am on Norwood 4 or may be in the starting stage of Norwood 5.

 

 

Can any one make out any moneyhow many graphs would be needed to give an

appreciable look, maintaining a fair density of around 45-50 Sq.cm?

 

 

As per Dr. Madhu, as my donor area skin is being bit tight, he suggests to take out only

1500-1700 graphs. But other surgeons whom i consulted, are ready to take out

between 2500-3200 graph units.

 

I cannot underestimate Dr. Madhu's opinion as he is a reputed surgeon. I still do not

know how other doctors can extract more than what Dr. Madhu promised. I am confused

a bit.

 

 

I don't see any reason going for HT with this much of less graphs, as this cannot give

a good result in terms of my overall look. Even Dr. Madhu is agreeing to this. He is

leaving the decision to me whether to do HT or not with this much of graphs only.

 

What's your opinion?

 

Is it because, other surgeons are over promising me and are making me in discomfort later

by taking out much broader strip and destroying the symmetrical form of follicles and the losing the essential elasticity of the skin ?

 

I dont want to compromise any excessive scalp skin tightness post surgery, for the

sake of other surgeon's business interests. Sorry correct me if i am wrong.... At the same time, i wish to perform the surgeory if there will not have much tightness even if they take 3000 unit bearing strip.

 

I am eagerly looking for the replies from the members those who have done HT surgery through STRIP method.

 

 

Regards,

Dactum

[Mickey85]

Hey there. I think the large discrepancy and difference between Dr. Madhu and the other Doctor's assessment should tell you something. Dr. Madhu could quite easily say he could get more grafts at the sake of scalp tightening and the scar stretching but instead he gave you an honest and ethical assessment. I would take his advice. Your donor area looks very dense, you could get the 1,700 grafts via FUT and possibly look into FUE to obtain even more grafts on top. I would not chance it with the other Doctors saying 3,000 is possible when Dr. Madhu has said 1,700... That is a big difference.

[dactum]

Hey there. I think the large discrepancy and difference between Dr. Madhu and the other Doctor's assessment should tell you something. Dr. Madhu could quite easily say he could get more grafts at the sake of scalp tightening and the scar stretching but instead he gave you an honest and ethical assessment. I would take his advice. Your donor area looks very dense, you could get the 1,700 grafts via FUT and possibly look into FUE to obtain even more grafts on top. I would not chance it with the other Doctors saying 3,000 is possible when Dr. Madhu has said 1,700... That is a big difference.

 

Thanks Mickey, i appreciate your comments.

 

As you suggest, my opinion is too take the Dr.Madhu's advice. But those 1700 graphs wouldn't fair enough to cover my baldness to atleast 50% less.

 

Do you think is it worth to take pain for this much only small benefit? I don't mind about cost but overall 1-2 months intensive effort and time is required for this.

 

 

Sorry for making you for confused.

Edited February 16, 2013 by dactum
1-2 months added

[Mickey85]

i personally would not undergo fut for that amount of grafts. given that you are limited due to scalp laxity, to obtain more grafts you would have to undergo fue anyway. you could do a fut/fue combo butthere are no gaurantees in regards to yield and a fine scar. i think with your thick donor area, you could easily obtain 4000 maybe 5000 grafts via fue alone. my thoughts on fut are pretty well known, but i do see the appeal where alot of grafts are needed and a large area covered with fewer sessions. given that your scalp is tighter than average, i would forego fut the potential for the scar stretching is increased and you cant get more than 1700 grafts safely. just my opinion.

[1978matt]

You're about a NW5 and to lose a Norwood number takes about 1250 grafts.

 

So with 1700 I think the best result you could expect is NW3.5.

 

I think FUE could be the way to go for a more significant result.

[HairE]

I learn something new everyday that I am on this site: how do I check this on myself?

[nativeremdies]

yes, you need to do strip method. You need to be careful because you are addressing two fronts of hairloss. The hairline and the crown. Any super awesome results you have seen only hits the hairline OR the crown.

 

I would fill in the natural "island" front you have now, make sure there is enough grafts to flow back toward the crown, and see what kind of illusion coverage you can have with the crown. Obviously you do not need a dense pack in the crown, just enough to make it look like you have hair.

[Thomas2012]

stupid question, but why wouldn't scalp laxity excercises help out, or maybe in this case and others, the scalp is just that tight.

[Mickey85]

yes, you need to do strip method. You need to be careful because you are addressing two fronts of hairloss. The hairline and the crown. Any super awesome results you have seen only hits the hairline OR the crown.

 

I would fill in the natural "island" front you have now, make sure there is enough grafts to flow back toward the crown, and see what kind of illusion coverage you can have with the crown. Obviously you do not need a dense pack in the crown, just enough to make it look like you have hair.

 

He needs to do a strip method that can only ethically and safely yield 1,700 grafts on a Norwood 5??? To get any more he would have to go FUE anyway. This is one of the rare cases where he can obtain more grafts safely in one session from FUE than FUT!

[dactum]

He needs to do a strip method that can only ethically and safely yield 1,700 grafts on a Norwood 5??? To get any more he would have to go FUE anyway. This is one of the rare cases where he can obtain more grafts safely in one session from FUE than FUT!

 

 

Thank Mickey for your excellent views. You made me think in another direction.

 

Now i think i should complete a 1700 FUT from Dr.Madhu at first and then consider a FUE/FUSE of around 2500 in the second session.

 

Dr.Madhu is expert in FUT only, but they are few many who are famous in FUE.

 

Can you suggest a time interval between these sessions? Because these are to be done by two surgeons at different clinics. Can we do these with a gap of two weeks time?

 

Do you have any idea about FUSE advantages over FUE technique? FUSE is basically FUE only, but they claim it is more result oriented.....as the trans-section rate will be less compared to normal FUE technique as they use a special device to extract the graphs.... is it so? Or is it an another business name they set for FUE ?

[Mickey85]

Thank Mickey for your excellent views. You made me think in another direction.

 

Now i think i should complete a 1700 FUT from Dr.Madhu at first and then consider a FUE/FUSE of around 2500 in the second session.

 

Dr.Madhu is expert in FUT only, but they are few many who are famous in FUE.

 

Can you suggest a time interval between these sessions? Because these are to be done by two surgeons at different clinics. Can we do these with a gap of two weeks time?

 

Do you have any idea about FUSE advantages over FUE technique? FUSE is basically FUE only, but they claim it is more result oriented.....as the trans-section rate will be less compared to normal FUE technique as they use a special device to extract the graphs.... is it so? Or is it an another business name they set for FUE ?

 

 

I would not suggest a gap of two weeks no. You would need to give the recipient and donor area time to heal between sessions. Just my opinion but we have learnt that laxity can be a factor in ease of extraction for FUE, Dr Devroye mentioned this very recently. I would give at least 8 month gap to be safe and also time to evaluate the success of the first procedure so the 2nd procedure can fix any unsuccessful areas.

 

In regards to FUSE, I think it is just another term for FUE. Like FUE-u, it is FUE but the Doctor might use special tools or technique but the method remains FUE on a whole. It may give better success, it may not. I really do not know how FUSE differs.

 

Hope this helps.

[dactum]

I would not suggest a gap of two weeks no. You would need to give the recipient and donor area time to heal between sessions. Just my opinion but we have learnt that laxity can be a factor in ease of extraction for FUE, Dr Devroye mentioned this very recently. I would give at least 8 month gap to be safe and also time to evaluate the success of the first procedure so the 2nd procedure can fix any unsuccessful areas.

 

In regards to FUSE, I think it is just another term for FUE. Like FUE-u, it is FUE but the Doctor might use special tools or technique but the method remains FUE on a whole. It may give better success, it may not. I really do not know how FUSE differs.

 

Hope this helps.

 

 

What about having a combo session at a time with 1700 FUT and 2500-3000 FUE? May be it can take 3-4 consecutive days? Dr.A's clinic is suggesting me this. Is it advisable?

 

Waiting for a gap of 8 months seems to be big. But i understand the benefit of correcting any problems that can happen in first HT.

 

Which is better?

[Mickey85]

What about having a combo session at a time with 1700 FUT and 2500-3000 FUE? May be it can take 3-4 consecutive days? Dr.A's clinic is suggesting me this. Is it advisable?

 

Waiting for a gap of 8 months seems to be big. But i understand the benefit of correcting any problems that can happen in first HT.

 

Which is better?

 

Not a fan of joint FUE/FUT sessions myself. If the procedure fails you basically burn out your available donor options in one go. Same reason I'm not a fan of massive 5,000+ megasessions in one go. But that's just my opinion and I'm far from an expert champ. I just haven't seen too many successful joint FUT/FUE sessions but I have seen a few failed ones.. I think it's just too much trauma to the donor. Again, my opinion based on my limited knowledge. Continue with caution, do not jump into a procedure as you have to be careful with your options.

[dactum]

Ok. That's a great advice by Mickey. You are absolutely correct. A gap of 8 months waiting has more benefits than a combo session.

[Mickey85]

Ok. That's a great advice by Mickey. You are absolutely correct. A gap of 8 months waiting has more benefits than a combo session.

 

At least you are researching you options. Take your time and even when you think you know what you will choose, stop and think more. In the span of a few days you have learnt of options that were not known to you. Imagine what you can learn in 3 months.

[dactum]

Yeah... I see you have lots of patience,.. Mickey ....

 

You are reminding me the proverb "patience bring more happiness".. Thanks for your help.

[Mickey85]

Yeah... I see you have lots of patience,.. Mickey ....

 

You are reminding me the proverb "patience bring more happiness".. Thanks for your help.

 

I learnt the hard way by rushing and regretting my procedure.... I don't want anyone to feel the way I do.

[dactum]

I learnt the hard way by rushing and regretting my procedure.... I don't want anyone to feel the way I do.

 

Mickey,

 

I have finally done HT with Dr. Radha rani through FUT method extracting 3200 graphs..... Absolutely perfect. There is no any scalp tightness... I am happy that i have not gone for time and money consuming FUE technique.

 

Even if i have gone for FUE, i would have a wastage of 40-50% as per Dr. Radha rani, as she saw my hair roots are in crossed order when she dissected through FUT method. For FUE, the roots are to be in straight fashion to reduce wastage rate. This is is the reason Negroes are not good candidates for FUE at least.

 

 

Sorry to be for being just over happy.. I am really happy now.

[Mickey85]

hmm just because there is no tension right now doesnt mean the scar wont stretch. i wish you all the very best with your transplant.

[nativeremdies]

I have consulted with several doctors about my strip scar. They have all more or less said because my skin is flexible. I should leave the sutures in for two weeks versus the 7 to 9 days Lindsey suggested.

[Mickey85]

I have consulted with several doctors about my strip scar. They have all more or less said because my skin is flexible. I should leave the sutures in for two weeks versus the 7 to 9 days Lindsey suggested.

 

I had a virgin scalp and left the sutures in for 2 weeks. Scar stretched. Basically sent me into a depression along with the terrible yield and permanent shockloss.

[chrisdav]

Mickey,

 

How do you wear your hair normally and do you have any pictures of your first procedure?

[Mickey85]

Mickey,

 

How do you wear your hair normally and do you have any pictures of your first procedure?

 

Hey Chrisdav, hope you are well champ. I used to alternate between long hair and short(grade 3-4ish) back and sides with short top. Now I can't do either. I do have before/after pictures of my first and only procedure but I don't look at them, it's too painful... Please understand..

[dactum]

hmm just because there is no tension right now doesnt mean the scar wont stretch. i wish you all the very best with your transplant.

 

I am perfectly fine. Just removed the sutures now. And felt more better.

[chrisdav]

Ok no problem- I understand.

 

Look forward to your write up when you have had your surgery with Dr Feriduni.