Donor scar options

[Cautiouslyconsidering]

I'm planning on going for a HT and recently consulted two top HT docs both highly recommended on this forum. One recommended an FUE and the other a strip, both recommended between 1500-2000 grafts. I'm tring to consider worst case senario for both options and am wondering if the scar is poor with the strip-how well does FUE into donor scar work to cover it up if I want to keep short hairstyle as an option in the future. Has anyone done it successfully?

Thanks.

[greatjob]

I wouldn't recommend going into a strip procedure already planning to FUE into the scar unless you have a significant amount of loss. If you are not comfortable with the linear scar then go FUE

[Nick153452]

Call me crazy, but of all of the pictures I've seen on this forum, most scars are virtually undetectable if done correctly, even if the hair is relatively short. Even if people can sometimes notice it, if your hair looks overall good, why can't you just tell someone you can surgery; the type of surgery doesn't have to be explicitly stated. Maybe I'm just being overly confident in FUT?

[james84]

For a procedure of 1500-2000 i would go FUE, man for a lot higher i would go FUE, why risk a scar? however this is only my opinion and like others have stated the scar is a non issue for them but not everyone;)

[JohnnyDrama]

OP, what age are you? What hair characteristics do you have? What pattern of loss do you have?

[HairKlepto]

Most of the scars that get posted are good ones... Scars can easily be 1 inch tall... I have seen plenty of them. Having a good surgeon doesn't guarantee a good scar. Wide scars are especially common with younger patients. A good surgeon will tell you there is no guarantee. Also if you ever want to buzz you head, don't even think about strip. I think for people with major hair loss, strip is the way to go, but people can debate on that all day.

[Dr. William Lindsey]

Strip is WAY more consistent at providing good results and unless you are planning on really short hair, our office would strongly suggest strip. PLUS if you are likely to need more hair later on, Strip limits the quantity of scar tissue in the donor area.

 

I have posted lots of threads on scars and the writers above are correct...you can wind up with a bad strip scar from even the best of surgeons, but its not common.

 

Just yesterday I saw another 30ish year old Class 5 MPB patient who'd had 600 FUE's (more likely 2mm punches) to attempt to rebuild his frontal hairline... Now he presents for repair of that plus addressing some of the "further back" loss he's had since that procedure. Well his donor area is all full of scar and we'll be lucky to get 2500 grafts out of him and more likely 2200 at one setting since there is so much scar tissue in his donor region.

 

Fue is an excellent option but one which has pros and cons, just as strip does. Specifically ask the doctors you consulted with about their philosophy on these topics, then make your decision. Putting a case off til you are comfortable is not a bad thing.

 

Good luck.

 

Dr. Lindsey McLean VA

[Mickey85]

For 1800 to 2000 grafts I would say FUE all the way(is anyone surprised?) as it would be done in one session. No Doc can guarantee a 1mm scar(which is best case scenario) and FUT has other inherent problems that FUT Docs won't mention like the change in hair calibre and grouping gradation(it eliminates the natural and smooth transition of thicker multi-hair grafts to finer, single hair grafts), higher potential for permanent numbness as the nerves are cut deeper and reconnected at vastly different points) and the eradication of natural hair direction and flow.

 

Dr Lindsey is correct, both methods present their pros and cons, but that is a blanket statement. FUE has much more advantages over FUT as shown in my advantages and disadvantages list. If FUT is still more appealing to you after making a conclusion, then by all means, go FUT. But make sure it is your conclusion and not a surgeon's. If you have a failed FUE, you can get more FUE, if you get a stretched scar, you have to deal with the unpredictable yield that grafts have in scar tissue or potentially worse stretching through a revision.

 

For those that will attack me for pro-FUE stance:

1) the OP asked specifically about both methods

2) Dr Lindsey posted his sentiments in regards to FUT and FUE

3) I have not been uncivil and have not broken any rules and

4) Rather than attack me, actually debunk me, that at least would hold some substance

 

Thank you

[HairKlepto]

Kudos on point #4 Mickey - spoken like a true intellectual.

[Mickey85]

Thanks HairKlepto. That's what I respect about you, you can be civil and express your opinion, why should anyone attack your character simply because they don't agree with what your sentiments are about a procedure or hair transplantation in general? We aren't criticising each other's deities here. Always good to hear your opinions.

[Shampoo]

make sure it is your conclusion and not a surgeon's.

 

Another option is after extensive study and investigation to possibly trust many of the best hair transplant surgeons in the United States and Canada.

 

I would think it is logical that most people would give more serious weighted consideration to the opinions of most (not a "fue") of the top, most respected, hair transplant surgeons in the world on this matter.

 

Yes each patient should do a thorough investigation, but if most of the top hair transplant surgeons in the US and Canada are primarily recommending FUT as the Gold Standard of hair transplant surgery, then a patient must decide who he is going to trust.....the majority of top hair transplant surgeons in the US & Canada or somewhat knowledgeable well intentioned internet message board posters and a tiny minority of doctors that use FUE as their primary method of surgery.

[greatjob]

For 1800 to 2000 grafts I would say FUE all the way(is anyone surprised?) as it would be done in one session. No Doc can guarantee a 1mm scar(which is best case scenario) and FUT has other inherent problems that FUT Docs won't mention like the change in hair calibre and grouping gradation(it eliminates the natural and smooth transition of thicker multi-hair grafts to finer, single hair grafts), higher potential for permanent numbness as the nerves are cut deeper and reconnected at vastly different points) and the eradication of natural hair direction and flow.

 

Dr Lindsey is correct, both methods present their pros and cons, but that is a blanket statement. FUE has much more advantages over FUT as shown in my advantages and disadvantages list. If FUT is still more appealing to you after making a conclusion, then by all means, go FUT. But make sure it is your conclusion and not a surgeon's. If you have a failed FUE, you can get more FUE, if you get a stretched scar, you have to deal with the unpredictable yield that grafts have in scar tissue or potentially worse stretching through a revision.

 

For those that will attack me for pro-FUE stance:

1) the OP asked specifically about both methods

2) Dr Lindsey posted his sentiments in regards to FUT and FUE

3) I have not been uncivil and have not broken any rules and

4) Rather than attack me, actually debunk me, that at least would hold some substance

 

Thank you

 

I think saying you would reccomend fue all the way for 1800-2200 grafts is also a blanket statement without knowing a lot more about this patients situation. As I have said before I do think fue is better than strip in many ways, however fue will never be able to touch strip in terms of the total available donor, at least not until regeneration or multiplications is in wide spread use. For example a patient might have 8,000 grafts available via strip, and then still has the option to harvest more via fue later on. Whereas that same patient probably only has 4,000 grafts or so available strictly from fue. So while there are definite advantages to fue, if a person needs a high number of grafts for a cosmetically acceptable result often fut is the only route unless the person has a freakishly high donor density.

[Mickey85]

The patient was recommenddd 1800 to 2000 grafts.i recommended fue for him due to the low number used. I didnt mean i recommend fue all the way as in for every norwood. I then went on to give specific disadvantages for fut and fue in regards to fut scarring and fue yield and what is harder to solve. Hardly a blanket statement champ. A blanket statement would be 'fue is superior in mosy ways' without or elaborating, where i not only elaborated but made a whole thread on it i do agree about getting more grafts out of both fue and fut and fut in general obtains more grafts even exclusively though.

[Mickey85]

Another option is after extensive study and investigation to possibly trust many of the best hair transplant surgeons in the United States and Canada.

 

I would think it is logical that most people would give more serious weighted consideration to the opinions of most (not p, most respected, hair transplant surgeons in the world on this matter.

 

Yes each patient should do a thorough investigation, but if most of the top hair transplant surgeons in the US and Canada are primarily recommending FUT as the Gold Standard of hair transplant surgery, then a patient must decide who he is going to trust.....the majority of top hair transplant surgeons in the US & Canada or somewhat knowledgeable well intentioned internet message board posters and a tiny minority of doctors that use FUE as their primary method of surgery.

 

let us trust the fut dominent surgeons for get 90% of their income from performing FUT. Ever occur to you that the ones downplaying fue are the ones that rarely post cases? While people like bisanga, lorenzo, feriduni, erdogan get by just fine performing both equally or fue exclusively? Ever occur that the ones downplaying fue are the ones that simply are not as good at it as they are fut(or good at fue at all)?

Edited May 14, 2013 by Mickey85

[Cautiouslyconsidering]

thanks for the replies and especially thanks for Dr Lindsay's professional opinion.

I went for a consult with two of the highly recommended surgeons on this website and one recommended strip and the other FUE for~1500 grafts. the strip proponent stated that yield will not be as good as FUE and there's potential for coalescence of dot/scars. The FUE proponent claims that over the last few years, with refined technique, the yield is comparable and FUE noticable scarring is rare. I'm still contemplating between the two, but in my opinion I agree with Mickey, that worst case senario, the potential disadvantages of strip seem to outweigh the advantages, compared with the disadvantages and advantages of FUE. In other words the risk: reward ratio of each in my opinion favors FUE. If I get suboptimal yield with FUE, I can always go back and get more or finally come to terms with my hairloss and buzz my head. If I have a bad scar from strip, there's no option around it. Granted, most strip scars look fine but what if I'm the outlier. Isn't that the point of all this research-to prepare for potential less then optimal situations. I mean if we knew the recipient and donor sites looked great a certain way every time, and with a certain doctor, then noone would argue about the method or clinic in which a patient should have it done.

Just my thoughts, but curious to hear others' opinions about that line of logic.

Thanks

[greatjob]

I agree with your logic. I am not someone who buys the low fue yeild argument any more. At one point in time there was a big difference in yeild, but I think the procedure has advandced to the point that in capable hands the difference in yeild is a non issue. The reality is that every patient is different and wieghs certain advantages more important than others. That was the case for me. I have advanced loss, limited donor density and finer caliber hair, so in my case I needed to maximize my donor. I would never have been able to obtain enough grafts via fue to give me an acceptable result, so the difference in available donor outweighed all other advantages of fue in my case. If I however I had unusually high density or minimal loss with a weak family history of mpb then I probably would have been more inclined to go the fue route. That is what I was stating with my last post, with the very minimal information on the op situation other than a graft count it is impossible to say he should go either fue or strip.

[Shampoo]

let us trust the fut dominent surgeons for get 90% of their income from performing FUT.

 

Ever occur to you that you whine about personal attacks but then you indirectly personally attack and question the honesty of world respected surgeons like Dr. Hasson, Dr. Lindsey, Dr. Wong, Dr. Konior, Dr. Feller, Dr. Arocha, Dr. Shapiro, ect..? Do you really think Dr. Hasson, Dr. Feller, Dr. Konior, Dr. Lindsey, Dr. Wong, Dr. Shapiro can't be trusted on which procedure they think is best because they primarily perform the type they believe in? So since they perform the procedure that is the Gold Standard to this day you feel ok smearing their reputation by making statements like the quote of yours above? Sure you try to gain "cover" by not naming names, but your point is clear. Why can't you just accept the fact that very highly skilled doctors with world class reputations have studied the issue and arrived at a different conclusion than you?...why the need to say in-between the lines that their opinions cant be trusted because they make their livings doing FUT the procedure they feel is best for their patients? I think you owe an apology to these outstanding surgeons who you have basically besmirched by saying they can't be trusted or that they lack the skill levels needed to do FUE. Ever occur to you maybe they studied it as doctors and decided they did not think it was best for the majority of their patients and it has nothing to do with skill or money?

[StaggerLee123]

Ever occur to you that you whine about personal attacks but then you indirectly personally attack and question the honesty of world respected surgeons like Dr. Hasson, Dr. Lindsey, Dr. Wong, Dr. Konior, Dr. Feller, Dr. Arocha, Dr. Shapiro, ect..? Do you really think Dr. Hasson, Dr. Feller, Dr. Konior, Dr. Lindsey, Dr. Wong, Dr. Shapiro can't be trusted on which procedure they think is best because they primarily perform the type they believe in? So since they perform the procedure that is the Gold Standard to this day you feel ok smearing their reputation by making statements like the quote of yours above? Sure you try to gain "cover" by not naming names, but your point is clear. Why can't you just accept the fact that very highly skilled doctors with world class reputations have studied the issue and arrived at a different conclusion than you?...why the need to say in-between the lines that their opinions cant be trusted because they make their livings doing FUT the procedure they feel is best for their patients? I think you owe an apology to these outstanding surgeons who you have basically besmirched by saying they can't be trusted or that they lack the skill levels needed to do FUE. Ever occur to you maybe they studied it as doctors and decided they did not think it was best for the majority of their patients and it has nothing to do with skill or money?

 

Amen brother. Well said.

[Mickey85]

I agree with your logic. I am not someone who buys the low fue yeild argument any more. At one point in time there was a big difference in yeild, but I think the procedure has advandced to the point that in capable hands the difference in yeild is a non issue. The reality is that every patient is different and wieghs certain advantages more important than others. That was the case for me. I have advanced loss, limited donor density and finer caliber hair, so in my case I needed to maximize my donor. I would never have been able to obtain enough grafts via fue to give me an acceptable result, so the difference in available donor outweighed all other advantages of fue in my case. If I however I had unusually high density or minimal loss with a weak family history of mpb then I probably would have been more inclined to go the fue route. That is what I was stating with my last post, with the very minimal information on the op situation other than a graft count it is impossible to say he should go either fue or strip.

 

I can totally understand that buddy what is paramont to someone like myself is totally trivial to someone else. I just want people to be fully informed and go into things by their own accord because hearing things from any doctor can sway you. I was swayed and i regret it big time. If i knew back then what i know now i wouldnt have had a ht or at most i would have had fue eith much less grafts than what i got and with a different doctor all is well though.

[Mickey85]

Ever occur to you that you whine about personal attacks but then you indirectly personally attack and question the honesty of world respected surgeons like Dr. Hasson, Dr. Lindsey, Dr. Wong, Dr. Konior, Dr. Feller, Dr. Arocha, Dr. Shapiro, ect..? Do you really think Dr. Hasson, Dr. Feller, Dr. Konior, Dr. Lindsey, Dr. Wong, Dr. Shapiro can't be trusted on which procedure they think is best because they primarily perform the type they believe in? So since they perform the procedure that is the Gold Standard to this day you feel ok smearing their reputation by making statements like the quote of yours above? Sure you try to gain "cover" by not naming names, but your point is clear. Why can't you just accept the fact that very highly skilled doctors with world class reputations have studied the issue and arrived at a different conclusion than you?...why the need to say in-between the lines that their opinions cant be trusted because they make their livings doing FUT the procedure they feel is best for their patients? I think you owe an apology to these outstanding surgeons who you have basically besmirched by saying they can't be trusted or that they lack the skill levels needed to do FUE. Ever occur to you maybe they studied it as doctors and decided they did not think it was best for the majority of their patients and it has nothing to do with skill or money?

 

This is the cosmetic industry. Should i just eradicate all belief and common sense because they are doctors? Have you not seen some(not all) of these doctor's replies when a patient who had a failed procedure is unhappy eith their results? It's a business they are in the business of hair transplantation. Anyone would be foolish to believe otherwise.

 

I tell the OP to check out the pros and cons behind each method and make his own conclusion but you tell him to believe all fut doctors?! Where is the logic behind that?

 

I owe no one an apology. Last i checked drs hasson and wong have not been deeply delving into fue so how can they make a good comparision. They do great fut dont get me wrong. But to recommend a much more invasive procedure with more drawbacks doesnt stick with me. Not when Feriduni, Bisanga, Lorenzo, Erdogan, De Reys, Umar, Mwamba, Bhatti, Hakan, Maras are getting yields close to the doctors you mentioned. I owe no one an apology and they owe me nothing back.

[Mickey85]

thanks for the replies and especially thanks for Dr Lindsay's professional opinion.

I went for a consult with two of the highly recommended surgeons on this website and one recommended strip and the other FUE for~1500 grafts. the strip proponent stated that yield will not be as good as FUE and there's potential for coalescence of dot/scars. The FUE proponent claims that over the last few years, with refined technique, the yield is comparable and FUE noticable scarring is rare. I'm still contemplating between the two, but in my opinion I agree with Mickey, that worst case senario, the potential disadvantages of strip seem to outweigh the advantages, compared with the disadvantages and advantages of FUE. In other words the risk: reward ratio of each in my opinion favors FUE. If I get suboptimal yield with FUE, I can always go back and get more or finally come to terms with my hairloss and buzz my head. If I have a bad scar from strip, there's no option around it. Granted, most strip scars look fine but what if I'm the outlier. Isn't that the point of all this research-to prepare for potential less then optimal situations. I mean if we knew the recipient and donor sites looked great a certain way every time, and with a certain doctor, then noone would argue about the method or clinic in which a patient should have it done.

Just my thoughts, but curious to hear others' opinions about that line of logic.

Thanks

 

I think your logic is very clever champ. I wish i had the same before undergoing my fut. I think its great that you thought about the what ifs because there are no guarantees in surgery. It is your scalp at the end of the day and you should listen to your own conscience but with as much information so you can make an informed and educated decision.

[Shampoo]

This is the cosmetic industry. Should i just eradicate all belief and common sense because they are doctors?

 

No....you should should have common sense and realize these doctors have worldwide surgical medical professional reputations and you have basically zero. These are not just any doctors. They are arguably the best of the best.

 

For you to pretend and lecture Dr. Lindsey today was laughable in exhibiting your arrogance. "Dr Lindsey .... that is a blanket statement. FUE has much more advantages over FUT as shown in my advantages and disadvantages list". Oh brother.....lol.

 

As if your message board guru "advantage/disadvantage list" somehow is on par with Dr. Lindsey medical opinions. How many hair transplant surgeries have you performed? What is your "the great writer of Fue vs Fut list" medical reputation vs. Dr. Lindsey?

 

I am sure Dr. Lindsey immediately went and read your list and freaked that you enlightened him and "proved" he must be doing FUT because of the money and his lack of surgical skills to handle FUE.

 

Do you really think Dr. Lindsey got to where he is by not doing his homework?

 

Can you not accept that many world class surgeons like Dr. Lindsey have a very different highly educated medical opinion than you do concerning FUT vs FUE? Why the need to imply these respected surgeons primarily choose FUT for their patients because of money grubbing or lack of skill reasons? That's so ignorant and below the belt to these outstanding surgeons and really sends the wrong message to newbies that may be browsing this forum.

[Mickey85]

Im glad i have that effect on you. Again, you have not debunked anything rather have made petty jabs at me. You basically tell the OP to blindly follow what doctors tell him. That is ignorant. Good day.

[scar5]

No....these doctors have worldwide surgical medical professional reputations and you have basically zero. These are not just any doctors. They are arguably the best of the best.

 

 

I had my first surgeries with one of the best surgeons I could find. He was a president of the International Society Hair Restoration Surgeons, well respected by his peers and a congenial and frank and friendly fellow to boot.

 

My scar was terrible and stretched. It was taken too high. The hair was planted like palm trees and at the same angle. The scars stretched. The plugs were wide and storky. The growth was stellar.

 

I asked about it at the time...but what did I know? He was the expert.. I was the guy with zero knowledge.

 

He said FUE was nonsense. He said mini grafts and micro grafts were not good enough for density. He soon changed his mind about the latter, but maintained FUE was hype last time I checked.

 

If you think, doctors enter the hair transplant industry to help us without regard to their bottom line you are on a cloud. If you think their techniques and practices are not economized to suit that bottom line and minimize their exposure to risk you are wrong.

 

And if you think the marketing shtick is not made to rationalize these choices of techniques and practices you are also ignorant. Like a school of fish swimming together for protection, clinics and docs have stuck to their rhetoric for decades and thousands upon thousands of people are wearing strip scars as a result.

 

I don't doubt Dr. Wong has given you a great result, but never assume that THE word of the doc/rep. doesn't come with baggage that needs to be carefully unpacked and examined.

[MAGNUMpi]

 

worst case senario, the potential disadvantages of strip seem to outweigh the advantages, compared with the disadvantages and advantages of FUE. In other words the risk: reward ratio of each in my opinion favors FUE. If I get suboptimal yield with FUE, I can always go back and get more or finally come to terms with my hairloss and buzz my head. If I have a bad scar from strip, there's no option around it.

This logic does make sense. (A person could potentially get the scar repaired, but that doesn't seem like much fun)