Does FUE cause more damage than FUT to donor area?

[Mickey85]

Look, there is a very, very simple way to resolve this question.

 

Step 1: Spend a few months on hair boards like this one.

 

Step 2: Total up all the people who talk about how much they hate their strip scar.

 

Step 3: Total up all the people who talk about how much they hate their FUE scars.

 

I have seen hundreds upon hundreds---possibly thousands---of people saying that a strip scar ruined their lives and made them desperate for corrective surgery. By contrast I have never seen *anyone* talk about how FUE ruined his life, disfigured him, or made him desire additional corrective surgery.

 

Now I fully understand (a) that modern strip procedures have better results than older ones; and (b) that strip procedures far outnumber FUE procedures, meaning that there will be more negative strip outcomes simply by force of the number of procedures. But even accounting for those factors, a strip scar is still much, much more likely to turn out badly than FUE scars. A cursory review of hair boards cannot yield any other conclusion.

 

Period.

 

This.

[Shadow of the EMpire State]

Here's one! http://www.hairrestorationnetwork.com/eve/168898-my-regretful-hair-transplant.html

If you don't look, you won't find them.

 

I've been on these boards forever. The point is, the strip-scarring complaints grossly outnumber any complaints about FUE. And when there *is* a problem, the severity of the problem is not even comparable.

Edited September 21, 2013 by Shadow of the EMpire State

[Nick153452]

To be fair also, a lot of the butchered scars I have seen have been from mill-like centers and from surgeons that need to be avoided for their botchy service. Truth be told, all they do is strip surgery.. My advice to anyone is, if you can get enough grafts to cover future and current hair loss, go FUE. If you're going to be a high NW patient who needs to have strip in order to address it, go strip. If I could have addressed my balding with FUE, I would have. However, I need far too many grafts, so I need to go the strip-FUE combo, with probably body hair mingled in there. That is, of course, assuming Dr. Mwamba can't cure baldness in the next few years

 

I agree with you Mickey about Drs performing small strip sessions. That should be an industry no-no, and hopefully it will be. I hear a lot of patients saying "The scar has never bothered me" which is great. Nevertheless, I believe it is much safer, to the point of necessary to go FUE on such cases.

 

I am not a OMG-STRIP-SURGERY-IS-FAR-SUPERIOR-TO-FUE person. To the contrary, I much prefer FUE as a surgical procedure. However, as I oulined in my previous comment, sometimes strip is necessary. And I know that you are a fair person Mickey. You always have the patients best interests in mind; that's why the forum loves you.

[xtatic5]

Does not even measure to the amount of patients coming on here seeking advice on how to repair their stretched strip scars, not even close. To do I have only seen a handful of people complaining about their FUE scars. I have lost count at the amount of people complaining about their strip scars. The guy in the thread wouldn't get looked at twice with his 6,000 graft depleted donor shaved that low. I wonder how he would go walking around with that buzz after a 6,000 graft strip procedure.

 

 

Before this devolves into a FUE vs strip debate, know that I am neither pro strip nor pro FUE. In fact, were it not for my curly hair I would have preferred FUE myself. My issue is when people make definitive statements such as "I have never seen *anyone* talk about how FUE ruined his life, disfigured him, or made him desire additional corrective surgery...Period." This can be misleading to new members and I consciously avoid making such one-sided remarks.

 

That said, I have also seen more disappointed strip patients than FUE patients. However, as Shadow pointed out, there may be statistical reasons for this such as the sheer number of strip procedures performed and that FUE procedures are relatively small. Most of the bad FUE reviews come from the larger sessions like the guy in the thread I posted.

 

As for your assessment of the guy in the thread, his feelings are all that matter. I probably wouldn't look twice either, but disappointment is disappointment. Had he gotten strip he could have filled it in with some FUE. It would have been, at worst, as spotty and his entire sides are now.

[Mickey85]

Before this devolves into a FUE vs strip debate, know that I am neither pro strip nor pro FUE. In fact, were it not for my curly hair I would have preferred FUE myself. My issue is when people make definitive statements such as "I have never seen *anyone* talk about how FUE ruined his life, disfigured him, or made him desire additional corrective surgery...Period." This can be misleading to new members and I consciously avoid making such one-sided remarks.

 

That said, I have also seen more disappointed strip patients than FUE patients. However, as Shadow pointed out, there may be statistical reasons for this such as the sheer number of strip procedures performed and that FUE procedures are relatively small. Most of the bad FUE reviews come from the larger sessions like the guy in the thread I posted.

 

As for your assessment of the guy in the thread, his feelings are all that matter. I probably wouldn't look twice either, but disappointment is disappointment. Had he gotten strip he could have filled it in with some FUE. It would have been, at worst, as spotty and his entire sides are now.

 

It's all cool champ, this thread is comparing strip to FUE anyway so I don't see how it could not become a discussion comparing both.

 

In regards to the guy in the thread. I would be equally(if not more) disappointed with the results. I think alot of his disappointment emanated from the bad hairline, poor yield(in areas) and uneven density moreso than the FUE scarring. I have a strip scar and let me tell you, I had a third of the grafts he had and my scar is MUCH more evident than his FUE scars at 6,000 grafts. But I don't expect people to feel sympathy for me at all as I am a low norwood with a good donor still and only one strip scar. I don't even feel sympathy for myself anymore. I feel much more sympathy for the others that have been taken advantage of by the whole cosmetic(not only hair related) industry.

[Mickey85]

To be fair also, a lot of the butchered scars I have seen have been from mill-like centers and from surgeons that need to be avoided for their botchy service. Truth be told, all they do is strip surgery.. My advice to anyone is, if you can get enough grafts to cover future and current hair loss, go FUE. If you're going to be a high NW patient who needs to have strip in order to address it, go strip. If I could have addressed my balding with FUE, I would have. However, I need far too many grafts, so I need to go the strip-FUE combo, with probably body hair mingled in there. That is, of course, assuming Dr. Mwamba can't cure baldness in the next few years

 

I agree with you Mickey about Drs performing small strip sessions. That should be an industry no-no, and hopefully it will be. I hear a lot of patients saying "The scar has never bothered me" which is great. Nevertheless, I believe it is much safer, to the point of necessary to go FUE on such cases.

 

I am not a OMG-STRIP-SURGERY-IS-FAR-SUPERIOR-TO-FUE person. To the contrary, I much prefer FUE as a surgical procedure. However, as I oulined in my previous comment, sometimes strip is necessary. And I know that you are a fair person Mickey. You always have the patients best interests in mind; that's why the forum loves you.

 

Thanks so much for the kind words, I really appreciate it.

[lucldh]

Did not expect such overwhelming responses. Thanks all.

 

Now, one thing that leaves me perplexed is whether I should go to FUT or FUE surgeon. An FUT surgeon will be more biased towards FUE and vice-versa.

[Nick153452]

It depends on your hair. I'm on my phone so I don't want to go back and lookat your balding class, family , donor supply etc. if your only needing about 4000 grafts over your life,I would go fue. Anything more,fut may be more appropriate.if I remember when I get back home from work I'll look into your case more and give you a better opinion for you

[lorenzo]

I assist Hasson and Wong. So I have seem many patients that have come from Italy to get repaired. At first it was mostly from FUT surgery but lately there are more coming in from FUE surgery as well. Lately a friend send me a picture of his beard FUE he received from Europe that not only didn't look right but he has noticeable scaring in the area in his face where it was removed.

Althought technique are important I feel the doctor you choose is even more important.

Are you going to say that Dr. Lorenzo FUE is the same as a doctor that just bought a Neograft machine and decided to start doing transplants. Is Dr. Shapiro FUT the same as a chain clinic that also offers FUT?

Absolutely not. I have seem in person the reality of both surgeries done by uncapable doctors and the horrible results. Whether its a big scar or wide holes with pitting its still not natural.

Good luck on your search.

[lucldh]

It depends on your hair. I'm on my phone so I don't want to go back and lookat your balding class, family , donor supply etc. if your only needing about 4000 grafts over your life,I would go fue. Anything more,fut may be more appropriate.if I remember when I get back home from work I'll look into your case more and give you a better opinion for you

 

Nick, I have not posted pics here. As soon as I do, I will let you know. I am probably advanced N2 or N3, but the issue is that my hair are thinning all over uniformly. If I cease to be medicines, I think that I will advance directly towards N5 or N6. So, yes, I will require around 8000 grafts keeping in mind my future HT needs.

[Nick153452]

Nick, I have not posted pics here. As soon as I do, I will let you know. I am probably advanced N2 or N3, but the issue is that my hair are thinning all over uniformly. If I cease to be medicines, I think that I will advance directly towards N5 or N6. So, yes, I will require around 8000 grafts keeping in mind my future HT needs.

 

 

I would say that you would benefit highly from FUT if your density and laxity allow for it. 8000 grafts is a lot of grafts.

[Noodles123]

A less than ideal extraction pattern can result in obviously thinned out areas.

 

It happened to me after only a 1500 graft FUE procedure. Luckily, the result up front is decent, but the extraction pattern which has clearly left a thinned out, sharply demarcated area in the back stops me from being completely happy with my procedure. This picture is with a # 3 hair clipper, and it already looks obvious.

 

The main reason I got FUE was to allow for shorter hair styles with no obvious signs of surgery. Now I have to wear my hair a little bit longer in the back anyway. Sometimes I wonder if I went with strip with a top clinic like H&W or Rahal, I could have gotten more hair for the same money since I really don't have the option to wear my hair super short as is...

Edited September 27, 2013 by blahblah1982

[Arrie]

Blahblah1982

Would you mind sharing who did your FUE procedure? Its not bad but it is slightly noticeable, Im just hoping that its not from a doc thats from here

[Mickey85]

A less than ideal extraction pattern can result in obviously thinned out areas.

 

It happened to me after only a 1500 graft FUE procedure. Luckily, the result up front is decent/good, but the extraction pattern which has clearly left a thinned out, sharply demarcated area in the back stops me from being completely happy with my procedure. This picture is with a # 3 hair clipper, and it already looks obvious.

 

The main reason I got FUE was to allow for shorter hair styles with no obvious signs of surgery. Now I have to wear my hair a little bit longer in the back anyway. Sometimes I wonder if I went with strip with a top clinic like H&W or Rahal, I could have gotten more hair for the same money since I really don't have the option to wear my hair super short as is...

 

It doesn't look too bad, but then again, we don't have the pre-op photos of the donor to compare. I'm not making excuses for FUE here, it is known FUE does thin out the donor. It is surprising that with only 1,500 grafts your donor thinned out so much though.. I personally can't shave down to under a 5 clipper because one section of my strip scar stretched to about 7mm(the worst part). I'm planning to have FUE grafting into the scar so I can shave down to a grade 3, I would be happy with that. Would it be ok if you told us who did your procedure?

[Noodles123]

Well thanks guys for being generous, but let's be real here, for 1500 grafts it's pretty thinned out. If the extractions were spread out more and less localized in one area, edges feathered out, and if it wasn't done in an obvious rectangular pattern, it would be much less noticeable. But I got all three working against me. Too many grafts taken from a small area, the periphery was not feathered out, and it should have been in a diffused pattern.

 

Honestly, it would have been easier to explain a longish scar in one area than an entire diffusely thinning area in an odd pattern that clearly shows it has been tampered with. Somewhat embarrassing each time I get my hair cut.

 

This is the conundrum I'm stuck in though, because if my hair is thinned out this much from just 1500 grafts, how could it withstand another procedure? And if I go the FUT route in the future to avoid more thinning of the donor, there's less density in the back to camouflage a strip scar. I would have a thinned out area, and a strip scar! Sheesh....

 

The point is that FUE scarring can be troubling. About the physician, I'm not really ready to name names yet, but I'm thinking of bringing this up to him because this is a legit concern. I think that at some point, I would have to do a SMP procedure to camouflage this obviously thinned area.

 

Right now, I look okay and hoping that I don't bald much more because of the aforementioned issues. I hope that I hold steady with the meds.

Edited September 27, 2013 by blahblah1982

[Noodles123]

Mickey, I don't even think you would need a pre-op photo, because you can just look at the hair right next to the donor area. There is a clear mismatch in density.

[Mickey85]

Was the extraction pattern taken from the sides and the rear of the head of just the rear? Looks like just the rear. It looks as it stops very abruptly. Whoever did the work should not be practicing FUE(I think I know who it is). It is concerning indeed, I would not be happy with this outcome.

[Noodles123]

Mickey, the extraction pattern is exactly how it appears. You described it exactly. On one side it stops abruptly in that pattern. Nothing was extracted from the sides, and it was all concentrated on the back. The part that baffles me is that one side is passable, but the right side (shown in the pictures) was not done well.

 

With a strip scar, you can make a case for the scar being less than optimal due to physiology. This is not that situation. This was clearly not a well thought out extraction pattern. I realize this will cause issues down the road if I get further work, be it FUE or FUT. Either option would be problematic. You can imagine how I feel a little stuck.

 

To the original poster though, whether it be FUE or FUT go to the best and your risks will be minimized. Everything has it's risks but you want to make calculated risks.

Edited September 28, 2013 by blahblah1982

[scar5]

...This was clearly not a well thought out extraction pattern.

... whether it be FUE or FUT go to the best and your risks will be minimized.

 

 

Poor FUE extraction pattern is clearly the fault of the doc.

It has nothing to do with the risks inherent in FUE.

 

A strip scar, continued hair-loss, poor or adverse response to meds down the road is unforeseen perfect storm, an inherent risk unique to the strip procedure.

 

the compromise, which I have lived for twenty years (not short enough to be cool (strip scar), not long enough to be attractive (balding and patchy top) continuously contemplating a shave down with scars, only to be deceived by my own willfullness and to retreat each time.. I truly hope they'll stop this strip scar caper soon.

 

We shouldn't blame docs for the choice between strip and FUE anymore, if we make it to these boards, we should blame ourselves. Doc's (as a collective group) will sell you roses, they'll sell you daffodils. It's up to us.

 

And the 'go with the best and you'll be in good hands' argument is not valid, tells us nothing, not falsifiable. The technical aspects of HT are easy (in 90% of cases) , its the modalities (strip, FUE, tools, protocols, assumptions, etc) that make or break the deal IMO.