FUT or FUE for Norwood 6?

[delancey]

I have a question concerning whether the landscape for FUE is changing and thus becoming more popular and acceptable for higher Norwood patients to consider FUE for full restoration. I have been following the forums now since October, and when I first joined, I was instantly set on FUT, for this was the conventional method for higher Norwood cases.

 

I have since consulted with one highly recommended Doctor who essentially evaluated that my donor density is 70/90/70. I am a Norwood 5 going on 6. I have about 6500 available via FUT, and 1500-2000 grafts available via the FUE method. When I asked the Doctor about only using the FUE method, he did not recommend it, saying that I would only have around 4000 grafts available via the FUE method. This doctor is one of the best doctors FUE doctors in the world. I respect his opinion a lot.

 

Recently, I have seen a lot of results of Norwood 5 and 6 patients being fully restored via FUE only, using anywhere between 7,000 and 10,000 grafts. One common characteristic that these patients usually have in common is that they are of Turkish or Spanish origin, meaning that they have darker and thicker hair, which appears to create a better result (better coverage for the same amount of grafts). I follow the forums daily, and this appears to be a trend; Norwood 5-6 patients getting fully restored by doctors such as Dr. Doganay and Dr. Lorenzo. Once again, though, these patients usually have dark thick hair; I have blonde, medium-fine hair.

 

So I have been watching these results appear frequently now, where Norwood 5-6 patients are being fully restored, and therefore am wondering whether I should go for the FUE option too. It makes me wonder whether these are unique cases, with very strong donor, or if I can also benefit from the advancements in FUE? The benefit, of course, is not having a strip scar. I am a young guy, age 28, and would like to avoid having a strip scar if at all possible (so that I can wear a buzz cut of 3 mm in the future, should I need it).

 

However, if there is one thing that these forums have engrained into my mind it is to have realistic expectations. The math simply illustrates that at least 7000 grafts are needed assuming an average area of 200 cm2, with 4000 grafts used for the first 100 cm2, and 3000 grafts used for crown. I am not after my childhood hair line; quite to the contrary, I am willing to compromise and have a conservative hair line, and thinner crown, especially if I go the FUE route.

 

I also know that some doctors are more conservative than others, only recommending that 25% of grafts be extracted from the donor area. I assume that doctors such as Dr. Lorenzo take more than 25% in order to reach 7,000-10,000 grafts. I consulted with two other doctors online, whereof one of them seemed confident that I can get 7000-7500 grafts via FUE.

 

 

Do you believe that FUE is becoming more popular for higher Norwoods?

 

Based on my pictures, how many grafts do you believe I can get via FUE?

 

How many FUE grafts should be done per day? In total over one session?

 

Please name the top 5 FUE surgeons in the world. Travel is not a problem.

 

 

Thanks guys.