Will doctors be doing FUT anymore in five years?

[olmert]

I foresee a day when no one does FUT anymore. If the best FUE docs currently get FUT level yield, then eventually all FUE docs will get FUT level yield. And these second tier FUE docs will charge Dr. Bhatti level FUE prices, which isn't much more than FUT. With price and yield barely favoring FUT, there will be almost no reason to do it anymore.

 

None of the remaining reasons for FUT, including doing more grafts at once, will justify the scar, tightness, and greater trauma from FUT.

 

Cloning might become an option, but it will be expensive in the beginning, so FUE will remain competing with it. Either way, FUT is out.

 

This doesn't mean every one who already got FUT made a mistake. Yield used to be worse with FUE, even with with the best docs. And not everyone was better off waiting for technology to improve to its current state. Also, the higher FUE cost might not have been justified for everyone.

[JimmyNeutron]

When I was a little bit younger than I am now, like around 18-23 years old, I was all for FUT. I was afraid of FUE and its "lower yield" plus the price kept me far away from it, at $25-35k for a 2500-3500 session, no way I could afford it, that's like a professional's salary after taxes. Maybe a lot of you here make more than that, seeing as how you can afford these doctors, but I am only a college student.

 

Now at 25 and a lot more research done, I was able to get a very cheap FUE and IMO very good so far and at 13 days post op my head looks normal, like nothing was done to it, with a buzz cut, although the hairs are falling now. It feels like it is the best thing i've done in my life and I still have a long way to go to see results but i'm positive it will all be good. I look back and I can't believe I considered FUT, and eliminating the option of shaving my head. With FUE I can shave my head and look normal.

[Transhair]

I plan to grow my hair out longer and never go for buzz/undercut hairstyles, so I'm fine with the FUT scar.

I guess it all depends on your future plans. If I somehow went full bald, I'd wear wigs because having a shaved head look is 100% not an option for me.

[Paulygon]

I never looked good with a shaved head.. so FUE was never a big deal to me.

I figure even if I were to go bald, I'd let nature take its course MPB-style.. so the FUT scar really isn't a detriment for me.

I'm all for the progress of tech in Hair Restoration, but as it stands, FUT is an excellent procedure, really not as painful as people make it to be in their minds (I was surprised at how painless it was for me, personally; of course I'm sure the drugs helped).

[olmert]

FUT is dead and has at most 10 years left. The only candidates for FUT will be those who don't care about a scar, and there aren't enough of those people.

 

When an industry is young, there is more opportunity for a provider to stand out. In the beginning, plumbing was a real skill. The best plumber gave you substantially more value than the average plumber and could charge a premium. As the industry matured, there were fewer opportunities for the best plumber to stand out. The best practices permeate and become known to the worst provider. The best become less and less distinguishable from the average. So today, the best plumber and even the best diamond cutter can't give you a much better product than an average one and cannot charge much of a premium.

 

Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices.

 

FUE is also more mature, and just starting to become mainstream option and take over market share from FUT.

 

So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor.

 

To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss.

 

But Dr. Hasson and all FUT experts are in a tougher situation than they were a few years ago. This even Jotronic will concede. And the FUE experts like Umar are in a better situation than they used to be in. As time goes by, things will get tougher for Hasson and easier for Umar. The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's.

 

Ultimately, the same process will happen to Umar once cloning starts.

 

You might ask why Hasson does not simply go FUE. It is because his expertise is all in FUT, and he can make more by sticking with it than by learning FUE from scratch.

[Since21]

I'm a little more than 5 months post-op (FUT) and got my haircut today for the first time in a couple of months. My hairstylist couldn't find my scar no matter how hard he tried. So he cropped my hair pretty close. Still couldn't find it. Like Paulygon, shaving my head was never an option for me, so I was ultimately more concerned with results when it came to choosing my doctor. I think I chose one of the best when it comes to results and donor incisions. He could have harvested the hairs from my tuchus for all I care as long as he gave me a full, natural head of hair.

 

As has been stated many times on here, both FUE and FUT have their place. I'm pro-great result, by whatever means it's accomplished. If the patient is happy in the end, that's all that matters. That said, I would be the first to educate someone on what to expect with FUT.

[1978matt]

FUT is dead and has at most 10 years left. The only candidates for FUT will be those who don't care about a scar, and there aren't enough of those people.

 

 

I couldn't agree less:D. Well maybe there are some valid point above, but unfortunately for most advanced baldness classes (Norwood 4 or above) it is not necessarily a straight choice between FUT or FUE.

 

I know what people will be saying: "But what about Lorenzo's results?" Well people should really take a good look at the patients donor areas and graft breakdown and ask themselves why all his posted results have an abundance of 3, 4 and sometime 5 haired follicular units. It's not a coincidence. If you don't have similar donor to that then taking more than 5000 FUE from it is going to leave the back of your head looking decidedly unnatural.

 

Ask all the composite guys: Bisanga, Feriduni, Shapiro, Diep and they will all tell you same.

 

The only way FUT will go is once hair cloning has been perfected.

[olmert]

If you don't have similar donor to that then taking more than 5000 FUE from it is going to leave the back of your head looking decidedly unnatural

 

Most doctors can take more grafts through FUT (over FUE) in one session. (Even this is becoming less true with Bhatti doing two day FUE sessions of 5K grafts.)

 

Anyway, what makes you say you can get more total lifetime grafts with FUT than what you can get in multiple FUE sessions?

[1978matt]

 

Anyway, what makes you say you can get more total lifetime grafts with FUT than what you can get in multiple FUE sessions?

 

Some people will get more grafts from one technique over the other. For example, some of those Lorenzo patients could have very tight scalps for all we know but the doc manages to get over 8,000 grafts from their donor area using FUE. Some of them may actually get less grafts from FUT. Lorenzo's not actually making 10,000 extractions at the back of the head, he's taking out a lot of 3s and 4s and splitting some of them into 1s and 2s (not for financial gain but for purposes of creating a hairline and getting the best coverage).

 

The problem is if you don't have all those 3s and 4s the doc is limited to extracting lots of 1s and 2s. Some people who want FUE will have to exhaust their donors so much in order to get enough 'hair' to such an extent it will not look natural when shaved at low grades.

 

Of course FUT has its fundamental disadvantage of not being able to shave close, but on the other hand you can take 4000+ grafts in some people without any noticeable density difference at the back of the head, plus the potential to take another 1,500FUT+ and possibly some moderate FUE.

 

So in summary what I am saying is that it is not that clear cut as to which route is best. Depends on the individual, donor density, laxity, level of eventual baldness and overall goals.

[olmert]

What about the average person, someone with average laxity/density and every thing else? Which technique gives you more lifetime donors for such person?

 

Why do you suggest FUE after FUT? Are you saying you normally will reach your FUT maximum and then still be able to get some more donors with FUE?

[Rootz]

Of course FUT has its fundamental disadvantage of not being able to shave close, but on the other hand you can take 4000+ grafts in some people without any noticeable density difference at the back of the head

.

 

To comment on this one part, I don't believe there is a noticeable density difference in the donor area after FUE from a reputable doctor. From the pictures and videos I've seen, in the final result I don't see any indication hairs are extracted.

 

But it is ironic you list an advantage of FUT as being able to take 4000+ grafts without any noticeable density difference, when you actually get a big scar which is typically very noticeable unless you hide it with long hair.

[1978matt]

>What about the average person, someone with average laxity/density and every thing else? Which technique gives you more lifetime donors for such person?

 

That's too vague a description to be able to generalise. If you added the words 'unlikely to proceed beyond NW4' I'd probably say they could do either FUT or FUE.

 

If you are only a NW4 but could end up a NW6-7 you run the risk of extracting grafts that are not safe so FUT may be the better option.

 

Of course there are exceptions, as demonstrated by Lorenzo.

 

>Why do you suggest FUE after FUT? Are you saying you normally will reach your FUT maximum and then still be able to get some more donors with FUE?

 

You can chose to extract hairs away from the scar in order to avoid it become more visible.

 

Some people have done the opposite: had FUE but left a 'strip area' untouched in case they need it in the future.

[SADbutTRUE]

Only time will tell, but i say fut will still be around, price wise and graft survival rates are two reasons, but i believe if you choose either strip or fue, your best chance to getting a good result is by going to a top doc,

[1978matt]

.

To comment on this one part, I don't believe there is a noticeable density difference in the donor area after FUE from a reputable doctor. From the pictures and videos I've seen, in the final result I don't see any indication hairs are extracted.

 

 

Yes but what is their donor situation? Was this their first procedure? Do they have lots of multi haired follicular units? How many grafts did they have?

 

The problem is not usually the first 4000FUE grafts, it's when you try to go in for a second pass because your hairloss has increased....that is unless, you have exceptional donor density which not everyone has.

 

.

But it is ironic you list an advantage of FUT as being able to take 4000+ grafts without any noticeable density difference, when you actually get a big scar which is typically very noticeable unless you hide it with long hair.

 

My hair isn't particularly long and I think I will eventually be able to go to a grade 3 without the scar visible. It depends how you define long hair. Grade 3 is quite short in my opinion.

 

The whole idea of going with FUE is to keep a short haircut but if you overharvest this objective is lost. There ends up being too much hair missing whether it is long or short, for it to look natural.

[Rootz]

I think it's much easier to control harvesting in FUE than the scar from FUT. To prevent FUE over harvesting, you basically just go to a high end, reputable FUE doctor. Such a doctor is not going to extract hairs unless you have the donor available. If you're out of FUE donor hair, you still have the option of going for body hair or FUT. And I'm not convinced once FUE donor is exhausted that FUT is really any worse of a choice. Having ~25% less hair along the edges of the strip area shouldn't make the scar much more apparent. I say this because as long as the hair is long enough to sufficiently go over the gap of the FUT scar and blend in with the hair on the other side, it's hidden. So even if there's 25% less hair there along the scar, it is still going to be covered because the length is there. Right?

 

On the other hand, you have much less control on how well your FUT scar will turn out. No FUT doctor can gaurantee a great scar... and if it does turn out great, you still need to hide it. And then of course, what if it doesn't? If your body likes to produce extra collagen or your skin laxity is poor, it will not turn out pretty.

[Spanker]

You are correct, scaring is always a possibility, but I don't think most people know what a fue donor looks like that's had 5000 grafts pulled from it. The vast majority are not going to be able to pull off a grade one and some a grade two without visible scaring showing or and obvious difference in density. It's not nearly as scarless as people sometimes act. Especially after mega sessions.

 

Your point about Hasson learning from scratch isn't accurate. When people talk about fue, sometimes they forget that they are talking about a small component of the surgery. The artistry and skill of putting them back in its not wasted and gone when a doctor moves to FUE.

 

You can get more quality grafts because you are taking the vast majority of your best grafts with fut vs about thirty percent with fue. You are also getting more because you are getting 100 percent of a certain sized area and still able to get about 30 percent of the rest later. The point is, you won't get your maximum harvest without a strip scar.

 

I do believe that in another 5 years that you won't see people without good laxity or cases smaller that say, 3000 grafts getting fut. Also, in another 5 to 10 years I think that there will be some surprised fue patients thinning more than they expected because in the search to make fue equal to fut in terms of graft availability we are seeing doctors stretch the limits on what the safe donor area is.

 

If I had a normal round head, I would have probably went for fue, but since I don't ever plan on cutting it that sort anymore, it's not an issue for me, however I do think that it's great that people have more choices with fue and there will probably come a time when fue is always the first choice and through a master plan makes strip a viable option in the future, especially for younger guys not needing huge cases at the time.

 

Hopefully by then, fue will be the next procedure that is on its way out and undermining the grafts or cloning will be the next big thing.

[olmert]

So if my hair loss will ultimately make me a norwood V-A or VI, if my goal is to max out the number of grafts, and if I have average density with only 7500 donors, my best bet is to get FUT 2 or 3 times, and then get one final FUE? And no matter how much FUE technology will advance, this goal of maximum grafts is served better with FUT than with FUE alone?

Edited April 25, 2014 by olmert
typo

[Jotronic]

Not sure why but you posted twice in two threads with the same post so I'll respond in both threads as well.

 

Olmert,

 

Quote:

Five years ago FUT was less mature as an industry. The best FUT docs were substantially better than the worst FUT docs and charged a substantial premium. Today, the technology is more mature, and the difference between the best and average FUT docs is less; so is the difference in their prices.

Five years ago, in 2009, FUT was already nearly 20 years old so while it was less mature than it is today it was still twice as mature as FUE is today. If you think that there is less difference between the best FUT docs and the rest of the field you are sadly, sadly mistaken. 30% of our business, and I'm certain that of Shapiro(s), Rahal, Feller, Konior, etc, is repair from the same class of surgeons that have always cared more about your dollar than doing the best job they can. That is a fact and I see it all the time.

 

Quote:

FUE is also more mature, and just starting to become mainstream option and take over market share from FUT.

No question it is growing but it is has a way to go before it overtakes FUT as the dominant form of hair restoration.

 

Quote:

So why did Hasson choose to develop his skill in the doomed field of FUT? Five and ten years ago, there were very good reasons for doctors like Hasson to develop expertise in FUT instead of FUE. FUT had more advantages over FUE (including better yield and much lower price) back then. I would wager that 5 years ago, Hasson was making more per hour than Dr. Umar. Dr. Umar, by opting to develop expertise in FUE, essentially took an immediate loss; the trade off was that as FUE matured, his product would make greater improvements than FUT would, and his profits would rise relative to Dr. Hasson's. This is exactly what is happening. Hasson is married to a diminishing industry and doomed to lower and lower the premium he charges over the average doctor.

 

To be sure, Dr. Hasson might make more lifetime profits than Dr. Umar. This would be because Hasson got an early start. Perhaps Umar's advantage and superior profit today and tomorrow will not prove so great as to overcome his initial loss.

Two reasons why this entire argument is moot.

1. Dr. Hasson started developing his skills almost 20 years ago, not five or ten.

 

2. You fail to understand that with FUE the profits are far higher especially when you are talking about an FUE doctor that routinely pushes several to tens of thousands of grafts (scalp and BHT) for roughly double the price of FUT. With our clinic each doctor has about 12 technicians most with close to ten years experience, some far more, and they all get paid very well to so they don't leave. With an average FUE clinic you need maybe two technicians and a receptionist. Double the cost per graft and 1/5 of the staff. Do the math.

 

Quote:

The premium Hasson charges over the typical doctor will go down and essentially be taken by the Dr. Umar's.

What premium do you refer to? If a patient gets 4000 grafts the fee is 4.00 per graft. It used to be a bit lower but about 7 years ago the price went up and it's still a bargain.

[Spanker]

And no matter how much FUE technology will advance, this goal of maximum grafts is served better with FUT than with FUE alone?

 

Better served with both. Unless fue technology advances in a way that it can take 90 percent or greater a few centimeters wide and 30 centimeters long.

[Rootz]

You are correct, scaring is always a possibility, but I don't think most people know what a fue donor looks like that's had 5000 grafts pulled from it. The vast majority are not going to be able to pull off a grade one and some a grade two without visible scaring showing or and obvious difference in density. It's not nearly as scarless as people sometimes act. Especially after mega sessions.

 

Skip to 3:00 minutes in the video below. They comb through his short hair, then shave it off. At this point he has had 8,000 grafts pulled from FUE. I cannot see or detect the "lower density" and "scarring". That's like a grade 1.

 

In FUE, if density isn't visibly lower after 2000-3000 grafts are pulled how does it make sense 5000+ grafts would be different? The density is the same, it's just a larger area.

 

Norwood 5 - 6 - 7 - 10666 FU's. Hair Transplant by FUE Technique. Advanced Alopecia. Shaved HT. Injertocapilar.com. 50/2008

[Mickey85]

I think there will still be clinics performing strip in the next 5 years. Not every individual around the world is privy to the benefits of FUE and some are put off by its disadvantages like cost and the inability to perform a big megasession(ie 5,000+ grafts in one sitting). Alot of people just Google hair surgeons around their vicinity and book with them after a consult because they just want more hair and might not know about FUE. Some individuals will be more suited to strip(if they have poor density but high laxity as well as alot of area to cover. In North America at least, strip is still the dominant method, that is changing quite fast however, but I don't see strip becoming totally extinct within the next 5 years. In Europe, I would venture to say that FUE is the dominant procedure with many surgeons(Erdogan, Hakan, Lorenzo, De Reys, Reddy) ditching strip altogether and others(Feriduni, Bisanga, Mwamba, Maras) using FUE more often than strip. I do see FUE as becoming the dominant method worldwide in the next 5 years however. Blake said that 40% of procedures were FUE in 2013(he can reiterate this) and the trend is climbing rapidly until it reaches an equilibrium. What is clear is that FUE is on the up and up and more people are after FUE.

[scar5]

Strip and male pattern baldness are only 'fair weather friends" in the long term, and a young man losing his hair would want options for his future with or without meds, so if market forces do their thing, FUE will wipe strip out, except there is another half of the human race called woman, and here I think is where strip will keep going and there will be some spill over for men.

 

For the longest time strip have been able to scare people away from FUE by pointing to FUE scarring. That excuse is wearing away, day by day. Many a strip patient will boast of their 'no worries' with the strip scar issue, but their follicles will not listen and time will tell.

 

FUE started in 1989 and was shut out as an evil and sinister con for ten years, then appropriated and boxed into an inconsequential ancillary to strip for another ten. Now The cat is truly out of the box and it ain't going back in.

 

I think woman will keep the demand for strip strong.

[JayWalker]

Bad scars can come from either procedure, I personally dont suit or want a shaved head, so FUE was never really a consideration for me.

[TommyLucchese]

Many a strip patient will boast of their 'no worries' with the strip scar issue, but their follicles will not listen and time will tell.

 

I fear this could be me in the long run.

[GBU]

I would not do FUE even if it were free .I can't shave my head . I don't wear my hair super short . The cost is not worth what you get for the money for me . I did great with strip and most guys are probably in a similar position as me .