Will doctors be doing FUT anymore in five years?

[1978matt]

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

 

That guy had a high density donor area. Your average person has about 70 follicular units per square cm and 2.2 hairs per follicular unit. For arguments sake the guy above probably had in the region of 90 and 2.6 respectively.

 

If that's the case then the percentage difference between the average density and high density scenario is 52%. So the high density guy could donate one third of all his hairs and still have as many left as the average density guy before he even had a transplant!

[glocktop]

As Joetronic said, 30% of Hasson and Wong's business are repair sessions. Skill of surgeon is paramount, no matter if which technique, FUE or FUT, is chosen. Although I am willing to bet there are a lot more strip repairs than FUE repairs.

 

All other variables being equal, I think recovery time will be a key selling point for many prospective patients. If you work in a professional environment, there's just no way to hide a FUT procedure post op. I've been in a very large meeting with a guy who just had a strip procedure done in the last ten days or so, with his shiny recipient area and angry pink strip scar wrapping around the shaved back back of his head with longer hair on top. It was awkward for me just to look at him, I couldn't imagine what he was going through. I knew what was going on, but I think most people did not. Thats when I started doing the math on how I could disappear for six weeks or more when I got a strip procedure, but I never could find a solution for that.

I'm personally relieved that after researching, saving, and waiting for the last six years, that high quality FUE options are plentiful. I'm more than willing to do two FUEs in 2 years to equal the results of one mega strip if my worst case scenario is the guys at work wonder if I got a sunburn on my forehead/recipient area.

[delancey]

The dilemma here is two-fold. Firstly, most patients have below average hair characteristics, which means that they need as follicular units as possible transplanted. Surely, there are some patients with excellent characteristics, and these are always showcased by the best clinics. However, most guys have fine hair with average characteristics. These are usually not showcased by clinics. Start paying attention to the hair characteristics of each patient showcased here and tell me how many fine haired patients you see!

 

Secondly, as long as donor hair in finite, we will continue to see strip surgeries being performed. And why shouldn't they? The true art of a business man is holding on to his product as long as it's good enough for the public to purchase; once there is a superior product on the market, the business will adapt and change or fail. FUE is superior for some patients with limited hair loss (I would argue NW4 or less for most cases) AND excellent hair characteristics. We don't really see many Norwood 6 patients being showcased WITH medium fine, straight hair. Once donor regeneration is a reality, strip will become obsolete. However, I am not impressed by how long it takes this industry to adapt and come up with new technology. I am not holding my breath. Point is: large balding area + average hair characteristics = FUT + FUE combo. Otherwise you will have to compromise. Doctors will continue to perform FUT.

 

Perhaps laxity can be improved upon in the future, allowing higher Norwoods to get more grafts?

[gillenator]

I think the best HT surgeons are ones that can do both/either technique with an extreme high level of expertise.

 

I have always said and will probably continue to state that both techniques have their place. And there really are many variables to consider in the final equation, many that were already mentioned, i.e. density, hair caliber, hair style, degree of loss, etc. Obviously guys with mild degrees of hair loss and low classes of MPB in their family history make excellent FUE candidates.

 

But here's the reality of the economic side of things. More than anything else, money drives the industry as well as the individual's decision. Give this some thought for a moment.

 

More doctors do not make a move to learn FUE because they know FUHT, are better at FUHT, and spend little time in the OR. Not all, but the majority. FUE is more doctor intensive and unless the manual skill is mastered, takes far more time per procedure. With FUHT, techs do the dissection, graft placement, etc.

 

In addition, as long as FUHT remains at an average cost of $3.50 - $4.00 per graft, then FUHT is going to be around. Think about it. Let's say one of two things occur in the near future. Either FUHT pricing goes up roughly $2.00 per graft to an average of $6.00, "or" FUE comes down to an average of $6.00 per graft. FUHT will never go up in pricing because if it does, it will bring far more patients to the FUE table IMHO.

 

In many cases, right or wrong, the bottom line is the cost to the patient which drives the final decision. There is a big disparity between FUHT and FUE. And in many larger FUHT cases, the more grafts over 3000, the lower the graft price. So in the end, ask yourself this question, "If the price per graft was the same whether FUHT or FUE, how many individuals would choose FUE?"

 

What would really change the shift more than anything is two-fold. More doctors learning FUE with proficiency and the results to prove it, "and" if the average FUE price came down to $6.00 per graft or lower.

 

There will always be guys like myself who do not care about the strip scar because they will never wear their hair short. These are guys who also heal well and do not have donor zone thinning in their family history.

 

And the guys who have below average donor densities with advanced classes of MPB, need a lot of work, would have a higher propensity to have post-op thinned out donors with FUE, will still want FUHT.

 

I still think there will be a more gradual shift to FUE in the years to come. It seems more and more men want the option to wear a buzzed hair style.

 

In the end, doctor skill and price is what drives the final decision IMHO.

[xtatic5]

Will someone please think of the [curly-haired] children!

 

I understand that this forum is dominated by straight/wavy-haired folk, but don't forget that there are plenty of curly-haired people for whom FUE is more of a risky proposition. Higher transection rates and larger punches mean lower yield and hole-punch scarring.

[KO]

While I am pro-FUE, I do hope that strip does not go the way of the dodo. I think if you have a stable pattern, and want to move a lot of hair in one sitting, strip cannot be beaten.

 

What I would like to see though is doctors to continue using FUE for large cases. Currently, Lorenzo is the only one doing this, and what I think will also be good is seeing strip + FUE combos for larger Norwoods, which I think will be quite good.