Scar--FUT & FUE

[quackhairny]

First off, I have to say this site has been incredibly helpful and is a true resource. I have had recession and thinning for years. Am on 1.5mg daily of Finasteride and have been for 15 years. It has helped but lately (last three years), feel like the battle is being lost. Therefore, I think transplant. My decision to do a transplant (have the dr. figured out) is still worrisome because I fear having it done, all the hair behind my transplanted space falling out, and having the need to ultimately shave my head and lo and behold I have this massive scar there for people to look at (especially in church!)...How do people who have had a transplant rationalize this last step before they take the plunge and if you do go fut should you expect that you will never be able to shave your head without someone completely noticing what has been done?

Many thanks for input. Really need that last push to cross the HT Finish line.

[TakingThePlunge]

quackhairny,

 

I'm sorry to hear that finasteride is no longer as effective for you as it once was. Medical hair loss treatments like Propecia (finasteride) and Rogaine (minoxidil) can help prolong the inevitable but, as we all know, there is no hair loss cure.

 

You haven't stated your age and, of course, that will play a role in evaluating your candidacy for hair transplant surgery. However, given that you've been on finasteride for many years andhave recently begun to see increased hair loss, you have a valid concern. Photos would help provide you with more realistic advice.

 

To answer you question, anyone planning to undergo strip surgery must come to terms with the fact that they will never again be able to shave their head bald without exposing the scar. Just how short you may be able to cut your hair after follicular unit strip surgery depends upon a number of factors like healing, skin color, physician skill, etc. In order to find out you just have to do it. There is really no accurate predictor. Some guys can get away with a #2 clip. Other guys need a #3 or #4 to hide the scar.

 

It's important to note that even follicular unit extraction (FUE) patients are not guaranteed the option to shave their heads in the future with no visible signs of scarring. There is simply no such thing as scarless surgery. But, the potential is certainly there in contrast to strip.

 

Back to the topic of hair growth drugs, have you considered talking to your doctor about Avodart (dutasteride)? It may be more difficult to get a prescription for it since it's not FDA approved for the treatment of androgenic alopecia but, while Propecia (finasteride) only inhibits the Type II isoform of 5-alpha reductase, Avodart (dutasteride) blocks both Type I and Type II, potentially making it a more effective treatment for hair loss. Some guys have been known to make the switch when finasteride is no longer doing the job.

Edited May 19, 2015 by David - Moderator

[TakingThePlunge]

I meant to add in the above response that, depending upon your age, current degree of hair loss, eventual Norwood Scale class and individual hair restoration goals, it may be possible to find a balance that will look natural over your lifetime and that you'll be happy with aesthetically. You mentioned having your hair transplant surgeon picked out already. Have you had a consultation yet?

[quackhairny]

Thanks David for your in depth response. I am 46 years old. I have looked into Avodart but have been told by my general internist to stay away from it. He is also not very fond of the propecia but I continue. I really haven't had a whole lot of side effects with the propecia to speak of, except slightly decreased libido (but may attribute that to aging as well!) I have had multiple consultations with some great surgeons, all the way from the east coast to the west coast, in my due diligence. The general feel was "I will not ultimately go completely bald" and some have even said I shouldn't obsess about it right now and consider something in the future. But, I must say, what I see, day in and day out makes me question otherwise. The general creeping back of the hairline and oh crap moments each week, as I see the hairline going back further and further and thinning all over. The one thing I have yet to see effected much yet at all is the crown. The surgeon plan was FUT and mainly into the recessed areas/temporal and about 3000 grafts.

[TakingThePlunge]

Thanks for shining a little more light on your case. Looks like you've covered all your bases. If you're conservative and if your doctor creates a plan that takes in to account the potential for future hair loss, I don't see why you couldn't get a result that would look natural as you age.

 

As I said before, unless you go FUE (the still there is no guarantee) you'll need to take shaving off the table.

[Uk86]

Scaring is the main thing holding me back from surgery. I worry if I lose so much hair on top I will not have enough donor to cover it, but can't shave it either because of the scaring! once you take the plunge there's no going back...

[hadenough2014]

Quack - yes, come to grips with never shaving your head if you go FUT. I would also add that you may have to come to grips with the idea of keeping your hair even a little longer as you get older as well. My father (72) has his hair trimmed way down to about a 2 on the clipper, and I see with his grey hair and how much it natural thins all over that I could not keep my hair at that length when I am his age without my scar probably being visible. So I came to grips before I did the FUT that I would need to keep my hair a little longer for life - probably no shorter than a 4 when I get up there in years.

 

When I go to church on Sunday (the place I see the most elderly people), I can see many older folks (75+) who have longer hair (5+ on the clipper) and it looks good, whether they are balding or not. So I came to grips with not shaving my head too close and went with FUT for many reasons that suited me best.

[HairJo]

I guess it comes down to what you care about what you look like now in your younger years vs when you get older. I personally would rather look great now while I can still enjoy myself who knows what the future brings and so what if I can't shave my head I will just wear it longer or date an older woman with bad eye sight

[KO]

My opinion is that FUT scars are less noticeable to other people than they are to you. One of the bosses in our department has an old HT, he has a strip scar and poor scraggly growth on top of his NW6 head. That said I only notice the scar when I intentionally stare at the back of his head.

 

I think the dead giveaway to an HT is not the FUT scar, but poor sparse and pluggy growth on top of a shiny bald head. The solution to that is finasteride though, which you are on.

 

So I think the more important question is how is the hair on top going to look like?

[BUSA]

the FUT scar is a reality no matter wat others tell u. patients post somthn monthly looking for solutions to repair or camouflage their FUT scar. save urself the misery and regret and go FUE.

 

I don't care how thin the scar is and it aint that thin even with a good one but ull never b able to shave ur head down without seeing it. who wants a scar from ear to ear on the back of their head? mite look great for a while but if ur hair thins it WILL become very noticeable! sorry but those are the hard facts.....

[voxman]

Here's a hard fact for ya - when I am dead and lying in my coffin, my loved ones and friends will see a nice hairline and the gorgeous face I see everyday - not the scar in the back of my long haired head. I got other scars anyway from a year in SEA in 1969.

[HairJo]

Great response I couldn't agree more

[BUSA]

Here's a hard fact for ya - when I am dead and lying in my coffin, my loved ones and friends will see a nice hairline and the gorgeous face I see everyday - not the scar in the back of my long haired head. I got other scars anyway from a year in SEA in 1969.

maybe tru but not many care wat they look like wen their dead.... its the living years that most ppl are concerned with..... not everyone can have long hair and wen u age u will lose more of it will thin out and therefore make the scar very noticeable for some.

 

just not a risk worth taking wen FUE can yield 7000-8000 grafts these days with ZERO chance of visible scaring and physiology plays no role in FUE. and the yield is nearly identical no matter wat the pro FUT guys claim. the same cannot be said for FUT which is why its a roll of the dice for many.

 

like I've said many times before you will NEVER see someone coming up here to have their FUE transplant fixed by an FUT doctor will ya?

[HairJo]

I disagree I'm sure plenty of people had FUE and were not happy with it and went to a strip HT for more density and correction.

[voxman]

maybe tru but not many care wat they look like wen their dead.... its the living years that most ppl are concerned with..... not everyone can have long hair and wen u age u will lose more of it will thin out and therefore make the scar very noticeable for some.

 

 

BUSA, I dig your posts and respect your take - you're a great guy - but really, in the end a guy has got to make his mind up, take a leap of faith and live wit it.

 

It a crap shoot either way, ain't it? A lot of FUE guys are just now coming on complaining about this n that. Even the most studied, researched and well armed and prepared patient can get an F'ed up HT if some facet of his own physiology throws him a curve.

 

Frankly ,I think we're all crazy.

[JohnArbuckle]

I think the dead giveaway to an HT is not the FUT scar, but poor sparse and pluggy growth on top of a shiny bald head. The solution to that is finasteride though, which you are on.

 

So I think the more important question is how is the hair on top going to look like?

 

Well put. A shitty recipient area can be as visually disconcerting as a linear donor scar.

[HairJo]

All the finesteride in the world cannot replace or even come close to a great FUT surgery . I can't believe so many people out there still think it's pluggy that was about 20 years ago or more. Or maybe if you go to someone who does HT as a side job . But a qualified HT doctor will give you the best results. Plugs are out people!!!!!!! they are tiny grafts now look at the picture especially Feller and Bloxham and then you decide do some research you'll be surprised on how great these HT's can look. Good luck whatever you chose .I'm an FUT believer.