Benefits of Combining FUT and FUE

[Bill - Seemiller]

Most discussion topics that include both FUT/strip and FUE in the subject line pin both procedures up against each other in some sort of competition. And while I'm sure this topic possesses the potential to go that route, I wanted to say something important.

 

Both FUT and FUE are excellent procedures that come with their own list of potential advantages and disadvantages. And while most seem to concern themselves with which one is "better" in terms of producing optimal scarring and growth yield (both of which typically produce difference answers), there's a much more important question that those with advanced balding should be asking. The question is this:

 

How can I move the most amount of hair from the donor area to the recipient area?

 

As previously stated, both procedures come with their own list of benefits and limitations. However, when both procedures are combined (typically starting with strip and ending with FUE), physicians are able to move more hair and provide patients with a fuller and denser look than either procedure on its own.

 

The truth is, both procedures can work synonymously and help patients get closer to their goals than either procedure can alone.

 

What are your thoughts on this?

[HairsGone]

That is my understanding of it. For high Norwood's the best approach seems to be maxing out strip first then moving to FUE to get more grafts.

 

What are people's thoughts on combining FUT and FUE in one surgical session, ie over 2 days to get maximum grafts in one sitting? Can this still yield a similar number of grafts over ones lifetime if it is performed where the surgeon carefully extracts FUE grafts from above the usual FUT area in order to allow for further FUT's (and FUE's) in the future?

[Rashid36]

I wonder if this should be put over the hair restortion side as this topic has come up alot over there.

 

I mentioned something very similar in one of my posts a few days ago.

 

H&W said this to me fut, fut, fue if i remember correctly

 

I agree for high norwoods especially this would be best atleast one strip to get max but the only disadvantage which i see is further hair loss and the need to shave or buzz down then how much scarring will show.

 

Interestingly only one doc from India Dr Kapil Dua mentioned the possibility of having an option of a Giga session - Strip Surgery + Bio-FUE + Body Hair Transplant 2 days surgery

[Dr Blake Bloxham]

Bill,

 

Very nicely stated. And I do agree: the best way to maximize the number of lifetime grafts is to start with FUT and then switch to a non-strip method -- IE FUE -- after you're "stripped out." I often hear patients say that they aren't overly concerned with maximizing or optimizing the donor because they don't believe they will ever truly need this number of grafts. However, hair loss is unpredictable and hair transplantation is truly a "long term" and strategic game. You never know what will happen, so I always advise keeping the donor in the best shape so you have all these grafts when or if you need them.

 

Obviously its a complicated and often personal topic, but I do this this is a good "rule of thumb" or way to look at it in general.

[Etownone]

I already did two FUT. Each one 2400 grafts.

 

Now I'm doing my next HT in October FUE. 3000 grafts with 400 going to my FUT scar

 

And then, a year later... One more FUE If I feel i need it.

[Rashid36]

Was your strip ear to ear or just at the back?

The ear to ear one looks scary.

I thought they could get like 4000 + grafts with a strip?

[Shampoo]

start with FUT and then switch to a non-strip method -- IE FUE -- after you're "stripped out." hair loss is unpredictable and hair transplantation is truly a "long term" and strategic game. You never know what will happen, so I always advise keeping the donor in the best shape so you have all these grafts when or if you need them.

 

that's my story exactly...

I had my first FUT when I was 37 years old

I am now "stripped out"

If I ever need more...I'm told it will need to be FUE.

And knowing me....I bet I will get some FUE in the crown down the road.

[Etownone]

I already did two FUT. Each one 2400 grafts.

 

Now I'm doing my next HT in October FUE. 3000 grafts with 400 going to my FUT scar

 

And then, a year later... One more FUE If I feel i need it.

 

 

It all deepens on the surgeon I beleive... I went to Dr Dorin in NYC. Maybe be doesn't get as much grafts as some other surgeons do from a strip... But 2400 is good. And he leaves a very thin scar. I wouldn't say ear to ear.... But it's not just in the back either. Like in between.

[Dr Blake Bloxham]

Shampoo,

 

You played the long-term strategy wisely and it paid off nicely. Well done.

 

Etownone,

 

Perfect example -- like Shampoo above too -- of why the FUT followed by FUE strategy truly maximizes the donor. So you've already had nearly 5,000 grafts out via FUT and still have another 3k to steal from other areas as an FUE. That's excellent.

 

Best of luck on the future procedures.

[Dr Blake Bloxham]

Rashid,

 

It depends on many factors -- scalp laxity, donor density, head circumference, etc -- but it's absolutely feasible for some to get out 4,000+ grafts in a single go as an FUT. For others, it's not. But I think most agree that FUT allows for the most grafts to be safely taken out in an efficient and precise manner in one sitting.

[HairsGone]

Dr Blake,

 

What are your thoughts on combining FUT and FUE in one surgical session, ie over 2 days to get maximum grafts in one sitting? Can this still yield a similar number of grafts over ones lifetime if it is performed where the surgeon carefully extracts FUE grafts from above the usual FUT area in order to allow for further FUT's (and FUE's) in the future?

[Shampoo]

anxious to hear Dr. Blake's answer......

 

but i can tell you the next day in the afternoon/early eve of BOTH my last two FUT surgeries I was not feeling well and really pretty drained from so many hours in the chair for the FUT

 

personally there is no way I could sit in the surgery chair all day again the following day after FUT on the first day

[Dr Blake Bloxham]

Hey Hairs,

 

There are some doctors -- whom I greatly respect -- who do this combined method. They seem to feel confident about it, and maybe one of them will chime in with their input as well.

 

Having said that ....

 

I personally don't perform or advocate them. And here's why: I become concerned with compromising the blood supply in the back of the scalp. With FUT, the disruption of the blood supply is very localized. All the tissue in the back stays healthy because there is still plenty of good supply that is untouched. But, you still do temporarily disrupt certain aspects of it. With FUE, there is a much more diffuse disruption of the blood supply. But it occurs in very small individual areas (less than 1mm) and is (usually) diffusely spread; so it's okay on it's own too. However, when you add the two together, I personally become concerned about too much disruption. When you disrupt the blood supply in this manner, you can get yourself into trouble.

 

Again, just my opinion. And others may differ. I hope they will chime in!

[HairsGone]

Thanks for taking the time out to reply Dr Blake.

[Rashid36]

Yes thanks...how long in between would you say would be safer?

 

Also can a person have fue first then after some time have fut ?

[Rashid36]

If a person has poor, not enough or questionable donor supply to meet demand...

Hair loss is not stable...

Hair loss pattern is not certain especially if they are 6 and may go 7...

 

If they wanted to risk it and really want a hair transplant,

 

I don't think they should do FUT

I think FUE would be better ?

[JohnArbuckle]

that's my story exactly...

I had my first FUT when I was 37 years old

I am now "stripped out"

If I ever need more...I'm told it will need to be FUE.

And knowing me....I bet I will get some FUE in the crown down the road.

 

Shampoo, can I ask, are you on meds (fin/dut, keto, minox) as well?

[gijedi]

My experience:

 

1) 2,270 grafts / 4,631 hairs FUT. Early 2015. Dr. Alba Reyes Sajiv, Santo Domingo , Dominican Republic, Frontal

2) 1,081 grafts / 4,445 hairs FUT Late 2015 Dr. Jeffrey Waesche, PAI Indiannapolis. Crown

3) 672 grafts / 1,284 hairs FUE (No-shave of donor or recipient areas!) Early 2017. Dr. James Harris, Colorado, Crown

 

All this has taken me from a Norwood 6 to a very happy Norwood 2. Reason for last procedure being FUE wasn't that I was "stripped out". Just wanted a much easier recovery.FUE is MUCH easier to go thru than FUT. Last procedure was 4.5 months ago so those grafts are just starting to come in, Looks like its going to finish filling in very nicely