FUT vs FUE

[ThinScalpSF]

I am trying to decide between FUE vs FUT. I want the procedure with the highest chance of success in one operation. I do not wear my hair super short, so a linear scar would be covered. While my initial feeling was favoring FUE (newer procedure, no linear scar), I am now favoring FUT (seems like better harvesting of hair follicles because you can directly visualize them under the microscope).

 

A little background on my case: I have significant hair loss (Norwood IVa or V) in the front and crown, so I am going to need a lot of grafts. I have consulted with 2 hair transplant surgeons in person (Berman and Rosanelli in SF) and 2 online (Hasson and Wong and Jim Harris). Berman only does ARTAS FUE, so he of course recommended it and told me I should NOT get FUT because its old school and barbaric. On the other hand, Rosanelli and Hasson/Wong strongly favored FUT and told me it was because I needed a lot of grafts. They said I could get a higher number of grafts and higher yield with FUT.

 

Once I decide FUE vs FUT, I can then pick the best surgeon. If I go with FUT, I am probably going to go with Rosanelli, Hasson/Wong, or Gabel. I am awaiting consultation with Gabel. If I decide FUE, then I have to keep looking. Thanks.

[E39]

You're in SF? Try consulting with Dr Diep in Los Gatos.

[hsrp10]

Once upon a time growth yields were superior with FUT, but recently as long as you are going with an elite and skilled FUE surgeon who performs manual FUE (stay away from the robots and automatic extraction tools) the disparity in growth rates is getting close to negligible.

They will examine the grafts in both cases under a microscope btw.

 

I posed this same question about growth yields in person to one of the leading hair restoration surgeons in N. America Dr. Raymond Konior who performs both FUT & FUE and his answer was "A graft is a graft."

Another aspect of FUT vs FUE is lifetime donor supply, the best way to proceed to maximize your donor supply is to go with FUT first then FUE later on. So if you're as stated a NW 4-4A going with FUT first makes sense.

 

As for surgeons, Dr. Gabel and Dr. Hasson are great surgeons and you might benefit from also researching the work of Dr. Konior and Dr. Rahal if going with FUT.

 

And and additional FUE surgeon to consider if you go that route is Dr. Diep in Los Gatos (edit: as mentioned by E39 too).

[aWidowsPeek]

ThinScalpSF post some pics to properly get advice. I myself love FUE. Strip is outdated and the risks are too great in my opinion.

[DavidAnderson]

Hsrp10 has given you some great advice here. When done correctly the difference in terms of growth from each graft whether FUT or FUE is negligible. However FUT will yield more grafts in a lifetime as you always have FUE to fall back on in the future.

 

You need to decide your goals. As a nw 5-6 does the crown bother you? How do you want to wear your hair post op.? Are you prepared for more than one or two surgeries? Have you tried shaving your head for a period of time to see how you like it? Are you taking medications to prevent further hair loss?

 

My advice would be consult with a number of Doctors and take your time until you are comfortable with the correct approach for you.

[Bill - Seemiller]

Thinscalp,

 

I think it's great that you are doing research on this topic, there is a lot to discuss and to go over regarding the benefits and limitations of both FUT and FUE. Physician selection will be vital to determining the success of your results however, based on your specifications, I would suggest FUT with one of our Coalition physicians who specialize in performing large, densely packed sessions of ultra refined follicular unit grafting. You are looking to maximize the amount of amount of hair that you have transplanted in one session with the highest success rate. You are also not concerned as much about the scar because you don't wear your hair ultra short on the sides and back of your scalp.

 

My opinion would be to go for strip and maximize the amount of hair you can have moved and transplanted in a single session and then if you need more work, continue to get FUT until you are "stripped out". At that point, you can move to FUE which is the best way to maximize the amount of available hair you have for transplanting over your lifetime.

 

At the end of the day, you need to do what you are satisfied with, but based on your specifications this is what I would suggest.

 

Best wishes,

 

Bill

[Melvin- Admin]

Ahh the age old question of whether to get FUT or FUE, IMHO there is no right answer, there is certainly an argument to be made about getting strip first and then going FUE, there is nothing wrong with that approach it's the most cost efficient approach. I myself was a Norwood VI as you can see from my profile picture, I've chosen to only undergo FUE, main reason is my short hairstyle, I've never worn my hair longer than a #2 on the sides.

 

Do you have a really short hairstyle? Is having long hair on the sides a big deal to you? If you answered yes to both questions you probably want to go FUE, if you answered no to both questions you should go FUT. Also what's your budget? If you have a budget and you want to stay within North America then you'd probably have to choose FUT because FUE is more expensive around $7-10 per graft. However, the price of FUE is mitigated by traveling outside of North America to places like Belgium, Turkey and Spain. I agree with E39 consult with Dr.Diep he's in the Bay Area, I've gone to him twice he's definitely worth considering.

[ThinScalpSF]

Thank you to everyone for their thoughtful responses.

 

I will check out Dr. Diep. I live in the San Francisco Bay Area, but I am willing to travel for an excellent surgeon. I feel most comfortable in the US, Canada, or maybe Europe. I worry about going to a far away country and then it not working out and having no recourse. I suppose you could demand that a US surgeon do a repeat procedure at a discount (or maybe even free) if it doesn't turn out well.

 

When I started doing research on this topic, I was hoping for one transplant and be done. Based on doctor's opinions and what I'm seeing on this forum, a lot of people get 2 or more transplants. If that may be the case, then many of you are recommending FUT first followed by FUE if needed. I am guessing that FUE might deplete any future FUT strips. But with FUT, you still have all the rest of your hair follicles in the back as donors. Also with FUT, it seems you can get more grafts in a single procedure.

 

The challenge here is getting good advice about graft numbers. How many do I really need to look decent? I am not expecting to look 18 again. I want to avoid future baldness, look natural, look younger, and be able to wear my hair short but not ultra short (I ask the barber to use a 3 on my sides and back). It seems the doctor's incentive is to place as many grafts as possible (more money). While it seems intuitive that more grafts equals better hair, I have seen pictures of people with 2000-2600 grafts that started out similar to me and looked decent afterward.

 

As requested, I have attached some pics so people can give me more customized advice. I am probably a Norwood IV or V. Thank you all again for this excellent help. I don't know where else I would turn to evaluate my options.

[nwood5]

I am in a very similar situation. Was told I am NW5A and with one of two options I could be a NW3V. Now I wear my hair very short and prefer it that way with the baldness. I think I would still like to wear it short. Could live with a #2 or maybe #3 on the sides.

 

The clinic with a very good reputation offered two options:

1 FUT for 3500 (~15,000)

or 2* FUE for 2000 and 1500

 

Cost is about $10,000 more for option 2.

 

There is another clinic with less reputation who indicates will do 3500 fue in one session for same cost as reputable fut. (~15,000)

 

Is it worth the extra $10k? Is it worth investing to get to NW3V. I think they are being conservative but my initial issue with balding was the crown and now obviously its spread. So do I go back to my original painpoint? Will I be happy there. I have taken no medication or used topical treatmen seriously but would do so if getting surgery and may do so anyway to keep what I have.

 

Any thoughts or advice?

[ussoccerfan1990]

ney nwood5, you should look into a company called MAXIM. They charge 2.95 per graft and specialize in large cases. I went through them and thought their work was solid and clean. This is all my opinion but they were bad at all. you can see pictures of my procedure on my forum if you scroll down. just thought id throw my 2 cents in :)good luck in your journey

[nwood5]

Thanks ussoccerfan, I am a big fan of the beautiful game myself. Although I did quote the cost of the procedures and of course this is a factor its not the biggest one for me.

 

For me my post was in hopes of reading thoughts/recommendations on fut vs fue. Opinions on what to expect from a HT with my level of hair loss. Is it common to have a recommendation of 2*fue vs 1*fut. Other then recovery and scar risk any other factors?

 

Some opinions seem very negative on fut because of scarring and others think it is a better way to start out.

 

Is using a hair trimmer (#2 or 3 setting) possible at all with fut?

 

I am reading through forums to get more info but there is a lot of conflicting info.

 

The clinic gave me a pretty detailed document on fut vs fue and it is pretty informative. They suggest there are better suturing techniques now for fut and list pro/cons of fue as follows:

 

Advantages of FUE

 

 

• 
  
• No linear scar
  
• No need for sutures
  
• Good choice of procedure for patients with short hair
  
• Good option for patients with previous scarring or a tight scalp
  
• Good choice if a limited number of grafts are required
  
• Quick healing time
  
• Minimal discomfort after surgery
  
• Less downtime/able to resume normal activities and exercise quickly
  

 

Disadvantages of FUE

 

 

• 
  
• Time consuming procedure
  
• Costs more than FUT
  
• Risk of damage to the follicular units
  
• Limited supply of donor hair as some hair must be left to cover the rest of that area
  
• Small scars may obstruct nearby follicular units which can be problematic if further sessions are required
  
• Not enough suitable candidates for unit extraction than with FUT
  
• May be difficult to achieve an 'even spread' of units
  
• More than one session is needed
  

 

Their comments on strip method:

....the only time you will actually be able to see the scar is if you decide to shave your entire head.

Suturing Techniques

Trichophytic scar, a unique way of removing the strip and closure, is currently used on all our patients. The advantage of this scar-closure technique is to allow the hairs at the closure point to grow right through the scar. This will add camouflage to the scar and reduce its visibility.

ps ussoccerfan... probably me being a newbie, how do I find your forum page?

[ussoccerfan1990]

FUT I can buzz with 3 and not see scar but that almost 12 months of healing as scar gets little smaller with time. FUT produces best yield. And it's cheaper. My opinion is you will need FUE but start out with strip then second surgery go to FUE. But that's my opinion. Talk to other as well.