FUT + SMP feedback

[sidbtz]

Hi all,

 

I think I am at a Norwood 7 (attached pics--I usually use a trimmer at level 4 and keep it short, in the pic I had not trimmed my hair in about a week and a half). I've been told that it may be possible to obtain 3000-3500 grafts by 3 recommended physicians on here, which can be used to recreate the hairline/frame my face. For the remainder, some felt it would be possible to do SMP and keep my hair short (I already keep it short), as the hairline will not be dense. SMP would also be used to cover the scar.

 

I know I won't ever be able to get full coverage with my limited/weak donor and extensive balding. But I feel SMP may be an option, if the hairline can be recreated to certain degree. I find the SMP hairlines look really fake. And FUT can add some texture, which SMP lacks.

 

This seems to be a decent example: https://tophairlosstreatments.com/fue-and-smp-combination.

 

A bit more about me, I am 31, have been using Rogaine for about 5 years on/off, used Propecia for 5 months but stopped due to pretty bad sexual sides.

 

I can't seem to find too many examples of SMP after HT on here, have many people done it?

 

Any thoughts, would really appreciate some feedback?

 

 

Thanks,

 

Sid

[Triple7]

With your donor, I would not recommend FUT especially if you get bad sides from Fin and are unable to take it. Have you ever thought about shaving and keeping the beard? It may not be a look that you want but in my opinion, you have a great head shape and skin tone for that look. I bet if you tried it you may like it and I think you would get some compliments.

[hairthere]

Hi Sidbtz,

I do lots of work on clients who have had transplants done. Most did not intend to have SMP as an adjunct, though. They had hoped for a full result from the HT and did not get one and were unhappy with the scar so were forced to turn to SMP. Please keep in mind that none of these clients went to a top surgeon like the ones you'll find recommended on this forum. They all went to clinics who I personally would have steered them away from.

 

I just worked on a client yesterday in fact like this. He did have some growth, but I don't feel he had optimal yield. I think you'll find we did a pretty good job at blending the HT and SMP. These pictures are after 2 passes. He will return in 4-6 weeks for another pass.

 

***Also, this client probably would have been better suited for FUE as his scalp/skin had a tremendous amount of laxity to it which may have contributed to the scar being less than pencil thin.

 

[sidbtz]

Triple7 I have shaved my head in the past but the shaved head/beard really doesn't suit me and the industry that I work in. Hairthere, that looks decent. Since I probably will have to continue to keep my hair short due to poor density, I am worried about the scar. It seems like SMP may be a good option. I am guessing SMP in the donor scar is a better option for my skin tone/darker skin tones? What has been your experience. Thanks guys.

[Melvin- Admin]

I would not get an FUT if I were you, the donor hair doesn't look stable, you are definitely a norwood 7, I wouldn't entertain the thought of having surgery until you have had your donor hair evaluated for miniaturization.

 

Once you have had your donor hair evaluated, then you can go from there, personally I like the idea of getting the hairline transplanted and having a full cap hair system behind it. I personally don't see a point in getting surgery and SMP to still have the shaved head look of course that's just my opinion.

[BadBeat]

OP: The example you showed was a FUE+SMP combo done by Dr. Ron Shapiro in Minnesota. I'm not sure if you meant FUE or not but I think generally you don't want to go the FUT+SMP route. FUE+SMP I would think would work better.

[sidbtz]

HTsoon, I live in Toronto Canada, would some of the HT surgeons be able to do a miniaturization test? None of the surgeons I consulted in person made note of this. I suppose if miniaturization is the issue, neither FUT or FUE would be a viable option?

 

I was told with FUT I could get the most return, and there is a greater chance of the grafts surviving versus FUE. The scarring is a concern. Although, I’ve seen some decent examples of SMP in the donor scar, with guys keeping their hair short, but these are after all just pictures and I have not seen anyone in person. Isn’t the risk of failure greater with FUE?

 

I’ve looked into hair systems but it just seems like an expensive huge life long hassle.

 

I was thinking of full on SMP but the hairlines seem really fake. But if the front/hairline can be built, then SMP can potentially compliment it.

 

BadBeat, good point, I didn’t realize that. Do you think FUE is better due to FUT scarring?

 

Thanks again,

 

Sid

[Melvin- Admin]

HTsoon, I live in Toronto Canada, would some of the HT surgeons be able to do a miniaturization test? None of the surgeons I consulted in person made note of this. I suppose if miniaturization is the issue, neither FUT or FUE would be a viable option?

 

I was told with FUT I could get the most return, and there is a greater chance of the grafts surviving versus FUE. The scarring is a concern. Although, I’ve seen some decent examples of SMP in the donor scar, with guys keeping their hair short, but these are after all just pictures and I have not seen anyone in person. Isn’t the risk of failure greater with FUE?

 

I’ve looked into hair systems but it just seems like an expensive huge life long hassle.

 

I was thinking of full on SMP but the hairlines seem really fake. But if the front/hairline can be built, then SMP can potentially compliment it.

 

 

Sid

 

I don't know anyone in Toronto, I know of two members here who live in Toronto maybe you can PM them and they'll know more, Dutchie and don174 they both live in Toronto and may know more about the local doctors. If your donor is miniaturized then yes I think choosing to undergo surgery would be a bad idea whether its FUT or FUE.

 

I know several doctors like Dr. Konoir who suggest that FUE in cases like yours work best for the simple fact that they can choose which hairs to extract, with a strip you remove the tissue and whatever hairs are there can be used, with someone who has a lot of miniaturization in the donor many of those hairs on the strip could be miniaturized therefore not viable for transplantation, with FUE the doctor can use high magnification glasses and extract all of the healthy follicles one by one.

 

In regards to the survival of the grafts, any grafts that have miniaturized follicles probably won't survive the trauma of surgery, even if they do survive they will eventually fall out due to being susceptible to DHT. That's why it is imperative that you first establish that you have a permanent zone. If you're willing to spend thousands on a hair transplant you should be willing to travel for a consult to a doctor who can inspect your donor. I know Dr. Wesley does in New York City, he does charge a lot for the consult though. There is also Dr. Bernstein I'm not sure how much he charges for a consult.

 

Believe me hair transplants are an expensive life long commitment, if you think you're going to have one surgery and be done then I think you haven't researched enough. Someone with your level of hair loss would need at least 3-4 surgeries to establish a hair line and midscalp coverage. Remember you're only 31 so you will inevitably lose more hair, which means that your density over time will decrease due to native hair being lost, believe me hair systems would be 100x less expensive then hair transplant's, this is coming from someone who's had 3 HT's already and I'm also 31, who knows how many more I'll have over a lifetime, probably at least another 2 using some BHT.

 

If I were in your shoe's I would probably choose to transplant all of my available grafts to the hairline and temple points, I would probably just use a full cap system behind it, the only part of the hair systems that can be detected is the hairline and temples, if you have that transplanted then the hair system would be virtually undetectable. If you don't like how you look with a shaved head, I doubt you'll like your look with slightly more hair but still buzzed, the whole point of getting surgery is to not be bald that's just my opinion though you may think differently.

[1978matt]

Forget the surgery and get the smp. Your donor is so sparse it is not worth the risk at this stage.

 

someone in my office I've seen in the elevator has had it. He's the same skin tone as you and it looks really good.

[sidbtz]

Thanks HTsoon, I’ve contacted those guys.

 

Yes I would need multiple procedures and this is not possible given my donor. Guess my logic is, if the HT can recreate the hairline to some degree, with SMP I could have a bit of a buzzed look. I used to buzz when I had more hair and I liked that look. Guess, worst case scenario, I’ll have a shaved head look with the SMP, but hopefully with transplanted hair in the front, SMP won’t look too fake.

 

1978matt, I feel like SMP alone is too much of a risk, I’ve seen so may examples online where the hairline looks like a tattoo, the rest of the head usually looks okay.

[harin]

I just looked at these pictures. Yes you are Norwood 7. Seems like the finer hairs on the scalp are growth induced by Minoxidil.

 

The donor area does not appear strong in my opinion, I do not know how thick your beard area is?. Though HT would be risky if you really want to go for it then you need to be ready for BHT and SMP combo. (beard, chest, armpit etc..), you would likely need significant number of grafts unless you plan to go for sparse coverage with buzz cut look as suggested.

 

Aesthetically pleasing result could be obtained provided there is realistic expectations (mature looking or sparse coverage) from your side and your doctor works with a careful plan on his hand.

[sidbtz]

Thanks Harin. Yes, I am hoping for a buzzed look. I have pretty good beard coverage, I think I am going to combine beard hair with donor and maybe add SMP.

[sidbtz]

I think I am going to go with Dr.Path, get about 3000 grafts, then consider BHT for a second round, depending on how the first round goes.