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Considerations for FUE after a previous FUT


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Hello all,

 

I feel like I've learned a lot by pouring over the info on this blog and researching surgeons and wanted to pick the brains of those who've debated FUT vs FUE as a second surgery option. I had my first surgery in 2009, a FUT strip procedure done by Paul Shapiro in Minneapolis (roughly 2,000 grafts). It turned out decently but I hated the recovery time for the strip, the tightness, the scarring, and the fact that I can't cut my hair down to a much shorter degree than I could before the surgery.

 

With that said, my temples were barely touched and have receded considerably since the first surgery (which was the main reason I elected for a HT in the first place). I am ready to opt into my second procedure but would much rather go with FUE. I was booked to do so with Erdogan in Istanbul this month but didn't have the cash funds in hand to make it happen. While I'm waiting to save up...

 

Is it a poor choice to move from a strip surgery to FUE since I already have the damage done from the first surgery? I would also be adding some hairs into the original donor scar from the first surgery so I can cut my hair a bit shorter - I realize that FUE produces scarring too, but not in a large line. Figure about 2,200 grafts maximum for this surgery.

 

 

  • Will FUE take away from the hair count of my future donor hair pool? How much less of a yield can one expect with FUE?
  • I will likely need another procedure years down the line as the hair on top starts to thin out more, so overall donor hair is a consideration
  • Is there anything else I need to consider?
  • If FUT is really my best option for a second surgery, do they use the same scarline for surgery 2? Can the overall scar be reduced?
     
    Thank you for any input you can offer. I am looking forward to making a decision and enjoying a nice hairline once again!

 

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  • Senior Member

I just did a FUE as my second surgery on Thursday. I had a FUT 6 years ago. The doctor recommended FUE as the best option for me personally. We went through the reasons why an FUE would be better, and it all made perfect sense. But again you have to consult with your doctor to see what is best for you personally.

 

Also, having gone through the FUT recovery, the FUE is a breeze compared to it.

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I just did a FUE as my second surgery on Thursday. I had a FUT 6 years ago. The doctor recommended FUE as the best option for me personally. We went through the reasons why an FUE would be better, and it all made perfect sense. But again you have to consult with your doctor to see what is best for you personally.

 

Also, having gone through the FUT recovery, the FUE is a breeze compared to it.

 

Thanks, Coach. Did your doctor offer both solutions but thought FUE was best for you? How'sd yours turn out? The two doctors I've asked thus far have both said to stick with FUT since I've already done one surgery and have that scar​ from the strip incision. I just haven't had a good pro con list for making an informed decision on this second go. I think Erdogan would be excellent as a hairline artist, and will maximize yield but it's the long term I'm thinking about.

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Yes, I went to the same doctor. Based on my scalp and donor supply, FUE was the best option. The procedure went as well as it could've and the recovery thus far is nothing like it was after the FUT. unlike the last time, I'm not going to stress over everything. Once I'm fully recovered I'm going to forget I even did it for the next 8 months.

 

Just talk it over with your doctor and make sure you trust his advice.

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  • Senior Member

To allow the forum members to give you better advice can you post your age and photos pre and post op from the first surgery and how you look now. If you're young and have advanced hair loss it would make sense to have a further FUT to maximise your available grafts for future use. If you already have a strip scar I would probably suggest another strip now then save the FUE for later when you need more grafts

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  • Senior Member

Yes I agree not sure you need another HT as your hair looks great. But if you wanted to have the temples done then FUE would be fine as you have lots of donor and it's unlikely you'll need another or many more HT's

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I agree with most others that your hair looks great right now, the temple recession is not obvious or glaring, although I know what it feels like when something bothers you! I have a small spot in my hairline that bothers me and you just seem to obsess over it... that being said, I would try and take a wait and see attitude if you can. If it bothers you that much, FUE for the temples would be best and it shouldn't be many grafts, except I would research surgeons who've done alot of temple restoration, its a particular skill as well. Konior, Shapiro, Gabel, Rahal, etc. Get a few opinions and consultations and make your informed decision from there. Good luck - fortunately, you're not in a bad place!

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Sorry, to be very honest, but you logic is flawed.

 

1. No one can tell you, what the difference between FUE and FUT in yield would be. There is a big dicussion ongoing in this forum and the numbers vary between 25-40 % in average (Dr. Feller) and 0-5 % in average (others). Personally I think 5-10 % (but this is really just a guess from a laymen).

 

2. With FUE you trade lower yield vs. a strip scar. The question is: Is it worth it? The answer depends on #1 (is the difference 5 or 40 %). Your case is different: You aleady have (!) a strip scar. You cannot do this trade any more. Your question has to be: Am I stripped out? If yes, you have to go FUE (or wait if you expect more less). If you are not stripped out, then you could even improve your currrent scar be another strip. Why go FUE then? Add FUE scars and risk potentially lower growth just because of a longer downtime with a FUT (with better growth and maybe a smaller scar than before) sounds like a bad decision.

 

Good luck!

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Thank you for the replies, everybody. I had planned on filling in the existing FUT scar with some FUE grafts too if I went that route, so I could hopefully have my hair pretty short again. That has been why FUE seemed like a good idea, plus the recovery time so I can be active right away again. The surgeons I've reached out to about a second surgery have had a mix of opinion too.

 

I guess I've looked at a second FUT surgery as an option if I needed a lot of coverage and needed to eclipse the 3,000+ graft mark and looked at this one as still a major decision and surgery, but one that would not require quite as many grafts.

 

Thank you to those complimenting my current hairline. We're always our worst critics, so it's good to hear a different voice. The right temple area does look a bit worse than the pictures and is the one glaring bald spot, but maybe I can live it without it until they invent a cure for baldness :-) Who am I kidding. I'll be staring at that missing divot of hair each time I look in the mirror wishing hair would appear...

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  • Senior Member

Your hairline does look pretty good, as others have pointed out. Where were the grafts placed during your FUT procedure?

 

Your scar does look a bit on the wide side, although I suspect that you could go shorter without it showing. The scar could potentially be improved during another FUT procedure.

 

If you're set on FUE then I can certainly understand that. I opted for FUE myself mainly to avoid the linear scar and for the shorter recovery time. It was simply the right procedure for me. But we're all different. If you've already had FUT then the main drawbacks of that procedure type may not apply, but as a veteran of FUT then you know what to expect and if you're apprehensive then that is understandable.

 

Those are my first thoughts. You've had a lot of good advice here already.

I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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mattj,

 

My first procedure was all frontal hairline, which was thinning a lot. For whatever reason, they really didn't go wider to go into the temple area. I really should have insisted at the time but went with their recommendations.

 

I'm able to bring my hair quite a bit shorter right now (maybe a 3 or so?) without the scar showing. I used to go really short in the back and just can't do that any longer. It's mostly okay. I just have to go with different hairstyles but it would be nice to have that freedom again. Hence wanting to explore FUE in the scar area and in the temples so I can have that option again.

 

Even at the time of the first surgery I preferred FUE but was talked into FUT. I don't necessarily regret it though if I went back in time I would have waited or opted for FUE. But, as others have pointed out, I do have that scar now. So, if another surgery could somehow reduce that FUT scar even that could be a win. Though if it went the other way and got bigger I'd be distraught.

 

I kind of like the idea of finding a doctor who is great at both techniques so they can really evaluate the donor area, scar, and coverage needed currently and in the future. I contacted Dr. Path and his initial recommendation was FUT. Though it's still a mix among (HRN recommended)doctors.

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  • Senior Member

Do you know about scalp laxity and the exercises that can increase it? This is important when considering FUT. It's possible that your scalp was tight which led to the wider scar. Although I must say it doesn't look too bad.

If you were to choose FUT again, it would be wise to do those exercises.

I am a patient and representative of Dr Rahal.

 

My FUE Procedure With Dr Rahal - Awesome Hairline Result

 

I can be contacted for advice: matt@rahalhairline.com

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Scalp laxity is new to me but I was sent some exercises to improve it by Dr. Path. I will certainly be doing them even while considering my options. I didn't know of them before my first surgery and wish that would have been part of the pre-surgery regimen.

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