The Research continues... but what next?

[moss]

hello all. hope you're all feeling nice and hairy!

 

Ive been researching the possibility of having a hair transplant for a couple of months. I am between a norwood II and IIa. Ive had several online consults in regard to having a FUE proceedure. (i buzz my hair to a No. 1 sides and back so would prefer this option at the moment, tho im not discounting anything as yet).

 

the 4 Drs i have chosen so far have given estimates of what i should expect would be nessassary, they are:

 

 

Dr 1 - 2000/2500

Dr 2 - 1500/2000

Dr 3 - 3000

Dr 4 - 4000 - doesnt do FUE (over 1200 grafts at least) but as this Dr was my first choice in the first place i had an online consult with him, (this would include adding some density behind the frontal area backwards towards the crown)

 

theres quite a difference as you can see, is the only reason for this because the very nature of an online consultation? in that i have not yet seen a Dr in person? and after a personal consult things/suggestions may very well change?

 

I'm interested to know if the FUT figure is bigger because of the pluses of that proceedure, so more hair can be taken safely. Or is it that Drs opinions vary quite a bit on what is best for their patients?

 

 

I mentioned that whilst I have expressed a preference for FUE I have not completely discounted FUT at this stage. My only concern about FUE is a worry that im being short sighted. If I continue to lose my hair behind the transplant it seems (from reading on here) that i may have less donor hair left for a possible 2nd HT in the future. Is this something I should be concerned with?

 

Ive read lots of FUE Vs FUT info, and ive come across the issue of hair 'quality'. I understand that FUE transplanted hair might not be as good a quality as a FUT transplanted hair, does that mean 'for good', as in forever? do the 2 differently transplanted hairs feel/look different after a year or so?

 

finally (for now!). whilst I have singled out my 4 fave coalition Drs (based on images of their work). how on earth do i decide between them?? and then, what next?

 

all the best

Moss

 

"I like a man who grins when he fights..."

Winston Churchill

 

edit: apologies , I may have posted this in the wrong section?

[windjc]

Why would FUE not be as high a quality as FUT? FUE hair should come from the same safe zone, so the quality should be the same.

 

Perhaps you mean you have read that the transection rate for FUE is potentially higher, so that more transplants my die in the extraction process. There is a possibility of this, but it isn't always true.

 

You also may have read that some FUE doctors use nape hair. There is a debate as to whether nape hair lasts a lifetime. The truth is that in some people it does and in some it does not.

 

However, as long as the doctor is conservative in using nape hair just to soften the hairline, I don't see why it would ever be an issue, even if it did fall out at an old age. Theoretically, the hairline would then just look less soft, which would have been the case without nape hair anyway.

 

As for how to choose from the 4 doctors you have narrowed it down to, the best thing you could do is visit them all. If you can't do that, I would perhaps ask to set up a phone consultation where you can talk to them and ask questions. You should gather as much information as you can until you have a clear decision you are confident in.

[mattj]

How much communication did you have with the doctors? You say you had an online consultation with one (the one who gave you the highest graft number estimate) but does that mean the others were just sent photos to evaluate?

[moss]

windjc - perhaps i misread the article (cant find it either!), i thought it said the hair was of a different qualty (less) because of the way in which it is removed. if this isnt the case then thats great obviously.

 

mattj - ive had 6 online consults, in that the Drs have evaluated photos ive sent. Thats as far as ive got.

 

I could certainly go and see 2 of them as they are in europe, but the other 2 are a long haul flight away. I didnt realise a telephone consult might be available. And Ive been wondering if it would be worth meeting 'any' HT patients in the UK or just patients of the Drs im considering....

[imissthebarber]

I think the usual arguments for doing FUT first are:

<UL TYPE=SQUARE> <LI>cost <LI> getting a big session done first time - more applicable to higher NW's

 

I think there could be a slight difference in your overall donor as discussed above if you did FUE then FUT rather than the other way around. However, I don't think it would be a huge difference. (This is because proportionately more grafts would likely be done via FUE if FUE is done first.)

 

If and when FUT was done it would yield less grafts per cm/sq but you would have already used those grafts in FUE so they would not be wasted.

 

Believe me having a strip scar is a big deal and I would avoid it if you can. It restricts your styling options severely even if the scar heals fine and doesn't stretch.

 

If you want more grafts some docs do FUE over multiple days...

[Julius]

If one doctor recommended 4000 it sounds like you should go with strip. I was under the impression that with tricho the scar would not really restrict styling unless one shaved right down. It would be interesting to hear who did imissthebarber's procedure.

[mattj]

Moss, the reason I asked that question is that depending on how much you discussed your wishes with those doctors, one might have a better idea of what you want than another, and this might account for the difference in graft numbers.

 

Can't you show us your photos?

[moss]

mattj

 

hi mattj. only have this to hand. as all the consults were online/email, i said the same to each Dr. I appreciate that an online consult is very basic and theres only so much a Dr could possible tell from a photo, i appreciate that the estimates may change on a face to face consult, which im guessing should be my next move...

[EpilepticSceptic]

Well, after seeing that photo you are clearly a Norwood 3.5 vertex heading to a NW4. The doctor who suggested 4000 FU grafts is the one who I would go with, and I would absolutely do STRIP 1st as Spex suggested.

 

Also, what is your age and family history of MPB ? This is also VERY important!

 

I'm 40 now, and a solid Norwood 3 vertex with no further substantial loss in nearly 15 years! Where I do have hair on top they are healthy non-minutiarized hairs. I'm certian that I will need at least 3500-4000 FU grafts to get me back to a mature Norwood 2 appearence.

[mattj]

Yes, I can see why you were quoted 3000 and 4000 grafts by two of the doctors. Those are the sort of figures you'll need for more thorough coverage.

 

Are you taking any medication for your hairloss?

[moss]

hi labrat69. i'm 41 and the family history is mixed, although my father has more hair than me! both grandfathers were different, one bald (from about the age of 20!), one with full thick hair (my dads dad)..

 

and mattj, no im not on any meds, tried regain for about 6 months, but found it a bit tiresome. im certainly not planning on taking any meds at the moment, especially ones that could have an impact on my 'crown jewels'..

[EpilepticSceptic]

Moss,

 

Well, for 41 and no meds you are looking pretty good. Most at your age are a barren wasteland cueball cojack NW6/7 without 10-15 years of "crown jewel" depleting meds daily. lol

 

I would suggest talking to Shapiro or Hasson. You need a doc who has ALOT of experience planting grafts between existing hair to avoid transection of follicles. I think with a 4000+ graft megasession you could maybe become one of the HT poster boys like Spex or Futzyhead. Of course, this largely depends on your donor hair "characteristics".

 

A word of caution: the art of HT is EXTREMELY complicated, so do your research thoroughly. Some guys' hair characterisitcs are so much better than others that 2000 grafts provide a better result than 4000 grafts of another guy with "poor" characteristics. LEARN thy hair characteristics thoroughly BEFORE proceeding !!!

 

Originally posted by moss:

hi labrat69. i'm 41 and the family history is mixed, although my father has more hair than me! both grandfathers were different, one bald (from about the age of 20!), one with full thick hair (my dads dad)..

 

and mattj, no im not on any meds, tried regain for about 6 months, but found it a bit tiresome. im certainly not planning on taking any meds at the moment, especially ones that could have an impact on my 'crown jewels'..

[moss]

yeh! i wanna be a poster boy!!!

20 years ago maybe...

[Balboa]

who are the docs

[moss]

in no particular order, they are:

 

Dr.'s...

Feller

Rahal

Devroye

Feriduni

 

these guys are on the definately list. I think, at this stage if i change my mind and have a strip proceedure, then Dr Rahal would be my first choice. The other 3 all produce really good FUE so i'm still undecided between them.

 

i also intend to reasearch:

 

Dr.'s...

Hasson

Wong

R. Shapiro

[EpilepticSceptic]

Moss,

 

I just don't really understand your aversion to strip. Why do you have such an issue with it ? Is it the linear scar ?

 

If so, then go over to the HLH forum and look up some posts by a dude called "WorkInProgress".

Check the repair section and you'll see some of his posts.

 

This guy had over 3000 FUs via FUE, and he describes the back of his head as looking like a shotgun blast went off on it at close range. He CANNOT shave his head down because the scarring is indeed very significant. Years ago so many people were gung ho about FUE because they felt there would be very minimal scarring compared to strip. I think if a patient only needs no more than 1500 grafts then this could be true. But when you need 3000+ I think there's going to be significant scarring back there preventing shaving it down. And the smaller the punch that the docs use (to reduce scarring) the greater the chance of transecting the follicles.

 

From your photo your condition looks quite similar to mine, but I would say it is actually worse. I'm a solid NW 3 vertex, but yours looks to be more on the diffuse thinning side. I'm positive I will need at least 3500 grafts to get me to a mature looking NW 2 with mild, normal adult non-MPB recession.

 

For me it's not an issue of money. If I really felt FUE was a viable alternative then I would probably go that route; but for 3500+ grafts I think that might be wrecking the donor area that might very well be needed for future surgeries down the road if MPB progesses. Plus, with that many grafts I just can't see the "shotgun blast" look being avoided if you want to shave down. So where's the benefit for the significant extra cost ?