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1st HT Best Doctor FUE or FUT, Advise please


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Hi

After 3 years of wait(worst decision) and 2 years of Rogaine(no guts to take propecia another worst decision) I decided to get my 1st HT done. I have advanced hair loss in the crown area and minimal hair loss in the frontal region. I sent photos to around 10+ doctors (Thanks to this forum as I am able to get list of good doctors) and most of them suggested to go for 2500-3000 grafts 1st and then 1000-1500 grafts later after 12 months for a FUE procedure. 1 of the top doctor suggested to go with 2000 grafts FUT 1st and 1500 grafts FUE after 12 months for maximum coverage and a decent hairline in the front. He suggested I should not go with aggressive hairline because of my Donor area. So I am in a dilemma now whether combination of FUT & FUE over a 12 months is the best scenario or should I go with FUE all the way? I would ideally wanna go to Europe but travel is a big no for me so I restricted myself to North America with top 5 doctors in my list are Dr Konior, Diep, Vories, Shapiro & H&W.

Please advise.

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Edited by karsri
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It’s impossible to provide good advice without any photos, generally when hairloss is extensive it’s rec to “strip” out first before going through FUE. But can’t really say anything on your personal situation without pictures. 

Warm regards-Melvin


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

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You have a lot of hair left, but you have an aggressive pattern, if you don't mind a strip scar then you should get as many strips as possible before getting FUE, this will ensure you receive the most grafts out of your donor area, but you will never be able to cut your hair short again, so weigh the pros and cons for yourself. If you never plan on cutting your sides short like below a #3 then you have nothing to worry about.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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Thanks @Melvin-Moderator

That's exactly Dr Konior suggested and BTW he is the best which I don't need to tell. He is the only one who questioned my Goals which I felt honest assessment and suggested to go with FUT 1st for 2000 grafts and then FUE for 1500 grafts in a span of 2 years (1 year ofcourse his wait time for 1st procedure). However After researching a lot on this forum & internet most of them are biased towards FUE and I am trying to convince myself to go with FUT 1st but this "linear Scar" issues like elasticity, infection etc., is giving me night mares. Otherwise I will not think twice as Dr Konior is the one who is suggesting to go with FUT 1st. Another reason is None of the Top Europe Doctors are not even considering FUT now a days. So I am trying to understand what are the CONS if I go with FUE all the way and never go with FUT or 1st FUE and worst case scenario FUT. Also like you said If I want to keep my Hair short at Guard 2 or 1 for my entire head in future I believe I can with FUE rt? Please advise. Thanks

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FUE pros you can cut your hair short in most cases up to a #1 clip. Cons for FUE you can not get as many grafts in one sitting as you could with FUT, it is also substantially more expensive.

FUT pros you can get a large amount of hair in one surgery, graft survival rate is slightly better depending on the surgeon. FUT cons the scar can stretch, shock loss can occur around the scar although this is almost always temporary, the area around the scar will also be numb for a few months, but this generally returns to normal. The biggest con with FUT is you can no longer cut your hair shorter than a #3 without the scar being visible.

With that said, your current hair is more than long enough to conceal a strip scar, so if that is the length you typically like to keep your hair I see no problem with going FUT.


I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice.

Check out my final hair transplant and topical dutasteride journey

View my thread

Topical dutasteride journey 

Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube.

 

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Thanks @Melvin-Moderator

Coming to Doctors list can you please advise?

Dr Konior, Diep, Rahal, Shapiro & Hasson are top 5.

For my case which doctor is best, I am not looking price per graft but the best dotor from the list above or any other good doctors I am missing.

Thanks

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No Response from Dr Lorenzo yet. Its 10 days since I sent email. Any idea (typically) within how many weeks he will respond? Almost consulted all top tier doctors in North America and I got a quote for 3000 - 4000 grafts with not aggressive hairline but decent coverage all over & a 2nd procedure after 12 months for 1000 grafts or so. All NA doctors are suggesting to go FUT 1st and then FUE which is understood. But I am still not convinced on Linear scar thing and in 2018/2019 FUT is a good option or not. I will most likely go with FUE with Dr K, Dr Ron Shapiro & Lorenzo are the final 3 and with Dr Ron wait time is less compared to other 2 doctors.

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On 7/30/2018 at 9:04 AM, karsri said:

No Response from Dr Lorenzo yet. Its 10 days since I sent email. Any idea (typically) within how many weeks he will respond? Almost consulted all top tier doctors in North America and I got a quote for 3000 - 4000 grafts with not aggressive hairline but decent coverage all over & a 2nd procedure after 12 months for 1000 grafts or so. All NA doctors are suggesting to go FUT 1st and then FUE which is understood. But I am still not convinced on Linear scar thing and in 2018/2019 FUT is a good option or not. I will most likely go with FUE with Dr K, Dr Ron Shapiro & Lorenzo are the final 3 and with Dr Ron wait time is less compared to other 2 doctors.

I think someone wrote Lorenzo was going on a break period for over 6 months. Not 100% sure though. Probably check your junk email too just in case also.

NA doctors have incentive to push FUT because there is less labour involved and of course labour costs are significantly higher than in many European and Asian countries. Few can afford 4-5000 grafts in a single sitting at standard USA FUE rates at the $8 mark. Also its not particularly true that at this point you can do more grafts in one go via FUT when Erdogan regularly does 5000-5500 in a two day session.

Most important isn't a surgeons reputation or their outlook on what you need but rather your own views on what you're looking for. If you don't want to risk a bad linear scar, then go to a surgeon like Lorenzo, if you think Konior produces the highest yields and most cosmetically appealing results to you, then you should go to Konior. All surgeons and particularly across continents would have different opinions on how to approach your case, you're best off selecting the one who produces the results you most prefer because of course speaking to them individually they inevitably market for their approach above others.

FUT vs FUE really depends on your donor capability also so no one here can give an accurate opinion without photos. Considering how long the process is (having been through it twice) I find it hard to suggest Konior if you're that far gone assuming its going to be 3 years at least before final results across two procedures due to his waiting list. I'd look more to the other two also due to likely higher graft numbers which will be beneficial and opt for Konior to do a touch up down the track.

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@Bill - Managing Publisher

Yes I Uploaded them and deleted after few days. Uploaded few pics now. Please advise.

@JeanLDD

Uploaded few pictures.

I kind of liked your idea to go with another doctor 1st and for touch up with Dr Konior as his wait list is 14 months currently. Since this is going to my 1st HT I am kind of OK on the price per graft and looking for best surgeon. I just saw your procedure with Dr Erdogan and I did research on him as well. I kind of freaked out on his aggressive approach to be honest :). 5000 - 5500 grafts in 1 FUE session? It worked out for you because you got plenty of Donor hair. My case I don't have that much Donor Hair and will be around average or below average Donor(6000 grafts maximum maybe?) and that's why some of the NA top surgeons assessment makes sense to me. So what I am thinking is Get my 1st HT done with Dr Ron for 3000 FUE and get a decent coverage (frontal & crown) and 2nd Procedure with Dr Konior for about 1500 FUE for Good density and good hairline? The only problem with this approach is I need to shave the head twice in 12-15 months. Other than that I dont need to worry about Linear Scar etc., I still have consults pending with Dr Diep & Dr Rahal.

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40 minutes ago, karsri said:

@Bill - Managing Publisher

Yes I Uploaded them and deleted after few days. Uploaded few pics now. Please advise.

@JeanLDD

Uploaded few pictures.

I kind of liked your idea to go with another doctor 1st and for touch up with Dr Konior as his wait list is 14 months currently. Since this is going to my 1st HT I am kind of OK on the price per graft and looking for best surgeon. I just saw your procedure with Dr Erdogan and I did research on him as well. I kind of freaked out on his aggressive approach to be honest :). 5000 - 5500 grafts in 1 FUE session? It worked out for you because you got plenty of Donor hair. My case I don't have that much Donor Hair and will be around average or below average Donor(6000 grafts maximum maybe?) and that's why some of the NA top surgeons assessment makes sense to me. So what I am thinking is Get my 1st HT done with Dr Ron for 3000 FUE and get a decent coverage (frontal & crown) and 2nd Procedure with Dr Konior for about 1500 FUE for Good density and good hairline? The only problem with this approach is I need to shave the head twice in 12-15 months. Other than that I dont need to worry about Linear Scar etc., I still have consults pending with Dr Diep & Dr Rahal.

Just based on those pics you do have a more extensive balding area than average and potentially some thinning in the donor. Agree that FUT is likely the better route, if you're going to touch both the hairline and crown in the first procedure I think minimum you're looking at 4000 grafts. Personally I think you would get the most cosmetic benefit out of a surgeon willing to do the highest graft numbers from your list. 

 

At the length your hair is currently I wouldn't worry too much about the linear scar. 

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On ‎7‎/‎24‎/‎2018 at 3:54 AM, karsri said:

Another reason is None of the Top Europe Doctors are not even considering FUT now a days. 

That is not true. There are still great clinics performing FUT in Europe. Just turkey is a FUT wasteland. Feriduni, Bisanga, Devroye and my favorite for your case Hattingen are all top notch FUT (and FUE clinics).

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12 minutes ago, Gasthoerer said:

That is not true. There are still great clinics performing FUT in Europe. Just turkey is a FUT wasteland. Feriduni, Bisanga, Devroye and my favorite for your case Hattingen are all top notch FUT (and FUE clinics).

Definitely agree with the Hattingen assessment and recommendation.  I think a certain JT is recommending them now also.

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Yaar this going to be a long road.  I would try to remain on meds.  You have some native hairs in between.  If you are a candidate for FUE, make sure doctor has a good surgical protocol and extracts grafts if it is FUE.  Considering you may need over 5000 grafts, surgery should be done imo in 2-3 day period (if fue as it takes longer). Grafts left out of body for a long time after extraction may die, resulting in chances of lower yield.  This is a possibility.  FUT may be a safer option, but No one knows how that scar can heal.  No one knows if your surgery will be a success or if you will be a repair after all this.  Muje dek

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13 hours ago, JeanLDD said:

Just based on those pics you do have a more extensive balding area than average and potentially some thinning in the donor. Agree that FUT is likely the better route, if you're going to touch both the hairline and crown in the first procedure I think minimum you're looking at 4000 grafts. Personally I think you would get the most cosmetic benefit out of a surgeon willing to do the highest graft numbers from your list. 

 

At the length your hair is currently I wouldn't worry too much about the linear scar. 

Only doctor from my list who does that is Dr Ron if I am going FUT1st and then FUE. He can do 3500-4000 grafts in 1 session. Another Doctor I am considering is Dr Hasson & Wong who does mega sessions for FUT & FUE.

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14 hours ago, Regs said:

Check out Dr Cooley. I think he is one of the best! 

Sure. I am limiting the list to Max 3 members. Dr Konior, Dr Ron & Dr Lorenzo/H & W (If Dr lorenzo doesn't respond). But will check

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10 hours ago, spex said:

is taking finasteride definitely not an option even if just intermittently ( every other day ) as you have diffuse thinning and without a comprehensive regime to help stabilise things I personally feel you might be setting your self up for a long rd ahead.

 

Regards

Spex

@spex

I will be starting on finasteride shortly as almost every doctor prescribed that to me. Am planning to take 1mg daily. 

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10 hours ago, Gasthoerer said:

That is not true. There are still great clinics performing FUT in Europe. Just turkey is a FUT wasteland. Feriduni, Bisanga, Devroye and my favorite for your case Hattingen are all top notch FUT (and FUE clinics).

Thanks. I am first time hearing about Hattingen. Will check

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1 hour ago, Sean said:

Yaar this going to be a long road.  I would try to remain on meds.  You have some native hairs in between.  If you are a candidate for FUE, make sure doctor has a good surgical protocol and extracts grafts if it is FUE.  Considering you may need over 5000 grafts, surgery should be done imo in 2-3 day period (if fue as it takes longer). Grafts left out of body for a long time after extraction may die, resulting in chances of lower yield.  This is a possibility.  FUT may be a safer option, but No one knows how that scar can heal.  No one knows if your surgery will be a success or if you will be a repair after all this.  Muje dek

sahi bola. Thanks. Your hair looks good now. Looks Dr Rahal did good job. I have appointment set with his advisor in 2 weeks. Do you know if Dr Rahal do online consultation or his techs?

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3 hours ago, karsri said:

Thanks. I am first time hearing about Hattingen. Will check

They are very popular in a german forum "alopezie.de", but you need to sign to see patient reports. I guess there is sth on youtube too, but real patient reports are better. Hattingen was specialised in FUT for a long time and only added FUE to their repertoire some years ago, kind of like H&W. Also they are very conservative in their hairlines which for some guys might be negative, but for you case it is a plus. I do not know pricing etc. and for sure it is not turkey or india price range. But maybe cheaper than US?

Anyway, most clinics I see in this thread are good and I think you will make a proper choice. My recommendation: Visit several clinics in person and see whose plan sounds good. Recommendation for me were totally different in a live consulation compared to assessment via pics.

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1 minute ago, Gasthoerer said:

They are very popular in a german forum "alopezie.de", but you need to sign to see patient reports. I guess there is sth on youtube too, but real patient reports are better. Hattingen was specialised in FUT for a long time and only added FUE to their repertoire some years ago, kind of like H&W. Also they are very conservative in their hairlines which for some guys might be negative, but for you case it is a plus. I do not know pricing etc. and for sure it is not turkey or india price range. But maybe cheaper than US?

Anyway, most clinics I see in this thread are good and I think you will make a proper choice. My recommendation: Visit several clinics in person and see whose plan sounds good. Recommendation for me were totally different in a live consulation compared to assessment via pics.

Thanks @Gasthoerer

Yes I am not compromising on price per graft even though some of my friends are laughing at me with the doctors I chose and they feel its not worth it. However thanks to this forum I can see honest opinions of actual patients and reviews of the doctors. I am not going with Aggressive hair line(That's why I ruled out 1 canadian doctor , 1 Turkish doctor & all Indian doctors) and my goal is conservative/good hair line with decent coverage on Crown area. With that goals I believe I can go with FUE as well and have 2 procedures in 1-2 years to get maximum coverage. So far with these goals Dr Konior, Dr Baubac, Dr Wong, Dr Ron Shapiro & Dr Diep (yet to be consulted) met the criteria and with this list I have flexibility of going FUT 1st except for Dr Baubac. I am guessing I will end up choosing 1 doctor from the above list in a month or so. If my choice tends towards the doctor who does everything like extractions and incisions then my list becomes even smaller with Dr Konior & Dr Baubac but its looks like its not a deal breaker to lot of patients. 

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