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Confused between FUT and FUE


Obaid6727

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I took these pictures today and I can see its worsening day by day, and hair has thinned from BACK too :(, I am confused now whether to opt for FUE or FUT, initially I was considering FUT with Dr Sunit Soni from Medispa but have seen few bad reviews of his hairtransplant recently, thus im confused now. Help me guys with choosing the best method and a good surgeon as I am not worried about money but want my hair back, I live in United Arab Emirates (Dubai) so please suggest and help me. Just using olive oil as of now and not on any medication.

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FUT is mostly outdated and for low budget jobs since it is less expensive. However some very good doctors still do it. Some because they are stuck in their ways and some for other reasons. But who the heck wants a huge scar across their head? Not me...ever.   That said FUT (strip) does have a few advantages. In really large transplant cases since they are removing an actual chunk of scalp they can remove every single hair from that removed piece of scalp. If it was still on your head that area could only be harvested to maybe 1/2 or even 1/4 as much to not end up with a bald area. So for all the faults, scars, ;pain and risks, you end up with maybe 600-1000 more grafts overall. Sometimes more than that over a completely FUE hair transplant. To me, large cases are the ONLY time anyone in their right mind would opt for FUT. Sure some great surgeons stick to FUT. But most have moved on.  The other advantage of FUT is slightly better graft survival. Maybe 5-10% better for several reasons. In your case...looks like you may need the max one day.  But you never know. So I would start with FUE for sure. The reality is you could always get a FUT if things get really desperate at the end and you want the absolute max possible. But I would personally never. I would rather live with a bald spot than look like a scarred freak if my hair ever got really thin in the back or wanted to shave my head. I will do the best I can with FUE and then FUE with beard and chest hair long before I let someone butcher my scalp like a spring calf. 

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2 hours ago, txtransplant said:

FUT is mostly outdated and for low budget jobs since it is less expensive. However some very good doctors still do it. Some because they are stuck in their ways and some for other reasons. But who the heck wants a huge scar across their head? Not me...ever.   That said FUT (strip) does have a few advantages. In really large transplant cases since they are removing an actual chunk of scalp they can remove every single hair from that removed piece of scalp. If it was still on your head that area could only be harvested to maybe 1/2 or even 1/4 as much to not end up with a bald area. So for all the faults, scars, ;pain and risks, you end up with maybe 600-1000 more grafts overall. Sometimes more than that over a completely FUE hair transplant. To me, large cases are the ONLY time anyone in their right mind would opt for FUT. Sure some great surgeons stick to FUT. But most have moved on.  The other advantage of FUT is slightly better graft survival. Maybe 5-10% better for several reasons. In your case...looks like you may need the max one day.  But you never know. So I would start with FUE for sure. The reality is you could always get a FUT if things get really desperate at the end and you want the absolute max possible. But I would personally never. I would rather live with a bald spot than look like a scarred freak if my hair ever got really thin in the back or wanted to shave my head. I will do the best I can with FUE and then FUE with beard and chest hair long before I let someone butcher my scalp like a spring calf. 

The fact of only 1/2 or 1/4th of the strip being used is new for me! Thanks a lot for this information, well I am not much eager for FUE due to the fact that when hair follicles are being extracted it may damage the root as they may be at an angle underneath the skin and if the surgeon uses larger diameter extraction tool then the neighboring hair follicle would be damaged too, but yes im more than willing to give away my chest hair and beard if the outcome is fruitful! Thanks again for the precious advice, I want to be more convinced about FUE now then i will jump into it :D 

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@Obaid6727 You have put yourself under some pretty harsh lighting conditions there. Great transparency. 

I read that you are not currently on any medication. Is there any reason why? Is it something that you are considering? If it could help you hold onto what you currently have then it would appear that you would be in a great situation to move forward with this. 

Regarding your doubts about the extraction process of FUE. Its great that you are educating yourself and becoming familiar with the process and techniques. Also, making a decision and choosing a physician can seem like a minefield, but you are in the right place. Search FUE Docs and get in touch with them. Have you sent any online consultations? Send them to a few of your favoured Drs and see what they recommend. Then speak to them and research their extraction process and obviously on here you can search for their results. Try and communicate and pm some of their patients that are or have been active and ask them regarding their experiences and concerns. 

Take some time. Consult. Continue to educate and see if FUE feels right for you and the process starts to "convince" you. If I can be of assistance, give me a shout!

Wishing you the best!

Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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- With strip the doctor cannot cherry pic which units s/he needs for the best result.

- You get a big scar

14 hours ago, txtransplant said:

 In really large transplant cases since they are removing an actual chunk of scalp they can remove every single hair from that removed piece of scalp. 

Not quite! At least 15% of follicles in a strip will be in the telogen phase. You can't see them with a naked eye or even under a microscope. So they cannot be extracted and used. As a result, those 15% or so of follicles that are unusable go straight into the trash.  

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9 hours ago, Raphael84 said:

@Obaid6727 You have put yourself under some pretty harsh lighting conditions there. Great transparency. 

I read that you are not currently on any medication. Is there any reason why? Is it something that you are considering? If it could help you hold onto what you currently have then it would appear that you would be in a great situation to move forward with this. 

Regarding your doubts about the extraction process of FUE. Its great that you are educating yourself and becoming familiar with the process and techniques. Also, making a decision and choosing a physician can seem like a minefield, but you are in the right place. Search FUE Docs and get in touch with them. Have you sent any online consultations? Send them to a few of your favoured Drs and see what they recommend. Then speak to them and research their extraction process and obviously on here you can search for their results. Try and communicate and pm some of their patients that are or have been active and ask them regarding their experiences and concerns. 

Take some time. Consult. Continue to educate and see if FUE feels right for you and the process starts to "convince" you. If I can be of assistance, give me a shout!

Wishing you the best!

I am really honored to have your reply on my post, I am not taking any medication because of their side affects and I was advised to use minoxidil back in 2012 by a doctor in Dubai but I discontinued after my hair fall stopped and I even did 6 sessions of mesotherapy with the same doctor in 2013 and i had very good result but I wasnt educated enough on this field so I stopped and hence this is my current condition, I consulted few local doctors recently and they advised PRP+finasteride but I have read about the consequences of finasteride so I got hopeless, then I began my study about HT and its different methods, but I am seeing many people who under went HT were advised to take Finasteride after HT, is there any alternative to this? I am ready to do PRP/Mesotherapy/Laser cap for the rest of my life but not willing to take finasteride. 

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4 hours ago, Baldrick101 said:

- With strip the doctor cannot cherry pic which units s/he needs for the best result.

- You get a big scar

Not quite! At least 15% of follicles in a strip will be in the telogen phase. You can't see them with a naked eye or even under a microscope. So they cannot be extracted and used. As a result, those 15% or so of follicles that are unusable go straight into the trash.  

Good info and makes perfect sense.

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@Obaid6727 Minoxidil is another option if you would prefer to stay away from Finasteride. I respect that decision. I think ultimately we would all prefer not to take Finasteride but providing side effects are non ocuring, the thought of further hair loss can be the deciding and eventually triumphant factor. 

Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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17 hours ago, Raphael84 said:

@Obaid6727 Minoxidil is another option if you would prefer to stay away from Finasteride. I respect that decision. I think ultimately we would all prefer not to take Finasteride but providing side effects are non ocuring, the thought of further hair loss can be the deciding and eventually triumphant factor. 

And what about PRP and mesotherapy on a regular basis besides minoxidil? 

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If you have good density and if the doctor harvests in a pattern that doesn't severely thin the donor area than FUE is the way to go.  If you do go the FUT route just go to a doctor that does a trycophytic closure as this lessens the look of the linear scar.  

Even if you do have a scar, it can be filled later with FUE, SMP or use facial or body hair to make it less noticable.  So many options.  

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My 2 cent advice would be , without 2nd thought go with FUE . Today almost all top notch doctors prefer FUE over FUT.

Why you want to have SCAR first and then get it corrected by placing grafts or smp over it , remember how your scar will look it depends on several factors 

So don't be in a condition that makes you regret all your life , take your decision wisely 

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On 2/22/2019 at 2:40 AM, Baldrick101 said:

Not quite! At least 15% of follicles in a strip will be in the telogen phase. You can't see them with a naked eye or even under a microscope. So they cannot be extracted and used. As a result, those 15% or so of follicles that are unusable go straight into the trash.  

Not sure about that. Bernstein estimates the number of one hair telogen follicles wasted in the strip to be as low as 1% of all follicles in the strip. Wasted telogen follicles from multis vary from 1%-5% depending on how the strip is trimmed.

https://www.bernsteinmedical.com/answers/telogen-phase-after-hair-transplantation/

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6 hours ago, Spaceman said:

Not sure about that. Bernstein estimates the number of one hair telogen follicles wasted in the strip to be as low as 1% of all follicles in the strip. Wasted telogen follicles from multis vary from 1%-5% depending on how the strip is trimmed.

https://www.bernsteinmedical.com/answers/telogen-phase-after-hair-transplantation/

Ok, but at any given time it is widely accepted that 10-15% of hairs on our head are in the telogen phase. So I'm not sure why a strip would be any different. In any case, we can perhaps agree that there is more wastage with FUT

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Assuming you are of young age, you should go with FUT. Chances are you are going to lose more hair and have to be conservative with your approach, esp since there is thinning all over. FUT maximises not onlyhow much hair you can get in a procedure, but doesn't damage the donor for future surgeries. FUE, even in the best of hands, is going to damage valuable donor. Personally, it someone who is having his first surgery should almost always never have FUE first. I would do FUT, then when you have only a few more grafts left, then go for FUE

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I have seen a donor area severely depleted and thinned out by an FUE procedure and the dot scars are noticable when hair is cut short.   I have also seen a good FUT with a faint scar that was repaired and filled in with FUE of body hair and scalp hair.  

Even though FUT is an antiquated procedure, I think it can be repaired with better success if needed than a botched FUE dot scars.  I think with an FUT you get a better yield as oppossed to FUE correct?  A good trycophytic closure seems to help with the scar to be less noticable.  

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15 hours ago, Baldrick101 said:

Ok, but at any given time it is widely accepted that 10-15% of hairs on our head are in the telogen phase. So I'm not sure why a strip would be any different. In any case, we can perhaps agree that there is more wastage with FUT

Yes, but it’s not as much wasted compared to FUE as you would think. That’s because when you extract a single or double with FUE it may in fact be a double or triple with one follicle in telogen and the telogen follicle can be transected during extraction. No question that FUE does prevent the wasting of one hair follicles in telogen, which is about 1% of the strip according to Bernstein.

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@Obaid6727 You have really created a topic of conversation here. I hope the discussion helps somewhat. Again, anything I can do to help.

@Qneedhair Whilst I value your opinion I feel that you are being unfair in your examples. You state a poor FUE with depleted done and dot scars noticeable, whilst also stating a good FUT with faint scar, the "still" needed repair? I don't understand. I good FUT shouldn't need "repairing".

Also, I could just as easily state a great FUE with great growth, natural hairline, no visible scarring and the possibility of shaving very low, and a poor FUT with a stretched scar that is visible and poor growth.

To be able to compare the two techniques, you must look at success rate, which would be a solid indication of which technique is generally more successful. If you find the results somewhat similar, then you must compare two similar cases, with similar loss/hair calibre/grafts counts to be able to compare the techniques in anyway.

The market has changed massively. In 2012 when I have my FUT, there was a 80/20 split in favour if FUT and apart from the very best Drs, I remember feeling that FUE was somewhat less reliable. That was just my opinion 7 years ago. Fast forward to today, I would say on the forums there is 70/30 in favour of FUE and the general success/growth rate is very reliable. 

I don't regret my FUT, it was the right decision at that time. Would I personally consider FUT now, no. But I think the key word in that sentence is "personally". We are all in different situations, different objectives, different hair. What is best for me may not be best for you and vice versa.

Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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On 2/21/2019 at 10:42 PM, Obaid6727 said:

hair follicles are being extracted it may damage the root as they may be at an angle underneath the skin and if the surgeon uses larger diameter extraction tool then the neighboring hair follicle would be damaged too,

This valid concern is mitigated with a trumpet shaped punch head when doing FUE

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On 2/24/2019 at 11:57 PM, vikasgupta123 said:

If you have confusion in FUE and FUT then. 

We’re not a free promotion platform, if you want to continue participating do not post any links thank you.


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

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Honestly, 

Stri has been villainised lately. While yes it leaves a linear scar. In most cases, the scar isn’t detectable and the results are great. You can move a large amount of grafts at one time. They’re both good procedures. This coming from a guy whose had three FUE’s.

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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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On 2/28/2019 at 6:49 AM, Raphael84 said:

@Obaid6727 You have really created a topic of conversation here. I hope the discussion helps somewhat. Again, anything I can do to help.

@Qneedhair Whilst I value your opinion I feel that you are being unfair in your examples. You state a poor FUE with depleted done and dot scars noticeable, whilst also stating a good FUT with faint scar, the "still" needed repair? I don't understand. I good FUT shouldn't need "repairing".

Also, I could just as easily state a great FUE with great growth, natural hairline, no visible scarring and the possibility of shaving very low, and a poor FUT with a stretched scar that is visible and poor growth.

To be able to compare the two techniques, you must look at success rate, which would be a solid indication of which technique is generally more successful. If you find the results somewhat similar, then you must compare two similar cases, with similar loss/hair calibre/grafts counts to be able to compare the techniques in anyway.

The market has changed massively. In 2012 when I have my FUT, there was a 80/20 split in favour if FUT and apart from the very best Drs, I remember feeling that FUE was somewhat less reliable. That was just my opinion 7 years ago. Fast forward to today, I would say on the forums there is 70/30 in favour of FUE and the general success/growth rate is very reliable. 

I don't regret my FUT, it was the right decision at that time. Would I personally consider FUT now, no. But I think the key word in that sentence is "personally". We are all in different situations, different objectives, different hair. What is best for me may not be best for you and vice versa.

Well im just confused like many others here and dont really know what to opt for, i dont really care until i have my hair back, im just worried about where to go, initially yes i was more worried about FUE vs FUT, now i have realized with all of ur help that it is the outcome that matters at the end. NOW most importantly I have over all hair thinning, its seen in the pictures i have uploaded. Now suggest me some surgeons who have a great consistency in DENSE hair transplant. 

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On 2/27/2019 at 8:10 PM, mhaider1991 said:

Assuming you are of young age, you should go with FUT. Chances are you are going to lose more hair and have to be conservative with your approach, esp since there is thinning all over. FUT maximises not onlyhow much hair you can get in a procedure, but doesn't damage the donor for future surgeries. FUE, even in the best of hands, is going to damage valuable donor. Personally, it someone who is having his first surgery should almost always never have FUE first. I would do FUT, then when you have only a few more grafts left, then go for FUE

Intrigued, and yes im 25 only. So you think for a person of my age and condition initially FUT is more of a better choice, thanks for the help, though now I just want a dense head regardless of the method.

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Hi Obaid,

You are 25, your whole scalp going back to your vertex shows an aggressive amount of thinning for your age and I would guess you are heading for a high Norwood, 6 or 7 perhaps. It is possible judging from your sides that you have some diffuse thinning but it may just be harsh lighting already pointed out.

The only thing in my opinion that will help slow down and somewhat recover this rapid loss is Finasteride which you are reluctant to take. Once its gone its gone.

If the whole visibly thinning area was to go you will need 5- 7000 grafts to give the "illusion" of a full set of hair.

Your donor area will be fully utilised and will be left rather thin to the extent that you may have to have SMP in this area to disguise the thinning. You do have the option of using body grafts to compensate for shortage of scalp grafts. If you decide to go initially down the FUT route then it is likely that your scar will be visible after the surgery with short hair or once you have had further surgeries to fix further progression of hair loss.

This is the harsh reality. You need to understand that without meds you need to be prepared for multiple procedures and have realistic expectations of what you can possibly achieve in the short and long term.

You could have a dense head of hair initially following surgery but I think you will face an uphill struggle in maintaining this density long term unless you have an abundance of decent body grafts that you are prepared to use or you reconsider going down the medical path to help sustain your native hair.

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@Obaid6727

I have been following your thread, and you have received some good advice, and confusing information. However, one thing that I feel that you should seriously consider.

You are 25, not taking Finasteride and have experienced a fair amount of hair loss. I hate to be so blunt, but you WILL more than likely lose more hair. 

I have been there, with excessive loss before turning 20 years old. In your consultations and inquiries, you will be looking for a Dr to tell you what you want to hear. Any Dr who recommends a graft count and long term plan that you don't want to hear, you will probably dismiss. That is exactly what I did initially. But understand that it is the easiest thing in the world to tell you what you want to hear. Not to mention that this is a much more sure approach to getting your business. For a Doctor to be honest, telling you their honest long term recommendations and potentially losing you as a patient, has much value, for YOU.

Why do I say this. Because you mentioned the word DENSE in capitals. Every patient has their own circumstances, age/loss/hair calibre etc... To give a more dense and pleasing result NOW, WILL most probably create a problem for you in the future. You may think thats fine, but without preventative medicine, when is the future? 3 years, 5 years, 10 years. Who knows?

Your situation cannot demand a DENSE result. You need a result that meets your REALISTIC needs, but just as importantly concentrates on planning for YOUR long term future. 

This is why it is essential for you to choose your physician extremely carefully. A physician that has your long term interest at heart.

Be aware! This isn't to say that you can't achieve a great short term result whilst also planning for the long term. Don't be fooled by promises and marketing.

Patient Advisor for Dr. Bisanga - BHR Clinic 

ian@bhrclinic.com   -    BHR YouTube Channel - https://www.youtube.com/channel/UCcH4PY1OxoYFwSDKzAkZRww

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

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