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Hi all,

I was wondering what everyone's perspectives are on the two main methods.

From my understanding (and please correct me if I'm wrong), the main advantage of FUE is the lack of scarring. One can simply return to work, their life, etc, very quickly after FUE potentially.

Whereas with FUT, often there is a better yield, and a better success concerning individual grafts. I have also read that FUT is better for conserving the donor region, for future transplants.

Am I missing anything here? I ask as I am weighing up my options for my first HT, in which I will inevitably need more, and wanted to discuss both options.

Eager to hear everyone's opinions :)

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It all depends.  How do you intend to wear your hair down the road?  If long, perhaps FUT.  If very short, to the point that you can clearly see the scalp, FUE. That is somewhat simplistic but not a bad way to think about things.  The way I see it, why do transplants if you want to continue wearing your hair short?  Just had transplants, show it!

The main advantage of FUE is NOT the lack of scarring.  There is scarring with FUE, it is just different.  Every time you violate the skin, it will scar.  Instead of having a linear scar, now you will have empty spots all over.  Little ones, mind you, but still empty spaces.  Depending on how much it is done per procedure, this can end up looking honeycomb-ish.  How many times have I seen patients with depleted donor areas that look as if a rooster pick all over it.  But, if done correctly, there can be many advantages to this technique.  It is, for sure, easier on the patient.  There is no cut, no elasticity issues. Within days you are pretty much back to normal.  If you need a bit of work and keep your hair military style, OK.  But if you need tons of grafts, perhaps considering both procedures would be the most effective way to tackle the issue.  This way you are taking advantage of the entire donor area.

Are you concerned that people will know you had a transplant?  Just tell them! If you do, you can return to work immediately.  If you wish for no one to know, it is easier to get away with it with an FUE.  Many factors involved but the doctor can guide you and make some suggestions to make it happen. Typically, to do an FUE, the donor area needs to be shaved.

Not sure about the yield issue.  But the grafts do seem to be more robust with an FUT.  Conserving donor?  Don't think so.  You can keep cutting, typically on the same scar to avoid multiple scars in the donor area.  There comes a point, however, that you run out of elasticity.  It is then time to move to FUE if you decide to have more grafts in the future.

Lastly, cost.  FUE is typically more expensive. On the average, FUT should be around the $4 range.  FUE is more towards the $7 range.  

Oh, regardless of what you decide, please review TONS of photos before making a decision.  It is always about results.  10 years from now, when you are enjoying a fuller set of hair, you will pay little mind to the type of technique you had. Rather, you'll be enjoying the hair particularly if the work was done correctly. If it's crap, you'll live with that for the rest of your life. Do your homework.  

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3 minutes ago, LaserCap said:

It all depends.  How do you intend to wear your hair down the road?  If long, perhaps FUT.  If very short, to the point that you can clearly see the scalp, FUE. That is somewhat simplistic but not a bad way to think about things.  The way I see it, why do transplants if you want to continue wearing your hair short?  Just had transplants, show it!

The main advantage of FUE is NOT the lack of scarring.  There is scarring with FUE, it is just different.  Every time you violate the skin, it will scar.  Instead of having a linear scar, now you will have empty spots all over.  Little ones, mind you, but still empty spaces.  Depending on how much it is done per procedure, this can end up looking honeycomb-ish.  How many times have I seen patients with depleted donor areas that look as if a rooster pick all over it.  But, if done correctly, there can be many advantages to this technique.  It is, for sure, easier on the patient.  There is no cut, no elasticity issues. Within days you are pretty much back to normal.  If you need a bit of work and keep your hair military style, OK.  But if you need tons of grafts, perhaps considering both procedures would be the most effective way to tackle the issue.  This way you are taking advantage of the entire donor area.

Are you concerned that people will know you had a transplant?  Just tell them! If you do, you can return to work immediately.  If you wish for no one to know, it is easier to get away with it with an FUE.  Many factors involved but the doctor can guide you and make some suggestions to make it happen. Typically, to do an FUE, the donor area needs to be shaved.

Not sure about the yield issue.  But the grafts do seem to be more robust with an FUT.  Conserving donor?  Don't think so.  You can keep cutting, typically on the same scar to avoid multiple scars in the donor area.  There comes a point, however, that you run out of elasticity.  It is then time to move to FUE if you decide to have more grafts in the future.

Lastly, cost.  FUE is typically more expensive. On the average, FUT should be around the $4 range.  FUE is more towards the $7 range.  

Oh, regardless of what you decide, please review TONS of photos before making a decision.  It is always about results.  10 years from now, when you are enjoying a fuller set of hair, you will pay little mind to the type of technique you had. Rather, you'll be enjoying the hair particularly if the work was done correctly. If it's crap, you'll live with that for the rest of your life. Do your homework.  

Thanks Laser, awesome reply.

I don't mind the scarring, to be honest, and some doctors are extremely skilled at leaving minimal scarring.

It should also be noted that I have, and probably always will, wear my hair pretty long. 

That makes sense about the donor, these are more-so things I've just read, and sometimes people just say things they've heard.

Thanks again!

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Definitely go for FUT if you're gonna need a lot of grafts. Your donor area will then be pristine above and below the scar, compared to an FUE session where you damage the entire donor area.

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Great replies thus far. 

Bonkling, 

Would you mind sharing a little more information about your specific situation? Age, level of hair loss, family history, and preventive medication regimen -- if any. 

I perform both FUT and FUE, but I am a pretty well known proponent of the FUT method in a lot of situations. In fact, I think most guys would probably benefit most in the long-run by starting with FUT. However,  it would be helpful to get a little more information about your case before making too strong of an endorsement either way. 

 

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2 hours ago, Dr Blake Bloxham said:

Great replies thus far. 

Bonkling, 

Would you mind sharing a little more information about your specific situation? Age, level of hair loss, family history, and preventive medication regimen -- if any. 

I perform both FUT and FUE, but I am a pretty well known proponent of the FUT method in a lot of situations. In fact, I think most guys would probably benefit most in the long-run by starting with FUT. However,  it would be helpful to get a little more information about your case before making too strong of an endorsement either way. 

 

Dr. B

typically, when you review family hair loss history with a male patient, how detailed does it get? Father, grandfathers, brothers? I’m asking because I have a mixed bag. Thanks in advance

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5 hours ago, Dr Blake Bloxham said:

Great replies thus far. 

Bonkling, 

Would you mind sharing a little more information about your specific situation? Age, level of hair loss, family history, and preventive medication regimen -- if any. 

I perform both FUT and FUE, but I am a pretty well known proponent of the FUT method in a lot of situations. In fact, I think most guys would probably benefit most in the long-run by starting with FUT. However,  it would be helpful to get a little more information about your case before making too strong of an endorsement either way. 

 

Hi Blake,

I'm mid 20's, probably approaching a NW 3 but sitting at a 2 at the moment

Im currently on medication (rogaine and fin) and i have strong balding on my dads side

thanks!

Edited by bonkling

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Great info, though I’m not sure I’d agree about FUE being superior in being easier to conceal right off the bat.

Recovery is certainly faster, but if you’re having a smaller hairline procedure in the ballpark of 2000 grafts you have the potential with FUT to grow your hair out to cover the graft zone. With FUE most doctors will want to do a full shave, forcing you to expose the recipient area and the subsequent redness (though some FUE patients have shaved just the back/sides to achieve the same trick).

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16 hours ago, PlzRespond said:

Dr. B

typically, when you review family hair loss history with a male patient, how detailed does it get? Father, grandfathers, brothers? I’m asking because I have a mixed bag. Thanks in advance

Plz, 

To be honest, family history and androgenic alopecia is a mixed bag. Genetic male pattern hair loss is poly-genetic with variable penetrance, which is a fancy way of saying that it can come from pretty much anywhere in the family and can "express" itself in all types of different ways. Just because your mother's father was a NW VI does not mean you are destined to experience aggressive hair loss. In the same sense, if every single male member of your family was a NW VI by age 32 and you have signs of aggressive loss in your late 20's (thinning in front of and above the ear, "sides" of the donor dropping, diffuse hair loss throughout the entire scalp, etc.) then it is more likely than not that you will go this route. There are also certain strong familiar hair loss traits -- such as a persistent frontal forelock -- that I like to explore because it helps with surgical planning. But I think it is best to just get a general dense of what the family history of hair loss is like and keep it in mind while developing our long-term plan. I really don't rely on it too heavily and I always try to put the patient in the best situation "up the road" regardless of how I believe they may or may not progress. 

 Hope this helps. 

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13 hours ago, bonkling said:

Hi Blake,

I'm mid 20's, probably approaching a NW 3 but sitting at a 2 at the moment

Im currently on medication (rogaine and fin) and i have strong balding on my dads side

thanks!

Thank you for sharing. 

Based on your age and the fact that it sounds like it is progressing (as it almost always does), I would likely advise one of my potential patients in this situation to start with FUT. It is not clear what will happen up the road and you will have more lifetime grafts and more certain surgeries in the future if you keep the donor in good shape with FUT

Hope this helps. 

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You can get more grafts out of Fue as you won't need to keep long hair in the back to cover the hugly scar 

I have a fair skin and had two Fue and it's totally scarless I can shave my back and sides to a zero guard and there is absolutely no scarring but that's how my skin heals this may be different for other people or when larger punches are used 

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53 minutes ago, elduterino said:

You can get more grafts out of Fue as you won't need to keep long hair in the back to cover the hugly scar 

I have a fair skin and had two Fue and it's totally scarless I can shave my back and sides to a zero guard and there is absolutely no scarring but that's how my skin heals this may be different for other people or when larger punches are used 

Hey mate,

I don't really understand how how not needing to keep long hair means you get more grafts? Can you explain?

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1368171437_images(19).jpeg.68e5b2691782683cf987885cf6e026d6.jpegIf you remove a lot of grafts from behind you will get low hair density but that OK if you keep hair short, cannot do that if you need to hide a scar that's why guys end up needing a Fue into the Fut scar 

Most guys would trade a low density thin back of the head for a high density lower hairline 

Edited by elduterino

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On 4/3/2019 at 9:38 AM, LaserCap said:

It all depends.  How do you intend to wear your hair down the road?  If long, perhaps FUT.  If very short, to the point that you can clearly see the scalp, FUE. That is somewhat simplistic but not a bad way to think about things.  The way I see it, why do transplants if you want to continue wearing your hair short?  Just had transplants, show it!

 

For me this sums it up.  I found FUT much easier to deal with because there is very little you can to to hide the donor area with FUE.  I have had both, and hated the ridiculous haircut I had with FUE.  I really don't see any difference between the results of my 2 transplants so it comes down to how it effected my daily appearance, and FUT wins hands down.  With either you have to deal with an ugly recipient area, but the donor area with FUT is easy to hide.

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For me the unpredictability of Hair transplants meant FUE was the only viable option for me.  Particularly comparing reality to those posted online.  So many sub par results out there which don't make it online and clinics quash with touch ups.

Buzzing the hair down  with FUE was always a get of jail option to keep in my back pocket.  In saying that not everyone is an FUE candidate particularly if your loss is extensive.

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On 4/4/2019 at 10:16 PM, elduterino said:

1368171437_images(19).jpeg.68e5b2691782683cf987885cf6e026d6.jpegIf you remove a lot of grafts from behind you will get low hair density but that OK if you keep hair short, cannot do that if you need to hide a scar that's why guys end up needing a Fue into the Fut scar 

Most guys would trade a low density thin back of the head for a high density lower hairline 

This seems incredible, to be able to shave to zero with no visible scarring.

In the picture, the skin in the donor above and behind the ear looks like it was digitally smoothed. Was this picture touched up at all? 

Regardless, the top looks great.

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