Fue or fut for me????

[Wendell]

I have a class 5 to 6 alopicia (see pic 1 and 2: pic 3 is not mine, its someone else). The problem is that if I go on the fut strip surgery with 1500 grafts  (amor that I was given by a doctor in the Dominican Republic) for which I need to wear long hair and fut technique demands or requires a high density in  my crown. 1500 grafts is like the density in in the crown in pic 3 which does not allow a fuss or strip surgery because it demands long hair for covering it (camouflage) and hair extraction might not keep my donor area for more for the front (20 grafts per cm2 is needed in the crown and like 12 grafts per cm2 in the front for a total coverage of about 70 cm2 in the crown and about 30 cm2 in in the front) Thats an issue for me, what COULD be your advise for me????? Thank you!!!!

[Wendell]

Your comment please!!

[pkipling]

Hi Wendell! Have you ever had a procedure before? The design/outline of the hairline in the top picture is very clean, and I'm unclear if that's natural or from a procedure. 

Regardless, I'm not sure you're even a good candidate for a hair transplant at all. Treating MPB is one thing. If what you're dealing with is Alopecia, that's a completely different beast and something to handle with caution. So my biggest question is this: How many consultations have you had? I would recommend doing lots of research to find top doctors, focus on the recommended surgeons in this forum, get consultations from at least 3 different surgeons, and then compare their notes/suggestions.  Please don't proceed with anything until you've done this. 

[Dr Blake Bloxham]

Wendell, 

Can you share a picture of the donor area on the sides and back of the scalp? This should be evaluated first. 

[Wendell]

I ve never had a hair transplant. I m not using any medication. I have made  consultation already here in the Dominican Republic. Outside the Dominican Republic I cant get a hair transplant for 3000 or less like in the DR. I am sending pics for my donor area. Thank you. 

[Wendell]

[Wendell]

Here some more pics of me. I am 42 years old. I started to loose my hair at the age 20. Now it is stabilized, no hair loss , just thinning hairs in the front and that annoying hole in the crown. Is my donor area density good for harvesting more than 1600 grafts without noticing the tiny fue holes ???? Which is the for my hair type  (curly hair) the best FUE or the trip one?????

[Wendell]

I want a HT for this month because with this hole in the crown I am very old , I want 10 years old less, jjj and my students and teachers (I am a teacher) are doing bulling for my alopicia jjjj. Please I need your answear before I get my hair transplant done. See my pics

[Dr Blake Bloxham]

Hi Wendell, 

Thank you for sharing. I thought this is what your donor may look like. Very classic for that type of hair we see in certain patients from the Dominican. These patients tend to have thick, coarse, hairs which typically equate to very large follicles. This usually means a decreased donor density because the large follicles take up more space and tend to be spread further apart. 

You appear to have advanced hair loss and a lower than average donor density due to the large, spread apart follicles. Now, the good news is that this type of follicle tends to give EXCELLENT coverage; the not as good news is that you are limited in the number of grafts you have available and scarring may be more difficult to conceal. If you came into my clinic for a consultation with this presentation, I would recommend two planned FUT procedures: the first to re-establish the hairline, densely pack the frontal scalp, and strategically work into the mid-scalp; the second would address the remainder of the mid-scalp and strategically address the crown. 

I see why FUE would be an appealing option with your donor area. While I think scarring from a 1,600 graft case would be reasonable if it were spread out properly, you will have noticeable "dot" scarring (especially with your nice tan skin tone) if you keep it very short, and I also think you are greatly reducing the number of lifetime grafts available if you start with FUE. Your hair type also tends to be a tricky one with the FUE approach. I believe you would likely have a fairly unpredictable curve to the follicle under the skin, and this can be challenging to get around. Doesn't meant that it cannot be done -- and some even have tools aimed specifically at addressing this issue; but it will make FUE even more challenging and the grafts will likely be a little more traumatized. 

As far as the estimate of 1,500 grafts to the crown: Keep in mind that I have not evaluated you in-person so I defer to whomever has; however, I have a sneaking suspicion that this amount may not achieve your goals in the crown. My guess is that to do the crown to the level at which you would like it filled, you are probably looking at closer to 2,000 grafts minimum, but likely closer to 2,500. I would also think about addressing the front first -- as it appears this region is thinning and will likely reach the level of the crown. 

I hope this helps. 

Dr Bloxham 

[Dr Blake Bloxham]

Also ... 

Please do not rush into getting a procedure. I understand the urgency to get it done; trust me, I do. However, it is far better in the "long term" to take your time now and make the best decision possible opposed to rushing into a procedure and being dissatisfied or spending more time and money (and irreplaceable donor follicles) to fix or augment things up the road. It is a common tale we see and something that you should do your best to avoid. 

[Melvin- Admin]

Wise words and great post^

[Wendell]

20 minutes ago, Dr Blake Bloxham said:

Also ... 

Please do not rush into getting a procedure. I understand the urgency to get it done; trust me, I do. However, it is far better in the "long term" to take your time now and make the best decision possible opposed to rushing into a procedure and being dissatisfied or spending more time and money (and irreplaceable donor follicles) to fix or augment things up the road. It is a common tale we see and something that you should do your best to avoid. 

You re right

[Dr. Patrick Mwamba]

you need 2000 in the back and 1000 to 2000 in front + prp + medication 

A lot of grafts .FUT will be the option if you are sure to keep your hair longer  ( because scar is never predictable ) .

If you plan to keep it short , go for FUE .The dots are not very noticeable in my  sample of black patient .

[haircrown123]

Follicular Unit Extraction (FUE), as opposed to the FUT procedure, is a hair transplant method in which the doctor extracts the follicular units of hair, from the donor area of your head, one by one. The doctor uses a small microneedle, which punches a tiny incision around a hair follicle before extraction. It is a less invasive surgery than FUT with no visible scarring in the donor area.FUE hair transplant is the advanced technology to restore your natural hair.

[JohnCasper]

Good advice from Dr. Bloxham.  Based on the pictures I’m just not sure you have ample donor area to really make the difference you may be looking for.   The crown area is difficult to cover.  I’ve had over 7,000 grafts transplanted with over 2,000+ in the crown area.  

Make sure you get more than one consultation.  Best of luck to you..

[Gabreille Nelson Mukhia]

On 4/19/2019 at 12:13 AM, Wendell said:

I have a class 5 to 6 alopicia (see pic 1 and 2: pic 3 is not mine, its someone else). The problem is that if I go on the fut strip surgery with 1500 grafts  (amor that I was given by a doctor in the Dominican Republic) for which I need to wear long hair and fut technique demands or requires a high density in  my crown. 1500 grafts is like the density in in the crown in pic 3 which does not allow a fuss or strip surgery because it demands long hair for covering it (camouflage) and hair extraction might not keep my donor area for more for the front (20 grafts per cm2 is needed in the crown and like 12 grafts per cm2 in the front for a total coverage of about 70 cm2 in the crown and about 30 cm2 in in the front) Thats an issue for me, what COULD be your advise for me????? Thank you!!!!

There are factors that need to be discussed accurately prior to you going for the procedure:

1. What is your expectation from this procedure? You must have a very clear expectation as "satisfaction" is the product being delivered to you in the long term.

2. How is the density in your beard? Are you okay with the doctors extracting the donor from your beard?

3. If extremely small and sharp punches are used, the scarring is minimal. Also the doctors must be very discreet in the extraction and make it look uniform. Planning is perfection.

4. Do you want to have the coverage of your entire scalp in a single sitting or over two sittings? Because that will also determine how many grafts can be extracted from the scalp. The doctors cannot afford to make too many wounds on your scalp donor in a single sitting. They must spread it out to extract with regards to the full potential of your donor availability.

5. Medicines could also help thicken your hair. But it is a option and you can choose to opt for it. You choice depends on your body's reaction to the medications. 

You should get a fair idea of the look and density the doctors can give you and compare it to your expectations. Thereafter, you should take each step carefully further into your hair restoration journey.

There are so many Senior members in this forum with ample knowledge to guide you. Wish you the best in your journey. 

[Lennney]

3 hours ago, Gabreille Nelson Mukhia said:

There are factors that need to be discussed accurately prior to you going for the procedure:

1. What is your expectation from this procedure? You must have a very clear expectation as "satisfaction" is the product being delivered to you in the long term.

2. How is the density in your beard? Are you okay with the doctors extracting the donor from your beard?

3. If extremely small and sharp punches are used, the scarring is minimal. Also the doctors must be very discreet in the extraction and make it look uniform. Planning is perfection.

4. Do you want to have the coverage of your entire scalp in a single sitting or over two sittings? Because that will also determine how many grafts can be extracted from the scalp. The doctors cannot afford to make too many wounds on your scalp donor in a single sitting. They must spread it out to extract with regards to the full potential of your donor availability.

5. Medicines could also help thicken your hair. But it is a option and you can choose to opt for it. You choice depends on your body's reaction to the medications. 

You should get a fair idea of the look and density the doctors can give you and compare it to your expectations. Thereafter, you should take each step carefully further into your hair restoration journey.

There are so many Senior members in this forum with ample knowledge to guide you. Wish you the best in your journey. 

First of all, @Dr Blake Bloxham is the MVP with the response! 

I agree with looking into using body hair as a supplement to whatever HT you ultimately go with. If I were you, to help you decide FUE v FUT, I would look at similar demographic patients and what hairstyle you would wear if you had the hair for it. There are definitely pros and cons to both procedures, but the scarring with FUE really is minimal, and less noticeable while FUT may (potentially) get you better HT results. I think the advice Dr. Blake mentioned about "unpredictable curving" is something you should pay attention to. Address the issue with all docs you reach out to. 

Your case is a little more complicated than others, so it is imperative you spend that much more time researching and collecting information.