FUT or FUE and Recommended Clinics?

[hairlineman]

Hello everyone!

Just want to say first that I truly appreciate this website and all of it's members. I've learned so much from this site even before I created an account in 2013. I've sent a couple private messages several months ago asking for opinions, but this will be my first public post where I'll finally share my story, hair transplant results with Dr. Rahal, and hopefully you all can give me some honest reviews/recommendations.  Two things before I get started. I don't have the best quality pictures nor very many of them and I apologize. And also I know my username is about as cheesy as it gets. It seemed appropriate at the time before I had my first hair transplant and my primary goal at the time was to create a naturally looking hairline. 

I'm 39 years old now and live in Missouri - United States. I started receding at 16 years old. Almost had a HT with Bosley in my early 20's but thank God I wrecked my car and then couldn't afford it. Going to Bosley would've been the worst decision ever. I took Propecia/Finasteride off and on in my 20's and early 30's which really helped. And then I stopped the medicine when I was around 32 because I knew at some point in the near future my fiancee and I would be trying to do In-Vitro Fertilization. Less than a year after I stopped Finasteride I had lost a lot more hair and it was driving me crazy. I was about to get married and I knew it was time to get a hair transplant asap.

After all the research I had done up until this point I was 100% sold on Dr. Rahal.  My goal was to create a new hairline that was dense and natural looking and I felt that Dr. Rahal was the surgeon I needed. I ended up having a FUT with Dr. Rahal in October, 2013. Based on my hair loss at that time, Dr. Rahal recommended 4000 grafts by FUT. Once the procedure was finished I only ended up with 2949 grafts based on my laxity and donor density. 

Four to five months after my FUT with Rahal I was feeling optimistic because more new hairs were starting to sprout. I was also given the okay from Rahal's team to use Toppik if I wanted. I had never used any hair fibers in the past and this was a complete game changer for me. Even though at 6 months my results were see through and not dense, with the help of Toppik, I was able to create an illusion of a full head of hair.

A year after my FUT with Rahal I took pictures and emailed them to Rahal’s team. I expressed that I felt my growth was not what I imagined it would be and that I’d like to hear Dr. Rahal’s opinion of my results. I didn’t make a big deal about it to Rahal’s team. Rahal’s team responded and said they covered an area of over 81cm with 2949 grafts, which is an average of 36 graft/cm squared. They also said at that density we expect to see some see though and visibility of the scalp. I was also advised that when Dr. Rahal reviewed my file that my grafts were fragile and my skin was tough to create popping. Dr. Rahal advised the fix would be to do another procedure/add more grafts and bring the density closer to 50 grafts/cm squared which would give a better illusion of density. Dr. Rahal also offered me 300 free grafts if I scheduled another hair transplant.

By the way, I financed the hair transplant with Rahal thorough my own bank in Missouri on a 5 year loan. So a year after my HT when I knew I needed another HT in order to add more density and getting a better result, I knew I simply couldn’t afford anytime soon. So I let it go and went on with my life using Toppik every day and making the most out of the hairs I had.

Also, I’m absolutely not blaming Rahal for my result. I think he is an amazing surgeon and I consider him to be very ethical. Even though I didn’t get a homerun result which I know now is not always the case, the result I got with the combination of Toppik changed my life and appearance in a very positive way. I’ve always known I’ve had thin hair, but I didn’t realize until lately that different hair characteristics play a very important role in the final result or the illusion of density. I also think it’s very likely that the reason I didn’t get a homerun is because my hair being very fine, not many triples and no quads, not able to get as many grafts needed to cover my larea needed, possible below average growth, and no finasteride.

Here I am now, five years since I had my FUT with Rahal. I haven’t taken Finasteride in 7 years or so and I’ve lost so much more hair. I still use Toppik almost every day, except for the days I wear my hat. I’m tired of using toppik and spending so much time fixing my hair and stressing over it. It’s exhausting and depressing to say the least. I’ve considered shaving my head and also considered getting a hair replacement system. My gut tells me I wouldn’t be happy with either of those two options. Since I was successful at IVF and had a healthy child, hopefully very soon I’ll get back on Propecia or Finasteride which I know will help.

What I really want and think I need is another hair transplant. In a perfect world I’d love to get one mega session and be done. Reality tells me I might not be the best candidate for that nor does that happen every time. So I want to be realistic. I’m not sure if I should go the FUT route again or if I should try FUE? Even though my hair characteristics are not amazing, if I were to get another FUT or FUE who would you guys recommend? Obviously I have a lot of area to cover and I’d love to cover as much area as possible in one session. Thank you all so much for reading this and sharing your opinions!

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited April 25, 2019 by hairlineman
pictures in wrong order

[CosmoKramer]

Hi

In my opinion, I agree, your hair caliber looks on the thin side and looks like you did have a large area to cover with just under 3k grafts so the see-through results make sense. Honestly, I don’t see why you couldn’t go FUE not sure about FUT again as you mentioned laxity issue, it would be my choice to go FUE after any FUT (although I only have done FUE), and from your photos you do seem to have some donor for a 2nd but would be good to see a fuller photo of your back donor area.

[harry_potter1]

I would recommend H&W or Diep if money isn't an issue for you, I think those 2 are the best for your case. 

Might Asmed or some other Turkish clinic if you want to save money

[Lennney]

I agree with Cosmo, if I were in your position, I would look for a doc who can maximize your hairs over the balding area. I also agree with Cosmo that your only option is FUE due to laxity. I think a little balding is fine, and lets you stay mortal. Your 1 year after surgery is a fine look (since you only addressed your hairline), and thinning isn't the end of the world - doesn't look nearly as bad as bald. In your soon-to-be 40s, I think adding density to the crown will benefit your image (and reduce your toppik use!).  Congrats on your healthy child. Glad to see you were successful at achieving what you thought fin was/could have kept you from achieving. Now that it's done, go back to fin ASAP!

Also, I am really curious now that you've mentioned it, but the terms on your loan. I've recommended to others to take a personal loan to finance the HTs, but I would love to know what to expect with such a loan (I've come close to taking them out when I was much younger, but it was for vehicles and auto loans are better and easier to get).

Feel free to answer in a PM if you're semi-comfortable. I think it is really helpful though for many readers.

1. Was your loan secured by any asset?

2. Credit union or bank?

3. Sum of the loan?

4. Rate on the loan?

5. Approximate credit score at time of loan creation? On the 300-850 scale in case it's not clear.

I assume it must have been significantly better than a credit card...

 

Best of luck on your decision(s)!

[hairlineman]

11 hours ago, CosmoKramer said:

Hi

In my opinion, I agree, your hair caliber looks on the thin side and looks like you did have a large area to cover with just under 3k grafts so the see-through results make sense. Honestly, I don’t see why you couldn’t go FUE not sure about FUT again as you mentioned laxity issue, it would be my choice to go FUE after any FUT (although I only have done FUE), and from your photos you do seem to have some donor for a 2nd but would be good to see a fuller photo of your back donor area.

Thank you for your feedback! I attached hopefully a better pic of my back donor area. You might be right about going straight for a FUE. I had reached out to @Gasthoerer a while back and he recommended to go check my laxity at a U.S. clinic which I thought was a great idea. I haven’t done that yet, but hopefully will be able to soon. 

[hairlineman]

12 hours ago, harry_potter1 said:

I would recommend H&W or Diep if money isn't an issue for you, I think those 2 are the best for your case. 

Might Asmed or some other Turkish clinic if you want to save money

Thanks for your feedback! You are right about H&W, I’ve always thought H&W’s results have been amazing and they have a great reputation. I’m not that familiar with Diep so I’ll have to research him. And I feel Asmed has had some outstanding “one pass” results. His graft calculator is pretty interesting as well. I will continue to keep Asmed in mind. Thank you!

[DrTBarghouthi]

Congratulations on your hairline work and the baby ;))

I agree with some comments here that laxity might limit the option for another FUT. Nonetheless, you have what seems to be a good donor area for extracting a good number. Just be sure to leave some for the crown at some point if you think it might be worth.

Can you perhaps share the laxity results with us? You can do this at home. Just place two dots over the scar and have both dots 5 cm apart. You then use both thumbs to try and push the dots closer to each other. From this you get a percentage which is basically your laxity index.

[hairlineman]

14 hours ago, Lennney said:

I agree with Cosmo, if I were in your position, I would look for a doc who can maximize your hairs over the balding area. I also agree with Cosmo that your only option is FUE due to laxity. I think a little balding is fine, and lets you stay mortal. Your 1 year after surgery is a fine look (since you only addressed your hairline), and thinning isn't the end of the world - doesn't look nearly as bad as bald. In your soon-to-be 40s, I think adding density to the crown will benefit your image (and reduce your toppik use!).  Congrats on your healthy child. Glad to see you were successful at achieving what you thought fin was/could have kept you from achieving. Now that it's done, go back to fin ASAP!

Also, I am really curious now that you've mentioned it, but the terms on your loan. I've recommended to others to take a personal loan to finance the HTs, but I would love to know what to expect with such a loan (I've come close to taking them out when I was much younger, but it was for vehicles and auto loans are better and easier to get).

Feel free to answer in a PM if you're semi-comfortable. I think it is really helpful though for many readers.

1. Was your loan secured by any asset?

2. Credit union or bank?

3. Sum of the loan?

4. Rate on the loan?

5. Approximate credit score at time of loan creation? On the 300-850 scale in case it's not clear.

I assume it must have been significantly better than a credit card...

 

Best of luck on your decision(s)!

Thanks for your feedback! Yeah my plan is to get back on Fin ASAP. We are actually attempting IVF again as we speak for a 2nd child, fingers crossed my wife gets pregnant so I can get back on Fin. This has been the holdup again as of recently.

I know you are recommending me do an FUE and I’m definitely considering it. I had thought if you’ve already done an FUT that you should do as many as you can before you start doing FUE. I also don’t know if that’s true. But I’d hate to go in for a FUT and only get like 1500 grafts. I’m not sure how common this is, but I’ve heard of some clinics doing a combo surgery where they perform FUT & FUE in same session. In a perfect world I’d love to get 3000 to 5000 grafts in one session. We’ll see. 

I’m happy to discuss how I financed my first HT with Rahal. 

*** My HT with Rahal was $13,500. I bank with a credit union and refinanced my car and that auto loan was $10,000. The car loan APR was in the 4% range. I opened a credit card at that credit union and put the remaining balance of the HT ($3,500) plus my airline ticket, and hotel purchases. So I believe I ended up putting a total of $6,000 or so on that card. The APR on that credit card was 9.99%. Luckily I was able to pay off that higher interest loan (credit card) within several months. As far as the car loan goes I took out a 5 year loan and payed it off in 4 years. I’m not saying this is a great way to get a HT if you don’t have the money already, but this decision changed my life and my confidence and I’d do it again. Hope this info helps! 

[Lennney]

1 hour ago, hairlineman said:

Thanks for your feedback! Yeah my plan is to get back on Fin ASAP. We are actually attempting IVF again as we speak for a 2nd child, fingers crossed my wife gets pregnant so I can get back on Fin. This has been the holdup again as of recently.

I know you are recommending me do an FUE and I’m definitely considering it. I had thought if you’ve already done an FUT that you should do as many as you can before you start doing FUE. I also don’t know if that’s true. But I’d hate to go in for a FUT and only get like 1500 grafts. I’m not sure how common this is, but I’ve heard of some clinics doing a combo surgery where they perform FUT & FUE in same session. In a perfect world I’d love to get 3000 to 5000 grafts in one session. We’ll see. 

I’m happy to discuss how I financed my first HT with Rahal. 

*** My HT with Rahal was $13,500. I bank with a credit union and refinanced my car and that auto loan was $10,000. The car loan APR was in the 4% range. I opened a credit card at that credit union and put the remaining balance of the HT ($3,500) plus my airline ticket, and hotel purchases. So I believe I ended up putting a total of $6,000 or so on that card. The APR on that credit card was 9.99%. Luckily I was able to pay off that higher interest loan (credit card) within several months. As far as the car loan goes I took out a 5 year loan and payed it off in 4 years. I’m not saying this is a great way to get a HT if you don’t have the money already, but this decision changed my life and my confidence and I’d do it again. Hope this info helps! 

So your loan was secured through your vehicle, and the rest was through credit cards?

I was curious to see what a loan not backed by an asset would get you. But it sounds like you were good with your finances.

I agree that loans for HT are worth it, especially if you put a value on time in your 20s and 30s.

Money doesn't make you happy. Being happy makes you happy. Being happy comes from feeling good, which comes from fixing what was making you unhappy. By this logic, a HT (and debt) in my opinion can make you happy.

Also, we all say FUE because of the laxity thing. Try the thing @DrTBarghouthi said, and see how much laxity you find.

[CosmoKramer]

7 hours ago, hairlineman said:

Thank you for your feedback! I attached hopefully a better pic of my back donor area. You might be right about going straight for a FUE. I had reached out to @Gasthoerer a while back and he recommended to go check my laxity at a U.S. clinic which I thought was a great idea. I haven’t done that yet, but hopefully will be able to soon. 

Your donor area looks good. Good luck in whichever route you choose!

[Al - Moderator]

I would definitely ask the Dr how many grafts he thinks he can get with another FUT. If you can get in the 2300 to 2500 range then I think that's the way to go. You have thin hairs which Dr Rahal said were fragile and your overall donor area is not very dense. That is not a great type of hair and donor for FUE. Trying to get 5000 FUE grafts out of a thin donor area may make it look overly depleted, so be careful with that. If you're only going to get 2000 to 2500 grafts FUE then you may as well go with FUT and save yourself the difference in cost. I would try to get 2300 to 2500 FUT in a first session and then another 1500 to 1800 in a second FUT session a year or two later to finish it if that's possible to do.

 

[Al - Moderator]

21 hours ago, Lennney said:

I1. Was your loan secured by any asset?

2. Credit union or bank?

3. Sum of the loan?

4. Rate on the loan?

5. Approximate credit score at time of loan creation? On the 300-850 scale in case it's not clear.

I assume it must have been significantly better than a credit card...

 

What I did was apply for a credit card that had an introductory no interest on balance transfers for one year. They gave me a $13000 credit limit. I then had the hair transplant and put it on my other credit card which has a $14000 credit limit with 1% cash back.

So lets say the procedure costs $13000. I put that on my original credit card and get $130 cash back. I pay $5000 to that card from what I saved up so far for the procedure (if you haven't been able to save anything in the year leading up to the hair transplant, then you can't afford it) and do a balance transfer to the new card for $8000. There was a 2% fee for balance transfers, so it cost me $160, but most of that was offset by the 1% cash back from the other card. Then I have no interest on the $8000 for one year, so I just had to make sure I paid around $700 per month towards it to get it paid off in a year. Those aren't my exact numbers, but that is what I did.

Some cards now give you up to a year and a half with no interest, so if you can get one of those then the payments aren't really too extreme. Just make sure to pay it off before the time limit or else they charge you interest from the beginning.

 

 

[Lennney]

3 hours ago, BeHappy said:

 

What I did was apply for a credit card that had an introductory no interest on balance transfers for one year. They gave me a $13000 credit limit. I then had the hair transplant and put it on my other credit card which has a $14000 credit limit with 1% cash back.

So lets say the procedure costs $13000. I put that on my original credit card and get $130 cash back. I pay $5000 to that card from what I saved up so far for the procedure (if you haven't been able to save anything in the year leading up to the hair transplant, then you can't afford it) and do a balance transfer to the new card for $8000. There was a 2% fee for balance transfers, so it cost me $160, but most of that was offset by the 1% cash back from the other card. Then I have no interest on the $8000 for one year, so I just had to make sure I paid around $700 per month towards it to get it paid off in a year. Those aren't my exact numbers, but that is what I did.

Some cards now give you up to a year and a half with no interest, so if you can get one of those then the payments aren't really too extreme. Just make sure to pay it off before the time limit or else they charge you interest from the beginning.

 

 

Absolutely love the balance transfer to an introductory 0apr card. I think it's under utilized if you are disciplined with making payments when they're "not due".

Good info, thanks!

[Shera]

Hi Hairlineman,

Going back to your donor, I too think it looks good to go and I can't see any reason why you shouldn't get 3000-3500 FUE grafts from it to reinforce your hairline and strengthen your mid scalp going back to your vertex. This will I believe make all the difference.

I would also point out that you may have lost most of your native hair in this area and all that remains could be the transplanted hairs from your first procedure. If that's the case then Finasteride use won't really make a difference here.

Also congratulations on your child, I hope that next round of IVF is equally successful.

[hairlineman]

On 4/25/2019 at 11:16 PM, BeHappy said:

I would definitely ask the Dr how many grafts he thinks he can get with another FUT. If you can get in the 2300 to 2500 range then I think that's the way to go. You have thin hairs which Dr Rahal said were fragile and your overall donor area is not very dense. That is not a great type of hair and donor for FUE. Trying to get 5000 FUE grafts out of a thin donor area may make it look overly depleted, so be careful with that. If you're only going to get 2000 to 2500 grafts FUE then you may as well go with FUT and save yourself the difference in cost. I would try to get 2300 to 2500 FUT in a first session and then another 1500 to 1800 in a second FUT session a year or two later to finish it if that's possible to do.

 

Thanks for your recommendation! Everything you said makes sense and trying to get my coverage in 2 sessions might just be a smarter route. 

[hairlineman]

On 4/25/2019 at 11:32 PM, BeHappy said:

 

What I did was apply for a credit card that had an introductory no interest on balance transfers for one year. They gave me a $13000 credit limit. I then had the hair transplant and put it on my other credit card which has a $14000 credit limit with 1% cash back.

So lets say the procedure costs $13000. I put that on my original credit card and get $130 cash back. I pay $5000 to that card from what I saved up so far for the procedure (if you haven't been able to save anything in the year leading up to the hair transplant, then you can't afford it) and do a balance transfer to the new card for $8000. There was a 2% fee for balance transfers, so it cost me $160, but most of that was offset by the 1% cash back from the other card. Then I have no interest on the $8000 for one year, so I just had to make sure I paid around $700 per month towards it to get it paid off in a year. Those aren't my exact numbers, but that is what I did.

Some cards now give you up to a year and a half with no interest, so if you can get one of those then the payments aren't really too extreme. Just make sure to pay it off before the time limit or else they charge you interest from the beginning.

 

 

Thanks so much for sharing! I wish I would’ve thought of that back when I had my HT with Rahal. This will be my game plan on HT # 2. 

[hairlineman]

On 4/25/2019 at 11:16 PM, BeHappy said:

I would definitely ask the Dr how many grafts he thinks he can get with another FUT. If you can get in the 2300 to 2500 range then I think that's the way to go. You have thin hairs which Dr Rahal said were fragile and your overall donor area is not very dense. That is not a great type of hair and donor for FUE. Trying to get 5000 FUE grafts out of a thin donor area may make it look overly depleted, so be careful with that. If you're only going to get 2000 to 2500 grafts FUE then you may as well go with FUT and save yourself the difference in cost. I would try to get 2300 to 2500 FUT in a first session and then another 1500 to 1800 in a second FUT session a year or two later to finish it if that's possible to do.

 

@BeHappy

 

On 4/25/2019 at 11:16 PM, BeHappy said:

I would definitely ask the Dr how many grafts he thinks he can get with another FUT. If you can get in the 2300 to 2500 range then I think that's the way to go. You have thin hairs which Dr Rahal said were fragile and your overall donor area is not very dense. That is not a great type of hair and donor for FUE. Trying to get 5000 FUE grafts out of a thin donor area may make it look overly depleted, so be careful with that. If you're only going to get 2000 to 2500 grafts FUE then you may as well go with FUT and save yourself the difference in cost. I would try to get 2300 to 2500 FUT in a first session and then another 1500 to 1800 in a second FUT session a year or two later to finish it if that's possible to do.

 

@BeHappy, May I ask who you had your HT with? 

[Al - Moderator]

38 minutes ago, hairlineman said:

 

@BeHappy, May I ask who you had your HT with? 

Dr Robert Dorin from True & Dorin in NY. They do both FUE and FUT. I don't know their current prices as I had body hair transplanted to my head which cost more than their normal rates.

 

[hairlineman]

On 4/26/2019 at 6:37 AM, Shera said:

Hi Hairlineman,

Going back to your donor, I too think it looks good to go and I can't see any reason why you shouldn't get 3000-3500 FUE grafts from it to reinforce your hairline and strengthen your mid scalp going back to your vertex. This will I believe make all the difference.

I would also point out that you may have lost most of your native hair in this area and all that remains could be the transplanted hairs from your first procedure. If that's the case then Finasteride use won't really make a difference here.

Also congratulations on your child, I hope that next round of IVF is equally successful.

Thanks for your help @Shera. If I were able to get 3000 to 3500 grafts and reinforce my hairline, strengthen my midscalp going back to my vertex, do you think it would be dense enough where I wouldn’t have the see through look anymore in the new transplanted area? I’m asking because my hair is so thin. 

[Shera]

On 4/28/2019 at 11:50 PM, hairlineman said:

Thanks for your help @Shera. If I were able to get 3000 to 3500 grafts and reinforce my hairline, strengthen my midscalp going back to my vertex, do you think it would be dense enough where I wouldn’t have the see through look anymore in the new transplanted area? I’m asking because my hair is so thin. 

I think after having 3000-3500 grafts your hair will appear to be full to anyone at first glance, but as you are in no doubt aware the density will never match your original so in strong lighting/sun there is always some transparency in the scalp.

You can counter this by keeping your hair at the optimal length of 1 to 1.5 inches to create the best fullest effect. Also your choice of style can play into this. Other options include using hair thickening shampoo/cream or you could have SMP done on the scalp to further enhance the denser look or a light sprinkling of fibers if need be.

I personally think you'll be happy with another 3500 grafts grown out.

[hairlineman]

On 4/28/2019 at 5:18 PM, BeHappy said:

Dr Robert Dorin from True & Dorin in NY. They do both FUE and FUT. I don't know their current prices as I had body hair transplanted to my head which cost more than their normal rates.

 

Was that your first HT or your last?

[hairlineman]

On 5/1/2019 at 6:13 AM, Shera said:

I think after having 3000-3500 grafts your hair will appear to be full to anyone at first glance, but as you are in no doubt aware the density will never match your original so in strong lighting/sun there is always some transparency in the scalp.

You can counter this by keeping your hair at the optimal length of 1 to 1.5 inches to create the best fullest effect. Also your choice of style can play into this. Other options include using hair thickening shampoo/cream or you could have SMP done on the scalp to further enhance the denser look or a light sprinkling of fibers if need be.

I personally think you'll be happy with another 3500 grafts grown out.

Thank you @Shera! Everything you said makes sense and it’s important that I be realistic. But I’d imagine I’d be happy with 3000-3500 grafts. Thanks again!