2nd HT Procedure, FUE recs?

[needmorehairs]

Hi All,

I am 34 years old and had my first FUT HT procedure in 2011. I had the procedure done with Dr. Wong and had approximately ~4000 grafts put in. Even at that time, I had pretty serious thinning from the front hairline to the crown. I have pretty thin hair and we focused our efforts on the front 1/3 of my scalp, then the crown and left the mid-section between front and crown relatively untouched. At the time, I wanted to lower my hairline as well, however because my hairline was already so receded, it was recommended to have a higher hairline and focus on density. I've been on Propecia since then as well.

As my native hairs have slowly been falling out (despite Propecia) I have been thinking about repeating a second HT procedure, this time with the FUE method. My scar has healed very well however I'd still prefer the FUE procedure. I know Dr. Wong is very skilled and I will be reaching out again, however I wanted to get your thoughts on other docs to consider. I currently live in NYC.

I know that my hair is pretty thin so I have realistic goals as to density and fullness. My main goals right now are to fill in the crown area (pretty large bald spot at this point), lower the front hairline, and strengthen the thinning hair behind the front hairline as well.

Please let me know your thoughts and if you have any recommendations! Thank you!

[Fozzie]

I think Dr Wong does some of the best crown work in the business. I'd be very tempted to stick with him for a crown procedure personally.

[1978matt]

While I can understand the desire for FUE I'd strongly consider at least one more FUT.

I would have done if my hair were a moving target but it has been stable (more or less) the last 7 or 8 years, and I am 41.  You also have quite fine hair which is more challenging to get density.

[jjsrader]

I think you should have H&W strip you again from the same strip scar area - cutting out the original leaving you w/just one scar (which you already have).  You'll get the best of the best donor area & you'll preserve outside that zone for an FUE down the road if you desire.

You have fine hair and alot of real estate to cover for your 2nd surgery & you already have a scar.  Down the road you could have fue into the scar if you want to go for shorter hair & you'll still have more hair for a full FUE session if you want.

You are only 34 and you'll continue to slowly lose native hair even if you were on stronger meds such as Avodart and oral minox (over time) - just more slowly than w/finasteride.

[needmorehairs]

Thank you for the input!

Do you both think an FUT would be the only way to get enough density to lower the hairline and cover the scalp? Or would it be possible to do it piecemeal as well via say 2 FUT procedures (one for each area)?

While I did have a good scar result without shock loss or deep scarring with the first procedure, I'm hesitant whether I will be able to have the same result with another FUT? Any thoughts regarding this? Also with removing more tissue for a strip, is there any risk for further retracting the front hairline with removing the strip area from the back of the head?

[jjsrader]

Lots of people do fine w/3 FUT's.  If you want a smaller FUT for your 2nd & 3rd surgery - go for it.  The frontal hairline will not be pulled back.  If you have alot of FUT surgeries the nape at the bottom of the hair zone might come up a bit - but that's not common.

I'd go back to H&W and get sorted out.  You can probably have another surgery w/that original scar & if you do a 3rd FUT you could have a 2nd smaller scar right underneath it.

[JohnCasper]

I know FUT produces good results but FUE yields great results as well.  I just can't imagine discussing lengthy linear scars when FUE leaves little to no discernible scarring.  I've had over 7,000 FUE grafts.  This picture shows my donor area after 1,750 grafts have been removed.  Best of luck with your next FUT but continue to consider FUE.

[pkipling]

Considering you've already had a successful FUT with Dr. Wong, I think it's definitely worth at least having another consultation with him and discussing your concerns with him. He's one of the most credible around, so his input on the matter - particularly on how/if he thinks the scar may differ on a 2nd pass - would be very valuable. (And this is coming from someone who was very adamant about doing FUE when I had my HT.)

[Noodles123]

Based on your hair characteristics (fine hair, advanced hair loss) I think you'd be better served by an FUT.  You need lots of grafts to make an appreciable difference and FUT is still the best way to maximize your total grafts.