reconstruct hairline - FUT vs FUE and choosing surgeon

[karatekid]

Ok so I got a little deeper, in my journey to HT, and have some considerations I would like to have your opinions for.

My first thread is (you dont have to read):

  My goal is reconstructing the hairline. Feriduni suggested 2000-2600 grafts, and Dr.Hasson suggested 1500-2000 both from online estimation. So I have few questions:

1. I wonder why is the difference? I made clear for both that I want to focus on good density, and even lower a bit the hairline. I said I have no problem to go for FUT, so it means I can get more from the donor and still save for long run. How do I know if Hasson suggested lower number to be conservative on the donor or because it's the maximum density he thinks possible to pack in this area?  Can I just tell that I was thinking for higher number?

2.  I got estimation from both, but they are not the final list. I actually have hard time to decide basically between 'saving for long term' and 'have the best hairline'. Because my 2 top docs for kickass hairlines, according to my research are Dr.De Freitas and Dr.Pekiner, but they both do only FUE, and while I can go for FUE since my hairloss isnt too advanced (Im 30 now), I dont really know how much it will progress, so I think going for FUT will be smart for long term.  Portugal suggested Dr.Rahal but I ruled him out due to bad cases of him that I encountered. If you have more suggestion for FUT doctors that have great hairlines I would be happy to hear.

3. Would you go to have a procedure with Doctor you didnt have consultation before (online or fronal)? It is problem for me to fly to Canada for consultation, and Dr.Hasson doesnt offer video  call. I wonder if it's smart to just set up appointment with him like that.

4. Which brings me to this question - isnt it weird that Dr.Hasson dont require live consultation for FUT? I have been told here that scalp laxity should be verified by the doctor before going with FUT,  what if I will get there at the operation day and he will find out Im not candidate for FUT?

 

Thanks guys!

[hairlossPA]

I had an in-person consultation with Doug (H&W rep). He was great. Felt my laxity. Explained everything very well. I felt comfortable. I would email/message/check their website if they’re coming to any cities close to you for in person consults. Unfortunately Dr. Hasson and Wong don’t usually visit since they are in the operating room doing their surgeries most days of the week, which I can totally understand.

As far as the graft estimation, they’re not totally far off. I would trust both as they are both reputable. I will say, Dr. Hasson has shown some of the most dense packs I have ever seen, that look super clean post-op. I cannot opine on the other surgeon you mention.

As far as FUT or FUE, i’m sure you know the pros and cons, and that really comes down to preference... are you on finasteride?

[karatekid]

Well they are coming to London in 10 days, but first it's not very 'close', still ~7 hours flight lol, and second due to short notice I cant make it anyway. But actually maybe I will ask just for a video call with a representative, hope it is good enough.

And ye I trust both of them, but it's not about trust, it's more like personal taste and priorities. and my priority is to get the best hairline, not being too conservative.

Yes Im on finasteride, I wasnt very consistent but I start now that Im getting a transplant

 

 

[hairlossPA]

where are you located? i feel like Dr. Hasson is anything but conservative

[karatekid]

I live in middle east.

Lol ye I know what you mean he usually uses large number of grafts. I wonder why he gave me relatively low estimation. 

[Portugal25]

@karatekid I said that in 2008 Rahal was the King of Hairlines but if you ask me today who I would chose for FUT it would be Konior, Diep or H&W. 
Having said that, with today’s advances in FUE results if I was doing my first HT in 2020 I would surely go for FUE.

[Gasthoerer]

8 minutes ago, Portugal25 said:

… if you ask me today who I would chose for FUT it would be Konior, Diep or H&W. 

Really? Can you elaborate on that? Melvin's result is great but Diep has to many "no go"-points to me. 

[Portugal25]

13 hours ago, Gasthoerer said:

Really? Can you elaborate on that? Melvin's result is great but Diep has to many "no go"-points to me. 

@Gasthoerer besides Melvin there are other great FUT results from Diep like this one but you can be right as I’m not informed on the specific of his FUT technique https://www.hairrestorationnetwork.com/topic/56095-dr-diep-fut-mega-session/?tab=comments#comment-531376

Its weird that for FUE there’s a lot of talk about the technique like pre-made slits or stick&place or DHI, etc, but for FUT nobody talks about how the grafts were implanted (or maybe I need to go read more FUT results threads). 

Edited February 6, 2020 by Portugal25

[Gasthoerer]

Like stated by me already in the thread you have linked: This is a result with great growth but technical issues in the hairline, which seems a general issue with this clinic from my personal point of view. Combine this with strange FUE (I know this is about FUT) extraction pattern and large punches sizes...to many "no go"-points to me. 

Edited February 5, 2020 by Gasthoerer

[Portugal25]

Thanks @Gasthoerer I will have to take a closer look. My recommendation was purely based on FUT results I liked when I was researching for my second HT. In all honesty I have no interest in researching FUT anymore as I just underwent FUE so I won’t be having FUT again.

Edited February 6, 2020 by Portugal25

[karatekid]

1 hour ago, Portugal25 said:

@karatekid I said that in 2008 Rahal was the King of Hairlines but if you ask me today who I would chose for FUT it would be Konior, Diep or H&W. 
Having said that, with today’s advances in FUE results if I was doing my first HT in 2020 I would surely go for FUE.

Ye but the main reason for me to prefer FUT is due to the fact that in this way you have more donor available for future transplant.  Also why you say you would go with FUE, your hairloss pretty advance from what I saw, so wouldnt it better for you to get anyway to maximize donor usage?

[Portugal25]

@karatekid you are right and I may come to regret my decision of choosing to have FUE instead of going for a second FUT and only after go for FUE. 
You will be in great hands with H&W or Feriduni for your FUT surgery 

Edited February 6, 2020 by Portugal25

[hairlossPA]

lets not get confused. there is no difference between FUT and FUE when it comes to hairline design...

FUT/FUE is merely the harvesting technique.. It's the surgeon who designs the hairline.

Yes maybe FUT will get that quoted 5-10% more yield, but for the most part it comes down to how the surgeon uses the grafts

[Al - Moderator]

You don't have to worry about laxity if it's your first hair transplant and you need less than 3000 grafts. You will most certainly have enough laxity for a 2000 or so graft session.

The difference in estimates may simply be because neither of them have actually seen you in person and they have to make some guesses about your hair quality.

If there are any hair transplant Drs near you that you think may be at least somewhat decent then you should think about having an in-person consultation with them to get a better idea of how many grafts you will need. You don't have to be considering that Dr to actually perform the procedure, but it will at least get you an actual live consultation. Then you can compare that to the non live consultations you had with other Drs. It's just to hopefully provide e better idea of what you can expect.

 

[karatekid]

15 hours ago, hairlossPA said:

lets not get confused. there is no difference between FUT and FUE when it comes to hairline design...

FUT/FUE is merely the harvesting technique.. It's the surgeon who designs the hairline.

Yes maybe FUT will get that quoted 5-10% more yield, but for the most part it comes down to how the surgeon uses the grafts

Ye my point was that I just dont know any surgeon that achieve really good hairline, and does FUT.

3 hours ago, BeHappy said:

You don't have to worry about laxity if it's your first hair transplant and you need less than 3000 grafts. You will most certainly have enough laxity for a 2000 or so graft session.

The difference in estimates may simply be because neither of them have actually seen you in person and they have to make some guesses about your hair quality.

If there are any hair transplant Drs near you that you think may be at least somewhat decent then you should think about having an in-person consultation with them to get a better idea of how many grafts you will need. You don't have to be considering that Dr to actually perform the procedure, but it will at least get you an actual live consultation. Then you can compare that to the non live consultations you had with other Drs. It's just to hopefully provide e better idea of what you can expect.

 

Great input! thanks

Ye you probably right, I will have some better sense after I visit Dr.Feriduni, which I already booked consultation with.

Also Im not sure how it works in the technical way - if I need to pay in advanced, but the precise number of gratfs is decided on the day of the intervention, does it mean I will be asked to add more after if the doctor use more than estimated?

[karatekid]

Ok I just got some dissapointing response from Hasson. I said I want FUT, and I sent a video demonstrating scalp laxity, and he responded that he doesnt recommend me FUT.  How can it be? I mean, I dont really know to judge my exact laxity level, but it doesnt seem too bad for me, according to their explaination video. how can it be that even small case of 2000 grafts  cant be achieved? And why he doesnt suggest maybe scalp exercise to increase laxity?  Its really depressing that I dont even have this option... 

Edited February 8, 2020 by karatekid

[hairlossPA]

can you post the video for us to see? hows the quality of the video?

[Tbcruz]

That’s very weird to say from a video. I’m curious of the video as well 

[karatekid]

well, sorry but I dont want to put my face here...  and  I dont know how to censor the video

 

[karatekid]

Im not even sure I understand what is exactly the reason. Here is what they sent me:

"Dr.Hasson does not recommend FUT method surgery for you. He added that with the FUE method it is easer to achieve density because grafts are smaller, they can be dense packed and he can transplant more hairs per graft"

 

Does someone understand what that means?  it sounds confusing to me and also not related to the laxity (although this was the response to my laxity demonstration video)

[Portugal25]

@karatekid with FUE the Doctor is using a microscope while extracting your grafts so he can see the best grafts to extract.
The Doctor can chose to extract thicker grafts, grafts with four follicles if he wants to add density or singles if he wants to rebuild the hairline (frontal hairline is done with grafts with one single hair). 

Edited February 9, 2020 by Portugal25

[Tbcruz]

29 minutes ago, karatekid said:

 

"Dr.Hasson does not recommend FUT method surgery for you. He added that with the FUE method it is easer to achieve density because grafts are smaller, they can be dense packed and he can transplant more hairs per graft"

My grafts were smaller and my doctor explained that’s why my fue did not turn out good with my first procedure. Smaller grafts tend to not survive as well during fue they get damaged too easily.

weird 

[karatekid]

32 minutes ago, Portugal25 said:

@karatekid with FUE the Doctor is using a microscope while extracting your grafts so he can see the best grafts to extract.
The Doctor can chose to extract thicker grafts, grafts with four follicles if he wants to add density or singles if he wants to rebuild the hairline (frontal hairline is done with grafts with one single hair). 

Ok I understand this, but the question is - what is special about me then? why he doesnt recommend FUE just in general? why he answered that just after I sent him the video (he said both option can be good before the video). It means that he indicates  I have gratfs smaller than average just by watching the video? I would think the pictures give more accurate view for this.

Edited February 9, 2020 by karatekid

[karatekid]

22 minutes ago, Tbcruz said:

My grafts were smaller and my doctor explained that’s why my fue did not turn out good with my first procedure. Smaller grafts tend to not survive as well during fue they get damaged too easily.

weird 

 

Interesting, so you say that for smaller grafts FUT is better and for bigger grafts FUE is better?

Also by your signature I see you have done FUT after FUE, which is unusual.  Dr. Bloxham think that you get better yield with the FUT?

[Tbcruz]

23 minutes ago, karatekid said:

 

Interesting, so you say that for smaller grafts FUT is better and for bigger grafts FUE is better?

Also by your signature I see you have done FUT after FUE, which is unusual.  Dr. Bloxham think that you get better yield with the FUT?

That’s what was said to me during my procedure. Dr. Bloxham (which is very knowledgeable and I believe him completely) said that about my grafts once he removed my strip. He said I have above average hair thickness but small frágil grafts which is not good for fue.

yea I don’t want to take any more chances with my donor. Hands down fut produces better yields period.