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topher1999

Considering FUT over FUE, but just a few questions

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I recently got quoted by H&W for about 3000 grafts, and won't lie, it's so expensive! But this isn't a surgery you want to cheap out on. Using their own calculator, a FUT surgery would run me about $13k while a FUE runs $22k. A 9k difference is no joke. They recommended me for FUE, but said I was a suitable candidate for either method. I'm seriously considering FUT mostly because of the insane price difference, but I had a couple of concerns:

  • If I grow my hair long anyway (scar isn't a worry), is there any reason I should get FUE over FUT? Because the research I've done tells me that doing FUT first will give you more grafts to work with over your lifetime should you need future surgeries. My research also seems to suggest FUT has a *very slight* advantage over FUE in terms of graft survival.
  • I heard some people can feel skin tightness near the scar for the rest of their lives. Is this true?
  • I have a scar elsewhere on my body from an unrelated past surgery and the skin texture feels different around the scar and it's uncomfortable when I touch it. Will this be the same case for the scar that would be on my head? I like getting my head scratched from behind, courtesy of my girlfriend, and I wouldn't want the scar to feel uncomfortable/weird when getting it scratched.

Thanks for the answers and I hope we can all get our transplants after this corona stuff is over with.

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I've had two FUTs and one FUE.  Folks will probably pipe in and tell you it all depends on your situation.   And i'd agree.  In the hands of a good HT doctor (H & W are up there among the best), you shouldn't have much problem with an FUT scar.   Unless you ever intend to buzz cut or wear your hair very very short in the back.  Also depends on your longer term concerns and goals.  If you think you'd be one and done (and most of us do and most of us are wrong), then FUE might be the way to go, despite the higher cost (you amortize the additional 9k over your lifetime, and it doesn't come to much).  But if you need another HT (or two) down the line, FUE probably isnt the most efficient use of your grafts.   For me, I maxed out on FUT in two surgeries (Konior was my doctor for all my surgeries) and my scar is pretty undetectable with really short hair (but definitely not buzzed) and I've never noticed anything about my scar area feeling weird.  This can vary from person to person though and your scalp laxity has a lot to do with it.  For my third surgery, my scalp laxity was not there so FUE was pretty much my only option.  But since I hadn't done FUE, my donor area was still very good and more easily pickable for the best FUE grafts.  Again, this can vary from person to person so you should think long term and sketch out a plan.

You can stop reading now unless you want to hear about my thoughts on the difference I experienced with the FUT and FUE techniques.

Here's how I experienced FUT and FUE.  My first two FUT surgeries (2800 and 2200 grafts) seemed more brutal than my latest FUE surgery.   In FUT, they are carving out a strip of skin and hairs from your head and then sewing that back up again, using staples and/or sutures.  The recovery was definitely a bit more intense (eye swelling, sore sore back of the head with annoying Frankenstein staples in for one to two weeks, need to apply ointment to scar, lack of feeling on my head for several months, etc.)  But with both of my FUT surgeries, I was back to work in two weeks and no one could really tell I had anything done (my existing hair covered my scar/staples) and I had minimum redness in the recipient area (granted, my doctor was Konior and he does amazingly clean work.  Amazingly clean).  For my latest FUE procedure, Dr. Konior had to shave my entire head to more easily get to my donor grafts and also more easily place the grafts in the recipient area.  The procedure was pleasantly easy and the recovery was essentially instantaneous.  I had no pain at all afterward and never took any medication after surgery.  I sprayed the grafts with salt water and because Konior's work was again so clean, I had no problems with scabs and if you looked at my donor area, you could hardly tell where Konoir took grafts from (in a week, you could definitely not tell).  That's the good.  The rough part is that whole shaving of the head thing.  I had pretty decent hair before the procedure so after the procedure, I suddenly was essentially buzzed down bald.   I gotta say, I hate that!  I don't have a great head shape to pull off the buzzed down or bald look (hence my HTs!).  And my hair is growing ever so slowly back, revealing the areas that were weak and had hair transplanted into (that will start growing in several months).  The payoff will be worth it no doubt but the the journey to that payoff is tougher appearance-wise.  Because my timing was about perfect (my HT was in early March before the social distancing and lockdowns), I havent had to go to work and appear to many people in a social setting without a hat on.  So my ugly ducklin phase is much easier to deal with, for sure. 

Anyway, there are advantages and disadvantages to FUT and FUE and price is definitely one of them.  More important though is the management and maximizing of your lifetime donor grafts. 

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I found the FUT much easier, and in retrospect I should have never bothered with FUE.  The Ugly Duckling stage with FUE seems to last forever.  I found the FUE extraction to be the worst part of the procedure.  They numbed the daylights out of me - still I was squirming like a toad during extraction.  On the other hand the FUT strip felt odd, but there was no pain, also I had no swelling.  All in all FUT was much easier.


"Imagination frames events unknown in wild fantastic shapes of hideous ruin, and what it fears, creates." Hannah More

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Interesting.  I guess it varies from person to person, doctor to doctor and day to day.    I really had no pain during any of my FUT and FUE surgeries.  Just much different recovery experiences.  And yes, the ugly duckling stage for FUE does seem to last forever (I'm only a month out and it feels like forever already).

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In my opinion, there’s no benefit in going with FUE unless you absolutely have to cut your hair short. Otherwise, FUT is more efficient, and you can maximize your donor  supply better. There disadvantages with both, but if you don’t mind wearing your hair long, definitely go FUT.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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18 hours ago, Tao said:

I've had two FUTs and one FUE.  Folks will probably pipe in and tell you it all depends on your situation.   And i'd agree.  In the hands of a good HT doctor (H & W are up there among the best), you shouldn't have much problem with an FUT scar.   Unless you ever intend to buzz cut or wear your hair very very short in the back.  Also depends on your longer term concerns and goals.  If you think you'd be one and done (and most of us do and most of us are wrong), then FUE might be the way to go, despite the higher cost (you amortize the additional 9k over your lifetime, and it doesn't come to much).  But if you need another HT (or two) down the line, FUE probably isnt the most efficient use of your grafts.   For me, I maxed out on FUT in two surgeries (Konior was my doctor for all my surgeries) and my scar is pretty undetectable with really short hair (but definitely not buzzed) and I've never noticed anything about my scar area feeling weird.  This can vary from person to person though and your scalp laxity has a lot to do with it.  For my third surgery, my scalp laxity was not there so FUE was pretty much my only option.  But since I hadn't done FUE, my donor area was still very good and more easily pickable for the best FUE grafts.  Again, this can vary from person to person so you should think long term and sketch out a plan.

You can stop reading now unless you want to hear about my thoughts on the difference I experienced with the FUT and FUE techniques.

Here's how I experienced FUT and FUE.  My first two FUT surgeries (2800 and 2200 grafts) seemed more brutal than my latest FUE surgery.   In FUT, they are carving out a strip of skin and hairs from your head and then sewing that back up again, using staples and/or sutures.  The recovery was definitely a bit more intense (eye swelling, sore sore back of the head with annoying Frankenstein staples in for one to two weeks, need to apply ointment to scar, lack of feeling on my head for several months, etc.)  But with both of my FUT surgeries, I was back to work in two weeks and no one could really tell I had anything done (my existing hair covered my scar/staples) and I had minimum redness in the recipient area (granted, my doctor was Konior and he does amazingly clean work.  Amazingly clean).  For my latest FUE procedure, Dr. Konior had to shave my entire head to more easily get to my donor grafts and also more easily place the grafts in the recipient area.  The procedure was pleasantly easy and the recovery was essentially instantaneous.  I had no pain at all afterward and never took any medication after surgery.  I sprayed the grafts with salt water and because Konior's work was again so clean, I had no problems with scabs and if you looked at my donor area, you could hardly tell where Konoir took grafts from (in a week, you could definitely not tell).  That's the good.  The rough part is that whole shaving of the head thing.  I had pretty decent hair before the procedure so after the procedure, I suddenly was essentially buzzed down bald.   I gotta say, I hate that!  I don't have a great head shape to pull off the buzzed down or bald look (hence my HTs!).  And my hair is growing ever so slowly back, revealing the areas that were weak and had hair transplanted into (that will start growing in several months).  The payoff will be worth it no doubt but the the journey to that payoff is tougher appearance-wise.  Because my timing was about perfect (my HT was in early March before the social distancing and lockdowns), I havent had to go to work and appear to many people in a social setting without a hat on.  So my ugly ducklin phase is much easier to deal with, for sure. 

Anyway, there are advantages and disadvantages to FUT and FUE and price is definitely one of them.  More important though is the management and maximizing of your lifetime donor grafts. 

Great insights here. Thx for sharing. Was interesting to go through your hairloss site.
 

Do you have updated info and pics for your FUE procedure? 

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3 hours ago, Melvin-Moderator said:

In my opinion, there’s no benefit in going with FUE unless you absolutely have to cut your hair short. Otherwise, FUT is more efficient, and you can maximize your donor  supply better. There disadvantages with both, but if you don’t mind wearing your hair long, definitely go FUT.

Hey Melvin. I know you like to keep your hair short, but do you wish you had started with FUT and just kept the back a little longer given your age and the extent of your MPB? I asked this previously and you said you would address it in a dedicated post. 

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15 minutes ago, yesplease said:

Hey Melvin. I know you like to keep your hair short, but do you wish you had started with FUT and just kept the back a little longer given your age and the extent of your MPB? I asked this previously and you said you would address it in a dedicated post. 

I think that will be my next video, the short answer is no.


I do not provide medical advice, recommendations, all responses are my opinion.

My Hair Transplant Journey

Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

Follow our Social Media Instagram @thehairtransplantnetwork FacebookPintrest, Linkedin and YouTube.

 

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49 minutes ago, Melvin-Moderator said:

I think that will be my next video, the short answer is no.

Interesting. Thanks. Looking forward to more of your thoughts once you put the vid together. 

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1 hour ago, yesplease said:

Great insights here. Thx for sharing. Was interesting to go through your hairloss site.
 

Do you have updated info and pics for your FUE procedure? 

I need to update the site soon.  I'm one month out of FUE.  I'll post the photos Dr. Konior sent me and then I'll take a few current shots.

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2 minutes ago, Tao said:

I need to update the site soon.  I'm one month out of FUE.  I'll post the photos Dr. Konior sent me and then I'll take a few current shots.

Awesome, looking forward to it. I identify with your overall situation and path. Thx 

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if you need a mega-session in one sitting and will need future surgery as your hair loss pattern progresses - go with the FUT gold standard 

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On 4/11/2020 at 9:28 PM, topher1999 said:

I recently got quoted by H&W for about 3000 grafts, and won't lie, it's so expensive! But this isn't a surgery you want to cheap out on. Using their own calculator, a FUT surgery would run me about $13k while a FUE runs $22k. A 9k difference is no joke. They recommended me for FUE, but said I was a suitable candidate for either method. I'm seriously considering FUT mostly because of the insane price difference, but I had a couple of concerns:

  • If I grow my hair long anyway (scar isn't a worry), is there any reason I should get FUE over FUT? Because the research I've done tells me that doing FUT first will give you more grafts to work with over your lifetime should you need future surgeries. My research also seems to suggest FUT has a *very slight* advantage over FUE in terms of graft survival.
  • I heard some people can feel skin tightness near the scar for the rest of their lives. Is this true?
  • I have a scar elsewhere on my body from an unrelated past surgery and the skin texture feels different around the scar and it's uncomfortable when I touch it. Will this be the same case for the scar that would be on my head? I like getting my head scratched from behind, courtesy of my girlfriend, and I wouldn't want the scar to feel uncomfortable/weird when getting it scratched.

Thanks for the answers and I hope we can all get our transplants after this corona stuff is over with.

Go with FUT. The scar from top clinics will be pencil thin anyway and you can also implant grafts (about 120) into the scar with FUE at a later date meaning you can shave the hair a bit shorter. Or even SMP. Your lifetime donor will last longer too with FUT. I had FUT from Hattingen and do not regret it all. 

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