FUT - stitches vs staples

[kirkland]

I live in Canada but I am planning on visiting India to have my first HT treatment. Given my extensive hairloss (NW 5A), I have decided to opt for FUT in order to maximize my donor area for future procedures (I am sure I will want a second HT). Some HT clinics uses staples, others use sutures and I have seen at least one use both to close the incision. The clinic that interests me uses dissolvable sutures so that you don't have to return to the clinc to have them removed. That is ideal for me given that I live halfway across the world and have no interest in staying behind two weeks just to have them removed by the same clinic which did my HT. However, I am wondering if the method used to close the incision may impact the esthetic of the scar itself. While I understand that individual physiology will be the biggest factor in scar formation, does anyone think that the use of sutures (dissolvable/non-dissolvable) vs staples will play a significant role? My quesion also applies to the differences between dissolvable and non-dissolvable sutures.

[gillenator]

As you stated physiology plays an important role in the healing process and the corresponding decision by the surgeon as to the best method of closure.

In my own case, my surgeon opted to use staples on my 4th and last FUHT procedure because my laxity was not as accommodating for the 2500 grafts that were being considered....subsequently,  only 2380 grafts were harvested,

Keep in mind that just about any licensed physician, RN, etc., can potentially remove stiches and/or staples....my PCP was the one who removed my staples.

[kirkland]

What is the purpose of using one method over the other? Are staples better for incisions which are harder to close? My biggest concern is the use of dissolvable sutures. 

[TrixGlendevon]

Some clinics, such as mine, use both as they both have pros and cons.

Which clinic are you going to in India?

[kirkland]

MediSpa - Dr. Suneet Soni. What are the pros and what are the cons? 

[Melvin- Admin]

Interesting question, I'd like to get a physicians input on this, let me ask. 

[TrixGlendevon]

1 hour ago, Melvin-Moderator said:

Interesting question, I'd like to get a physicians input on this, let me ask. 

@Dr Blake Bloxham replied on this thread here:

 

[TrixGlendevon]

8 hours ago, kirkland said:

MediSpa - Dr. Suneet Soni. What are the pros and what are the cons? 

Never heard of them. Where have you seen them and how did you find out about them? How many results have you seen? I would be very, very dubious about going to an unknown clinic in India. I assume they are cheap?

[kirkland]

7 minutes ago, TrixGlendevon said:

Never heard of them. Where have you seen them and how did you find out about them? How many results have you seen? I would be very, very dubious about going to an unknown clinic in India. I assume they are cheap?

https://www.medispaindia.in/dr-suneet-soni-best-hair-transplant-surgeon-india/

He has been a member of ISHRS, IAHRS amongst other associations. A good body of his work is shown on this forum and he has a lot of photos on his website. Seems like a safe bet. 

 

[kirkland]

13 minutes ago, TrixGlendevon said:

@Dr Blake Bloxham replied on this thread here:

 

Thanks for the info. I am still interested in hearing from more HT surgeons as to their choice and why.

[kirkland]

22 minutes ago, TrixGlendevon said:

Never heard of them. Where have you seen them and how did you find out about them? How many results have you seen? I would be very, very dubious about going to an unknown clinic in India. I assume they are cheap?

He is also a pre-screened/recommended surgeon on this site.

https://www.hairtransplantnetwork.com/Consult-a-Physician/surgeon-list/IND/India

I have been reading your responses to other threads and you have pointed out that finding an FUT surgeon seems harder these days. That's true! In Canada, we have H&W and Rahal but it seems that even Rahal is promoting FUE over FUT much more. I also like the combination of FUE and FUT in a single session as it seems it can yield more grafts without overharvesting.

Edited April 22, 2020 by kirkland

[TrixGlendevon]

If you can afford them, I would go with H&W - they will charge you in Canadian dollars as you are from/live there and are arguably the best clinic in the world. Why are you going to India for this?

I think FUT is becoming harder to find outside of the States. In the States it is still the main procedure of preference. I think clinics who offer both are the best ones to get consultations with as they will give you an impartial opinion so it is a shame about Rahal. If you give a workman a hammer, everything will look like a nail. In Europe the overwhelming majority of clinics (or at least ones you would actually want to go with) are FUE. Feriduni offers both but he is like Rahal he is moving towards preferring FUE. Hattingen offers both. 

I PERSONALLY would only ever go with FUT and would prefer to have FUT twice than FUT and FUE in the same session (which is what I am doing). I think choosing the right surgeon means the risk of the scar is minimal and then you can FUE into it so you can cut your hair short. I will look through this clinic later on tonight.

[kirkland]

@TrixGlendevon Thanks for your input. That's why I love this forum! I would love to choose H&W - I have even done a consultation with them. Unfortunately, even their FUT is beyond my financial resources at this moment. Years ago, an SMP treatment that went wrong left me feeling embarrassed and having to wear a hat all the time so I have taken on a labour job that is below my skillset but which allows me to wear a hat. Sad but true! Now I have to consider my finances when choosing my surgeon for the first HT.

[mitts]

On 4/22/2020 at 2:55 PM, kirkland said:

MediSpa - Dr. Suneet Soni. What are the pros and what are the cons? 

Hi @kirkland, I am also NW-5A and I am following Medispa for quite a long time now.

May I know you were only suggested FUT or combination of FUT+FUE ?

How many grafts required for HT ?

What are the charges per graft ?

[kirkland]

Hi @mitts Here is the reply from Dr. Soni's office re: HT:

 

"According to your scalp pictures around 4000 Grafts can be extracted from safe donor zone in order to get the best results by Combine technique (FUT+FUE)

 **FUT (Strip) procedure with TRICHOPHYTIC Closure (Trichophytic closure is a technique which leaves almost negligible or minimal scar at donor site).

  Cost  $ 1 USD/Graft 

 For 4000 Grafts =  4000 USD /-   

(Coverage will be Front and  Top)

 Other Expenses: - 500 USD/-

1.  OT Charges 
2.  Nursing Charges
3.  Investigation Fee
4.  Food Charges on the day of  procedure
5.  All Medicine expenses on the day of procedure 

 

 

Expense 4500 USD +18% TAX(GST)Extra."

[mitts]

11 hours ago, kirkland said:

Hi @mitts Here is the reply from Dr. Soni's office re: HT:

 

"According to your scalp pictures around 4000 Grafts can be extracted from safe donor zone in order to get the best results by Combine technique (FUT+FUE)

 **FUT (Strip) procedure with TRICHOPHYTIC Closure (Trichophytic closure is a technique which leaves almost negligible or minimal scar at donor site).

  Cost  $ 1 USD/Graft 

 For 4000 Grafts =  4000 USD /-   

(Coverage will be Front and  Top)

 Other Expenses: - 500 USD/-

1.  OT Charges 
2.  Nursing Charges
3.  Investigation Fee
4.  Food Charges on the day of  procedure
5.  All Medicine expenses on the day of procedure 

 

 

Expense 4500 USD +18% TAX(GST)Extra."

Hi @kirkland, Thanks for sharing the details.

There is not much difference in the fees. I had also received the exact same details except for the currency  Yours is in USD and mine in INR.

Did you make a decision already to where you are going and when ?

P.S. I saw your comment in other post which was around March, there you mentioned that you will require 7000 grafts. Was this number given by Eugenix ? because from Medispa its 4000, that's a huge difference of 3000 grafts..!!

[kirkland]

I have to be honest and say that I am not yet certain about which clinic to choose. As a NW5a, I estimate I have about 160 square cm to cover. At 30 FU's per square cm, that's about 5000 grafts. I have been quoted 3500 grafts by Eugenix, 4000 grafts by Medispa and 3000-3200 by Darling Buds (Dr. Bhatti). Medispa and Dr. Soni made the most sense initially because they are offering the higher yield with the combination of FUT/FUE. Since I will definitely want a second procedure in the future, it seems that most of the people I consider to be trusted advocates in hairloss (Joe TIllman, Spex, Melvin on this site plus doctors like Dr. Rassman) recommend FUT for high Norwoods in order to maximize the yield and set-up the donor area for future surgeries. Yet, I see great FUE results from Dr. Bhatti and Eugenix for patients like me, some of them with 7000 grafts or more (not all in a single session). Obviously the use of beard/chest grafts are used to supplement the donor area capacity. This has been making my decision harder since I would prefer to keep my hair shorter in the back. SMP is a great option for linear scars from FUT but it just adds another procedure I have to consider. So, to answer your question, I haven't yet made my final decision. If I choose Medispa, I will be going in December since I will have four weeks vacation, which gives the FUT surgery more time to heal before returning to work. If I get FUE done with either Dr. Bhatti or Eugenix, I can go earlier in the year, perhaps as soon as July, depending on the coronavirus situation. I really need the first surgery done so I can start getting past my obsession with my hairloss. It has simply dominated my life in the last few years, leading me to make poor decisions which have had a negative impact for me emotionally, financially and with my relationships. It's time to get the problem fixed once and for all! I wish I could say that cost isn't a factor, but it honestly is the biggest factor. However, all 3 of these clinics make me feel that I can't go wrong with them as my clinic of choice. 

How about you? What has made you consider Medispa? The FUT/FUE combo? I am starting to feel more confident that FUT is not the only option anymore for higher Norwoods, given the use of beard grafts and the experience of both Darling Buds and Eugenix in this area. It has really transformed the HT landscape having this option now. Before, FUT was the only option if you were a NW 5 and above. The donor area was simply too valuable to leave to the higher transection rates from FUE and lower number of hairs available. When I hear Dr. Bhatti talk of transection rates around 2% for FUE, that just boosts my belief that FUE, when combining scalp and beard grafts, is just as viable an option for extensive hairloss sufferers. 

[gillenator]

On 4/21/2020 at 5:17 PM, kirkland said:

What is the purpose of using one method over the other? Are staples better for incisions which are harder to close? My biggest concern is the use of dissolvable sutures. 

Yes that's true, not only for providing for a stronger closing method but also to help prevent the strip scar from stretching....sometimes the surgeon elects to go with a double closure technique where the stiches are done on the inner dermis layer but also the outer epidermis layer providing a very strong closure...obviously the stitches on the inner dermis layer would be dissolvable.

[mitts]

21 hours ago, kirkland said:

I have to be honest and say that I am not yet certain about which clinic to choose. As a NW5a, I estimate I have about 160 square cm to cover. At 30 FU's per square cm, that's about 5000 grafts. I have been quoted 3500 grafts by Eugenix, 4000 grafts by Medispa and 3000-3200 by Darling Buds (Dr. Bhatti). Medispa and Dr. Soni made the most sense initially because they are offering the higher yield with the combination of FUT/FUE. Since I will definitely want a second procedure in the future, it seems that most of the people I consider to be trusted advocates in hairloss (Joe TIllman, Spex, Melvin on this site plus doctors like Dr. Rassman) recommend FUT for high Norwoods in order to maximize the yield and set-up the donor area for future surgeries. Yet, I see great FUE results from Dr. Bhatti and Eugenix for patients like me, some of them with 7000 grafts or more (not all in a single session). Obviously the use of beard/chest grafts are used to supplement the donor area capacity. This has been making my decision harder since I would prefer to keep my hair shorter in the back. SMP is a great option for linear scars from FUT but it just adds another procedure I have to consider. So, to answer your question, I haven't yet made my final decision. If I choose Medispa, I will be going in December since I will have four weeks vacation, which gives the FUT surgery more time to heal before returning to work. If I get FUE done with either Dr. Bhatti or Eugenix, I can go earlier in the year, perhaps as soon as July, depending on the coronavirus situation. I really need the first surgery done so I can start getting past my obsession with my hairloss. It has simply dominated my life in the last few years, leading me to make poor decisions which have had a negative impact for me emotionally, financially and with my relationships. It's time to get the problem fixed once and for all! I wish I could say that cost isn't a factor, but it honestly is the biggest factor. However, all 3 of these clinics make me feel that I can't go wrong with them as my clinic of choice. 

How about you? What has made you consider Medispa? The FUT/FUE combo? I am starting to feel more confident that FUT is not the only option anymore for higher Norwoods, given the use of beard grafts and the experience of both Darling Buds and Eugenix in this area. It has really transformed the HT landscape having this option now. Before, FUT was the only option if you were a NW 5 and above. The donor area was simply too valuable to leave to the higher transection rates from FUE and lower number of hairs available. When I hear Dr. Bhatti talk of transection rates around 2% for FUE, that just boosts my belief that FUE, when combining scalp and beard grafts, is just as viable an option for extensive hairloss sufferers. 

I am totally with you on first part. I have actually contacted only Eugenix and Medispa. Both the clinics have qouted 4000 grafts. The first clinic has suggested 3K donor grafts and 1k beard gratfs whereas the latter suggested combo of FUT+FUE for better result. I am also looking to keep my hair shorter lets say grade 1 or 2 that is the reason i am quite concerned over FUT scar. I have also got the same response that FUT is always better for higher grade baldness as this way donor is safe for future HTs. But after seeing great FUE results from Eugenix for higher NW baldness I am confused to go with FUT combo or FUE that is the reason I am unable to make my final decision.

I have been doing my research since late 2017 and my decision about considering Medispa was because accidentally I came across one youtube video of their clinic showing amazing result of the HT then I started looking more about Medispa and after 6-7 months convinced that this is where I will be going for my HT. FF to 2019 July or August where I came across this amazing platform (accidentally again) and started going through posts one by one and I found about Eugenix and their HT results.

BTW I contacted these two clinics in Nov 2019 through emails and call, since I was going to India in Feb so thought of visiting these 2 clinics and consult them face to face but due to COVID situation I had to cancel it, lets see now!

[kirkland]

Well it seems that we have the same goals. Keep me updated on your progress through DM. I will do the same.