FUE or FUT for Norwood 6?

[Mike_2020]

If someone is at least a Norwood 5 and quite probably a Norwood 6, and has never previously had any hair transplant surgery, generally speaking, should they be thinking more along the lines of FUE, FUT or a combination of both?

 

[Melvin- Admin]

FUT gives you the most grafts, for the least amount of money, and slightly better growth. Downside is the linear scar, but if you can live with that, it’s the best way to go. 

[Dazed]

I was probably a 5 or bordering on 6, and I did as Melvin said with a FUT, and came back with FUE the 2nd time.  I can't say FUE was the best path the 2nd time, but I got better than expected results both times.  Maybe somebody more in the know will talk about FUT + FUT.

[aaron1234]

To get the most possible grafts you should (1) max out on strip, which could be a handful of surgeries depending on your scalp elasticity.  (2) Then max out on FUE.  For those of us who are predestined for NW6 (maybe NW5) or worse then the answer is do whatever will give you the most grafts.   

[Gabreille Nelson Mukhia]

8 hours ago, Mike_2020 said:

If someone is at least a Norwood 5 and quite probably a Norwood 6, and has never previously had any hair transplant surgery, generally speaking, should they be thinking more along the lines of FUE, FUT or a combination of both?

 

If you are willing to give beard hair as donor then with a mixture of scalp plus beard hair it would be possible to get a decent coverage with an appreciable density with FUE. 

But then again it depends on what kind of donor availability we are talking about. If you could share some pictures, we would have a better idea of what would be possible in that particular case.

Edited July 2, 2020 by Gabreille Nelson Mukhia

[kirkland]

For higher Norwoods (5 and above), FUT makes the most sense, Then you see FUE results at Eugenix and with Dr. Zarev and it makes you feel that it is now possible to get great results with this method. I can see why it is hard to make this decision.

[Future Hair Doc]

I suggest FUT as allowed by scalp laxity and then FUE. You should consider BHT if your donor area isn't good

[Gatsby]

22 hours ago, Mike_2020 said:

If someone is at least a Norwood 5 and quite probably a Norwood 6, and has never previously had any hair transplant surgery, generally speaking, should they be thinking more along the lines of FUE, FUT or a combination of both?

 

Mike in my humble opinion, a brilliant FUE surgeon will always be better than an average FUT surgeon and the reverse is the also true. Their are so many variables also to consider and weigh up (hair calibre, quality of donor area, scar preference, etc, etc). Personally I suggest looking at the top surgeons in the game and try and find patients who have as close to your hair loss and as close to the results that you are wishing to obtain. Start from there and then keep asking questions. Once an FUE or FUT has begun your scalp is no longer virgin and you want to take into account how your hair/scalp/scars will appear in years to come and to prepare for the future. All the best!

[Mike_2020]

Thanks guys!!

 

[Melvin- Admin]

17 hours ago, kirkland said:

For higher Norwoods (5 and above), FUT makes the most sense, Then you see FUE results at Eugenix and with Dr. Zarev and it makes you feel that it is now possible to get great results with this method. I can see why it is hard to make this decision.

It’s possible to get great results with FUE alone, I’m an example of someone who was Norwood 6 and had only FUE. The difference is the amount of sessions and practicality. 

It’s more practical to get one or two large FUT procedures, and then whatever is left over FUE out. You will get more grafts, than choosing FUT alone or FUE alone. The problem that many, including me have is the linear scar.

[kirkland]

I'm actually considering doing a large FUE session first then another large FUT session second. Here's my reasoning: as a NW6, I will need at least two surgeries to get to my happy place. The first FUE surgery will give me (I hope!) a decent hairline and a thin mid-scalp and vertex. For the period between the first and second surgeries, I want to wear the sides and back short as the top grows in over those first 6-8 months, getting past the ugly duckling phase. With FUT as the second surgery, I can let the hair grow out longer on both back/sides and top as the second transplantation takes root. The hair should be thicker on top to match with growing the hair out on the sides and back. I just hope that there will still be some docs who will still be doing FUT because it seems like it is becoming a dying method.

[Melvin- Admin]

27 minutes ago, kirkland said:

I'm actually considering doing a large FUE session first then another large FUT session second. Here's my reasoning: as a NW6, I will need at least two surgeries to get to my happy place. The first FUE surgery will give me (I hope!) a decent hairline and a thin mid-scalp and vertex. For the period between the first and second surgeries, I want to wear the sides and back short as the top grows in over those first 6-8 months, getting past the ugly duckling phase. With FUT as the second surgery, I can let the hair grow out longer on both back/sides and top as the second transplantation takes root. The hair should be thicker on top to match with growing the hair out on the sides and back. I just hope that there will still be some docs who will still be doing FUT because it seems like it is becoming a dying method.

Here’s the problem going FUE first. The surgeon will choose the most robust grafts, getting strip afterward wouldn’t be as beneficial. Many of the 2,3, and 4 hair grafts will he gone. You’ll have a strip of leftovers essentially. Best to go FUT first, and then go FUE. 

[kirkland]

That's a good point. Thanks for letting me know.

[Dazed]

On 7/3/2020 at 5:17 PM, Melvin-Moderator said:

Here’s the problem going FUE first. The surgeon will choose the most robust grafts, getting strip afterward wouldn’t be as beneficial. Many of the 2,3, and 4 hair grafts will he gone. You’ll have a strip of leftovers essentially. Best to go FUT first, and then go FUE. 

Melvin, you get the Gold Star for the best explanation yet.

[Curious25]

On 7/3/2020 at 10:17 PM, Melvin-Moderator said:

Here’s the problem going FUE first. The surgeon will choose the most robust grafts, getting strip afterward wouldn’t be as beneficial. Many of the 2,3, and 4 hair grafts will he gone. You’ll have a strip of leftovers essentially. Best to go FUT first, and then go FUE. 

This is tends to be true for the majority of cases, however there are exceptions after an evenly harvested FUE on a patient with a higher than average multi : singular graft ratio. In this instance , if the first procedure via FUE intervention was for hairline restoration, where a large degree of singles were purposely selected by the surgeon, amidst a donor region of predominantly multi hair grafts - a second procedure via strip should still amass to a decent HGI count. 

[Melvin- Admin]

5 hours ago, Curious25 said:

This is tends to be true for the majority of cases, however there are exceptions after an evenly harvested FUE on a patient with a higher than average multi : singular graft ratio. In this instance , if the first procedure via FUE intervention was for hairline restoration, where a large degree of singles were purposely selected by the surgeon, amidst a donor region of predominantly multi hair grafts - a second procedure via strip should still amass to a decent HGI count. 

Even if the first procedure is a hairline restoration. The surgeon will pick the most robust grafts. Only a couple hundred singles are needed, 2,3, and 4 hair grafts are still needed to add a thick wall behind the hairline. 

[Curious25]

2 hours ago, Melvin-Moderator said:

Even if the first procedure is a hairline restoration. The surgeon will pick the most robust grafts. Only a couple hundred singles are needed, 2,3, and 4 hair grafts are still needed to add a thick wall behind the hairline. 

Yea I'm not debating the numbers of singles required for a hairline, but the point was more in relation to the ratio of singular:multis within the donor.

If a hairline restoration has already taken place from a patient with a donor consisting predominantly of multi hair grafts, and where the emphasis has been to specifically go looking for, and cherry pick singles - If FUT is utilised for a second surgery, the chances of the strip containing a plethora of singles will, if anything be reduced, than if it was taken from a virgin scalp.