Advice from Hair transplant veterans?

[Style22]

Hi all

 

I’ve had some great consults over the past year and finally made the decision to book a procedure. However the more consults you do, it seems that the decision on which procedure and who to go with starts to become very difficult. I am currently 37 and on Finasteride 1mg EOD and using Minoxidil once per day on the crown.  Definitely feel like a NW 6 is what the final end point wants to become. I’ve narrowed down my choices and leaning towards an FUE with Dr. Wong or Shapiro. Any transplant vets that might have gone FUE first and regretted as things progressed? I currently wear the hair very short with my hair loss pattern. Thanks for any advice!

 

Dr. Wong - FUE 3500 grafts

Dr. Shapiro- FUE 2100-2700

Dr. Cooley - FUT 3500

Dr. Bloxham - FUT 3500 plus

Dr. Arocha- FUE 2500

[Melvin- Admin]

Honestly, 

I have had three HTs all FUE I’m close in age as well 35. Sometimes I think damn I should’ve bit the bullet and gone FUT first. I’d have a lot more hair. But then cut my hair and love the ability to go short on the sides. If keeping your hair at #3 doesn’t concern you, 100% go FUT. 

Btw I’ll be talking to Dr. Ron on Saturday on our Instagram live. Well be talking about donor maximizing and FUT + FUE life time grafts, etc. You might wanna join us.

[Style22]

Great to know! I’ll definitely be joining in on that. 

[Britanium]

As a Norwood 6 without any hts I’m pleased I started out with FUTs. It really does maximise your potential grafts. As you mentioned it’s likely you will end up a high Norwood too. A lot depends on how you like to have your hair. I was never too bothered about having to keep mine a certain length to cover my FUT scar. 

[RandoBrando517]

I’ve heard every where that FUT is worse. Why would you get more hair?

[Melvin- Admin]

6 minutes ago, RandoBrando517 said:

I’ve heard every where that FUT is worse. Why would you get more hair?

Contrary to what you hear in other places, FUT is not worse. In many cases, it’s better. The recovery is longer, the scar is more visible, those are trade-offs. But you can move a large chunk of hair in one sitting without any visible change to the donor i.e moth appearance. If you start with FUT first and strip out (no longer get strips due to elasticity), you could then get the rest of the hair below and above the strip for even more hair.

[hairlossPA]

I was in a pretty similar position as you when I made my jump for my first FUT... I'll let you know how I feel in about 3 more months lol.

I will say FUT was "scarier" to me before making my decision, but it's honestly not nearly as bad as you would think.

[deitel130]

With FUT you will definitely be able to move more in one sitting and if you are not concerned about keeping sides so short then FUT will allow you to really maximize your donor. I've had 2 FUTs myself and the recovery is not as bad as you may think. Although I do think that my first surgery with sutures was a lot easier to sleep with for the first 2 weeks compared to staples during my second surgery. Do keep in mind though that if you have a thick dense donor FUE may be a good option as well just that you won't be able to move a lot of grafts in each sitting.

[TommyLucchese]

I had FUT first (my only HT so far) 9 years ago and it has caused no problems at all.

There is a "classic" piece of advice that gets handed down here where you should do as many FUTs as possible until your scalp can no longer accommodate another strip procedure, and then you always have FUE to fall back on. This method can maximise your lifetime grafts.

I have since received some advice from a different doctor when consulting for my 2nd HT, who believes that FUT should only be done in the 3,000 and above cases because it diminishes your elasticity.

FUT seems like a good fit for you, although Dr Wong knows a hell of a lot more than me.

[Tao]

For sure FUT diminishes your elasticity.  But so what?  I had two FUTs, which maxed out my elasticity.  Then I went for a final FUE.  That combination definitely maximized the number of grafts I could use and transformed my head from very bald to almost completely not bald now.  My hair isn't super dense but it just looks like I have a mostly full head of hair with only a slight age-appropriate balding at the swirl on my crown - a dramatic and life changing transformation.  The FUT surgeries were definitely tougher than my last FUE, which was a breeze.  But I figured if I was going to spend major money, time and energy pursuing HTs, it was well worth it to maximize the gain.  Never had any problem with the FUT scar either.  Good luck to you!

[kramer79]

9 hours ago, TommyLucchese said:

I had FUT first (my only HT so far) 9 years ago and it has caused no problems at all.

There is a "classic" piece of advice that gets handed down here where you should do as many FUTs as possible until your scalp can no longer accommodate another strip procedure, and then you always have FUE to fall back on. This method can maximise your lifetime grafts.

I have since received some advice from a different doctor when consulting for my 2nd HT, who believes that FUT should only be done in the 3,000 and above cases because it diminishes your elasticity.

FUT seems like a good fit for you, although Dr Wong knows a hell of a lot more than me.

I was also under this impression after speaking with Dr. Wong, which makes sense. I guess it is something along the lines of 'go big or go home'. Since we are getting a strip scar, getting the maximum amount of grafts that our elasticity allows for is what makes it worth it alongside maximizing donor potential.

However, did he mean that a second FUT is only worth it if you can get another 3000+ grafts as well ?

[TommyLucchese]

15 hours ago, kramer79 said:

I was also under this impression after speaking with Dr. Wong, which makes sense. I guess it is something along the lines of 'go big or go home'. Since we are getting a strip scar, getting the maximum amount of grafts that our elasticity allows for is what makes it worth it alongside maximizing donor potential.

However, did he mean that a second FUT is only worth it if you can get another 3000+ grafts as well ?

Yeah go big or go home, basically. If you're going to lose that best elasticity, do so for a big number of grafts.

For my potential 2nd HT - 1,500 grafts to the crown - he said it didn't make sense to go through the trauma of a second FUT for such few grafts. He said to keep that elasticity there for if I ever need 3,000 or more down the line if my loss my progresses. My age (31) and the fact I began losing hair at 16 played a big part in this thinking.

Dr Wong has been such an outstanding FUT performer for all these years, so if he recommends FUE for your case then he probably has very good reasons. You have a difficult choice, your level of loss usually means a large FUT case is best....why don't you go back to Dr Wong again and find out why he recommends FUE for you? 

[edit] just realised kramer isn't OP!

Edited February 4, 2021 by TommyLucchese

[RandoBrando517]

Damn great information, seems like I’ve been fed BS before coming here. 

[kramer79]

Just now, RandoBrando517 said:

Damn great information, seems like I’ve been fed BS before coming here. 

Marketing and misinformation can go a long way when words like: modern, scar-less and minimal recovery are thrown around.

Knowledge is power, and you will usually get that from sources that look beyond the marketing. 

This is because they have the knowledge to do so.

[Style22]

Thanks for all the feedback guys. I’ve got a Skype with Dr. Wong and going to ask in depth how many more grafts may be harvested starting with FUT first and moving over to FUE. 

[Style22]

23 hours ago, Melvin-Moderator said:

Honestly, 

I have had three HTs all FUE I’m close in age as well 35. Sometimes I think damn I should’ve bit the bullet and gone FUT first. I’d have a lot more hair. But then cut my hair and love the ability to go short on the sides. If keeping your hair at #3 doesn’t concern you, 100% go FUT. 

Btw I’ll be talking to Dr. Ron on Saturday on our Instagram live. Well be talking about donor maximizing and FUT + FUE life time grafts, etc. You might wanna join us.

Melvin, quick question. Do you think you can get away with a one guard on your head all over? The one thing in the back of my mind with FUE is if shit completely hits the fan with my hair down the line, I could still possibly hit the emergency button and go to a 1 guard. Obviously I’m not getting a transplant with plans on shaving that tight but it makes me think. 

[Melvin- Admin]

6 minutes ago, Style22 said:

Melvin, quick question. Do you think you can get away with a one guard on your head all over? The one thing in the back of my mind with FUE is if shit completely hits the fan with my hair down the line, I could still possibly hit the emergency button and go to a 1 guard. Obviously I’m not getting a transplant with plans on shaving that tight but it makes me think. 

I could but I’d have an obvious horse shoe pattern. If you’re gonna shave, go razor or nothing at all l. Otherwise you will looks like this

[kramer79]

3 hours ago, Style22 said:

Thanks for all the feedback guys. I’ve got a Skype with Dr. Wong and going to ask in depth how many more grafts may be harvested starting with FUT first and moving over to FUE. 

Let us know how your skype consultation with Dr. Wong goes. Maybe ask him why he suggested FUE as opposed to FUT as well

[Style22]

Absolutely and Will follow up afterwards. Skype is next week 👍

[Melvin- Admin]

8 hours ago, Tao said:

For sure FUT diminishes your elasticity.  But so what?  I had two FUTs, which maxed out my elasticity.  Then I went for a final FUE.  That combination definitely maximized the number of grafts I could use and transformed my head from very bald to almost completely not bald now.  My hair isn't super dense but it just looks like I have a mostly full head of hair with only a slight age-appropriate balding at the swirl on my crown - a dramatic and life changing transformation.  The FUT surgeries were definitely tougher than my last FUE, which was a breeze.  But I figured if I was going to spend major money, time and energy pursuing HTs, it was well worth it to maximize the gain.  Never had any problem with the FUT scar either.  Good luck to you!

The forum legend. Would be great to update your blog with your recent results. 

 

1 hour ago, Style22 said:

Absolutely and Will follow up afterwards. Skype is next week 👍

Great, looking forward to your update 👍🏼

[aaron1234]

All the hair you have on top right now will eventually fall out, even with the meds.  You'll eventually become a NW6.  So plan on having multiple procedures and try to maximize the amount of lifetime grafts you can get.  This means you should do FUT first (and again if possible 2nd and 3rd round), then FUE.  It's the route I've taken and I'll be approaching 9-10k grafts and I need every single one.

[TommyLucchese]

On 2/2/2021 at 10:51 PM, Melvin-Moderator said:

Honestly, 

I have had three HTs all FUE I’m close in age as well 35. Sometimes I think damn I should’ve bit the bullet and gone FUT first. I’d have a lot more hair. But then cut my hair and love the ability to go short on the sides. If keeping your hair at #3 doesn’t concern you, 100% go FUT. 

Btw I’ll be talking to Dr. Ron on Saturday on our Instagram live. Well be talking about donor maximizing and FUT + FUE life time grafts, etc. You might wanna join us.

 

15 hours ago, Tao said:

For sure FUT diminishes your elasticity.  But so what?  I had two FUTs, which maxed out my elasticity.  Then I went for a final FUE.  That combination definitely maximized the number of grafts I could use and transformed my head from very bald to almost completely not bald now.  My hair isn't super dense but it just looks like I have a mostly full head of hair with only a slight age-appropriate balding at the swirl on my crown - a dramatic and life changing transformation.  The FUT surgeries were definitely tougher than my last FUE, which was a breeze.  But I figured if I was going to spend major money, time and energy pursuing HTs, it was well worth it to maximize the gain.  Never had any problem with the FUT scar either.  Good luck to you!

I got that point from a consultation for my 2nd HT. I had a 2,000 graft FUT and have now been quoted 1,500 for the crown, and the doctor said FUE would be better because he doesn't want to waste my elasticity for a smaller procedure....the doctor said to keep that elasticity for a large FUT session if it's needed down the road. I've always expected to stay on the FUT path though since I was 23 when I had that first HT. What do you think about FUT to FUE and then back to FUT again?

11 hours ago, Style22 said:

Thanks for all the feedback guys. I’ve got a Skype with Dr. Wong and going to ask in depth how many more grafts may be harvested starting with FUT first and moving over to FUE. 

I got you mixed up with kramer in my post yesterday - yes I definitely think you should talk to Dr Wong again and find out why he thinks a large FUE session is right for you over FUT. 

5 hours ago, aaron1234 said:

All the hair you have on top right now will eventually fall out, even with the meds.  You'll eventually become a NW6.  So plan on having multiple procedures and try to maximize the amount of lifetime grafts you can get.  This means you should do FUT first (and again if possible 2nd and 3rd round), then FUE.  It's the route I've taken and I'll be approaching 9-10k grafts and I need every single one.

Oh man that makes my head spin 🤮🤮  please God no I really hope that doesn't happen. Your point makes complete sense and I have always thought that too....I trust the doctor who said FUE would be better for my 2nd HT to save elasticity for a large session down the road...but what do you think? How many FUTs do you think are possible? What do you think about going back to FUT after FUE? I don't want to hijack the thread but it's all healthy FUE or FUT discussion. 

[Tao]

This is an interesting and helpful thread here.  I think each situation is a little different and therefore requires a specific plan, discussed thoroughly between the patient and doctor.  I had my HTs when I was older so I didn't really have to save a ton of grafts for later.  I needed them all right away! : )  Well, not exactly.  But it made sense to go as big as I could each time since my pattern was well established.  I did think two sessions would be sufficient but I ended up losing some more native hair through the years and had to go for a smaller third session.  My thinking is if you go FUE before FUT, you thin out your donor, making an eventual FUT yield not as high.  If you do FUT first and then do FUE later, you still have hair density back there where the doctor can pick and choose the best grafts for the job at hand.  I'm not a doctor though so I'm sure its more complicated than that.  Again, I think the answer is to have a long term plan and assume you will need more than one (or even two) procedures.   

[Style22]

Hey Guys

Did the Skype with Dr. Wong this week. Great talk with him 👍. Few points to follow up with everyone.

He definitely agreed starting with FUT would be the best way for me to proceed if I wanted crown coverage in the future. He also said I would be a better FUT candidate with my specific hair loss pattern and need to maximize graft count numbers. I’d say this Skype vs just sending In pictures was very helpful.

[Style22]

Also I specifically asked about how many more grafts available starting with FUT then moving to FUE and was told of course depends on patient but in general around 2-3k.