First Ht approach

[Hair4Days]

For a while now, i was set on getting a strip procedure, setting myself up to utilize my donor to it’s highest potential (according to many Ht surgeons). I’m a diffused nw 5/6 which is not noticeable with hair grown beyond 1 inch. With hair grown longer + toppik in the frontal zone, i look like i have a full head of hair. However, Having shaved my head down to a number 3 during COVID, i saw the diffused pattern throughout my top + my crown dipping downward similarly to  @Zoomster .. This confirms i will be a Norwood 6 as my final pattern once developed over time. This is why i was pretty set on starting with FUT. But as of late, I’ve been seeing more and more advanced Nw patients go the FUE route and the results look good. Between having an above average donor + good beard supply, I’m beginning to lean towards fue even as a future nw6.  I currently use minoxidil and topical fin As a preventative. I’m considering Dr Konior & Hasson for FUE, but both have way different approaches. dr. koniors strategy consists of a “density boost” in the frontal hairline of 1500-2000 grafts. He explained he doesn’t feel comfortable grafting at a high density  To avoid shock loss. He told me I’d need to come back to readdress the same area in the future once the native hairs fall out, or i could wait til I’m much balder and do a larger procedure grafting at higher densities. 
Dr Hasson on the other hand recommended 3000 grafts in the frontal third and working into the mid scalp. This would provide a new hairline and dense pack the entire front working through the existing thinning zone. This would future-proof the area so i would not need to return for the same area. I’d only need to return for non transplanted zones in the future like the mid scalp and crown. Does anyone have any opinions on each of these approaches? One sounds conservative and one sounds more aggressive. Ideally I’d like to limit how many times i go in for surgery. And for the record, i am willing to compromise a couple thousand grafts that could be used in the crown by going fue, but with a solid beard this could hopefully makeup for those scalp grafts I’d be giving up  

[Curious25]

Given your desire to limit the amount of times you go under the knife, Dr Hasson's approach seems to be the more suitable of the two for you, however both approaches have their merits, and both are very skilled and informed surgeons. 

FWIW - I'm in a similar boat to you, I imagine I will eventually reach NW5 at least, and I have opted for FUE all the way through, however will be following a path which is more closely aligned with Dr Konior's proposed strategy. I also have a pretty good beard, and that was one of my justifications for 'sacrificing' more grafts via a combination of FUT and FUE, that I will be able to get over 2000 BHT to place around my mid scalp areas as a filler. 

I'm watching the donor restocking threads with huge interest, to see whether it eventually turns out to be a more optimal strategy to deplete the donor and maximise scalp grafts into the recipient area, and then later restock the donor with BHT. I like the theory, yet the jury is still seemingly out as to whether or not this practice is beneficial, so I will keep my eye on this movement as I say, and make up my own mind in years to come. Thankfully I'm still a long way off having to worry about this just now, so I have the luxury of sitting back on industry development for the next 10 plus years. 

 

[Hair4Days]

4 hours ago, Curious25 said:

Given your desire to limit the amount of times you go under the knife, Dr Hasson's approach seems to be the more suitable of the two for you, however both approaches have their merits, and both are very skilled and informed surgeons. 

FWIW - I'm in a similar boat to you, I imagine I will eventually reach NW5 at least, and I have opted for FUE all the way through, however will be following a path which is more closely aligned with Dr Konior's proposed strategy. I also have a pretty good beard, and that was one of my justifications for 'sacrificing' more grafts via a combination of FUT and FUE, that I will be able to get over 2000 BHT to place around my mid scalp areas as a filler. 

I'm watching the donor restocking threads with huge interest, to see whether it eventually turns out to be a more optimal strategy to deplete the donor and maximise scalp grafts into the recipient area, and then later restock the donor with BHT. I like the theory, yet the jury is still seemingly out as to whether or not this practice is beneficial, so I will keep my eye on this movement as I say, and make up my own mind in years to come. Thankfully I'm still a long way off having to worry about this just now, so I have the luxury of sitting back on industry development for the next 10 plus years. 

 

Seems like very similar boats. I’m in no rush personally since I’m not 30 yet, however I’m prepared to address my hairline fairly soon. As far as the opting for fue topic, it just makes me feel more comfortable. I know people say you lose the opportunity to shave your head regardless of which method you use, but if im god forbid in that situation, i rather have fue scarring. dr konior also explained beard hair is an excellent source, so at this point it seems like a no brainer for fue if you can make up those grafts you leave on the table by not doing strip.. Unless you get that transaction and growth rate argument from people who say the growth survival isn’t as good with fue

 

 

 

 

[Curious25]

4 hours ago, James C said:

Unless you get that transaction and growth rate argument from people who say the growth survival isn’t as good with fue

Thats a prehistoric trail of thought these days. Top tier clinics experience near identical levels of transection between FUT and FUE procedures now.  
 

I occasionally wear a skin fade after 2500 FUE , and no one notices the scarring. That’s not to say that it’s not there, and it’s also not to say that some people experience worse scarring than others. @Rolandas has experienced this, despite an excellent overall procedure. 

[WhiteyUK]

Agree ..

8 minutes ago, Curious25 said:

Thats a prehistoric trail of thought these days. Top tier clinics experience near identical levels of transection between FUT and FUE procedures now.  
 

I occasionally wear a skin fade after 2500 FUE , and no one notices the scarring. That’s not to say that it’s not there, and it’s also not to say that some people experience worse scarring than others. @Rolandas has experienced this, despite an excellent overall procedure. 

Agree .. I always get skin fades

Theres probably only HT boffs who would see anything 

[gillenator]

A good friend of mine who does landscaping had several FUE procedures with a skilled reputable FUE surgeon.

He also does a fade style and as the summer months passed he suddenly noticed white spots in his donor area because the area became tanned however the extraction scars did not tan and so they were noticable....so now, he has to let the hair grow a good inch or so in the summertime.

[Hair4Days]

7 hours ago, Curious25 said:

Thats a prehistoric trail of thought these days. Top tier clinics experience near identical levels of transection between FUT and FUE procedures now.  
 

I occasionally wear a skin fade after 2500 FUE , and no one notices the scarring. That’s not to say that it’s not there, and it’s also not to say that some people experience worse scarring than others. @Rolandas has experienced this, despite an excellent overall procedure. 

That’s incredible. To be able to do a skin fade. Explain to me why someone would go fut nowadays? Lol.. and that’s becoming a serious question.

[Curious25]

5 hours ago, James C said:

That’s incredible. To be able to do a skin fade. Explain to me why someone would go fut nowadays? Lol.. and that’s becoming a serious question.

People who have longer hair styles, and wish to, or need to maximise their lifetime grafts.
I also think fine haired candidates tend to usually be better suited to FUT, due to requiring higher overall graft counts for creating the illusion of density. 
People who don’t have BHT as an option - this really is a game changer for the amount of grafts we can play with now. If you dedicate a good few thousand grafts to your hairline and frontal third, and a solid few thousand to the crown . . You can get away with a more conservative number of scalp hair grafts in the mid scalp area, by boosting this region with BHT. I’ve seen some really great examples over recent years! 
 

When it comes to shaving down to a 0 guard , even with the thinnest and most delicate FUT scar, I still believe the worst FUE scarring to look a little less obvious at that grade - at worst it could look like some sort of skin condition, as opposed to a rather obvious HT scar. I also think SMP results are more successful on FUE scars than FUT, which is always an option.