FUE vs FUT for young person

[HairEnthusiast101]

So much you here how your first HT should be FUT to preserve donor. Some doctors view it as reckless if you do fue early on when you don’t know how much more you will bald. Is fue safe in younger patients and do results for fue yield better than FUt? Or does FUt seem to be the best always in case you do end up NW5+?

[StillAlive]

FUT is an obsolete procedure, mostly used for covering large Norwoods satisfactorily, usually with a plan to hide the scar with beard or body hair or SMP. For the most part, it is used when considering NW5 or higher. If you are young and your hair loss has yet to stabilize, I would recommend either going on meds (Fin + Minox) if you are willing to accept the side effects and marry the routine or seeing how far your loss advances, set realistic goals and get the procedures that will give you the best possible coverage. 

[mafpe]

the combination of fut then fue is in order to yield as much as possible result. at least that's the theory.

if you have tons of money though, you can do a fit farming instead, which would be better with no strip scar, and the safety of being able to restock donor at will.

this is going to cost you a whole ton though, plus the commitment and time.

[TommyLucchese]

The advice I got from Dr Muresanu (Hattingen) is that FUT is best for when you need 3,500 grafts or more. That's because you lose scalp elasticity with each FUT so it doesn't make sense to waste the laxity for smaller surgeries. He also said that you can switch back and forth between FUT and FUE no problem.

The length you plan to have your hair will also come into it and if you are on fin/minox.

I had an FUT when I was 23 and 10 years later everything is great so far....FUE has come a long way since then so who knows if I'd have made that same decision today.

Consulting with doctors who offer both options would be best so you can get an unbiased view. 

[New_Barnet_Please]

This question is more from when FUE techniques were poor. Now they are extremely good it’s FUE all day. FUT shouldn’t be considered except for rare cases imo.

Just make sure you pick a top class surgeon though..

Edited August 22, 2022 by New_Barnet_Please

[HelpfulFriend]

6 hours ago, StillAlive said:

FUT is an obsolete procedure, mostly used for covering large Norwoods satisfactorily, usually with a plan to hide the scar with beard or body hair or SMP. For the most part, it is used when considering NW5 or higher. If you are young and your hair loss has yet to stabilize, I would recommend either going on meds (Fin + Minox) if you are willing to accept the side effects and marry the routine or seeing how far your loss advances, set realistic goals and get the procedures that will give you the best possible coverage. 

I don't think it's obsolete, considering some of the best docs in the world still use it.

Edited August 22, 2022 by HelpfulFriend

[HelpfulFriend]

Also, FUT is something that needs to be considered for people who will need a lot of grafts.

To maximise your donor, you are still best to start with FUT, and then move to FUE for the subsequent procedures. If you do a large FUE early on, and require a lot more grafts down the road, it can sometimes be difficult to cover enough area.

People telling you not to do it are going against the advice of top-tier surgeons who can do both, i.e. Konior, Cooley, Hasson and Wong, etc. Docs make a lot more $ by going FUE, so FUT wouldn't still be widely practiced if there wasn't a reason/place for it.

[StillAlive]

You raise a good point @HelpfulFriend, 'obsolete' was a poor choice of word. It definitely has its place, but in specific scenarios. I was biased and spoke on behalf of the NW3-NW4 cohort  

Edited August 22, 2022 by StillAlive

[Z--]

At least three of the best doctors (Konior, Shapiro, Josephitius) in the world (both who do FUT and FUE, so no ulterior motive) have agreed that FUT will yield more than 2,000 to 3,000 more hair grafts in a lifetime if you max out a strip first. For most people who are stabilised on medication at a lower Norwood (no higher than Norwood 4), those extra grafts probably aren't needed needed, especially if they have an normal donor or beard hair to use. 

That said, FUT is ideal if you are a higher Norwood where every graft counts -- 3,000 grafts can make a big difference in the right hands. It also is probably more ideal for young guys who are currently losing and predisposed to a higher Norwood as it's way more likely that you'll pull the strip from the safe zone, whereas with FUE, due to the need for donor to avoid the depleted appearance, they need to pull from all over the place, so there is a minor risk that you pull from a place one may lose in the future. Unfortunately, the price you pay for the 3k grafts is the scar, so it's not a one size fits all. Might be worth having less hair to work with in exchange to be able to cut your hair short w/o the scar. I have seen some folks fill in the scar with beard hair though.

Still, FUE has come a long way and many of us baldies can achieve a solid head of hair using beard and FUE alone. I think, though, if you want to play it safe to have those extra hairs in the bank or if you're young (and have bad loss), I think FUT is a great option. Personally, I had an FUT of around 2.5k grafts and can do another 2.5k graft session before I plan to switch over to FUE/BHT.

[Rahal Hair Transplant]

JoDimaggio,

if you could remind us, how old are you and what exactly does your hair loss situation look like? You’re asking some good questions but they are all spread out in different posts so it’s hard to keep track of your entire situation.  In order to answer your question in the best way possible, i’d like to suggest that you share your details including

1. your age

2. family history

3. current hair loss

4. photos of your hair loss and your donor area

5. whether or not you’re on any hair loss medication such as finasteride or Knoxville and if so, how long you’ve been on it and if not, whether or not you’ve tried it and how long ago you came off of it, etc.

6. whether or not you are still losing your hair and if so is it aggressive or gradual and if not, when did it stop

In my opinion, the better issue to focus on isn’t whether or not someone young should consider FUT versus FUE but whether or not someone young is a good candidate for a hair transplant surgery based on their specific situation.

In general however, there are several schools of thought here but there are those who believe including our clinic that in the majority of cases if you are a good candidate for FUT than you are also a good candidate for FUE.

At the end of the day, FUT and FUE are both donor harvesting techniques and nothing more. That’s essentially only 1/4 to 1/3 of a hair transplant procedure. You also have to consider implantation, storage of the grafts outside of the body, design and placement of the follicular units, determining what’s appropriate for each patient, etc.  

Of course, there may be some situations where a patient is a candidate for FUT and not FUE but the opposite is also true.

I hope this information helps and once you provide some additional information, it will be easier to value with a more detailed opinion of what may be best in your situation. That said if you are interested in a one on one information session with Dr. Rahal Who could help you map out a short and long-term hair restoration plan to meet your ultimate goals, please send me a private message and I’ll be happy to set this up for you.

Best wishes,

Rahal Hair Transplant 

[HairEnthusiast101]

6 hours ago, TommyLucchese said:

The advice I got from Dr Muresanu (Hattingen) is that FUT is best for when you need 3,500 grafts or more. That's because you lose scalp elasticity with each FUT so it doesn't make sense to waste the laxity for smaller surgeries. He also said that you can switch back and forth between FUT and FUE no problem.

The length you plan to have your hair will also come into it and if you are on fin/minox.

I had an FUT when I was 23 and 10 years later everything is great so far....FUE has come a long way since then so who knows if I'd have made that same decision today.

Consulting with doctors who offer both options would be best so you can get an unbiased view. 

I see you went To feller and company. That is kinda why I asked the question because they are adamant about young individuals to do fut and how fue early on can lead to scarring around that follicle so If you do decide to go to fut after an fue then hair may not even be capable to be used. 

 

8 hours ago, mafpe said:

the combination of fut then fue is in order to yield as much as possible result. at least that's the theory.

if you have tons of money though, you can do a fit farming instead, which would be better with no strip scar, and the safety of being able to restock donor at will.

this is going to cost you a whole ton though, plus the commitment and time.

Isn’t FIT what Mwamba does? How does one have donor restocking with fit? I assumed it was just fue with more regard for better hair characteristics. 

 

1 hour ago, Rahal Hair Transplant said:

JoDimaggio,

if you could remind us, how old are you and what exactly does your hair loss situation look like? You’re asking some good questions but they are all spread out in different posts so it’s hard to keep track of your entire situation.  In order to answer your question in the best way possible, i’d like to suggest that you share your details including

1. your age

2. family history

3. current hair loss

4. photos of your hair loss and your donor area

5. whether or not you’re on any hair loss medication such as finasteride or Knoxville and if so, how long you’ve been on it and if not, whether or not you’ve tried it and how long ago you came off of it, etc.

6. whether or not you are still losing your hair and if so is it aggressive or gradual and if not, when did it stop

In my opinion, the better issue to focus on isn’t whether or not someone young should consider FUT versus FUE but whether or not someone young is a good candidate for a hair transplant surgery based on their specific situation.

In general however, there are several schools of thought here but there are those who believe including our clinic that in the majority of cases if you are a good candidate for FUT than you are also a good candidate for FUE.

At the end of the day, FUT and FUE are both donor harvesting techniques and nothing more. That’s essentially only 1/4 to 1/3 of a hair transplant procedure. You also have to consider implantation, storage of the grafts outside of the body, design and placement of the follicular units, determining what’s appropriate for each patient, etc.  

Of course, there may be some situations where a patient is a candidate for FUT and not FUE but the opposite is also true.

I hope this information helps and once you provide some additional information, it will be easier to value with a more detailed opinion of what may be best in your situation. That said if you are interested in a one on one information session with Dr. Rahal Who could help you map out a short and long-term hair restoration plan to meet your ultimate goals, please send me a private message and I’ll be happy to set this up for you.

Best wishes,

Rahal Hair Transplant 

I guess the biggest question is knowing if you further bald or how you heal. I tend to hypertrophic scar so that is why I am scared to go through with an fut procedure but since I am in my mid 20s and may decide to get an HT in 3-5 years I also want to be smart with the idea I could further lose. Some doctors basically state in your 20s-30s with the potential to bald further fut is always the smartest option, but as I stated the fut scar scares me due to my ability to scar while fue can still leave scarring I presume but maybe not as noticeable? Regardless I am married to Finasteride(last 2-3 years have taken every day) and get no side effects and I am also open to oral minox in my life. But even with those treatments I could still further bald and would be a bummer if I am only able to get 5k lifetime donor grafts compared to 8k or so if I mixed fue/fut

[New_Barnet_Please]

2 hours ago, HelpfulFriend said:

Also, FUT is something that needs to be considered for people who will need a lot of grafts.

To maximise your donor, you are still best to start with FUT, and then move to FUE for the subsequent procedures. If you do a large FUE early on, and require a lot more grafts down the road, it can sometimes be difficult to cover enough area.

People telling you not to do it are going against the advice of top-tier surgeons who can do both, i.e. Konior, Cooley, Hasson and Wong, etc. Docs make a lot more $ by going FUE, so FUT wouldn't still be widely practiced if there wasn't a reason/place for it.

I mean, many other top tier surgeons mostly don't do FUT also..

If you are taking FUE individual units, why would there be less grafts available later? The other units are untouched and still there?

[HairEnthusiast101]

2 minutes ago, New_Barnet_Please said:

I mean, many other top tier surgeons mostly don't do FUT also..

If you are taking FUE individual units, why would there be less grafts available later? The other units are untouched and still there?

I think because they take up hair from all over donor compared to a strip being taken and all the hair above and below that strip being completely unused 

[New_Barnet_Please]

Just now, JoDimaggio22 said:

I think because they take up hair from all over donor compared to a strip being taken and all the hair above and below that strip being completely unused 

Yes but so what? If you want to add more grafts from FUE then as long as they have been taken carefully, more grafts can be taken from all over in the same way. The unused ones aren't damaged or anything which seemed to be implied in the post I replied to. 

[HairEnthusiast101]

Just now, New_Barnet_Please said:

Yes but so what? If you want to add more grafts from FUE then as long as they have been taken carefully, more grafts can be taken from all over in the same way. The unused ones aren't damaged or anything which seemed to be implied in the post I replied to. 

Well that’s kinda what I thought so that’s why I was curious why some doctors urge people to do fut to have more donor capacity when to me hair is hair

[New_Barnet_Please]

Top doctors manage FUE donor area very carefully, using a mircoscope to see that caliber of the hair and account for future loss. There is no such thing as a general  "safe zone", as it should be carefully analysed in person for each patient.

Edited August 22, 2022 by New_Barnet_Please

[New_Barnet_Please]

I can see why someone very high on the Norwood scale that needs a large number of grafts might be advised to use FUT, but this was a question asking for a young person.

[HelpfulFriend]

13 hours ago, StillAlive said:

You raise a good point @HelpfulFriend, 'obsolete' was a poor choice of word. It definitely has its place, but in specific scenarios. I was biased and spoke on behalf of the NW3-NW4 cohort  

Haha, I too am in that cohort - and am admittedly always quietly rooting for my specific pattern  

[HelpfulFriend]

11 hours ago, New_Barnet_Please said:

I mean, many other top tier surgeons mostly don't do FUT also..

If you are taking FUE individual units, why would there be less grafts available later? The other units are untouched and still there?

Yes but we've already established that a lot more money can be made when doing FUE, so there's a profit incentive there - and some surgeons are more skilled in one vs the other. 

I'm not too sure of the exact mechanism, but doctors that do both all say that to maximise grafts over a lifetime, FUT and then FUE is the way to go.

Most people might not need this, but if your family are all NW7's, then it's something to consider. No one is ever "one and done" with transplants, they are a lifetime commitment in which most people will need multiple.

[HairEnthusiast101]

16 minutes ago, HelpfulFriend said:

Yes but we've already established that a lot more money can be made when doing FUE, so there's a profit incentive there - and some surgeons are more skilled in one vs the other. 

I'm not too sure of the exact mechanism, but doctors that do both all say that to maximise grafts over a lifetime, FUT and then FUE is the way to go.

Most people might not need this, but if your family are all NW7's, then it's something to consider. No one is ever "one and done" with transplants, they are a lifetime commitment in which most people will need multiple.

If there is no sign of NW7 in your family that doesn’t prevent you from NW7 I assume? So fut then fue would still always be smart? It seems some of these gigassesions from zarev or others are fully fue so wondering where they get the grafts necessary maybe an overharvest

[New_Barnet_Please]

2 hours ago, HelpfulFriend said:

Yes but we've already established that a lot more money can be made when doing FUE, so there's a profit incentive there - and some surgeons are more skilled in one vs the other. 

I'm not too sure of the exact mechanism, but doctors that do both all say that to maximise grafts over a lifetime, FUT and then FUE is the way to go.

Most people might not need this, but if your family are all NW7's, then it's something to consider. No one is ever "one and done" with transplants, they are a lifetime commitment in which most people will need multiple.

I don't buy that it's financial, FUE has been clearly superior technique to FUT for a long time being less invasive. It's only in the USA really that they have been slower to let go of it.

Everyone is free to have their preference but many will have a large amount of FUE grafts available anyway if donor is managed carefully. FUE techniques are so good now, for my surgery the donor looks almost untouched, you would never know - and there's a ton in the bank for more FUE grafts as needed. I would disagree as a young person it's necessary to have an an invasive procedure and have a scar on the head for life.

[HairEnthusiast101]

8 hours ago, New_Barnet_Please said:

I don't buy that it's financial, FUE has been clearly superior technique to FUT for a long time being less invasive. It's only in the USA really that they have been slower to let go of it.

Everyone is free to have their preference but many will have a large amount of FUE grafts available anyway if donor is managed carefully. FUE techniques are so good now, for my surgery the donor looks almost untouched, you would never know - and there's a ton in the bank for more FUE grafts as needed. I would disagree as a young person it's necessary to have an an invasive procedure and have a scar on the head for life.

How many grafts do you have available through fue? When you say untouched like if I shaved you bald I would not see anything?

[HelpfulFriend]

On 8/23/2022 at 4:22 PM, New_Barnet_Please said:

I don't buy that it's financial, FUE has been clearly superior technique to FUT for a long time being less invasive. It's only in the USA really that they have been slower to let go of it.

Everyone is free to have their preference but many will have a large amount of FUE grafts available anyway if donor is managed carefully. FUE techniques are so good now, for my surgery the donor looks almost untouched, you would never know - and there's a ton in the bank for more FUE grafts as needed. I would disagree as a young person it's necessary to have an an invasive procedure and have a scar on the head for life.

I don't think it's necessary, just something to consider.

You are correct that it's less invasive, and I'm glad you had a great procedure, but I've seen FUE donors in person that look horrendous. So it's definitely a case-by-case and depends on the surgeon. 

I've also seen FUT that can't be seen at a close guard, and vice-versa. If you don't plan on having short/buzzed hair, then I don't see a reason to avoid either procedure.

[New_Barnet_Please]

14 minutes ago, HelpfulFriend said:

I don't think it's necessary, just something to consider.

You are correct that it's less invasive, and I'm glad you had a great procedure, but I've seen FUE donors in person that look horrendous. So it's definitely a case-by-case and depends on the surgeon. 

I've also seen FUT that can't be seen at a close guard, and vice-versa. If you don't plan on having short/buzzed hair, then I don't see a reason to avoid either procedure.

It’s not case by case but is of course highly dependent on going to a top surgeon which is why this forum is here - comparing FUE from a bad surgeon is not helpful at all.

[John1991]

"At least three of the best doctors (Konior, Shapiro, Josephitius) in the world (both who do FUT and FUE, so no ulterior motive) have agreed that FUTwill yield more than 2,000 to 3,000 more hair grafts in a lifetime if you max out a strip first. For most people who are stabilised on medication at a lower Norwood (no higher than Norwood 4), those extra grafts probably aren't needed needed, especially if they have an normal donor or beard hair to use."  Z

If this is true - and I have no reason to believe it's not - then any person like OP in there early/mid 20s, who, by definition, can't know how much loss they will have, should start with FUT.  Pretty much period.  End of story.  Everything around hair transplants - and life in general - is about playing the most favorable odds.  You come on this forum to find a quality surgeon so the odds are in your favor that you have a good procedure.  Why wouldn't you also then play the odds of 2-3 thousand extra grafts on the chance that you lose more hair than you're expecting to lose?  This is of course excluding those who truly can't have a strip taken due to scalp laxity issues.

Edited August 25, 2022 by John1991