Fut after Fue?

[HairEnthusiast101]

People talk about how fut first maximizes lifetime grafts by 2-3k. Can one do fue first and then get fut or is that negligible and will add no benefit in terms of maximizing grafts?

[davidn]

I talked about this with Muresanu who deemed it possible given it is a good fue extraction. I read the same from Dr Shapiro.

[WhereIsMyMind]

You are mixing two things.

One is, the best possible survivality comes on virgin non-scarred scalp. Scar tissue is known to yield less survivavility because of reduced blood supply. So in that sense, no matter what you do, an implanted follicle will always be best in the 1st ever transplant, or at least in an area that was never transplanted before nearby.

Secondly, FUT ensures that your surgeon won't transect any graft, because its impossible when picking it out of a FUT strip. Although, most skilled surgeons have close to 100% no transection rate in FUE nowadays to be fair. That is a benefit that will always be there regardless of first or second HT, but many people argue the tradeoff for scar is not worth it.

With those two things in mind, the conclusion depends basically on your personal goals. Personally I don't like FUT since I don't think benefits outweigh costs.

Edited January 3, 2023 by WhereIsMyMind

[NARMAK]

Dr Mwamba states FUT after FUE is a better way to go about things, as you cherry pick FUE for the frontal hairline and then FUT to max out the donor for the crown etc. but personally i think FUE is so good that it's almost not necessary for FUT at all. 

[HairEnthusiast101]

9 hours ago, WhereIsMyMind said:

You are mixing two things.

One is, the best possible survivality comes on virgin non-scarred scalp. Scar tissue is known to yield less survivavility because of reduced blood supply. So in that sense, no matter what you do, an implanted follicle will always be best in the 1st ever transplant, or at least in an area that was never transplanted before nearby.

Secondly, FUT ensures that your surgeon won't transect any graft, because its impossible when picking it out of a FUT strip. Although, most skilled surgeons have close to 100% no transection rate in FUE nowadays to be fair. That is a benefit that will always be there regardless of first or second HT, but many people argue the tradeoff for scar is not worth it.

With those two things in mind, the conclusion depends basically on your personal goals. Personally I don't like FUT since I don't think benefits outweigh costs.

So really in skilled hands like a Pittella or Eugenix,etc. the fue will almost equal fut for lifetime grafts?

[mister_25]

19 hours ago, NARMAK said:

Dr Mwamba states FUT after FUE is a better way to go about things, as you cherry pick FUE for the frontal hairline and then FUT to max out the donor for the crown etc. but personally i think FUE is so good that it's almost not necessary for FUT at all. 

What would you say is the ideal candidate for a FUT/FUE mix? I would probably say a high Norwood (5/6/7) with limited donor (poor density w/ retrograde)

[NARMAK]

8 hours ago, mister_25 said:

What would you say is the ideal candidate for a FUT/FUE mix? I would probably say a high Norwood (5/6/7) with limited donor (poor density w/ retrograde)

I would actually argue that it all comes down to the skill of the surgeons and clinics. FUT becoming less common has led to quite a fall in the people with the skill required for the smallest looking pencil line scar which you could deal with more easily imo. 

Imho, imagine anybody, that has an average laxity etc. gets FUT and then a pencil line scar. You can then more easily SMP and FUE in even beard hairs to there and make it much more easily invisible. 

FUE covers a much larger area, whereas with FUT you can recut into the same line and only marginally increase it. 

[Rahal Hair Transplant]

@JoDimaggio22,

In my opinion it’s a bad idea to do FUT after FUE for several reasons. The primary reason however, is because when grafts are extracted via FUE, some of the hair follicles surrounding the ones that have been extracted become a bit more fragile. I don’t want to call them damaged because that indicates that those hairs won’t continue to grow where they currently are. But because they’re more fragile, harvesting them via a strip and then dissecting them under microscope‘s and re-planting them may result in lower growth yield than if FUE was not first performed.  And because hair is extracted evenly throughout the donor area via FUE, there will be many of these more fragile hair follicles left in the donor area that may result in little to no growth if they are harvested and then re-implanted.

Also, one of the primary reasons why people undergo FUE in the first place is to eliminate the linear scar. What reason would you want to undergo FUT if you’ve already undergone FUE? Do you not have any more grafts available via FUE?

Best wishes,

Rahal Hair Transplant 

Edited January 4, 2023 by Rahal Hair Transplant

[HairEnthusiast101]

1 hour ago, NARMAK said:

I would actually argue that it all comes down to the skill of the surgeons and clinics. FUT becoming less common has led to quite a fall in the people with the skill required for the smallest looking pencil line scar which you could deal with more easily imo. 

Imho, imagine anybody, that has an average laxity etc. gets FUT and then a pencil line scar. You can then more easily SMP and FUE in even beard hairs to there and make it much more easily invisible. 

FUE covers a much larger area, whereas with FUT you can recut into the same line and only marginally increase it. 

When we refer to skin laxity are we referring to the tightness of your skin to head? My skin has like zero fat or zero ability to pinch anything so I’d say it is as tight against my skull as possible. That is probably a bad thing for fut because it can stretch it?

[HairEnthusiast101]

2 minutes ago, Rahal Hair Transplant said:

@JoDimaggio22,

in my opinion it’s a bad idea to do FUT after FUE for several reasons. The primary reason however, is because when graphs are extracted via FUE, some of the hair follicles surrounding the ones that have an extracted become a bit more fragile. I don’t want to call them damaged because that indicates that those hairs won’t continue to grow where they currently are. But because they’re more fragile, harvesting them via a strip and then dissecting them under microscope‘s and re-planting them may result in lower growth yield than FFUE was not first performed.  and because hair is extracted evenly throughout the donor area the FUE, there will be many of these more fragile hair follicles left in the donor area that may result in little to no growth if they are harvested and then re-implanted.

Also, one of the primary reasons why people undergo FUE in the first place is to eliminate the linear scar. What reason would you want to undergo FUT if you’ve already undergone FUE? Do you not have any more grafts available via FUE?

Best wishes,

Rahal Hair Transplant 

Just curious really if it is even possible. I want to get fue because of the fut scar but also want to maximize lifetime grafts. It seems fue doesn’t get as many grafts as fut does in the lifetime

[Rahal Hair Transplant]

OK so I know you’ve been posting for a while but remind me, have you gotten a hair transplant at all yet?   If not, then I strongly recommend working with a skilled and experienced surgeon to work out a long-term hair restoration plan.   If you’re interested in a one on one information session with Dr. Rahal, feel free to send me a private message and I’ll be happy to set this up for you.

But if you want more specific advice from the whole community, I suggest maybe creating a single post showcasing photos of multiple angles of the balsing areas and donor area, your goals, your age, whether or not you’re on any medication and if so for how long, whether or not you’ve had any hair restoration surgery previously and if so, the type of procedure, the number of grafts, doctor, etc.

This would enable members of this community to give you the best advice about what they recommend given your particular situation.

In general, yes it’s certainly possible to do FUE followed by FUT but it’s not something I would recommend. If you insist on doing both to maximize the amount of available donor hair, I suggest starting with FUT and ending with FUE.   But that may not be something you require.

Best wishes,

Rahal Hair Transplant 

[HairEnthusiast101]

2 minutes ago, Rahal Hair Transplant said:

OK so I know you’ve been posting for a while but remind me, have you gotten a hair transplant at all yet?   If not, then I strongly recommend working with a skilled and experienced surgeon to work out a long-term hair restoration plan.   If you’re interested in a one on one information session with Dr. Rahal, feel free to send me a private message and I’ll be happy to set this up for you.

But if you want more specific advice from the whole community, I suggest maybe creating a single post showcasing photos of multiple angles of the balsing areas and donor area, your goals, your age, whether or not you’re on any medication and if so for how long, whether or not you’ve had any hair restoration surgery previously and if so, the type of procedure, the number of grafts, doctor, etc.

This would enable members of this community to give you the best advice about what they recommend given your particular situation.

In general, yes it’s certainly possible to do FUE followed by FUT but it’s not something I would recommend. If you insist on doing both to maximize the amount of available donor hair, I suggest starting with FUT and ending with FUE.   But that may not be something you require.

Best wishes,

Rahal Hair Transplant 

Thank you. I was just curious about the industry and questions pertaining to it. I am 25 so I am in the planning process and don’t plan on undergoing anything until 28+. I have spoken to Dr Rahal about a year ago and he said I was way too young. So for now I just ask questions because I know there are many knowledgeable people on here that can help give me answers. Thank you for all your responses!

[NARMAK]

6 hours ago, JoDimaggio22 said:

When we refer to skin laxity are we referring to the tightness of your skin to head? My skin has like zero fat or zero ability to pinch anything so I’d say it is as tight against my skull as possible. That is probably a bad thing for fut because it can stretch it?

That is a form of skin laxity in that specific area. So usually if you firmly press your hand/fingers against the back of your head, if it moves enough or more, that indicates it has more elasticity. However, the thing that kind of puts me off FUT is the fact that the scar has got the possibility to stretch too over time. 

I just wish we frigging get unlimited clone grafts sooner rather than later. I would much prefer a top notch clinic use those for the obvious reasons that you don't exhaust a finite donor supply and can actually get massive amount of potential to even address a desire to increase density from what you may natively have that you don't like. 

[HairEnthusiast101]

1 minute ago, NARMAK said:

That is a form of skin laxity in that specific area. So usually if you firmly press your hand/fingers against the back of your head, if it moves enough or more, that indicates it has more elasticity. However, the thing that kind of puts me off FUT is the fact that the scar has got the possibility to stretch too over time. 

I just wish we frigging get unlimited clone grafts sooner rather than later. I would much prefer a top notch clinic use those for the obvious reasons that you don't exhaust a finite donor supply and can actually get massive amount of potential to even address a desire to increase density from what you may natively have that you don't like. 

So years after fut it can still stretch the scar to take up a bigger space? Wow. Respect to people who undergo that procedure knowing the risk. Mine would definitely scar bad due to poor healing

[NARMAK]

5 minutes ago, JoDimaggio22 said:

So years after fut it can still stretch the scar to take up a bigger space? Wow. Respect to people who undergo that procedure knowing the risk. Mine would definitely scar bad due to poor healing

Best thing to do is not hyper focus on one thing but get a proper professional consultation with a top clinic whose work you like and trust the consistency of. 

For me personally, i do not think we have a "Perfect" option right now for hair loss whether that is medication or hair transplants. We have an option though that can help and improve the well being i would say of those people that usually undergo it. 

[HelpfulFriend]

I think it depends on how big the FUE is.

Dr Konior said after 1200 grafts taken via FUE, that FUT is very easily done for my next op (if I chose to go down that route).

So it can definitely be done, unsure as to what the defining variables are though.