Dr. Nakatsui vs. Dr. Wong

[MaximusEastwood]

Dr. Nakatsui vs. Dr. Wong

Right now debating between these two doctors for my HT. Quick background:

1. Young 30's male with advanced hairloss (Norwood 5-6)

2. Want a FUT to maximize liftetime graft availability. Hoping for at least 3200 grafts in first session

For quick pros/cons of each:

Dr. Nakatsui

1. Trained with Dr. Wong

2. Half as expensive (but still not cheap, maybe around $10k instead of $20k)

3. Doesn't have any patient posted reviews (most are from his clinic, though they look nice)

4. Clinic doesn't focus exclusively on HT

Dr. Wong

1. More renowned, many patient reviews

2. Known for doing dense, mega-sessions

3. More expensive

4. Has more examples of row-like patterns (search his name for examples), that some people don't like

Any tips/advice on picking between these two? I also researched a bunch of others, but ultimately would like to pick either Dr. Nakatsui or Dr. Wong. Thanks!  For more background, I chose these two over US surgeons (I live in California) because they estimated a higher possible graft count in one surgery (3-4k vs. most US are 2k)

[BurnieBurns]

I don't know much about Dr Nakatsui but haven't seen anything negative. He seems to be knowledgeable and skilled plus his posted results look great (though the pictures could be better). It could be worth asking the clinic if they can any former patients you could be put in touch with.

I recently did an FUT megasession with Dr Wong and I cannot praise it enough (albeit the result will be several months away). The 'rows' that people talk about here (which are more like 'paths' than rows) are done purposely for ensuring survivability, protecting native hair, and minimising trauma. There is a reason H&W achieve high density megasessions with full growth, while most other surgeons can't. Unless you plan of wearing your hair shorter than an cm, this should be that last of your concern.

Are you on medication? If you really truly to push the brim on maximising grafts then Wong is one of the only 3 doctors I'd trust to get the absolute most from my scalp via FUT. I consulted with another experienced (airquotes) doc who said I couldn't get more than 5000 grafts via FUT in in my lifetime. Dr Wong got about 5700 and said a lot could still be taken in future!

Moneywise, if 10k vs 20k was here nor there I'd go with Wong, but I wouldn't rule Dr Nakatsui out if would lift a heavvy burdon off me. 

Edited January 10, 2023 by BurnieBurns

[HairEnthusiast101]

7 hours ago, BurnieBurns said:

I don't know much about Dr Nakatsui but haven't seen anything negative. He seems to be knowledgeable and skilled plus his posted results look great (though the pictures could be better). It could be worth asking the clinic if they can any former patients you could be put in touch with.

I recently did an FUT megasession with Dr Wong and I cannot praise it enough (albeit the result will be several months away). The 'rows' that people talk about here (which are more like 'paths' than rows) are done purposely for ensuring survivability, protecting native hair, and minimising trauma. There is a reason H&W achieve high density megasessions with full growth, while most other surgeons can't. Unless you plan of wearing your hair shorter than an cm, this should be that last of your concern.

Are you on medication? If you really truly to push the brim on maximising grafts then Wong is one of the only 3 doctors I'd trust to get the absolute most from my scalp via FUT. I consulted with another experienced (airquotes) doc who said I couldn't get more than 5000 grafts via FUT in in my lifetime. Dr Wong got about 5700 and said a lot could still be taken in future!

Moneywise, if 10k vs 20k was here nor there I'd go with Wong, but I wouldn't rule Dr Nakatsui out if would lift a heavvy burdon off me. 

I usually shave down to a 1 on the sides. Would fut be a no then if I like to do 1-2 guard fades?

[BurnieBurns]

11 minutes ago, JoDimaggio22 said:

I usually shave down to a 1 on the sides. Would fut be a no then if I like to do 1-2 guard fades?

I'd say an FUT scar could still be visible on a 2 unless you get a perfect outcome and it stays 1mm. There is unfortunately no way to guarantee this even in the best of possible hands

[HairEnthusiast101]

11 minutes ago, BurnieBurns said:

I'd say an FUT scar could still be visible on a 2 unless you get a perfect outcome and it stays 1mm. There is unfortunately no way to guarantee this even in the best of possible hands

Is there a group of surgeon or surgeon in particular that Always seems to have great fut scars? Like scars are always minimal when they are performing fut?

[BurnieBurns]

43 minutes ago, JoDimaggio22 said:

Is there a group of surgeon or surgeon in particular that Always seems to have great fut scars? Like scars are always minimal when they are performing fut?

You can greatly improve you chance of having a great scar but going to a great surgeon but like I said there's no guarantee. 

Dr Wong would probably be in the top 3 FUT doctors in terms of skill, but some will always be better than others. Individually some people scar more than others. JT can a few FUT surgeries with him. One had a good amount of stretch-back then he performed a scar revision and luck for him that one stayed fine.

There's also doctors that use things like A-cell claiming it results in a better scar. There's no proper data to support this but that's been their experience for what it's worth.

Another interesting point is apparently you're more likely to get a better FUT scar when you're older. If the collagen content in the skin in lower with age, it can't produce as much scar tissue. Weird huh? 

[Tiger2050]

You sort of answered your own question. You know that Wong is a better doctor and safer choice but Nakatsui is half the price. If you’re looking for a discount, I would look at European doctors over Nakatsui who have much stronger reputations. Hattinggen in Switzerland is excellent at FUT and cheaper than Wong, about $3.5/graft for FUT over 3000 grafts. I personally wouldn’t risk it with Nakatsui, this is a life long decision that you can’t undo once it’s done. I think your best options are to save up for Wong or book a flight to Switzerland. H&W and Hattingen are probably the 2 best clinics in the world for FUT mega sessions. The inconvenience of flying to Switzerland is a short-term problem, a bad hair transplant is much worse long-term problem. You’re a Norwood 5/6 at a young age so you can’t afford to risk wasting grafts on a subpar first surgery. 

Edited January 10, 2023 by Tiger2050

[HairEnthusiast101]

6 minutes ago, BurnieBurns said:

You can greatly improve you chance of having a great scar but going to a great surgeon but like I said there's no guarantee. 

Dr Wong would probably be in the top 3 FUT doctors in terms of skill, but some will always be better than others. Individually some people scar more than others. JT can a few FUT surgeries with him. One had a good amount of stretch-back then he performed a scar revision and luck for him that one stayed fine.

There's also doctors that use things like A-cell claiming it results in a better scar. There's no proper data to support this but that's been their experience for what it's worth.

Another interesting point is apparently you're more likely to get a better FUT scar when you're older. If the collagen content in the skin in lower with age, it can't produce as much scar tissue. Weird huh? 

Do you think it is a dramatic difference between lifetime grafts available if fut is done first? It seems more are going to fue

[BurnieBurns]

6 minutes ago, JoDimaggio22 said:

Do you think it is a dramatic difference between lifetime grafts available if fut is done first? It seems more are going to fue

Most do FUE because that's where the market is. On the forefront of their mind is avoiding a scar rather than maximising donor - keep in mind many people won't even need to as they won't progress into advanced stages be that genetically or due to a treatment regime.

[Z--]

29 minutes ago, JoDimaggio22 said:

Do you think it is a dramatic difference between lifetime grafts available if fut is done first? It seems more are going to fue

2,000 - 3,000 according to some reputable surgeons who practice both.

Many go FUE because (i) it's less painful, (ii) more widely offered, (iii) aren't Norwood 6/7 and may not need the additional grafts; or (iv) want to avoid the scar.