How many grafts do I have available? FUT or FUE?

[MaximumMM]

Hi there,

I've recently had (day 25) a first FUE procedure of about 4.4k grafts to hairline and mid-scalp. The procedure seems to have gone quite well, but having started from NW6 I will certainly need another, which was always the plan.

I understand I'd need a minimum of 8k grafts overall for a decent result. 

I'm trying to calculate my donor capacity based on trichoscopy reports, which have me the following data:

Donor zone surface area = 266 cm2
Donor density = 70 FU/cm2
Coverage value = 15
Donor hair calibre = 72-82 microns

Total lifetime grafts in the donor area are 18,000, of which 22.5% have apparently been used.

Am I right in thinking therefore, that's it's wise not to use more than 33%, in total? So that would leave me only another 2k or so, maximum, from a second FUE.

I'm therefore thinking FUT may be the way to go? And yes, I know it's better to have done FUT first if doing a combo, but that's obviously not an option now.

Or, would a clinic like Eugenix possibly be able to get sufficient FUE grafts through BHT?

Thank you all!

 

 

 

[BurnieBurns]

Whether Eugenix would be able to get the surplus needed outside the scalp would once again depend on your donor. Do you have a thick, dense beard that matches your hair hair colour and texture? Same with your chest and you'd need to consult with them to find out.

Remember body/beard grafts usually contain 1 or 2 hairs which means a higher count is needed than scalp generally.

If you go FUT I wouldn't worry too much about having already done an FUE (provided it was done by a good doctor and you didn't have any permanent shock loss in the donor)

[Z--]

I don’t think you’d be able to reap the benefits of additional lifetime grafts using FUT if you’ve already had 4.4K FUE pulled. I’d stick to FUE at this point. 

[mr_peanutbutter]

can you post a pic?

[mr_peanutbutter]

12 minutes ago, Z-- said:

I don’t think you’d be able to reap the benefits of additional lifetime grafts using FUT if you’ve already had 4.4K FUE pulled. I’d stick to FUE at this point. 

in this video it said it can be done

 

[MaximumMM]

20 minutes ago, BurnieBurns said:

Whether Eugenix would be able to get the surplus needed outside the scalp would once again depend on your donor. Do you have a thick, dense beard that matches your hair hair colour and texture? Same with your chest and you'd need to consult with them to find out.

Remember body/beard grafts usually contain 1 or 2 hairs which means a higher count is needed than scalp generally.

If you go FUT I wouldn't worry too much about having already done an FUE (provided it was done by a good doctor and you didn't have any permanent shock loss in the donor)

Thanks. Attaching pictures. My beard is fairly thick, I think? I'm not sure how well it matches my hair (I've attached a picture of my hair before shaving).

Any opinions on that?

My chest is fairly hairy I would say too.

[MaximumMM]

22 minutes ago, Z-- said:

I don’t think you’d be able to reap the benefits of additional lifetime grafts using FUT if you’ve already had 4.4K FUE pulled. I’d stick to FUE at this point. 

Would you mind elaborating?

As I understand, FUT/FUE combo if generally considered to provide the maximum number of grafts, with FUT done first. As that video posted by @mr_peanutbutter shows, up to an additional estimated 3k than if you just did one or the other. 

I get that if I have a strip at this point it will have fewer grafts than before the FUE, but I suppose the question is how much does having had a prior FUE change the above calculation?

[mr_peanutbutter]

id consult with fut surgeon like hattingen hair, bloxham or saifi and ask for their opinion. according to thr video it seems definitely possible

[Rahal Hair Transplant]

@MaximumMM,

Firstly, congratulations on your recent hair transplant. My question to you is, did your surgeon tell you how many graphs he thinks you have available over the course of your lifetime?  For instance, I know Dr. Rahal has the formula that he uses to determine approximately how many follicular units a patient has over the course of their lifetime.   Remember also that in, determining this, one also has to take into consideration  what the donor area will look like after extraction. In other words, you certainly don’t want to end up With a scarce donor area where the hair has been overharvested.  Clearly, donor density will help in determining this.   But hair caliber and hair to scalp color ratio can play a role.

So in my opinion, the best thing to do would be to ask your surgeon/clinic to see what they have to say about your available donor hair over the course of your lifetime since they have seen you in person and hopefully were able to evaluate that.

Best wishes,

Rahal Hair Transplant

[MaximumMM]

6 hours ago, Rahal Hair Transplant said:

@MaximumMM,

Firstly, congratulations on your recent hair transplant. My question to you is, did your surgeon tell you how many graphs he thinks you have available over the course of your lifetime?  For instance, I know Dr. Rahal has the formula that he uses to determine approximately how many follicular units a patient has over the course of their lifetime.   Remember also that in, determining this, one also has to take into consideration  what the donor area will look like after extraction. In other words, you certainly don’t want to end up With a scarce donor area where the hair has been overharvested.  Clearly, donor density will help in determining this.   But hair caliber and hair to scalp color ratio can play a role.

So in my opinion, the best thing to do would be to ask your surgeon/clinic to see what they have to say about your available donor hair over the course of your lifetime since they have seen you in person and hopefully were able to evaluate that.

Best wishes,

Rahal Hair Transplant

Thanks. Yes, my total lifetime grafts are estimated at 18000. Which would give me roughly 6k total grafts from my scalp, or an additional 1.5k, which is not enough for good coverage.

So my question is therefore how many additional grafts could I get from either body hair fue, or FUT, and which would be the best option?

I will ask the clinic of course as well, but am interested in other opinions. 

Edited April 25, 2023 by MaximumMM

[Gramatik]

Clinics like Eugenix are able to extract many grfafts from beards...so theres no reason to do FUT. You would do FUE + BHT for best result.

[Bucky O Hair]

Excellent results by the way.

I would avoid FUT and opt for the beard hair route, since you have quite a solid beard and will have plenty to spare.

You also have a pretty good head shape and could pull off a nice short cut on the sides and back (which will work well if you have beard hair grafts, and you won't have the option to wear this style if you have an FUT scar).

I'm in a similar boat as you, where my lifetime available grafts are roughly around 7,000 and I used up 3,200 for the front and am deciding on how much to use on my crown HT (that I will be planning in a year from now) but at the same time want to be mindful of future loss.

There is also the option of using SMP to mask some of the FUE gaps that may exist if you decide to 'overharvest'.  I'm actually curious to see if there are photos on this board of any strategic cases where people purposely overharvest their donor area, then mask it with SMP tattoos.  

I would definitely opt to go with FUE + Beard hair over anything FUT, simply because the linear scar may limit you with some hair styles that could work really well for your look.  

 

Edited April 25, 2023 by Bucky O Hair

[mr_peanutbutter]

@Bucky O Hair

 

apparently zarev „overharvest“ the donor but it still looks insane

[mr_peanutbutter]

you could also wait the trial of dr.b with fut and verteporfin, if there is little scaring it could be a game changer

[MaximumMM]

8 hours ago, Bucky O Hair said:

Excellent results by the way.

I would avoid FUT and opt for the beard hair route, since you have quite a solid beard and will have plenty to spare.

You also have a pretty good head shape and could pull off a nice short cut on the sides and back (which will work well if you have beard hair grafts, and you won't have the option to wear this style if you have an FUT scar).

I'm in a similar boat as you, where my lifetime available grafts are roughly around 7,000 and I used up 3,200 for the front and am deciding on how much to use on my crown HT (that I will be planning in a year from now) but at the same time want to be mindful of future loss.

There is also the option of using SMP to mask some of the FUE gaps that may exist if you decide to 'overharvest'.  I'm actually curious to see if there are photos on this board of any strategic cases where people purposely overharvest their donor area, then mask it with SMP tattoos.  

I would definitely opt to go with FUE + Beard hair over anything FUT, simply because the linear scar may limit you with some hair styles that could work really well for your look.  

 

Thanks for the feedback. The top pic is before btw, so not a 'result' exactly if that's what you mean!

That's an interesting point about deliberately overharvesting and then using smp. I wouldn't do it myself as it would effectively mean you'd need to have a shaved fade for the rest of your life. I already have smp on top so hopefully that will help with density.

It's sounding like fue + bht is the best way to go.

A couple of questions I have:

Does anyone know how well dark beard hair would blend into slightly lighter hair like mine on the crown? I have seen some cases like @Bandit90 where it is still noticeably different, but I have heard this blends over time. I wonder why this would be? Is it because the hair lightens over time? Or is it simply that it is less noticeable as the scalp-harvested implants grow out? I would love to see some more examples of beard hair into crown recipient on lighter hair if anyone knows of them.

Are there any other good clinics that are not wildly dissimilar to Eugenix in price that specialise in bht, closer to the UK? Having to travel less far would be better, but Eugenix seem to be the best at this from what I can see.

Thanks!

 

[Bucky O Hair]

4 hours ago, MaximumMM said:

Thanks for the feedback. The top pic is before btw, so not a 'result' exactly if that's what you mean!

 

 

Oh.  I meant the second photo with the shaved head.  I thought it was a postop result. 

I didn't realize it was SMP.  I like the hairline design.

[Bucky O Hair]

5 hours ago, mr_peanutbutter said:

@Bucky O Hair

 

apparently zarev „overharvest“ the donor but it still looks insane

Maybe "overharvesting" the donor is an overrated fear?

Are there many examples of people who have overharvested their donors, and it's been a problem?

I find that whenever you get a donor hair estimate from a HT doctor, the estimates tend to vary from doctor to doctor, which makes me wonder how subjective it is.  Zarev just takes it to another level.  

On a funny note, I have a friend who has a full thick head of hair...yet he has very oddly thinning temporal points and sides.  The sides of his head look like they have been overharvested, but he's never actually had a hair transplant and his hair on his head looks awesome.  Nobody notices, and the only reason I do is because I am a hair loss forum poster who likes to analyse everybody's hair when I see then.  Either way, I would take his situation over mine 10 times out of 10.  

It makes me wonder if having a thinning donor area matters all that much if you have attained your goals on the top of your head.

I'm sure there are photos of "overharvesting" floating around here and there, but I don't really see many (mind you, I'm not out looking for them) and the examples would probably still look better with full coverage on their heads (with thinning donor) than having a thick donor with, say, a balding crown.

It may not be as big a problem as we (in the over analyzing hair loss forum world) make it out to be.

Also, I'm extra curious if there was anyone who purposely overharvested, then used SMP to make up for it.  The examples I've seen of SMP being used to cover up FUT and FUE scars have looked fantastic.  Curious if it could do the same for masking an overharvested donor.  

 

 

[mr_peanutbutter]

36 minutes ago, Bucky O Hair said:

Maybe "overharvesting" the donor is an overrated fear?

Are there many examples of people who have overharvested their donors, and it's been a problem?

I find that whenever you get a donor hair estimate from a HT doctor, the estimates tend to vary from doctor to doctor, which makes me wonder how subjective it is.  Zarev just takes it to another level.  

On a funny note, I have a friend who has a full thick head of hair...yet he has very oddly thinning temporal points and sides.  The sides of his head look like they have been overharvested, but he's never actually had a hair transplant and his hair on his head looks awesome.  Nobody notices, and the only reason I do is because I am a hair loss forum poster who likes to analyse everybody's hair when I see then.  Either way, I would take his situation over mine 10 times out of 10.  

It makes me wonder if having a thinning donor area matters all that much if you have attained your goals on the top of your head.

I'm sure there are photos of "overharvesting" floating around here and there, but I don't really see many (mind you, I'm not out looking for them) and the examples would probably still look better with full coverage on their heads (with thinning donor) than having a thick donor with, say, a balding crown.

It may not be as big a problem as we (in the over analyzing hair loss forum world) make it out to be.

Also, I'm extra curious if there was anyone who purposely overharvested, then used SMP to make up for it.  The examples I've seen of SMP being used to cover up FUT and FUE scars have looked fantastic.  Curious if it could do the same for masking an overharvested donor.  

 

 

i think zarev „overharvested“ all over so that no pattern is recognizable, thats the key

 

if only certain areas are affected and there is contrast then whej its start to become a problem, it will give you the moth eaten appearance