FUT or FUE for 2000 Grafts.

[ChefP]

For 2000 grafts which would you think is the better procedure? Booking in to get my surgery next 4 months. Will document the process.

[Z--]

Who is the doctor? 

What is your age?

What is your level of loss? 

90% of time it’s best to go FUE, but in a certain subset of circumstances, FUT might be ideal. 

[mr_peanutbutter]

for a very small procedure its not recommended to start with fut, even if you want to maximise lifetime graft counts

 

 

[Bucky O Hair]

15 hours ago, ChefP said:

For 2000 grafts which would you think is the better procedure? Booking in to get my surgery next 4 months. Will document the process.

FUE

[Mike10]

the issue with FUT is the scar. you can't predict it. with FUT you get more grafts from the safe zone. in FUE it is more widespread, they go outside the safe zone.,

[ChefP]

So had some updates and this is what I've been told. I'm 42 and been told I should do some scalp stretching. I use minoxidil and finasteride topical foam last 4 months.

So 2 surgeons below had said this to me:

Dr Wong (h&w) 4500 grafts or more (5000) with FUT on the top and mid scalp. Nothing on crown. Start using their Xyon finasteride gel and take oral minoxidil.

Dr Nakatsui in Edmonton. Do 2000 grafts either FUE or FUT. Front and mid scalp only. Then another procedure hopefully for crown down the road. 

 

So that where im at .. dilemma??!!

@Z-- @Mike10 @mr_peanutbutter @Bucky O Hair

[mr_peanutbutter]

well if you need 4.000 and more grafts and are basically bald then id start with fut 

 

also ask dr wong when he considers a scalp having good laxity

 

i know they all recommend these exercises but how do you know where you stand after this exercises?

 

 

Edited May 2, 2023 by mr_peanutbutter

[Bucky O Hair]

I see the two doctors have given you wildly different estimates.  So, I think you need to determine the following:

 

#1. - What is your balding area that you are trying to cover (in cm2)?

#2. - How may total available follicular unit (FU) grafts do you have in your donor area?  

#3. - What is the average density you are trying to achieve?  Is it 50 FU/cm2 or something less (like 40 or 30 FU/cm2)?

#4. - How many grafts are available to be removed via FUT (with your current scalp laxity) and how many can be removed via FUE?

 

Ask your doctor to measure your balding area and ask them to analyze your donor area to give you an estimate of how many total lifetime grafts you would be able to transplant into that area.  This should immediately answer questions #1 and #2 and this is something ALL doctors should be able to provide you.  If they are not able to provide you with an answer to these two questions, then they are not qualified to give you a hair transplant.

With some simple math, you should be able to answer question #3 and calculate the density (in FU/cm2) for your balding area, and you can have a conversation with your doc about how you want to distribute that across your balding area (i.e. do you want to go more dense in the hairline and less dense in the crown...or just an even distribution of grafts across your scalp).

If you are actually interested in FUT over FUE, then you have to have the doc confirm how many of your lifetime grafts will realistically be able to be removed with your current scalp (question #4).  Never mind the stupid scalp exercises.  The doc should be able to give you an estimate of how many they should be able to remove, and you can decide if it's worth putting a wide linear scar on the back of your head for the amount that FUT can provide.  If you have a tight scalp, it won't be worth it.

Once you have the answer to all these questions, then you can probably make a sound decision on whether or not you will be able to get the HT that meets your expectations.  Always plan for the most realistic case scenario.  Having the answers to these questions will help you with that.

Also, remember to plan for the worst case scenario too (in case you have future loss and whether you are comfortable with a buzz cut years down the road).  Are you okay with a linear scar in the back of your head?  Are you comfortable sporting a balding manlet to hide the scar?  Would you do SMP to hide that scar?  Would you go the BHT (with beard and body hairs) to fill any future gaps in case you've exhausted your lifetime grafts?

Don't mean to scare you, but these are the questions that need to be asked to each doctor and yourself before making the jump.

 

 

[ChefP]

@Bucky O Hair This is EXCELLENT advice and questions. Thank You so much. I was hoping for this kind of advice from this forum. I'll relay these questions to my doctors and see the responses I get. Will keep you posted on results 

And @mr_peanutbutter not bald have fair bit of hair left on my head just rock the combover lol

[Vann]

Think of it this way… if you have a large enough to cover then you may want to consider your future options and the surface area.

perhaps you go FUE first for a small procedure and avoid the spots of an FUT strip. You can potentially still do both.

if you consider FUT first just know that  you may want more than 2.5k not saying that is the magic number but if you’re going to cut a chunk of skin and get a scar… it should be worth the investment.  
 

however I’d you do a large FUE. It doesn’t mean you can’t do an FUT it will just harvest less since the surface area of hairs has been depleted in the same area the FUT would’ve been used in. Meaning less density per skin mile FU.

if you have 80FU^2 and harvest 3k grafts in total. It would depend on the size of your donor, the density you want let’s say 50cm^2. You could probably do the math and deplete the total surface area with FUE. Which if you go back in the future you can still take the same FUT area but have significantly different numbers for the same scar you would have originally got.

 

long story short ask a plethora of surgeons in their opinions and try to get your coverage measured and checked prior. I think that might be your best bet before committing to anything permanent.

Edited May 2, 2023 by Vann

[ChefP]

@Bucky O Hair This is EXCELLENT advice and questions. Thank You so much. I was hoping for this kind of advice from this forum. I'll relay these questions to my doctors and see the responses I get. Will keep you posted on results 

And @mr_peanutbutter not bald have fair bit of hair left on my head just rock the combover lol

 

Thank @Vann also killer advice. Have asked all these questions and from what I can see I"m leaning way more towards FUE for my first procedure. 

[Rahal Hair Transplant]

@ChefP,

In my opinion, FUE is an ideal procedure for many patients but it’s true that some patients are better suited for FUT.  that said, with the limited information you provided, it’s not possible to provide you with an educated opinion on what would be ideal for you.  2000 grafts can certainly be performed using either procedure but there any question percent remain for example, where did you get the number 2000 from?  did Dr. provide you with this number as an estimate or are you just guessing that’s what you need currently? How old are you? Are you still using your hair?  What does your current hair loss pattern look like and does your current hair loss pattern enable us to use the predict how much hair you would likely lose in the future?  What’s your donor area look like?   Pictures would help to answer some of these questions.  But as far as what technique is best and whether or not you’re a candidate, more information is needed.

Best wishes,

Rahal Hair Transplant