over harvest

[Pelange]

Hello everyone,

I am thinking about doing a 2nd HT. Most of US surgeons I consulted will not do over 3000 grafts. And they all say that over harvest is not good for the donor area.

But Dr. Zarav, Dr. Pitella etc do large FUEs like over 6000. Is that not over harvesting? 

A lot of you guys are expert on this, any thoughts will be greatly appreciated. I am so confused.

Thanks so much.

 

[BaldGuy]

18 minutes ago, Pelange said:

Hello everyone,

I am thinking about doing a 2nd HT. Most of US surgeons I consulted will not do over 3000 grafts. And they all say that over harvest is not good for the donor area.

But Dr. Zarav, Dr. Pitella etc do large FUEs like over 6000. Is that not over harvesting? 

A lot of you guys are expert on this, any thoughts will be greatly appreciated. I am so confused.

Thanks so much.

 

Basically dr Pittella is doing much larger sessions than 6000 grafts without any problem at the donor...He can extract 6000 grafts per day and 11500-12000 grafts in a 2-day session.

Look at his example below a patient got a procedure with 11.547 grafts from Dr Pittella in a two-day session :

 

 

Edited June 7, 2023 by BaldGuy

[Pelange]

10 minutes ago, BaldGuy said:

Basically dr Pittella is doing much larger sessions than 6000 grafts without any problem at the donor...He can extract 6000 grafts per day and 11500-12000 grafts in a 2-day session.

Look at his example below a patient got a procedure with 11.547 grafts from Dr Pittella in a two-day session :

 

 

Yea. That is my confusion. Based on the US doctors, more than 3000 grafts is probably over harvest, if I am right. How he does 6000 and is not over harvest? The donor area is ok after this?

[BaldGuy]

2 minutes ago, Pelange said:

Yea. That is my confusion. Based on the US doctors, more than 3000 grafts is probably over harvest, if I am right. How he does 6000 and is not over harvest? The donor area is ok after this?

You can check the results of Dr Pittella to see that the donor areas of his patients look great even if he extracts very large number of grafts like 10.000-12.000 grafts in a 2 day session. So it depends on the clinic, some clinics are able to extract large number of grafts without problem while other clinics do not have experience in doing larger sessions and they do only smaller ones.

[duckling]

1 hour ago, Pelange said:

But Dr. Zarav, Dr. Pitella etc do large FUEs like over 6000. Is that not over harvesting? 

see over harvesting isnt visible because they increase the donor area. they extract a lot from sides , nape area and also from area very close to crown. The sides area extraction nearly goes upto temple. yes its outside of traditional safe zone but for a nw 6-7 you need to go all in approach.

over harvesting is visible when area of extraction is small and lot of grafts extracted from that limited area. And also its lot of their skill. the way they extract , unless there is shock less in donor / more hair loss in donor it always looks good at present.

they also use beard grafts when the donor is slightly average or when 9k-10k grafts are done. That way the scalp donor area gets a little relief and doesnt look depleted and shock loss can be avoided.

[Pelange]

45 minutes ago, duckling said:

see over harvesting isnt visible because they increase the donor area. they extract a lot from sides , nape area and also from area very close to crown. The sides area extraction nearly goes upto temple. yes its outside of traditional safe zone but for a nw 6-7 you need to go all in approach.

over harvesting is visible when area of extraction is small and lot of grafts extracted from that limited area. And also its lot of their skill. the way they extract , unless there is shock less in donor / more hair loss in donor it always looks good at present.

they also use beard grafts when the donor is slightly average or when 9k-10k grafts are done. That way the scalp donor area gets a little relief and doesnt look depleted and shock loss can be avoided.

I might need a lot of grafts for Nw6. Do you guys recommend to do FUT first and then FUE? Some doctors I consulted told me that I should do FUT first to get more hair grafts and then do FUE. This way they can guarantee that I have some grafts left for future. 

Is the beard hair the same survival rate? 

Thanks.

[duckling]

26 minutes ago, Pelange said:

I might need a lot of grafts for Nw6. Do you guys recommend to do FUT first and then FUE? Some doctors I consulted told me that I should do FUT first to get more hair grafts and then do FUE. This way they can guarantee that I have some grafts left for future. 

Is the beard hair the same survival rate? 

Thanks.

if you are a good candidate for FUT due to great scalp laxity then you can hope for a thin scar, otherwise scar may stretch. and if it does then you might end up using up grafts to fill in the scar area.

FUT does open a chance for you to get 1k+ grafts if you are actually a good candidate. People go FUE so that if they have low yield or failed HT then they can just have a buzz cut or shave it off or go smp. but with FUT due to scar, they will have to rely on smp to fix that scar spot too.

in body hair, the beard has best survival chance but its slightly(1 percent) lower than scalp donor survival rate.

[Pelange]

6 minutes ago, duckling said:

if you are a good candidate for FUT due to great scalp laxity then you can hope for a thin scar, otherwise scar may stretch. and if it does then you might end up using up grafts to fill in the scar area.

FUT does open a chance for you to get 1k+ grafts if you are actually a good candidate. People go FUE so that if they have low yield or failed HT then they can just have a buzz cut or shave it off or go smp. but with FUT due to scar, they will have to rely on smp to fix that scar spot too.

in body hair, the beard has best survival chance but its slightly(1 percent) lower than scalp donor survival rate.

Thanks so much for your kind reply. learned a lot from you.

[duckling]

1 hour ago, Pelange said:

Thanks so much for your kind reply. learned a lot from you.

welcome.. as a norwood 6 do a thorough research and wait out long waiting periods for good surgeons if you have to  because any failure can be a big setback at this stage. if you are doing right procedure FUT/FUE and are in great hands then you stand best chance to utilize your donor to max limit and get good coverage.

in my opinion search for surgeons who do nw6 cases.. the names you mentioned are one of the best 2 in FUE. you can search for more surgeons based on budget. if going FUT then hasson and wong in canada do good work. they are best in FUT.

[Digs49]

@Pelange have you watched the recent podcast that Melvin did with Dr. Pittella? If not, it’s on this forum, you should watch it. 

Towards the end, Melvin asks Dr. Pittella the very question you started with and essentially it comes down to the surgeon. If he/she are experienced in doing large sessions (history of many cases, takes a calculated/mathematical approach, etc), then you may get a very good result with a mega session. 

I hope everything works out for you.

[Digs49]

Here it is.

[Pelange]

19 hours ago, Digs49 said:

@Pelange have you watched the recent podcast that Melvin did with Dr. Pittella? If not, it’s on this forum, you should watch it. 

Towards the end, Melvin asks Dr. Pittella the very question you started with and essentially it comes down to the surgeon. If he/she are experienced in doing large sessions (history of many cases, takes a calculated/mathematical approach, etc), then you may get a very good result with a mega session. 

I hope everything works out for you.

Thanks so much. That makes sense. 

[Al - Moderator]

On 6/7/2023 at 1:07 PM, duckling said:

over harvesting isnt visible because they increase the donor area. they extract a lot from sides , nape area and also from area very close to crown. The sides area extraction nearly goes upto temple. yes its outside of traditional safe zone but for a nw 6-7 you need to go all in approach.

 

If you are going far outside the traditional safe zone then that can be considered over harvesting as well. Those grafts are much more likely to not last very long especially in a NW 6 or NW 7 which happen to be the cases where you would need to go outside the safe zone to get a lot of grafts. US Drs are generally more conservative than Drs in some other countries and they won't use grafts from those areas.

 

[duckling]

12 hours ago, BeHappy said:

 

If you are going far outside the traditional safe zone then that can be considered over harvesting as well. Those grafts are much more likely to not last very long especially in a NW 6 or NW 7 which happen to be the cases where you would need to go outside the safe zone to get a lot of grafts. US Drs are generally more conservative than Drs in some other countries and they won't use grafts from those areas.

 

true i dont disagree. those grafts may not last long. but people are willing to take that risk when they are nw6 and nw7 so surgeons have to go outside safe zone and are now trying to take out grafts such that it doesnt look like its overharvested. if it doesnt last then either way they shave it off or go smp so those remaining grafts do helps them.  but if a nw6 or nw7 gets back hair for 10 years also (due to meds i think they can keep atleast that long if meds work) then its a win for them. and if it lasts longer then its a big bonus. anything less is not a great reward yes.