Restoring temporal points: is it worth it?

[Kevin Mendez]

Hi everyone,

I’m planning to get a transplant next year, around this time. I haven’t decided on a surgeon but I have a few in mind, though I’m waiting a few months to reach out for consultations as my tentative procedure date is a ways away.

I wanted to get some opinions on possible temporal restoration. I understand everyone’s case is highly individual but just wondering what others think of my situation. I’m 29, and have diffuse thinning. As well as retrograde alopecia. I posted pictures, because of the retrograde thinning my donor area is reduced as such I’m planning for FUT. 

If I do the frontal half, and leave out the crown, will I have enough grafts to restore the temporal points? I’m thinking due to my hair thickness and color I could do SMP in the crown. Thanks in advance for your opinions.
 

 

[Kevin Mendez]

I should clarify, I’m not planning on lowering the hairline. I think it’s at a good height, just want to fill in what has recessed. I’m also not a stickler for high density. The frontal hairline is what bugs me most. Would love to hear some opinions. Thank you guys 🙏

[BaldDude]

your temple points don't look bad at all. I would just stick to finasteride.

[Kevin Mendez]

18 minutes ago, BaldBobby said:

your temple points don't look bad at all. I would just stick to finasteride.

Thanks man. I did just start finasteride this year, but I’ve gotten good regrowth from the frontal part to crown and not the sides. The hair on my temple points is the most miniaturized so the difference in color and thickness is what bothers me. Hoping to get it done and still achieve ok density in the mid scalp. But if not oh well. Thanks for the feedback

[Melvin- Admin]

I don’t think your temporal points are bad enough to restore. Let the meds get them stronger.

By chance is this you?

 

[mavigo]

I agree with not lowering the hairline. I disagree with FUT, if you intend to wear your hair as short as you have in these photos, you will be able to see the scar. FUT is rarely used now a days. I would only recommend FUE. 

[Kevin Mendez]

1 hour ago, Melvin- Moderator said:

I don’t think your temporal points are bad enough to restore. Let the meds get them stronger.

By chance is this you?

 

I’m now thinking that might be the best option too. Haha no that’s not me but it seems like there’s a lot of people looking for an update from him. Thanks for the feedback Melvin! 

[Kevin Mendez]

25 minutes ago, mavigo said:

I agree with not lowering the hairline. I disagree with FUT, if you intend to wear your hair as short as you have in these photos, you will be able to see the scar. FUT is rarely used now a days. I would only recommend FUE. 

I’m planning to grow my hair out again. I’ve just kept it short because I felt the hairline recession is more noticeable when it’s long, but I’m letting it grown now so the surgeon can see an accurate future snap shot and can plant grafts accordingly. 
 

I do agree the FUT scar could be noticeable at this length. I do think FUT has its advantages though. For example in my case, since I have retrograde alopecia on the sides it reduces the density, and also the“safe” area of the donor zone. So if I did FUE there’s a much smaller area, and amount of grafts to pull from before risking the donor looking over-harvested. Another thing to consider is generally (from my understanding), doing FUT first increases the maximum number of grafts you can extract from the donor. One study suggests that number can be as high as an extra 2500 grafts. For some people a number that high is a whole separate transplant.

And medically speaking, the strip scars of today have gotten much smaller. So while I do understand people not wanting a big ugly scar on the back of their head, I think it might not be as bad as they imagined, and does have some pro’s. I was one of those people myself until I started researching and looking at peoples results with FUT. and after all FUE is not scarless, and depending on how short the hair is and how many grafts are taken, would also be noticeable.

Overall I think FUE and FUT both have advantages and disadvantages, but it’s up to the individual and their specific case for them to decide which works best.

[mavigo]

I've had both. I would not recommend a FUT to anyone, it's not forward thinking. If you ever decide you'd like to have short hair, you'll have a big problem. Also, you can have graft counts of 2,500 with FUE too. I had 2,400. My personal experience, don't do FUT unless a doctor who is good at both highly recommends it. 

I had your mindset, it was up to me to decide what worked best - and I chose FUT and regret it terrible. I also went to a terrible doctor so there's that too. 

[Kevin Mendez]

8 hours ago, mavigo said:

I've had both. I would not recommend a FUT to anyone, it's not forward thinking. If you ever decide you'd like to have short hair, you'll have a big problem. Also, you can have graft counts of 2,500 with FUE too. I had 2,400. My personal experience, don't do FUT unless a doctor who is good at both highly recommends it. 

I had your mindset, it was up to me to decide what worked best - and I chose FUT and regret it terrible. I also went to a terrible doctor so there's that too. 

I’m sorry to hear yours didn’t go as planned. You can definitely wear your hair short with FUT though. If you wanted to do a buzz cut or skin fade you might need to do SMP or place a few grafts into it but nothing major. I think the problem for you like you mentioned was not having a skilled surgeon perform it. If done correctly it’s not as jarring as you’re making it sound.

Take a look at this FUT scar for example. It’s very thin and easily camouflaged. 

[mavigo]

@Kevin Mendez SMP is not a silver bullet and it only works for a straight buzz cut.

I will advise you again not to do FUT. It's not just the look of the scar but the experience, it hurts, it gets tight, I had residual pins and needles feeling for years. Only in rare cases, doctors opt for FUT.

The scar will be as visible as that tattoo you have on the left side. But that's another option, covering up the scar with a legitimate tattoo instead of SMP. I won't graft into it because it doesn't seem worth it. Save the grafts for the top. 

You'll also run into problems if you need a second FUT, they'll have to resect out the first scar and it might stretch. It's highly invasive and you have sutures to deal with too.

You seem already set on FUT. I would advise you to be neutral and let the doctor decide. Consult with 3 - 4 doctors without telling them you want FUT and see what they recommend. And go with the consensus. 

I consulted with 5 forum approved doctors and most were stunned that I got an FUT in 2019. The FUE experience was so much better for me. It's up to you obviously but my 2 cents. 

[Kevin Mendez]

On 9/13/2023 at 6:03 AM, mavigo said:

@Kevin Mendez SMP is not a silver bullet and it only works for a straight buzz cut.

I will advise you again not to do FUT. It's not just the look of the scar but the experience, it hurts, it gets tight, I had residual pins and needles feeling for years. Only in rare cases, doctors opt for FUT.

The scar will be as visible as that tattoo you have on the left side. But that's another option, covering up the scar with a legitimate tattoo instead of SMP. I won't graft into it because it doesn't seem worth it. Save the grafts for the top. 

You'll also run into problems if you need a second FUT, they'll have to resect out the first scar and it might stretch. It's highly invasive and you have sutures to deal with too.

You seem already set on FUT. I would advise you to be neutral and let the doctor decide. Consult with 3 - 4 doctors without telling them you want FUT and see what they recommend. And go with the consensus. 

I consulted with 5 forum approved doctors and most were stunned that I got an FUT in 2019. The FUE experience was so much better for me. It's up to you obviously but my 2 cents. 

I was actually originally set on FUE, and really opposed to FUT. but after reading about how it increases the maximum amount of grafts you can extract from the donor I started to look more into it. Especially since I was already worried about my donor being too weak for a transplant. I’m not taking any option off the table for now, and it all ultimately depends on what I hear in consultations since they’re obviously far more experienced. I was really just looking to get others opinions on if I would have enough grafts for my temple points, since like I said I was worried about donor density. But it seems like most say to let them be. 
 

Truly thank you for the feedback on your procedure and trying to spare me from a less than ideal outcome. I’m going to reconsider FUE, especially after seeing Melvin’s new video with Dr. Zarev. He does some truly amazing work with FUE.

[mavigo]

No problem, I'd like others to glean from my mistakes. 

Here is an interview Melvin did with Dr. Hasson a while ago. Hasson & Wong are one of the best HT practices in the world, renown for both FUT and FUE. 

The only time I really see FUT (for legitimate reasons, no being tricked by unethical doctors like my first one) is for high NWs (5 & 6) with poor donors where ~3500 grafts are knocked out in 1 go. You don't need that. 

The key thing is to go to a reputable clinic that is good at both. I made the mistake of going to an pro-FUT doctor (who really is bad at HT's in general) who of course pushed FUT and the results were horrible. Likewise, you don't want to go to a hairmill where they push FUE and the results are just as botched. 

What you need is "a" transplant from a good doctor. So I would consult with a handful and let them advise you on what method instead of you advising them. 

 

[JoeD]

While quality of grafts transplanted has essentially caught up with FUE vs FUT, the real debate is still there for a high NW patient who needs essentially their whole scalp covered with grafts.  An interesting point, which I haven’t seen brought up before on here, is that while there’s only a very very small group of doctors frequently rec’d for FUE for Norwood 6/7 (eugenix, pitella, zarev), theres an equally small group rec’d for high quality FUT (h&w, bloxham, hattington).  Maybe a few others. 
 

thoughts?

[Kevin Mendez]

On 9/17/2023 at 7:04 AM, JoeD said:

While quality of grafts transplanted has essentially caught up with FUE vs FUT, the real debate is still there for a high NW patient who needs essentially their whole scalp covered with grafts.  An interesting point, which I haven’t seen brought up before on here, is that while there’s only a very very small group of doctors frequently rec’d for FUE for Norwood 6/7 (eugenix, pitella, zarev), theres an equally small group rec’d for high quality FUT (h&w, bloxham, hattington).  Maybe a few others. 
 

thoughts?

I’m not completely sure about the question you’re asking. And by “rec’d” do you mean recommended? 
 

If so, I think the reason there’s only a small group of doctors that do successful transplants on high Norwood cases (whether FUT or FUE) is that these cases require a high level of expertise. Most doctors simply do not have that skill/ experience for these challenging cases. 

[GoliGoliGoli]

You should listen to Melvin's recent podcast with Dr Zarev, he gives his philosophy on temple points at some point in it, and his philosophy is generally the one i agree with. 

[mrmane85]

If you choose the FUT route I'd go with Hattingen or Konior. They produce the best FUT results in my opinion, especially the scar. 

[Melvin- Admin]

17:10

[TrixGlendevon]

Your temple points look fine. I have had two FUTs and the scar is non-detectable, even to my girlfriend when she looks for it who knows it is there and where it is. Sounds to me like Mavigo went to a bad clinic, not that FUT is to blame.

Edited October 6, 2023 by TrixGlendevon