Clinic Considerations

[make_aaron_great_again]

Hi Everyone,

My name is Aaron, I'm a long-time lurker on the forums and socials. I'm currently 38 years old and very much considering a hair transplant as a 40th birthday gift to myself. I'm living in Ireland, but I'd be willing to travel to get a great result - none of the Irish clinics have great results in my opinion.

I'm very much considering FUT (or a combination FUT/FUE) as my procedure of choice as the idea of the linear scar doesn't put me off and I'd like to make the most of my donor as I have a fine-to-average hair type (similar to Mr. Rolandas) that tends to get oily every few days due to what I believe is excess sebum (a family trait).

If I was to guess, I'd say that I'm a Norwood 3V -- so, thin enough at the crown with temporal point recession. I was taking Oral Min 5mg (now 2.5mg due to heart palpitations over a few months on the 5mg -- no sides on 2.5mg btw) which I've been taking since October 2022 x5 a week, and Finasteride, which I've been taking since 2019 x5 a week have done a lot to slow this down and improve it somewhat (especially the crown) - though I'm not exactly a 'hyper responder', and the hairline continues to weaken albeit at a slower rate.

I'm very aware of Hattingen  / BHR / DHT Clinic in Thailand as possible choices. I'm not shutting the door on FUE or FUT-only procedures by the way, with the incredible results of the likes of Eugenix, Bruno Ferreira, Clinica De Freitas ect I'd be a fool to, I'm just thinking of what may happen further down the road.

I guess my questions to you fine fine people Is: is my thinking sound on an FUT/FUE combo? and also, who would you choose to do this in Europe (possibly Asia)? Is there anyone else I should be considering?

[Melvin- Admin]

I think the FUT +FUE thing is an outdated view. People like Dr. Zarev have been showing that a well-planned FUE can get you just as many grafts and last for many years. 
 

This is a 10 year old case:

https://www.instagram.com/p/C0E25hNqOPf/?igsh=MzRlODBiNWFlZA==

[jjalay]

4 hours ago, Melvin- Admin said:

I think the FUT +FUE thing is an outdated view. People like Dr. Zarev have been showing that a well-planned FUE can get you just as many grafts and last for many years. 
 

This is a 10 year old case:

https://www.instagram.com/p/C0E25hNqOPf/?igsh=MzRlODBiNWFlZA==

You are once again giving false information. It is widely accepted from the most well reknowed surgeon that the best way to maximize your donor area is to start with an fut procedure, especially for hihger NW cases that will need a lot of grafts. This is not outdated because until now there no hair multiplication or any other way to increase the hair count on the donor area. Zares is superselective with his patients and takes patients with great donor density for such procedures. In this case you have posted the photos are with flash and with the best possible angle. And even with that the donor area of the patient is already thinned out and doesnt look nice. If in 10-20 years from now he is going to loose more hair on the donor he will look like a plucked chicken on the back of his head. Your case was also the same, if you have started with an fut you would have gotten a much better result and much better looking donor area, without even the need of getting into body hair. But your plan was to overharvest the donor and after that to do fit farming on the donor area with body hair? Please no.

OP good option fur fut or fut and fue combo are Hasson and wong in canada, Hattingen hair, dr Pathomvanich and dr Laorwong in Thailand, Carlos wesley, dr arocha and many other options. This is not outdated!

[make_aaron_great_again]

13 hours ago, Melvin- Admin said:

I think the FUT +FUE thing is an outdated view. People like Dr. Zarev have been showing that a well-planned FUE can get you just as many grafts and last for many years. 
 

This is a 10 year old case:

https://www.instagram.com/p/C0E25hNqOPf/?igsh=MzRlODBiNWFlZA==

Thanks for chiming in @Melvin- Admin. The only thing I'd say there is that the Dr. Zarev's of the world are few and far between, also because of the Doctor's reputation and hands-on approach to the surgery it could be cost prohibitive - it is supply and demand, and Dr. Zarev's service is an exclusive premium (as it should be). 

My hair would be naturally finer than yours, so my thought process on a combination of FUT/FUE is to get the most I can from my donor. 😄 I also have f-ck all body hair so there isn't much in reserve there for me outside of decent facial hair.

I'll document what I do here when my journey begins 🙂 , thanks for your two cents! Your result is killer.

.

@jjalay Thank you for your opinion, I know you guys are opposed in your views on this subject, but the difference of opinion is valuable too 🙂 . I'll look into Dr. Laorwong and some other names you suggested here. I'll have a look on the forum for users and their results. Thank you so much for your time.

.

I've been contemplating getting a HT for almost 10 years since I noticed my recession and thinning crown first, I'm so glad I didn't jump the gun and run into surgery and took the time to educate myself, and get on medication (a little later than I should have). I'm not 100% in favour of one procedure over the other, but thinking about the future and what I have to work with - longevity and naturalness is the goal, so whether that's with FUE, FUT, or a combo it doesn't matter. Thanks guys!

[Melvin- Admin]

12 hours ago, jjalay said:

You are once again giving false information. It is widely accepted from the most well reknowed surgeon that the best way to maximize your donor area is to start with an fut procedure, especially for hihger NW cases that will need a lot of grafts. This is not outdated because until now there no hair multiplication or any other way to increase the hair count on the donor area. Zares is superselective with his patients and takes patients with great donor density for such procedures. In this case you have posted the photos are with flash and with the best possible angle. And even with that the donor area of the patient is already thinned out and doesnt look nice. If in 10-20 years from now he is going to loose more hair on the donor he will look like a plucked chicken on the back of his head. Your case was also the same, if you have started with an fut you would have gotten a much better result and much better looking donor area, without even the need of getting into body hair. But your plan was to overharvest the donor and after that to do fit farming on the donor area with body hair? Please no.

OP good option fur fut or fut and fue combo are Hasson and wong in canada, Hattingen hair, dr Pathomvanich and dr Laorwong in Thailand, Carlos wesley, dr arocha and many other options. This is not outdated!

I’m providing my opinion. You can disagree with me, but there’s more than enough data that shows FUT is unnecessary for maximizing donor capacity. Look at @Gatsby @Digs49 @Zoomster @HugoX @captaincalico these aren’t “isolated” patients either. Heck, I’m no special case and even Ive restored everything via FUE alone. That’s with a very average donor. 

To hide an FUT scar you need density. So if you get FUT first, that will lower the amount of FUE you can harvest. It’s unnecessary when you can extract enough grafts using FUE alone. Now, not every patient is a candidate for FUE. So it’s a case by case basis. But if you’re a candidate for FUE, there’s ZERO reason to go FUT. That’s my opinion.

[Gatsby]

Hey @make_aaron_great_again. This is just my opinion but I agree with @Melvin- Admin. This industry is consumer driven. Today most people want FUE and that dictates what is offered (generally) by most surgeons. You could go with strip and depending on your scalp laxity have a second strip (if needed) leaving you with just the one donor scar. If you run out of scalp laxity you could then opt for FUE. Personally having lived the scars in my donor for so many years I would go with an elite surgeon with FUE. All the best. 🙏

[make_aaron_great_again]

8 hours ago, Gatsby said:

Hey @make_aaron_great_again. This is just my opinion but I agree with @Melvin- Admin. This industry is consumer driven. Today most people want FUE and that dictates what is offered (generally) by most surgeons. You could go with strip and depending on your scalp laxity have a second strip (if needed) leaving you with just the one donor scar. If you run out of scalp laxity you could then opt for FUE. Personally having lived the scars in my donor for so many years I would go with an elite surgeon with FUE. All the best. 🙏

Extremely valuable advice from one of the greatest, thanks @Gatsby - long time fan.

[make_aaron_great_again]

16 hours ago, Melvin- Admin said:

I’m providing my opinion. You can disagree with me, but there’s more than enough data that shows FUT is unnecessary for maximizing donor capacity. Look at @Gatsby @Digs49 @Zoomster @HugoX @captaincalico these aren’t “isolated” patients either. Heck, I’m no special case and even Ive restored everything via FUE alone. That’s with a very average donor. 

To hide an FUT scar you need density. So if you get FUT first, that will lower the amount of FUE you can harvest. It’s unnecessary when you can extract enough grafts using FUE alone. Now, not every patient is a candidate for FUE. So it’s a case by case basis. But if you’re a candidate for FUE, there’s ZERO reason to go FUT. That’s my opinion.

Hi @Melvin- Admin, thanks for chiming in again, getting a HT -- or even considering it -- is a semi-stressful process, after almost 10 years of research and hovering around a NW 3V - 4 I'm trying to consider all viable options 🙂. I'll shortlist a few great clinics and get in touch to see what can be done.

[A_4_Archan]

The ongoing discussion between FUT and FUE is perpetual, and I hold the view that it's not imperative for one method to triumph over the other. Instead, the victory should be for the patient, who can opt for either or both techniques based on their individual conditions, needs, expectations, and resources. I advocate selecting a method that aligns with your specific candidacy rather than following current trends or past beliefs. In essence, the suitability of the technique to your unique condition should be the determining factor.

It is my contention that declaring one technique superior to the other oversimplifies a complex decision. Rather, the focus should be on identifying which technique best suits the patient's unique candidacy. This entails a careful evaluation of factors such as hair loss pattern, donor site availability, recovery time, and personal preferences.

I emphasize the importance of avoiding the temptation to choose a technique solely based on current trends or popular past beliefs. Instead, the decision should be rooted in a thoughtful analysis of one's unique condition, ensuring that the selected method aligns seamlessly with individual circumstances. Hence, the choice between FUT and FUE should be a personalized decision tailored to the specific needs and conditions of the patient.

I hope this helps you. Best of luck.

[Z--]

I think you ought to seek out the view of doctors who can do both. FUT-only doctors and FUE-only doctors tend to have biased views and will obviously push for what they can do.

That said, in the majority of cases (maybe 90%+), FUE alone is sufficient, but for diffuse thinners, FUT + FUE is a wonderful alternative. Most avoid it because FUT is rather painful and fear of the scar (which can limit shaving the sides, if you don't want people to know you've had work done), but if neither deters you, I'd reach out to Konior, Hattingen, Shapiro, Laorwong and H&W to get an unbiased perspective.

I understand that Zarev, Pitella and Eugenix are all pulling 10k grafts these days, but I honestly am not a huge man of how the donor looks after such a large extraction, and, excluding the first in the list, they often require a mix of beard/body grafts as well, which are suboptimal in terms of survival.

Personally, I think the FUE / FUT combo works. I personally did over 4,000 grafts of FUT and roughly 800 FUE, and my donor looks completely untouched when my hair is around a 2.5 grade (any lower and the scar is visible). I've seen many that have done 4,000 grafts from FUE and the donor is noticeable in thinness, imo. The idea is that with FUE/FUT combo, you should be able to achieve an additional 1 - 3k grafts, depending on whether you have sufficient laxity. If the scar stretches, you would obviously lose that benefit, so it's critical to go to a doctor that understands what they're doing.

[hairman22]

3 hours ago, Z-- said:

I think you ought to seek out the view of doctors who can do both. FUT-only doctors and FUE-only doctors tend to have biased views and will obviously push for what they can do.

That said, in the majority of cases (maybe 90%+), FUE alone is sufficient, but for diffuse thinners, FUT + FUE is a wonderful alternative. Most avoid it because FUT is rather painful and fear of the scar (which can limit shaving the sides, if you don't want people to know you've had work done), but if neither deters you, I'd reach out to Konior, Hattingen, Shapiro, Laorwong and H&W to get an unbiased perspective.

I understand that Zarev, Pitella and Eugenix are all pulling 10k grafts these days, but I honestly am not a huge man of how the donor looks after such a large extraction, and, excluding the first in the list, they often require a mix of beard/body grafts as well, which are suboptimal in terms of survival.

Personally, I think the FUE / FUT combo works. I personally did over 4,000 grafts of FUT and roughly 800 FUE, and my donor looks completely untouched when my hair is around a 2.5 grade (any lower and the scar is visible). I've seen many that have done 4,000 grafts from FUE and the donor is noticeable in thinness, imo. The idea is that with FUE/FUT combo, you should be able to achieve an additional 1 - 3k grafts, depending on whether you have sufficient laxity. If the scar stretches, you would obviously lose that benefit, so it's critical to go to a doctor that understands what they're doing.

Yeah in europe a fade is so popular many are not concerned about a thin donor.

Possibly different in the states & Asia perhaps

[jjalay]

32 minutes ago, hairman22 said:

Yeah in europe a fade is so popular many are not concerned about a thin donor.

Possibly different in the states & Asia perhaps

Fade in europe is not that polular, mostly in the us.