FUE vs. FUT final density

[xapato]

Hi,

I'm considering a hair transplant, most probably a FUE procedure. My hair is dense but I have recession in the temples and a naturally large forehead. So I'd like to have a slightly lower hairline and more full temples, like a Norwood 1.5. I'm just guessing that I'll need around 3000 grafts. You can see pictures of my hair here: http://www.gourmetstylewellness.com/interact/showthread.php/95819-37yo-probably-a-NW3-starting-recovery

I worry that I wouldn't achieve the density required to have a naturally appearing hairline, and that I would end up with noticeably thinner temples and frontal region. Having a FUT scar might be better than that.

Do we have any numbers as to the density achieved via FUE vs. FUT, or the frequency of very low density / yield?

 

[shookwun]

Virtually no difference.


No reason to go for FUT unless their is not enough grafts available FUE.

In the begging their was speculation that FUE method could potentially damage grafts.

 

[David Leung]

Don't think there will be a difference, Doctor can extract hair from a large donor area including back and side of your head

 

[xapato]

I'm definitely in favor of FUE. What kind of evidence do we have to know that FUE is just as good as FUT?

By the way I'm talking about survival rate and density at the recipient site. I am sure the FUE scars would be much better than a FUT scar for 3000 grafts.

 

[Pequod]

I think FUT has a better chance of follicle graft survival rate. As far as density that does not depend on the type of extraction, it is how they are placed and both are equal as far as I know.

 

[follicle2001]

I have read from multiple sources that the survival rate and yield are higher with FUT, but I think FUE is catching up. Most FUT scars are very difficult to detect, but it is true you cannot have super short haircuts afterwards. Most people can cut their hair in the back about 1/2 inch long after FUT and keep the scar invisible.

 

[arfy]

Your hair is still looking quite amazing. It's pretty much impossible to duplicate your existing density with transplants. Transplants can achieve the "illusion" of density. You notice visible signs of hair loss when you go below 50% of the original density (if I recall correctly). And hair transplants can only achieve roughly 50% density (higher densities have negative impact on graft survival). Your current hair is quite dense. In my opinion, transplanted hair will never look as dense as the hair you have now.

I am always shocked and amazed when I see fellows like this (with a ton of hair, and only the slightest evidence of hair loss) asking about hair transplants. It would be like getting a facelift, because you think you see the beginning of a wrinkle forming. You don't need cosmetic surgery! You have a completely normal, mature hairline, and an awesome 99% full head of hair.

 

[xapato]

Thanks arfy for the compliment. I'm lucky to have maintained such density and I'm probably fixating on my hair.
My hair is thin at the temples, so after I see the results of dutasteride I'll consider a hair transplant. I am starting to think that lowering the hairline too much would be a mistake, because there would be a large forward region of low density contrasting with denser native hair. Filling in the thinning edge of my hairline and temples a little bit could help as long as it is not too much and looks natural. I'll try to post better pictures.

 

[xapato]

Adding some new pics below.

Around 2 and a half weeks into dutasteride 0.5 mg / day + ketoconazole 2% 2 x / week. Loaded 2.5mg / day of dutasteride for the first 10 days, to achieve steady state after 10 days.

 

[arfy]

Thanks arfy for the compliment. I'm lucky to have maintained such density and I'm probably fixating on my hair..

Well you should stop doing that. You're even considering surgery now, and you don't need it. Getting a transplant is a big commitment, and it's a flawed process with definite limitations (not the magical solution to hair loss).

There's an old saying - "if you hang around the barbershop, eventually you're going to get a haircut" (it means that alcoholics shouldn't hang around at bars, even if they aren't drinking). The same holds true here - you should stop hanging out on hair transplant forums. I'm not sure if you need Dutasteride (possibly - that's up to you and your doctor) but if I were you, I'd try to stay away from hair loss forums for a while. Don't worry, if there are any big breakthroughs, it will be all over the news.

 

[xapato]

Hi arfy. I'm waiting at least a year to get a hair transplant so that I have time to figure out the pros and cons. I learned a long time ago that when I see something I want to buy, I should just wait and come back the next day to see if I still want it. But I should still try to make a decision as soon as possible.

I would love to be able to create a risk & benefit matrix to really analyze the decision objectively. The problem is that I don't think we have good data on hair transplant success rates, etc. And there is no one I know with a hair transplant. I can't really go out and run my fingers through the hair of a former FUE patient to see whether it feels natural. I'll probably need to become a regular on at least a few forums to make an informed decision.

By the way arfy, when do you think a hair transplant is a good idea? Or do you think the risks almost always outweigh the potential benefits?

 

[arfy]

By the way arfy, when do you think a hair transplant is a good idea? Or do you think the risks almost always outweigh the potential benefits?

There's a bunch of different factors to consider, when deciding if a transplant is worth doing. Age (mature is usually better), financial status (wealthy is preferred, obviously), pattern of hair loss (isolated frontal loss is better than diffuse thinning or crown loss), caliber of hair (coarse is better, although it means the hairline can require extra attention. Etc. I never say that "nobody" should get hair transplants. But certainly there are specific guys who probably shouldn't. And if you have a mix of factors, it will likely have a negative impact on your final results.

If I read your story correctly, you are 37? Your photos are pretty terrible quality, as you admit, so it's hard to be certain. But I don't see anything really wrong with your hair. Your hairline looks fine for your age. In your other thread, you say you are looking into experimental treatments (like wounding... really?) and you're obviously here thinking about surgery. Since it seems like you only have recession of the hairline (and not bad - just an inch or so higher than you would like) you might very well be pleased with your results, after a couple of surgeries (doctors usually can't dense pack grafts very closely in one single pass, as it it impacts graft survival, so it will take multiple surgeries). However, your hairline is totally acceptable now, at this "mature" level, and it's also quite strong (no diffuse thinning in the hairline) which in my view makes surgery unnecessary.

So weight the pros and cons yourself. You have an idea of what you think the pros might be. The cons are the financial costs, the experience of multiple surgeries (I find it unpleasant, and would compare it to dental surgery except it lasts for an entire day), the downtime waiting for your scalp to heal (can you wear a hat at your job?) Also, waiting for the hairs to grow in, then grow to proper length (your second surgery would occur at some point, so you'd go through the healing process a second time, then the growth stage). They say it takes 12 to 18 months for a transplant surgery to "mature" (and you might want multiple surgeries, and they can't be performed too closely together in time - so it's a slow process). There's a chance that the transplanted hairs don't match the other hair perfectly (direction, texture, density, styling ability) or that the surgery causes shock loss (more of a concern for diffuse thinners, but still possible).

I would like to see better pics. From what I see, there's no real reason for you to even consider a transplant, except you have very good hair and you have the idea that a transplant can help you achieve perfect hair. Most of us talking here have lousy hair, and are trying to get it to look average (in my case, just hoping to look normal after experiencing bad work). In my view, you may be on a foolish mission (better pics would help) but who am I to say how you spend your life? I think hair transplants are a last resort for most people, and I don't see you needing to use that option. Who knows though, maybe you will be pleased. But there's no free lunch. Your hair won't really be perfect. You'll have a strip scar or you'll have FUE scarring (maybe impossible for others to see, but it will be there). The surface of the recipient area will be affected too. Your scalp is permanently altered by surgery. It's not like getting a haircut. They are moving very small skin grafts (which happen to contain hairs). In the best case scenario, the surgical evidence is not noticeable. In the worst case scenario, it's very noticeable.

One more thing... somebody said that FUE yield and strip yield are the same. It really depends on the doctor, but generally speaking strip is easier to perform correctly (all things being equal with a competent clinic) and the graft survival rate should be higher. Since you have a limited recipient area, it won't matter (you're not going to be pushing the limits of your donor supply) and many guys are willing to sacrifice almost-perfect graft survival with strip surgery, for the much less invasive (but slightly less efficient, survival-wise) FUE surgery. (This logic makes sense to me as well). I don't think either method can honestly claim 100% survival rates though. And there are a lot of FUE doctors still learning the procedure (so their survival rate will be lower) and certain guys have even worse FUE survival rate because of their hair characteristics (very curly hair is said to be difficult, for example). But FUE is not as efficient as strip for survival rates. Some of the FUE doctors make a big point of claiming a high survival rate (because it's been an issue in the past). That should tell you something (FUE doctors still feel they have something to prove to their strip-performing colleagues).

My bottom line advice for you though is probably to move on, and obsess about other more productive things. There will be plenty of other guys who urge you to "go for it!" but they will be nowhere to be found, should something go wrong. Maybe you should "go for it" I don't know. But I don't think people should get cosmetic surgery on a casual basis. Would you get a nose job if your nose was only 95% perfect? That's kind of what you're asking about, only with your hair. However, for some reason, hair is a lot trickier to get right than nose jobs and other cosmetic surgeries.

A good option for you would be to go meet some recommended doctors, on a purely informational mission. Gather a bunch of opinions... see what the doctors say. Ask them what the pros and cons are. It's easier to discuss this stuff accurately when looking at somebody in person. And you shouldn't be getting diagnoses from other patients. A lot of guys don't know what they're talking about, and occasionally there are people online who are paid to shill for the doctors, either they work for the clinic or the doctor provides free grafts. Take any online encouragement with a grain of salt. Anybody who who works at a clinic (besides the doctor) who had a transplant works probably there because their results are above average. Try to meet average patients who look like you do. I don't know your location but see if there is anybody who you can meet in person, from online discussion boards.

 

[xapato]

I'm working on a setup for better pics. Here are a few clearer ones for now:





It seems like I've shed a bit after running dutasteride for over 3 weeks, but it could just be in my head.

I'm not well enough informed about the pros and cons. I mean usually I expect to have some idea of the risk curve of any procedure I undergo, but it seems we don't have any info regarding hair transplants. Since I have at least a year to consider, I'm going to visit a local hair transplant clinic for info. I'm located in Hong Kong. If I do get a hair transplant, my plan is to go to a top Doctor such as Feriduni. I guess it will cost a bit over 11k euros for the first procedure, but that's worth it to me. I think having a second procedure to add thickness would be pretty annoying, but at least the redness would soon be covered in hair from the previous hair transplant. I'm ok with that as long as it looks natural enough after the first donor grafts have grown in.

One of the reasons I'm interested in a hair transplant is that I've got a fairly young looking face. People usually guess I'm around 28. And I still do like girls of all ages, down to lower 20s.

By the way that was a very informative response. Really awesome how you addressed the graft survival issue of FUE. Actually, I think a low survival rate means an effectively lower density from a single procedure.

 

[arfy]

Thanks for providing better pics. You simply don't "need" a transplant. You might very well get good results and be happy... I have no way of knowing. I think using hair transplant for "touch up" work to try to make great hair look perfect, is kind of a misuse of the procedure. But that doesn't mean you absolutely shouldn't get one, or won't be satisfied. In a way, you are kind of an ideal candidate... no real degree of male pattern baldness, no diffuse thinning, a limited area to address. But I honestly think your desire for a hair transplant is dumb. Take that money and buy a sports car, buy some property, get an advanced degree.

You should meet some patients in person. Examine their hair up close, and see what you think. Understand hair transplants for what they are (and not what you hope they are).

 

[Sub8large]

ignore arfy. he is projecting his own failures on to you. A full head of hair will give you way more confidence and affect your life way more positively than a sports car. you want to look good, or you want a flashy car to "show off"?

get the hair transplant and look great, enjoy your youth, you only live once, don't waste your time like arfy probably did.

 

[xapato]

I agree that a great head of hair would be worth the money, and it being "dumb" is not a reason to not get a hair transplant. hair transplants not really being that good would be a reason to not get a hair transplant. So I think arfy is making me more objective.

I'm not really unhappy with my hair. I wouldn't, for example, trade the ability to lift weights for more hair. One thing I would like to know is this: For me, what is the level of hairloss that would be equally desirable to the expected result of a pretty good hair transplant? Obviously a hair transplant isn't as good as native dense hair. And you've got to factor in risk and opportunity cost (ugly ducking phase, cost, etc.). So where is the tipping point where getting a hair transplant makes sense? Lets assume we are vain as ****.

When I move into a new apartment, I make a floorplan to scale and paper furniture to scale, to decide what furniture to buy and where to place it. That's sounds obsessive, but it actually pays off. A few hours of work yield months or years of comfort and convenience. I think a hair transplant decision is something I should be meticulous about, so I'm interested in anyone who is willing to sit down and really explain what it's like and all the pros and cons in ridiculously pedantic detail, especially the cons.

 

[Jonny Craig]

I agree that a great head of hair would be worth the money, and it being "dumb" is not a reason to not get a hair transplant. hair transplants not really being that good would be a reason to not get a hair transplant. So I think arfy is making me more objective.

I'm not really unhappy with my hair. I wouldn't, for example, trade the ability to lift weights for more hair. One thing I would like to know is this: For me, what is the level of hairloss that would be equally desirable to the expected result of a pretty good hair transplant? Obviously a hair transplant isn't as good as native dense hair. And you've got to factor in risk and opportunity cost (ugly ducking phase, cost, etc.). So where is the tipping point where getting a hair transplant makes sense? Lets assume we are vain as ****.

When I move into a new apartment, I make a floorplan to scale and paper furniture to scale, to decide what furniture to buy and where to place it. That's sounds obsessive, but it actually pays off. A few hours of work yield months or years of comfort and convenience. I think a hair transplant decision is something I should be meticulous about, so I'm interested in anyone who is willing to sit down and really explain what it's like and all the pros and cons in ridiculously pedantic detail, especially the cons.

Your hair and mine look very similar, except I am 28!

How are you doing on dutasteride? Any sides? I am also considering hair transplant, we should keep in touch!

 

[arfy]

I already said this... Go meet some patients in person. Just chatting about this online is no substitute for seeing what transplants look like in person. If you're serious, then you should make a short list of top doctors and consult with them (for informational purposes only, don't decide anything during a consultation). Get referrals to meet their clients (not the guys who work in the clinic - the main reason they were hired is because they got exceptional results). Meet as many guys as possible, and examine their hair closely. Decide for yourself using your own two eyes, and don't rely on the opinions of anonymous posters.

Do me a favor - come back and report your findings. Ever hear the saying "You can't fool Mother Nature"? You seem to be a discerning individual. Do some further research, and let us know what you think.