Is it worth getting another FUE

[Keith]

Hi I'm just after some advice on whether I should get my third FUE surgery.

Here's my journey so far:
I have had 2 FUE surgeries each with 2500 grafts

FUE 1 (March 2022) pretty much a total failure. I had necrosis and a lasting scar ( see FUE 1 photo)

FUE 2 ( Jan 2024) performed by the same company that did FUE1 but they offered the same sugery for free. Results were much better than the first although I'm not still not sure if the results could and should have been a lot better ( see FUE2 photo) However the surgeon after 18 months suggested that my results were good given that I had nearly no hair to begin with in the area

I'm just wandering if you think given the outcome if my first 2 if it is worth the hassle of having another ? If I can get a significant improvement I'll do it. But will I achieve much better than what I have now? Also is there any chance of me losing existing hair I have grown by having another surgery?

NB the photos that aren't in a collage labelled FUE1/ FUE2 are the photos taken recently, two years after my second surgery.

Thanks in advance

 

[Dr Bicer’s Consultant]

Hello @Keith ,

Sorry to see you had necrosis. What are your expectations from a third surgery, as that will be an important consideration for you, and can your expectations be met. If not, you either have to lower expectations or not go for a third. For instance, do you want more hair coverage going back, or do you want to focus on the areas already treated and improve the hair fullness/density.

Do you have any information on the quality of your donor hair quality and density? 5000 "grafts" removed already, is that hairs removed, or intact follicular units (1-4 hair units) as that will change the impact on the remaining donor resource. While it´s possible to have more than 5000 grafts, generally you need an above average donor to ensure the area is not over harvested. Have you considered using body hair and scalp to maximise the hair coverage and density.

 

[David Anderson]

Hi Keith, I am very sorry to hear about your experience and the necrosis. Did the surgeon offer a reason for the necrosis, do you smoke or did you at the time? Did they provide any insight into why the surgery was unsuccessful? Your donor area does look very limited but would need to see some clearer photos to be able to determine how much or any can be removed. You mention that if a significant improvement were possible then you would go through another procedure. Where would you focus any remaining grafts? Thicken up the front or add some into the crown?

 

[Keith]

Hello @Keith ,

Sorry to see you had necrosis. What are your expectations from a third surgery, as that will be an important consideration for you, and can your expectations be met. If not, you either have to lower expectations or not go for a third. For instance, do you want more hair coverage going back, or do you want to focus on the areas already treated and improve the hair fullness/density.

Do you have any information on the quality of your donor hair quality and density? 5000 "grafts" removed already, is that hairs removed, or intact follicular units (1-4 hair units) as that will change the impact on the remaining donor resource. While it´s possible to have more than 5000 grafts, generally you need an above average donor to ensure the area is not over harvested. Have you considered using body hair and scalp to maximise the hair coverage and density.

Thanks. I have no idea about the quality of the donor or the information on the grafts.

I think I want to focus on the areas already treated and improve the hair fullness/density. The consultant thought that I had enough for another surgery as it was him who suggested it.

I've never heared of using body hair for my FUE and that has not been suggested to me or even possible

 

[Keith]

Hi Keith, I am very sorry to hear about your experience and the necrosis. Did the surgeon offer a reason for the necrosis, do you smoke or did you at the time? Did they provide any insight into why the surgery was unsuccessful? Your donor area does look very limited but would need to see some clearer photos to be able to determine how much or any can be removed. You mention that if a significant improvement were possible then you would go through another procedure. Where would you focus any remaining grafts? Thicken up the front or add some into the crown?

Thanks David. There was no explanation for the necrosis, and I have never smoked. He seemed to suggest that I must have knocked the area but I know I didn't. They did however give me my second surgery free of charge which was a nice gesture

The consultant seemed to think that my donor was sufficient as it was himself who suggested the surgery.

I think I would rather improve the existing area rather than go for more coverage

 

[Dr Bicer’s Consultant]

Thanks. I have no idea about the quality of the donor or the information on the grafts.

I think I want to focus on the areas already treated and improve the hair fullness/density. The consultant thought that I had enough for another surgery as it was him who suggested it.

I've never heared of using body hair for my FUE and that has not been suggested to me or even possible

Hello @Keith , you may want to consider how your donor, if you take too much it will not look good, so ask about grafts and hairs. Probably a good idea to focus on adding to the treated area, but it's objective, same as body hair may or may not be an idea, it is worth looking at, have you looked at other clinics?

 

[David Anderson]

Thanks David. There was no explanation for the necrosis, and I have never smoked. He seemed to suggest that I must have knocked the area but I know I didn't. They did however give me my second surgery free of charge which was a nice gesture

The consultant seemed to think that my donor was sufficient as it was himself who suggested the surgery.

I think I would rather improve the existing area rather than go for more coverage

Thanks for the update. I think thickening within the same area makes sense and leaving the crown. At this point I would invest a a few detailed consultations. It is unclear how permanent areas of your donor area are and how much you have left to move. Are you on finasteride or minoxidil?

 

[Keith]

Hi. Yes I'm on a combination of finasteride and minoxodil using a serum from a company called Twentyone again.
Here are some more pics of my hair taken today so hopefully this gives you a better view

May I ask what is your experience with hair transplants, are you a surgeon?

Also in your honest opinion, do you think my procedure was successful given how bare my scalp was initially?
It is difficult if gauge what is successful or not.

Also, the thickest part of my hair seems to be around the sides. Do you know if it is possible to extract hair from the sides as well as the back?

Thanks

 

[David Anderson]

Hi Keith,
The photos are a little blurry to be able to tell the detail of how strong your donor hair is.

I have worked for hair transplant clinics for 15 years as a patient advisor and before that I was a patient. I am now independent offer my own consultations for patients.
I feel you have had a disappointing result for what you say is 5000 grafts. You do appear to have fine to medium calibre hair overall.You can extract from the sides but these are usually lower density. It looks like you have some retrograde in the nape of your neck and around the ears. I think with a combination of carefully extracted scalp hair and some beard hair you could potentially get a good improvement, it depends whether it will be enough for you to be happy with.

 

[Keith]

Hi. Thanks
I discount the first FUE treatment that gave me necrosis since it yielded no success which was why my clinic offered me the second treatment for free.

So please base your opinion of my results on just 2500 grafts.

 

[David Anderson]

For 2500 grafts over a fairly large area with fine hair then I think the result is acceptable in terms of growth. More importantly how do you feel about it?

 

[Prohairclinic]

Just want to point out there might be an alternative solution, non surgical : Scalp Micro Pigmentation.

You seem to have dark hair and fair skin.

You may be an ideal candidate.

Here is an example of a densification SMP treatment.

 

[mania]

Yes, getting every other FUE may be very well worth it, regularly to add density, refine a hairline, accurate previous work, or hold up with endured hair loss, leading to extra herbal, fuller outcomes, however achievement hinges on a healthful donor place and a skilled health care provider. Many patients want a 2d session for thickness, and success quotes are high (ninety-ninety five%), but it's crucial to have a session to assess your donor supply and goals

 

[Bigmac]

Hi Keith, did you decide on a treatment option?