Am I a candidate? What's reasonable for # of grafts from donor in a session? FUT or FUE

[steve1565]

40yo. Hair loss started at 22years. I tried finasteride but the side effects are not bearable.
I use minoxidil.
Would like as much as possible from a single transplant, if I am a candidate.
I've sent inquiries to Hasson & Wong, Hattington Hair, Feller & Bloxham. Anyone else to consider?

 

[Techno1]

There is still a possibility your hair loss will continue without the use of Finasteride. Did you try a dosage less than 1mg at all? Oral Minoxidil is an option that more and more people are using these days.
What side effects did you experience?

An FUT procedure could provide you with 3 or 4 thousand grafts in one pass which could be used to create a hairline and density in the frontal 3rd or half. If scalp laxity was still ok, then a 2nd FUT to address the crown and finally FUE using beard and scalp hair.
This would all be dependent on the suitability of your donor after an examination by one of the doctors you mention who all produce consistent results with FUT. Others options I’d add to your list would be Dr. Wesley, Dr. Ron Shapiro, Dr. Gabel, and Dr. Cooley.

 

[bullitnut]

Dr Ron Shapiro did amazing FUT for me….He is world class….Your other choices are right up there with him.
Having a hair transplant without having it stabilised is risky….more so when you’re a higher Norwood.

 

[steve1565]

There’s still a possibility your hair loss will continue without the use of Finasteride. Did you try a dosage less than 1mg at all? Oral Minoxidil is an option that more and more people are using these days.
What side effects did you experience?

An FUT procedure could provide you with 3 or 4 thousand grafts in one pass which could be used to create a hairline and density in the frontal 3rd or half. If scalp laxity was still ok, then a 2nd FUT to address the crown and finally FUE using beard and scalp hair.
This would all be dependent on the suitability of your donor after an examination by one of the doctors you mention who all produce consistent results with FUT. Others options I’d add to your list would be Dr. Wesley, Dr. Ron Shapiro, Dr. Gabel, and Dr. Cooley.

Finasteride gave me nasty fatigue, brain fog, general poor feeling. I had no idea what was going on.. it took me a week before I thought it might be the Fin and I stopped it. Thankfully things returned to normal after a week off it. That was about 3 years ago.
I think my hair loss has been relatively stable for the past 3 or 4 years. Yes, of course, hairloss will always progress. It doesn't just magically start growing back.

 

[steve1565]

Dr Ron Shapiro did amazing FUT for me….He is world class….Your other choices are right up there with him.
Having a hair transplant without having it stabilised is risky….more so when you’re a higher Norwood.

Thanks. What do you mean stabilized? I haven't noticed much additional loss in the last 3-4 years.

 

[steve1565]

There’s still a possibility your hair loss will continue without the use of Finasteride. Did you try a dosage less than 1mg at all? Oral Minoxidil is an option that more and more people are using these days.
What side effects did you experience?

An FUT procedure could provide you with 3 or 4 thousand grafts in one pass which could be used to create a hairline and density in the frontal 3rd or half. If scalp laxity was still ok, then a 2nd FUT to address the crown and finally FUE using beard and scalp hair.
This would all be dependent on the suitability of your donor after an examination by one of the doctors you mention who all produce consistent results with FUT. Others options I’d add to your list would be Dr. Wesley, Dr. Ron Shapiro, Dr. Gabel, and Dr. Cooley.

Thanks for the additional recommendations. It seems both H&W and F&B are both booking a year out!! Is that true for all of these "high end" clinics?

How do these compare to some other alternatives like HLC in turkey, HDC in Cyprus, Eugenix in India?

 

[bullitnut]

Thanks. What do you mean stabilized? I haven't noticed much additional loss in the last 3-4 years.

Exactly that, no more progressive hair loss.

 

[Techno1]

Thanks for the additional recommendations. It seems both H&W and F&B are both booking a year out!! Is that true for all of these "high end" clinics?

How do these compare to some other alternatives like HLC in turkey, HDC in Cyprus, Eugenix in India?

I have no idea if they’re all booked a year in advance. Contacting them directly is the only sure way of finding out. The other 3 clinics you mention have good reputations.

 

[Bigmac]

Hi Steve. Your donor area looks intact but your hair looks as though it’s on the finer side and possibly thinning just below your crown. This might be the lighting though. That being said, once you are evaluated in person, no donor miniaturisation, good laxity, age and family history there’s a very high chance you’d be a suitable candidate.
From your list I assume you’re primarily looking at a strip procedure, correct me if I’m mistaken. I believe having a strip first will utilise your donor to it’s fullest capacity. If you could get around 4000 grafts from it, then you’ll be in a good position moving forward. You will have a couple of options where the grafts are placed. Full coverage across the whole head giving a thin look with a slightly denser hairline or concentrate on the frontal third, maybe half to have fuller coverage, then consider a second surgery to add density if needed and work on the crown area.

What is your preference for surgery and what is the general opinion from the clinics you’ve contacted?

 

[steve1565]

Hi Steve. Your donor area looks intact but your hair looks as though it’s on the finer side and possibly thinning just below your crown. This might be the lighting though. That being said, once you are evaluated in person, no donor miniaturisation, good laxity, age and family history there’s a very high chance you’d be a suitable candidate.
From your list I assume you’re primarily looking at a strip procedure, correct me if I’m mistaken. I believe having a strip first will utilise your donor to it’s fullest capacity. If you could get around 4000 grafts from it, then you’ll be in a good position moving forward. You will have a couple of options where the grafts are placed. Full coverage across the whole head giving a thin look with a slightly denser hairline or concentrate on the frontal third, maybe half to have fuller coverage, then consider a second surgery to add density if needed and work on the crown area.

What is your preference for surgery and what is the general opinion from the clinics you’ve contacted?

Hi all, thanks for all the helpful replies.

I'm looking at strip procedure because I've read that FUT gives better graft survivability. Also, the cost is much lower when considering these more expensive north american and swiss clinics. I am certainly open to FUE if it can be cost-effective and good result.
I am not sure if H&W docs actually looked at me, but their "official" consultation actually recommended FUE for me. They said 4,500 - 5,000 grafts for FUT and 4,000 - 4500 for FUE may be possible.
Dr Feller estimated 2500-3500 FUT. He said his estimate is conservative and could be more.
Hattington asked me to get a USB microscope before their consultation.

 

[Prohairclinic]

"I'm looking at strip procedure because I've read that FUT gives better graft survivability."

Whoever planted that in you brain has no clue.

FUT grafts, or FUE grafts, if properly handled they will give exactly the same survivability.

 

[Bigmac]

Opinions will differ on graft survivability but in my opinion from what I`ve seen and lectures I’ve attended at vairious hair loss conferences the survival rates are that close with both procedures it should not make any difference which method is used. This is providing it’s done by someone who is good at what they’re doing.
I do believe having strip first will yield more grafts for Norwood 5 and upwards. Then look at scalp and body fue.
As for cost, the clinics with larger staff can acclimate strip surgery but the clinics with fewer staff may have to hire in extra staff to perform a large strip, sometimes making it more expensive than Fue.

 

[Techno1]

In a study by Shapiro Medical Group, Minnesota the difference was minimal to zero for graft survival between FUE v FUT. They placed one side of a patients head with FUE grafts and the other side with FUT grafts. Both sides turned out fine.

 

[steve1565]

That's good to hear. It all comes down to the skill of the doc/technicians and their procedures.
I imagine that a clinic that does FUT is more likely to be skilled than your average FUE only clinic.
It doesn't necessarily mean that an FUE only clinic can't be excellent.
There is an additional possibility of damage to a graft during extraction with FUE especially when using an extra small punch, but again, it comes down to the skill of the person doing the work.

 

[Techno1]

FUE transaction rates are low when done by skilled extractors. It’s the same for FUT, grafts can be damaged when the slithers are cut into follicular groupings.

 

[Bigmac]

That's good to hear. It all comes down to the skill of the doc/technicians and their procedures.
I imagine that a clinic that does FUT is more likely to be skilled than your average FUE only clinic.
It doesn't necessarily mean that an FUE only clinic can't be excellent.
There is an additional possibility of damage to a graft during extraction with FUE especially when using an extra small punch, but again, it comes down to the skill of the person doing the work.

Grafts are often transected by inexperienced people or people who just aren’t good at it. My personal opinion is a punch in the size range of 0.7 to 0.9 are the best to use. Other opinions may differ from mine. Grafts can be damaged during the pulling out stage, the implantation stage and even the storage stage.

 

[Philw]

My opinion I think if u have a transplant u will.just be chasing for the rest of ur life
U have alot of hairloss
Personally I would have as much fue grafts on top of ur head focusing more on the front to mid section maybe abit on crown and just clipper ur hair short
Yes it will.look thin but it would be the easiest option
I think u will just get a thin comb over appereance if u grew longer

 

[anthony_constantinou]

Anthony Constantinou | Anthony Constantinou CEO CWM FX says During hair transplantation surgery, follicles are removed from the back and sides of the head. These follicles are then extracted from the surrounding tissue and then reinserted into the balding areas of the scalp.