Thank your for your comments and questions.
@HairHunter - I think that it is fair to say that FUT is slowly being phased out in the industry. Whilst some doctors are still FUT driven, from our experience at BHR, only a very small percentage of patients are now open to the idea of considering FUT. The results that FUE can now achieve with a quality surgeon, are very impressive, even in larger Norwood cases, so it is understandable that individuals prefer to avoid the strip scar and the longer and more intense healing phase. FUT will continue to decline purely due to the lesser demand which is a natural evolution considering the much lesser invasive technique that FUE presents. However it is also true that in specific cases with individuals who have extensive loss and donor challenges/restrictions, a combination of both methods can be the most effective in terms of total graft count.
We do not feel that FUT is more appropriate in younger patients. We support the idea that proceeding with a quality surgeon who has a thorough understanding and respect of the patient´s donor area and the patient´s long term situation as a priority is essential. This is in terms of future loss, optimal donor management to preserve the donor area as much as possible, and proceeding based on the data that a thorough donor assessment provides. When FUE is planned effectively and appropriately based on each particular patient´s characteristics, any such risk is managed.
Each case is very unique and factors such as age, loss, donor density, hair groupings, medication, miniaturisation are all influential in our recommendations to the patient and if they are a viable candidate for surgery.
Regarding achieving a more homogeneous appearance in terms of density, this is certainly an element that needs to be considered. Hair restoration is the illusion of density and so a quality surgeon will take into account all such details. Oftentimes patients who have retained some hair on top, albeit at a lesser density, present the appearance of thinner hair due to the contrasting thickness of the higher donor area. By extracting grafts from this area of the donor, and therefore reducing density, this in itself can achieve a more homogenous appearance and provide the illusion of more hair on top due to a lesser contrast. Any such approach would be decided on a patient by patient basis. Extracting from the higher donor in younger patients who may be susceptible to further recession and dropping of the lateral humps and lower crown for example, would result in a less natural appearance and have the risk of the back and sides becoming disconnected to the transplanted hair in the recipient, and so this approach is not always suitable. This is where a doctors experience and artistry become so important and a "one size fits all" approach is never appropriate.