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Q: BHR + Prohair reps concerning FUE

S

solar panel

Valued member
Hi all,

If a person was to max out using FUE only approx 5000 FU, how short would they be able to cut there hair in the doner region G1- 3mm , G2- 6mm , G3- 9mm , G4-12mm ?

Also if i where to utilise strip/fue combo how short would i be able to cut hair after strip G1-3mm etc.. basically what i,m asking is the difference negligible perhaps the difference between a G2 for fue and a G3 for strip ?

cheers all

SP
 
P

Philb

Member
solar panel wrote:
Hi all,

If a person was to max out using FUE only approx 5000 FU, how short would they be able to cut there hair in the doner region G1- 3mm , G2- 6mm , G3- 9mm , G4-12mm ?

Also if i where to utilise strip/fue combo how short would i be able to cut hair after strip G1-3mm etc.. basically what i,m asking is the difference negligible perhaps the difference between a G2 for fue and a G3 for strip ?

cheers all

SP
Hi SP,

What will depend a great deal is the extraction pattern used, tool size and surface area harvested to name a few. For example many do not like to harvest passed the ear because the angle of hairs changes and makes it much harder and if you do not understand this then transection increases, secondly if FU are over harvested in a high density area to make up the numbers this will unbalance the scalp laxity, potentially cause more fibrosis within the skin making it harder for secondary procedures be it Strip or FUE. Then you have the 30% rule that we adhere to as a protocol and this has to be measured not just down to the donor density but also the % of miniaturisation and average hair per FU to ensure that you do not cause areas weaker than others.

This picture is of a patient who has now had around 6000 FUE extractions, his donor density was well above average to start with and he always keeps his hair short to shaved and says no one gives him a second look.

over12monthspostop5000plusgrafts.jpg


The next point is if you maxed out with FUE what length could you keep your hair if you then had Strip, some will obviously depend on your hair characteristics but also what density you are left with after the FUE. A saving grace with theses clinics that say 50% harvesting is in the donor the hair lays almost flat and down so it hides the lack of density, only when wet or actually parted does it become obvious to the eye, but to the touch you cannot remove 50% and not expect a massive change; and if you expect to be able to shave with said harvesting and it look natural it would probably be impossible because to be able to harvest over the scalp in such a random pattern so as to avoid the look of "hair less" areas is nigh on impossible because of the nature the FU are naturally situated.

If the strip closure was good, 2mm tricophytic say and your hair characteristics allowed you could have it shaved but I doubt a #3. The hair direction in the donor will also change slightly with either technique, more so with Strip and in a more obvious way because the change is linear whereas with FUE it is dispersed but this will also have limitations as to how close you can shave and a scar not noticeable, the scar it itself maybe very good and even when the hair is pulled up not obvious but the hair change will make it more visible when very short. For the record here are two pictures, same patient one with shaved donor showing the scar line after more than 4000 strip procedure:

P1080188.jpg


IMG_0264.jpg


I hope this answers, sorry if it turned a little rambling but many points seem to come up while I was writing the reply.

 
Last edited:
S

solar panel

Valued member
hi philb,

thx for the comprehensive reply i guess what your saying is there is no way of knowing how short the doner can be cut until a patient has had a procedure be it FUE or strip.

the patient you posted has had 6k FUE and it looks like he's buzzing down to a G1 -3mm with no obvious signs, have you any pics of this patient Pre , post an 12 months post-op? i would really appreciate you taking the time to post some because this is my goal

also what would you say is the maximum grafts the average person has if a FUE/Strip combination was used

cheers Philb

SP
 
P

Philb

Member
solar panel wrote:
hi philb,

thx for the comprehensive reply i guess what your saying is there is no way of knowing how short the doner can be cut until a patient has had a procedure be it FUE or strip.

the patient you posted has had 6k FUE and it looks like he's buzzing down to a G1 -3mm with no obvious signs, have you any pics of this patient Pre , post an 12 months post-op? i would really appreciate you taking the time to post some because this is my goal

also what would you say is the maximum grafts the average person has if a FUE/Strip combination was used

cheers Philb

SP
Hi SL,

Well I would say it is easier to predict they can buzz lower with our FUE and even clean shave because we have a strict protocol about harvesting, but with Strip there are more contraindications and hair characteristics will play a part also.

The patient above will be posting his results in full quite soon, sorry you'll have to wait, his scalp FUE is over as far as we are concerned and we have done a test of his chest and beard hair, both of which he says are showing good growth; his aim is total restoration hair line to crown and I think this proves even with very good hair characteristics like his the probability of success is low.

As for max grafts with combo, many varients here, do strip or FUE first, then combine in a second and then a smaller strip or FUE for a third maybe. If we took a candidate with a good density, say 85-90 then a strip could harvest 5500-6000 and then FUE at the same time another 1000-1500. Wait for the growth and the donor to relax, possible another Strip, not push the limits and say 2000-2500 and maybe another 1000 FUE. That is a good donor in fairness so the average guy will not reach these figures. What's important is the planning and both patient and doc being on the same page from the start, be open about your goals otherwise your intentions maybe misunderstood.
 
S

solar panel

Valued member
Thx Philb,

11k grafts for above average doner strip/fue would basically fully restore a NW5-6 thats great news, is there anyway of telling from pics if a person has good doner characteristics density wise? I believe i have good laxity, reading up on the forums some one posted if you can pinch scalp between fingers you have good laxity,if you are only able to move scalp up and down this is average laxity and poor laxity is when there is minimal movement in scalp as i said i,m able to pinch probably 20mm between finger and thumb.

I,m really leaning towards FUE with your clinic at the moment though as i would prefer to buzz down as low as doner allows, does Dr Bisanga utilise nape and beard hair when the doner is maxed out ?

I,m basically a NW2.5 hairline but diffuse all over in what i believe is a nw4-5-6 (i,m unsure of the difference between a NW 4-5-6) any examples would be appreciated.

If i was to get 2500 FUE in the 1st pass could the doc address the thinning areas 1st? basically 1000 FU in the front third ,1000fu in second third 500 in the final third(crown) and the same again if needed for the second pass for a total of 2000 FU in the front 2000 for mid scalp 1000 crown does this seem like a good plan? i would prefer to to stay conservative with a restoration to minimise signs ie.. redness

could Dr Bisanga estimate how many Fu i would need from a buzzed down pic ?if not what would be the minimum length to get a accurate estimate

Thx Philb your a great help

SP


P.S looking forward to the 6k FUE patients final pics



 
P

Philb

Member
solar panel wrote:
Thx Philb,

11k grafts for above average doner strip/fue would basically fully restore a NW5-6 thats great news, is there anyway of telling from pics if a person has good doner characteristics density wise? I believe i have good laxity, reading up on the forums some one posted if you can pinch scalp between fingers you have good laxity,if you are only able to move scalp up and down this is average laxity and poor laxity is when there is minimal movement in scalp as i said i,m able to pinch probably 20mm between finger and thumb.

I,m really leaning towards FUE with your clinic at the moment though as i would prefer to buzz down as low as doner allows, does Dr Bisanga utilise nape and beard hair when the doner is maxed out ?

I,m basically a NW2.5 hairline but diffuse all over in what i believe is a nw4-5-6 (i,m unsure of the difference between a NW 4-5-6) any examples would be appreciated.

If i was to get 2500 FUE in the 1st pass could the doc address the thinning areas 1st? basically 1000 FU in the front third ,1000fu in second third 500 in the final third(crown) and the same again if needed for the second pass for a total of 2000 FU in the front 2000 for mid scalp 1000 crown does this seem like a good plan? i would prefer to to stay conservative with a restoration to minimise signs ie.. redness

could Dr Bisanga estimate how many Fu i would need from a buzzed down pic ?if not what would be the minimum length to get a accurate estimate

Thx Philb your a great help

SP


P.S looking forward to the 6k FUE patients final pics
Hi SL,

To be honest scalp laxity is a funny one to judge, I have seen very lax scalps and the doc has said he would prefer to air on the side of caution and then what seemed to be tight and he has been more than happy to go more grafts than predicted; my feeling it is something that has to be left to the doctor to measure as they have the "feel" and understanding of what they can do. Open & closure techniques of Strip are changing also and this has enabled us to be able to take more grafts than say a few years ago even from a below average donor and still maintain a neat closure and good healing.

In respect of nape and beard, nape hair the doctor is not a big advocate of because the long term effects are too unpredictable, there is plenty of fine hair for hair line work around the safe zone with FUE, just have to take the time to look for it rather than risking removing from a potentially unsafe area. Beard hair is another matter and we have recently been trailing this and so far with success, the hair can be a different calibre so placement is crucial to making a natural look, but certainly it seems more predictable than traditional BH has done.

The basic difference with the high NW's without just stating the obvious...less recipient hair is really how far your front laterals, sides and back drop, this will greatly reduce the donor surface area and obviously increase the size of the recipient area, so it is a lose lose situation, more demand and less supply.

You have to be careful about spreading hair around the scalp and amongst existing hair without ensuring what you are doing will give a natural result even if your native hair thins further, planning is very important with cases of diffused thinning. The areas have to be measured for the extent of miniaturisation. 1000 grafts spread over the frontal 1/3 is very minimal and when creating a hair line 1000 grafts does almost no where in terms of coverage, so again we have to ensure that when we place we take into consideration now and the future and whether the cosmetic impact will be great enough to warrant the procedure.

Buzzed down pics can sometimes help and hinder when assessing, when possible take some of both, buzzed and with a cm or so of hair so a comparison can be made between the two.

Good luck with your research!
 
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