Hi HairLossTalk,
Hope all's well. My name is Shad, 32yrs old from NY. Hair loss that runs in the family. I'm leaning towards FUT because of better yield and price. I shared pictures of my loss.
I've been doing a lot of reading and now have a question regarding conflicting approaches from 2 doctors. Unless you guys prefer I mention doctor names, I kept names out of my post. This is more about an informed decision anyways. Based on what I read online and impressions from consultation, both docs seem great. Just their approach on surgery was different.
The short story:
The 1st doctor I saw recommended an surgery of 1200 grafts, and mentioned I should be committed to come back 6 months later for a 2nd surgery. This approach is essentially more surgeries and less grafts. The 2nd doctor I saw recommended one surgery of about 2300-2600 grafts. I think he mentioned I'd only need 1 surgery. His approach is less surgery and more grafts. Which approach do you think is right for me, as well as the typical patient? Prices were somewhat similar.
The longer story:
I asked both doctors about the opposing approaches. The 1st doctor essentially said:
"I thought you had indicated to me that you were leaning toward an FUE procedure. Given your donor density and height of donor region, one (you) is more limited to the total numbers of high quality grafts harvested via FUE that is equal to a strip harvest. I could harvest more in quantity, but the quality will likely diminish.
Secondly, I designed this to give you the most positive change with the least potential shocking. If you are now leaning towards strip procedure, I could harvest 2000 grafts and place them into the top and back bridge as well as the succinct location I had allocated the 1200 grafts for originally. Here is the draw back - you will likely loose 30-70 percent of the native hair in the region receiving the grafts of which a percentage may not regrow (permanent shocking). Further, even if you were to do a 2000-2300 graft treatment you will most likely STILL want or require a second touch up treatment because we are treating a region that still has native hair that is going to continue to fall."
I then asked if he recommended FUT with 1200 or 2200 grafts as his primary recommendation. He said: "You can do either FUT or FUE if you choose to do 1200 grafts. If you choose to accept a larger region of shocking in the recipient region, I can reach about 2000 grafts but only with FUT not FUE. I recommended 1200 grafts as a minimal approach to your beginning thinning pattern but you can do either."
The 2nd doctor essentially said:
"This (1st doctor) implies that hairs that would be vulnerable to shock loss will no longer be present 6 months later? I disagree with the 2-step process, rather than traumatizing the scalp twice, it's better for patients to have the benefit from a full session and minimize any risk of shock loss by optimizing the solution in which the grafts are stored. The PRP/ACell/ATP/Hypothermosol combination is used to keep graft survival rate as high as possible, and for pre-existing hair preservation. Harvesting more in quantity doesn't necessarily mean the quality would likely diminish. It's simply not true if the optimal graft holding solutions are used. There is not a difference in graft survival between a 1200 and 2500 graft session. Those assumptions are outdated and only would apply to storing grafts in saline at room temperature (hopefully, no office does that anymore). I also disagree with the rates of permanent damage. That is simply a question of technique and attention to detail. The same reason that we do not require patients to shave their hair in the recipient area - it's a matter of performing the procedure slowly and carefully, rather than performing multiple surgeries in a single day."
Hope all's well. My name is Shad, 32yrs old from NY. Hair loss that runs in the family. I'm leaning towards FUT because of better yield and price. I shared pictures of my loss.
I've been doing a lot of reading and now have a question regarding conflicting approaches from 2 doctors. Unless you guys prefer I mention doctor names, I kept names out of my post. This is more about an informed decision anyways. Based on what I read online and impressions from consultation, both docs seem great. Just their approach on surgery was different.
The short story:
The 1st doctor I saw recommended an surgery of 1200 grafts, and mentioned I should be committed to come back 6 months later for a 2nd surgery. This approach is essentially more surgeries and less grafts. The 2nd doctor I saw recommended one surgery of about 2300-2600 grafts. I think he mentioned I'd only need 1 surgery. His approach is less surgery and more grafts. Which approach do you think is right for me, as well as the typical patient? Prices were somewhat similar.
The longer story:
I asked both doctors about the opposing approaches. The 1st doctor essentially said:
"I thought you had indicated to me that you were leaning toward an FUE procedure. Given your donor density and height of donor region, one (you) is more limited to the total numbers of high quality grafts harvested via FUE that is equal to a strip harvest. I could harvest more in quantity, but the quality will likely diminish.
Secondly, I designed this to give you the most positive change with the least potential shocking. If you are now leaning towards strip procedure, I could harvest 2000 grafts and place them into the top and back bridge as well as the succinct location I had allocated the 1200 grafts for originally. Here is the draw back - you will likely loose 30-70 percent of the native hair in the region receiving the grafts of which a percentage may not regrow (permanent shocking). Further, even if you were to do a 2000-2300 graft treatment you will most likely STILL want or require a second touch up treatment because we are treating a region that still has native hair that is going to continue to fall."
I then asked if he recommended FUT with 1200 or 2200 grafts as his primary recommendation. He said: "You can do either FUT or FUE if you choose to do 1200 grafts. If you choose to accept a larger region of shocking in the recipient region, I can reach about 2000 grafts but only with FUT not FUE. I recommended 1200 grafts as a minimal approach to your beginning thinning pattern but you can do either."
The 2nd doctor essentially said:
"This (1st doctor) implies that hairs that would be vulnerable to shock loss will no longer be present 6 months later? I disagree with the 2-step process, rather than traumatizing the scalp twice, it's better for patients to have the benefit from a full session and minimize any risk of shock loss by optimizing the solution in which the grafts are stored. The PRP/ACell/ATP/Hypothermosol combination is used to keep graft survival rate as high as possible, and for pre-existing hair preservation. Harvesting more in quantity doesn't necessarily mean the quality would likely diminish. It's simply not true if the optimal graft holding solutions are used. There is not a difference in graft survival between a 1200 and 2500 graft session. Those assumptions are outdated and only would apply to storing grafts in saline at room temperature (hopefully, no office does that anymore). I also disagree with the rates of permanent damage. That is simply a question of technique and attention to detail. The same reason that we do not require patients to shave their hair in the recipient area - it's a matter of performing the procedure slowly and carefully, rather than performing multiple surgeries in a single day."
