1st timer for hair transplant...strip or FUE?

Scoobysnack

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I just did my 2nd and final strip procedure and would vote for strip. I went to my first consultation asking for FUE, money isn’t a problem for me, but after the consultation I changed my mind and opted for strip. That was 2019. I just did another smaller strip procedure several weeks ago.

despite what the fue proponents are saying, a Dr will usually get better yield and graft quality with a stip. both have their disadvantages - strip you have a scar so you won’t be shaving the back of your head ever, FUE results in thinning of the donor area.

regardless of cost I would vote strip. Keep in mind the quality and ability of the dr and their staff will play a large role in the end result.
 

trialAcc

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I just did my 2nd and final strip procedure and would vote for strip. I went to my first consultation asking for FUE, money isn’t a problem for me, but after the consultation I changed my mind and opted for strip. That was 2019. I just did another smaller strip procedure several weeks ago.

despite what the fue proponents are saying, a Dr will usually get better yield and graft quality with a stip. both have their disadvantages - strip you have a scar so you won’t be shaving the back of your head ever, FUE results in thinning of the donor area.

regardless of cost I would vote strip. Keep in mind the quality and ability of the dr and their staff will play a large role in the end result.
From my early research, this seems to be the correct answer, both have their merits. I think most young guys would be doing themselves a massive favor in the future if they opted for the strip first, because you'd be giving yourself an average of 3k more graft down the line if your loss pattern gets more aggressive or the results aren't to your liking.

The reality is that the majority of people with early balding do not make good candidates for FUE surgery, despite what the marketing/surgeons would tell you. Under 8k graphs in a NW5/6+ is going to leave you with a very thin and sometimes unappealing thin look of your hair as you age, where as 10-12k would make a world of difference.

You see all the time on these forums or even in news articles. Guys get 5k graft procedures done covering the entire NW5 area and the end result is patchy and see-through. Then they have 3k grafts left and it isn't going to be enough to cover the entire top so they focus on the hairline and are left with a balding crown for the rest of their life and no tools left in the toolshed if they go from NW5 to NW6/7.
 

trialAcc

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Problem with strip is that you can't go short on the back of your head...
That's a trade off I'd happily make to have thick looking hair on top. With a good surgeon you can easily buzz to a #2 anyways, and that's with 0 scar work done.
 

follicle2001

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FUT versus FUE was just discussed on the most recent episode of The Bald Truth, and they talked about pros and cons of both and the idea of starting with FUT and then moving to FUE if needed. Spencer Kobren said he would have FUT if he had to have hair transplant surgery.

The discussion starts at around the 1 hour mark.

 

global

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Both FUT and FUE have advantages and disadvantages.

One big misconception with FUE is that you can easily shave your head in the future. This isn't true for many people especially if you've had a large number of grafts extracted ( even without overharvesting) For many people all those small dot scars are visible even if a 0.9mm or 0.8mm punch is used (I've seen many) Many factors affect the visibility of the scarring including skin tone etc. Even if you don't scar there is a space with no hair which is nearly as noticeable.

I'm talking about shaving your head here, but if you trim with clippers and leave your hair at least 2-3 mm then you can get away with it. In any case you can always wear your hair shorter with FUE than with FUT. Also you can camouflage FUE scars with SMP much easier than with an FUT scar if you want the total shaved look.

FUT is a good option if you need a very large number of grafts. Also FUT surgeries only take one day, if you need large numbers of grafts with FUE you'll need a two day surgery or even multiple surgeries spread over months/years to achieve what can be done in one day with FUT

FUT is more aggressive and painful but cheaper, FUE is less painful but slower to perform and for larger graft numbers will require a two day surgery.

Both procedures require you to shave the recipient area for a good result. The clinics that tell you you don't need to shave just don't want to put you off and lose your money so they tell you what you want to hear.

Whether the doctor or a tech does the implanting doesn't depend on the technique it depends on the clinic. Most clinics nowadays use techs to do all the implanting as they can be rotated to avoid fatigue. It's really difficult for the doctor to do all the work unless it's a very small surgery so I would be wary of any clinic using that as a selling point.

The only exception to this is if they use implanter pens which I believe are quite common in Korea. In this case its the doctor who should do the implanting as it requires making an incision with the pen which in most places only a doctor can legally do.

In your case you say you still have good coverage on top so my advice is DON'T do any transplant in that area, you could do more damage than good and end up with no net benefit. You should try meds first.

In summary FUE is safer/less invasive and better for most people unless you need really large graft numbers. At a good clinic the yield should be very similar. And if the transplant fails or the result isn't good you'll regret it much less with FUE than if you have a long scar at the back of your head for nothing.
 

trialAcc

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Both FUT and FUE have advantages and disadvantages.

One big misconception with FUE is that you can easily shave your head in the future. This isn't true for many people especially if you've had a large number of grafts extracted ( even without overharvesting) For many people all those small dot scars are visible even if a 0.9mm or 0.8mm punch is used (I've seen many) Many factors affect the visibility of the scarring including skin tone etc. Even if you don't scar there is a space with no hair which is nearly as noticeable.

I'm talking about shaving your head here, but if you trim with clippers and leave your hair at least 2-3 mm then you can get away with it. In any case you can always wear your hair shorter with FUE than with FUT. Also you can camouflage FUE scars with SMP much easier than with an FUT scar if you want the total shaved look.

FUT is a good option if you need a very large number of grafts. Also FUT surgeries only take one day, if you need large numbers of grafts with FUE you'll need a two day surgery or even multiple surgeries spread over months/years to achieve what can be done in one day with FUT

FUT is more aggressive and painful but cheaper, FUE is less painful but slower to perform and for larger graft numbers will require a two day surgery.

Both procedures require you to shave the recipient area for a good result. The clinics that tell you you don't need to shave just don't want to put you off and lose your money so they tell you what you want to hear.

Whether the doctor or a tech does the implanting doesn't depend on the technique it depends on the clinic. Most clinics nowadays use techs to do all the implanting as they can be rotated to avoid fatigue. It's really difficult for the doctor to do all the work unless it's a very small surgery so I would be wary of any clinic using that as a selling point.

The only exception to this is if they use implanter pens which I believe are quite common in Korea. In this case its the doctor who should do the implanting as it requires making an incision with the pen which in most places only a doctor can legally do.

In your case you say you still have good coverage on top so my advice is DON'T do any transplant in that area, you could do more damage than good and end up with no net benefit. You should try meds first.

In summary FUE is safer/less invasive and better for most people unless you need really large graft numbers. At a good clinic the yield should be very similar. And if the transplant fails or the result isn't good you'll regret it much less with FUE than if you have a long scar at the back of your head for nothing.
It's not really a misconception. Yes they are visible but unless you scar terrible and they actually turn into keloid bumps there is no reason why you can't shave your head even with them present. The eye isn't drawn to them like they are with a strip scar because your eye is used to the dots of hair on someone's head.

The main issue with FUE is that I almost guarantee a large portion of people getting FUE procedures are going to experience some degree of graft miniaturization in the future. Most people getting FUE are getting hair taken from much too high up on their heads.

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global

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It's not really a misconception. Yes they are visible but unless you scar terrible and they actually turn into keloid bumps there is no reason why you can't shave your head even with them present. The eye isn't drawn to them like they are with a strip scar because your eye is used to the dots of hair on someone's head.

The main issue with FUE is that I almost guarantee a large portion of people getting FUE procedures are going to experience some degree of graft miniaturization in the future. Most people getting FUE are getting hair taken from much too high up on their heads.

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Well I've seen many patients with visible FUE scarring even from top doctors and the eye is drawn to anything which looks unnatural even if it's just a space with no hair. But yes I've also seen many people with no visible scarring, the point I'm making is don't assume you'll be easily able to shave your head to a zero after, there's a reasonable chance that won't be possible. But in every case you can wear your hair shorter with FUE.

Agree with your point about hairs being taken from the non safe zone, this is usually because it's much easier to extract those nice fat hairs from high up on the back of the head with the skull behind for support than extract finer hairs from the difficult areas like the nape of the neck with just soft tissue behind or around the side where they grow at a much more acute angle!
 

trialAcc

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Well I've seen many patients with visible FUE scarring even from top doctors and the eye is drawn to anything which looks unnatural even if it's just a space with no hair. But yes I've also seen many people with no visible scarring, the point I'm making is don't assume you'll be easily able to shave your head to a zero after, there's a reasonable chance that won't be possible. But in every case you can wear your hair shorter with FUE.

Agree with your point about hairs being taken from the non safe zone, this is usually because it's much easier to extract those nice fat hairs from high up on the back of the head with the skull behind for support than extract finer hairs from the difficult areas like the nape of the neck with just soft tissue behind or around the side where they grow at a much more acute angle!
It sounds like you're talking about seeing the spots while hair is still there though, not fully shaven. It also isn't even about the doctor, it's about how the patients body scars.

I got pretty bad scaring from acne in my teen years, to the point where I have small raised white dots under my jaw line from even the smallest acne lesion. I suspect if I got an FUE I'd be one of the patients who has very visible scars that were possibly raised. I probably have a collagen or other substance deficiency or something that causes this.
 

global

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It sounds like you're talking about seeing the spots while hair is still there though, not fully shaven. It also isn't even about the doctor, it's about how the patients body scars.

I got pretty bad scaring from acne in my teen years, to the point where I have small raised white dots under my jaw line from even the smallest acne lesion. I suspect if I got an FUE I'd be one of the patients who has very visible scars that were possibly raised. I probably have a collagen or other substance deficiency or something that causes this.
No I'm talking about fully shaven, small circle scars visible with no raised areas, keloid etc. I have seen many people with this in person. Have you actually done a hair transplant yet? It sounds to me like you just want to believe that there are no scars but believe me this isn't always the case. Anyway I'm not trying to convince you just sharing my experience, do what you want.
 

trialAcc

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No I'm talking about fully shaven, small circle scars visible with no raised areas, keloid etc. I have seen many people with this in person. Have you actually done a hair transplant yet? It sounds to me like you just want to believe that there are no scars but believe me this isn't always the case. Anyway I'm not trying to convince you just sharing my experience, do what you want.
No, I have not. I've done extensive research though because I have one of the best surgeons in the world in my backyard (Hanson & Wong) and they've had openings for months.

I literally just said some people scar very poorly and will have very visible scars, and that I am probably one of them.
 
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