Every time I think about FUE I can't help but wonder about the donor area. In a strip surgery the doctor cuts out a fairly significant area of skin and then connects the remaining skin to create a seamless(well, mostly) skin layer. This stretches the skin, thereby slightly increasing the distance between the hair follicles throughout the rest of the scalp. The extracted hair is put where needed and the appearance of a fuller head of hair is the result.

Now, in FUE, individual follicles are extracted. The remaining skin isn't touched and the distance between follicles left on the head remains the same. Now, in my mind this translates into one major issue.

If enough hair follicles are extracted using FUE there will be a noticable density problem relative to after a strip surgery. The same number of hairs are now spaced differently(vs. a strip effect) and the difference will definitely be seen in the donor area. Now, since the skin isn't stretched(and follicles remain the same distance apart), I guess that the same density in the transplant region can be reached with less follicles. Still, I can't imagine that losing 5000-8000 grafts all in the same area(rather than taking a strip and stretching out the affected area) wouldn't have an effect on the visible density, especially for someone(like me) with a large amount of single-hair follicles and lower density.

If there were no risks I'd sign up for a transplant tomorrow. The strip scar worries me because a strip of my skin would be removed, the scar is kind of scary, and I believe there are more potential problems regarding the scar. FUE/FIT kind of worries me because it's relatively untested and my donor area could look bad if I get a bunch of follicles extracted over the next couple of years. I'm definitely not going to rush into a decision of this magnitude, but it would be helpful if a doctor(or someone with a lot of knowledge on the matter) could clearly answer my questions.

But here's some thoughts. I've seen a similar thread on another forum. It looks like Dr. Woods usuall stops around 4000 grafts when using FUE, and that seems to be the upper limit of what can be done without significant damage to the donor area (you will only notice minor thinning, but nothing major). In my opinion, the best approach (if you are high on NW scale), is to go for a strip mega-session first, and then follow up with FUE procedures. If on the other hand, all you need is 500-2000 grafts total, then FUE would definitely be a good choice.

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

Here is my idea :
I assume an average donor area is 20*5 cm long and about 100 FU/cm2.
That makes a total of 10.000 graft. I would say grafting up to 25% (2500 grafts) will go unnoticed, unless the doc does not to a good spread taking them out.

I am just assuming that these numbers are reasonable. If not please correct me.

[This message was edited by bverotti on June 26, 2003 at 08:24 AM.]

With FUE, you can also take some hair from the sides. This is good for us with "bozo hair". My sides are so thick, that I always have to tell the barber to cut more off with respect to the length in back. My sides look "puffy".
Anyway, decreasing the density on my sides would actually be doing me a favor. Interesting but true.
I kind of agree with the strip then FUE, maybe because I'm in that boat. I needed the strip to harvest a lot of FUs quickly to cover a large bald area. That area is now covered with decent density, but I can now see that I want a little "fine tuning". I'll use FUE to accomplish that, because I don't need very many more FUs and we can pull just the 1 and 2 hair FUs I'll mostly need. Yes, it costs more, but at this stage, I think it is the right approach for me.

vocor1
Knowledge is Power
If the worst question is the one never asked, then the worst answer is the one never shared.

That makes sense. Considering that one day I'll be like my dad(NW6 or so) I don't think that I could go all FUE and get reasonable coverage. I also have lower hair density, although my head is smaller than average(meaning lower needed coverage areas) and my hair is faily thick. So, if I choose to get a transplant done(and if some incredible new breakthrough doesn't happen soon) my only real choice is to get a strip surgery done. At that point(1500-2000 grafts later) I can make a choice between getting another strip surgery done to get better density in my frontal area(even after the 1st surgery I'd only be in the mid-20s for average density) or have some FUE sessions spreading out the donor area through the back and side of my head. Oh well. I guess it's better than being totally bald.

BTW, at the point I'm at(NW3 and probably getting worse at only 23) I don't think a transplant is a great option. I'd rather have thinner hair than risk a surgery and get a scar running from ear to ear on the back of my head. I realize that to others the trade-off is easy to make, but I think other issues are at work besides hair loss. One of the best things about reading the message boards(especially the one at hairlosshelp.com) is that it helps me keep things in perspective and realize just how strange some people's view of themself can get.

you think hairloss is strange? check out support group forum on the hairsite.com. There are posts of people talking about commiting suicide because of hairloss issue.

"Any sufficiently advanced technology is indistinguishable from magic''. Arthur C. Clarke

No, I don't think hair loss is strange. I just think it's weird(and sad) that people can't get past their hair loss and get truly depressed about it. I'm 23 and losing my hair and it sucks, but there are a ton more important things in life than hair on my head. If people want a transplant because they need hair to frame their face and the cosmetic difference is huge then that's a good reason, but if the goal is to pump up their self-confidence then they need some counseling first.