This is not something I can write about. I would need to know much about your first. Are you Asian or Caucasian or African. IS your balding pattern advanced or early, what can you afford to do. These are just a few of the many questions I need to know before helping you with the type of decision you are asking about. What is right for one person, may not be right to the next. What are your goals and what time frame have you put aside to follow whose plan?
The decision to choose FUE vs FUT needs to be based on many factors such as your age, your hair loss pattern, how short you wear your hair, how acceptable it is to have a scar on the back of the scalp, how many grafts you need, etc. I would recommend meeting with a few hair restoration specialists in person so they can examine your scalp and discuss with you the pro's and con's of each procedure in respect to your needs.
FUE vs FUT or combination
FUE technique has become very popular amongst clients who prefer to keep their hair very short. However, there are many disadvantages to using this technique. Due to blind site incisions made in the donor area, there may be collateral damage to the existing donor hair. This could cause damage to the donor site and also the hair follicles being extracted, thereby resulting in poor growth and limiting the donor hair available for future use. Since hair loss is progressive, if a client is young and will continue to lose hair, is a patient with curly hair, a patient with more advanced hair loss or a patient with limited donor hair, this technique is not recommended. Body hair transplant and beard transplant are offered by many clinics for patients who have a limited number of donor hair in the safe zone,however the long term growth result from those surgeries have not been proven. Therefore, if you think you have limited donor hair and are considering doing both surgeries, you may want to consider just doing FUT.
It does not really matter if you use FUE or FUT first. You have to see what priorities you have and whether or not you want to avoid having a scar on the back.
Unlike a few years ago, we believe both procedures are equally effective and can provide full growth. I don't see much advantage of combining the two unless:
- If you want to maximize the numbers of grafts with FUE. FUE can get hair from the areas that FUT might not like some areas of temples, beard and body hair
- Save money by doing a portion of grafts through strip. In this case you still get a scar on the back and you don't even have to do the FUE part.
I think the best is to discuss this with your hair transplant surgeon and the two of you will find the best way of doing it based on your priorities and limitations.
Virtually all our San Diego hair transplant patients who have experienced both follicular unit extraction (with Neograft) and follicular unit transfer procedures say they much prefer FUE because of the quicker recovery, decreased pain, and no linear scar. FUE does decrease hair density in the donor area and therefore may reduce yield of a future FUT procedure. However, most patients will continue with FUE if they need future sessions and therefore it is not an issue. You should discuss the plan with your chosen physician and how he would address future sessions.
The choice of donor harvest technique really depends on who is doing the work and their level of skill and experience. You would want the least damage to donor hairs that are left behind.
As someone who does a great deal of hairline advancement, I get occasional requests for that procedure to be done years after a hair transplant. If that is the case, I much prefer that FUE was done first.
Combination hair transplant
This is something we see a lot. Some people do fue first, others do fut first. Often it is easier if you do the fue first.
The decision to have FUE or FUT or ARTAS or Neograft should be up to you. If you understand the limitations and benefits of each, you are empowered to make the decision. The doctor can only recommend certain methods.
It does not matter if you have FUE first and FUT second. The difference is the type of scarring (a line versus thousands of dots).
Finally, FUE or FUT are just a method to HARVEST (or take out) the hairs. The most important factor is how well the grafts are re-implanted / transplanted and how well the surgeon designs the hair line.
A great surgical result does not depend on FUE or FUT method of harvest. It depends on the surgeon.
FUE or FUT for 1st timers
In my experience, patients tend to lean to the least invasive procedure with the least amount of downtime. FUE offers very little to no downtime. A recent patient of mine went back to work the next day and worked 13 hours that day.