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Different patients, different choices, different methods


#1

Dear forum readers,
Different patients wonder which method or combination of methods would best suit their hair restoration goals.

A hair restoration surgeon has various techniques (strip FUHT, stitchless FUSE/fue, beard hair to scalp transplant and BHT) at his/her disposal.

The final plan of action has to be based on the doctor’s as well as the surgeon’s decision based on

  1. the patient’s current requirements/preference,
  2. the patient’s current and total donor hair availability,
  3. the long term possible requirements (should hairloss progress).

Prospective patients often ask which method (or combination thereof) will best suit them.
It is difficult for the HT surgeon to make the decision for them solely at his discretion.
I believe the educated, aware patient should contribute in a major way to the decision making process.

In this thread, I will discuss a variety of patients that chose different options for their hair restoration.
I hope this will serve to educate future patients make an informed choice.


#2
  1. Strip FUHT
  2. FUSE/fue
  3. FUHT + robust BHT
  4. FUHT + beard hair to scalp + bht
  5. FUSE + bht + beard hair to scalp transplant
  6. FUHT + FUSE (with or without bht and beard hair to scalp)
  7. BHT + beard hair to scalp transplant.

We shall discuss which methods suit which conditions best with case illustrations.


#3
  1. An aggressive megasession aimed at near complete hair restoration

  2. A moderate approach addressing most areas, albeit in a prioritised manner

  3. A conservative approach using moderate graft numbers and conservative hair restoration goals

  4. The less is more approach

  5. Repair only.


#4

Good topic, what about the cost for different approach? The best approach for me may not necessarily be the one within my budget, for me it’s not so much the best approach but the most cost effective.


#5

The readers are familiar with these options given the large number of patients that have opted for them.

Some examples are available at the following links.

FUHT only
Mahi
http://www.hairsite.com/hair-loss/board_entry-id-39229-page-0-category-2-order-last_answer-descasc-DESC.html

Sunil
http://www.hairsite.com/hair-loss/board_entry-id-39119-page-0-category-2-order-last_answer-descasc-DESC.html

Jiggy
http://www.hairsite.com/hair-loss/board_entry-id-15838-page-0-order-time-category-0.html

FUSE/fue only

http://www.hairsite.com/hair-loss/forum_entry-id-16430.html

http://www.hairsite.com/hair-loss/forum_entry-id-8934.html

http://www.hairsite.com/hair-loss/board_entry-id-7864.html

http://www.hairsite.com/hair-loss/board_entry-id-3636-page-0-order-time-category-0.html

More examples are available at


#6

» Good topic, what about the cost for different approach? The best approach
» for me may not necessarily be the one within my budget, for me it’s not so
» much the best approach but the most cost effective.

Quite true. One has to figure out how to fit the HT in one’s life. Not the other way around.


#7

The combination of the various methods will depend on the graft availability + patient preference.
Its in the combination approach where the patient’s input is required to a greater degree.

These cases (FUSE + bht), for example, are young patients desirous of a youthful hairline. At the same time, if hairloss progresses relentlessly for them, they retain the option of going for a buzz cut.
For those young and experiencing extensive hairfall early in life, this approach has its merits.

jk1
http://www.hairsite.com/hair-loss/board_entry-id-38662.html

Rajesh
http://myhairtransplant101.blogspot.com/

http://www.hairsite.com/hair-loss/board_entry-id-33091-page-0-order-time-category-0.html


#8

For those with extensive hairloss (Norwood 5 and above)

A combination of scalp, beard and robust body hair is an option, especially where the aim is to go for a youthful hairline and to cover most or all areas of hairloss.

Examples of such an approach are
TH
http://www.hairsite.com/hair-loss/board_entry-id-38093.html

and

Viking
http://hairtransplantcentre.blogspot.com/2007/09/10000-fuse-grafts-for-extensive.html

My preference is to choose the most robust hair for such cases rather then to transplant immensely large number of non robust hair.


#9

The one aspect that is independent of these observations is wether Strip+FUE outperforms, in terms of numbers FUE alone over entire donor area.

If FUE can acheive all that other scalp combinations can then of cause FUE would be the way to go. This simple question remains in the iar even after several years.


#10

» 1. Strip FUHT
» 2. FUSE/fue
» 3. FUHT + robust BHT
» 4. FUHT + beard hair to scalp + bht
» 5. FUSE + bht + beard hair to scalp transplant
» 6. FUHT + FUSE (with or without bht and beard hair to scalp)
» 7. BHT + beard hair to scalp transplant.
»
» We shall discuss which methods suit which conditions best with case
» illustrations.

Dr. A, you should add one more:

“FHUT (strip) + FUE in strip scar if necessary”

let me know if you want me to explain this one altho I think this is pretty self explanatory.


#11

» The one aspect that is independent of these observations is wether
» Strip+FUE outperforms, in terms of numbers FUE alone over entire donor
» area.
»
» If FUE can acheive all that other scalp combinations can then of cause FUE
» would be the way to go. This simple question remains in the iar even after
» several years.

Dear Marco,
Combinations of the various techniques is often used to enhance the total number of donor grafts.

In my experience, most patients prefer one pass, larger session taking care of most (if not all) areas of concern. That requires large number of donor grafts.

In the case just completed, for example, the patient is from Argentina, and went for 11,400+ grafts in a single visit. Being a Norwood 6, he had large area to cover.
Utilising robust hair from the scalp, chest, beard and to a small extent armpits, this could be accomplished in 1 go. Without using strip.

Regards,
Dr. A


#12

»
» Dr. A, you should add one more:
»
» “FHUT (strip) + FUE in strip scar if necessary”
»
» let me know if you want me to explain this one altho I think this is
» pretty self explanatory.

Dear Readyfreddy,
Yes, that too is an option and, as you wrote, self explanatory.

Regards,
Dr. A


#13

» 1. Strip FUHT
» 2. FUSE/fue
» 3. FUHT + robust BHT
» 4. FUHT + beard hair to scalp + bht
» 5. FUSE + bht + beard hair to scalp transplant
» 6. FUHT + FUSE (with or without bht and beard hair to scalp)
» 7. BHT + beard hair to scalp transplant.
»
» We shall discuss which methods suit which conditions best with case
» illustrations.

Why can’t we have just BHT to scalp without adding beard hair, just plain old BHT and nothing else.


#14

» My preference is to choose the most robust hair for such cases rather then
» to transplant immensely large number of non robust hair.

I think you have the right approach, Dr Umar tends to use large number of grafts for his patients, maybe 1/4 more than what is necessary in my opinion.


#15

Patient details - An Argentina based Caucasian
Norwood 6
Underwent 2 previous strip surgeries at some other clinic in 2002.
Went through a repair procedure involving grafts from scalp, body and beard.

Graft details
Scalp - 2000
Beard - 6873 (including 207 moustache grafts)
Chest (+abdomen) - 2285
Armpit: 302

Total - 11,460 FUSE grafts (in 1 procedure performed over 8 days)


#16

Where are the results for this? only post op pics?


#17

» Where are the results for this? only post op pics?

Will be posting follow up pix as we recieve them. The patient has agreed to send regular updates.