Home | News | Find a Doctor | Ask a Question | Free

Question for the surgeons


#1

Is it possible / sensible / plausible to perform a strip and FUE in the same session or on consecutive days of a session?

thanks.


#2

» Is it possible / sensible / plausible to perform a strip and FUE in the
» same session or on consecutive days of a session?
»
» thanks.

Marco, as you know I am not a surgeon, but I thought that my answer might help you. Dr. Cole has done strip and FIT in the same session. For example, one patient in particular had very think, coarse donor hair. So, Dr. Cole harvested the strip and then used FIT to harvest some finer hairs from the nape of the neck to use for the hair line details. In other cases after the strip is harvested and transplanted, Dr. Cole might say that he wants 13 more grafts to touch up an area; those were then taken via FIT. The combination of strip and FIT is common for patients that are good candidates.


#3

» » Is it possible / sensible / plausible to perform a strip and FUE in the
» » same session or on consecutive days of a session?
» »
» » thanks.
»
» Marco, as you know I am not a surgeon, but I thought that my answer might
» help you. Dr. Cole has done strip and FIT in the same session. For
» example, one patient in particular had very think, coarse donor hair. So,
» Dr. Cole harvested the strip and then used FIT to harvest some finer hairs
» from the nape of the neck to use for the hair line details. In other
» cases after the strip is harvested and transplanted, Dr. Cole might say
» that he wants 13 more grafts to touch up an area; those were then taken
» via FIT. The combination of strip and FIT is common for patients that are
» good candidates.

Thanks Jessica, I am really thinking a bout a full strip (say 2500) and a full FUE (say 2000).


#4

» » » Is it possible / sensible / plausible to perform a strip and FUE in
» the
» » » same session or on consecutive days of a session?
» » »
» » » thanks.
» »
» » Marco, as you know I am not a surgeon, but I thought that my answer
» might
» » help you. Dr. Cole has done strip and FIT in the same session. For
» » example, one patient in particular had very think, coarse donor hair.
» So,
» » Dr. Cole harvested the strip and then used FIT to harvest some finer
» hairs
» » from the nape of the neck to use for the hair line details. In other
» » cases after the strip is harvested and transplanted, Dr. Cole might say
» » that he wants 13 more grafts to touch up an area; those were then taken
» » via FIT. The combination of strip and FIT is common for patients that
» are
» » good candidates.
»
»
» Thanks Jessica, I am really thinking a bout a full strip (say 2500) and a
» full FUE (say 2000).

Generally, this approach is not a problem. Based on your pictures, I would say that it would be a valid and reasonable direction to head in. Would you like Dr. Cole’s opinion on your pictures? Perhaps he could tell you more specifically if this would be a good idea for you and why.


#5

» Thanks Jessica, I am really thinking a bout a full strip (say 2500) and a
» full FUE (say 2000).

Dear Marco,
Combination HTs involving strip + FUSE/fue or strip + bht have been performed before. One thing you need to factor into your plan is that since you have got a strip, there will be a suture line, that, since you would have shaved for fue, will be visible for quite sometime.

On another note, I thought you mentioned that you had a dense donor area. If so, then why do you say a full strip (only 2500 grafts) and a full fue (only 2000 grafts)?
A full length strip, for example, not going beyond the safe zone, results in an average of 3500 to 4000 grafts. That is for average density and laxity.
Regards,
Dr. A


#6

» » Thanks Jessica, I am really thinking a bout a full strip (say 2500) and
» a
» » full FUE (say 2000).
»
» Dear Marco,
» Combination HTs involving strip + FUSE/fue or strip + bht have been
» performed before. One thing you need to factor into your plan is that
» since you have got a strip, there will be a suture line, that, since you
» would have shaved for fue, will be visible for quite sometime.
»
» On another note, I thought you mentioned that you had a dense donor area.
» If so, then why do you say a full strip (only 2500 grafts) and a full fue
» (only 2000 grafts)?
» A full length strip, for example, not going beyond the safe zone, results
» in an average of 3500 to 4000 grafts. That is for average density and
» laxity.
» Regards,
» Dr. A

Thanks Dr. A, point taken about strip exposure. Regarding the numbers; I was just being conservative as the question wasa general one not just pertaining to myself.


#7

This is Dr. JHarris’s words concerning your question Marco.

Tom,

"Yes, we’ve done it several times. You can maximize the number of grafts in a
single session (done over two days). It’s useful for people from out of town
wanting to minimize trips.

I do think that you can extract just as many grafts as you can remove by strip but I do have a suspicion that you may be able to get more grafts by using a combination of strip and FUE. I think the strip method leaves high density areas above and below the scar that are amenable to FUE. I have many patients who have had 7000-8000 strip grafts and based on their residual donor density I could easily extract several thousand additional grafts if they needed them. The combination of strip and FUE works well in a single setting, the only problem is that if you extract from the potential strip area for the subsequent surgery, your available grafts will decrease. You have to account for this in your surgical plan."

Dr. James Harris


#8

» This is Dr. JHarris’s words concerning your question Marco.
»
» Tom,
»
» “Yes, we’ve done it several times. You can maximize the number of grafts
» in a
» single session (done over two days). It’s useful for people from out of
» town
» wanting to minimize trips.
»
»
» I do think that you can extract just as many grafts as you can remove by
» strip but I do have a suspicion that you may be able to get more grafts by
» using a combination of strip and FUE. I think the strip method leaves high
» density areas above and below the scar that are amenable to FUE. I have
» many patients who have had 7000-8000 strip grafts and based on their
» residual donor density I could easily extract several thousand additional
» grafts if they needed them. The combination of strip and FUE works well in
» a single setting, the only problem is that if you extract from the
» potential strip area for the subsequent surgery, your available grafts
» will decrease. You have to account for this in your surgical plan.”
»
» Dr. James Harris

There really is a maximum number that can be taken from the scalp in a lifetime no matter if it’s taken by strip or FUE.


#9

Does your surgical plan signal a loss of faith/hope in HM ?


#10

» Does your surgical plan signal a loss of faith/hope in HM ?

I never really had much faith in HM in the short term. The reason is that the molecules that I am aware of that are being used have been around for a while (proteoglycans fibroblasts burst factors (PGF EGF and some ILs etc) neuropeptides etc etc). They do not generally lead me to believe that they will do much to stem cells that look exciting since injection of these stem cells under the influence of differentiating factors will still recruit the local dermis for follicle generation but not the local follicles and that does not bode well to me. I think the results will be badly angled weak hairs. Growth of complete follicles of a sort in vitro would be the most exciting to me. I may be wrong and I maybe a bit out of touch but I am not banking on it.

Maybe the straight answer is that nothing that looks good has ever been reported. As for Acell, I don’t think there is anything in it. Extracellular matrix just doesn’t mean much that has not been done in the lab for years. Healing yes, regeneration maybe but not denovo differentiation. The pics on their site show wound contraction but nor diferentiation. One qualifier, I was an authority on these areas but that was 10 years ago. Now I am into whole genome sequencing so what do I know!!!


#11

denovo…I haven’t heard that term used since molecular biology and immunology in college. I used to like that term.