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» the last picture shows a horizontal scar from STRIP
» but it also illustrates the decrease in density that would result from
» strip, by the stretching of the scalp skin
Oh yeh, sorry, you are right. I thought I was in another thread in my reply.
»
I’ve got bigger ears
» I have enclosed a depiction of a highly stylised and theoretical, but
» relevant all the same, pictorial demonstration of the effect of FUE Vs
» strip. A shows a section of scalp with 100Fu (dots). B shows the effect of
» removing some of the dots to achieve a 50% removal such as might be
» performed by FUE. C shows the effect of “stretching the area” to remove
» 50% which approximates more closely to strip. Obviously this is not exact
» but it shows a potential limitation of FUE when talking bigger numbers.
»
Marco, I understand what you are trying to say and agree with your general premise. There is no question that the grouping of follicles is thinned (FU/CM2) when you take a strip. It is much more noticeable in the areas that are closest to the scar and may not be affected much if any farther away.
The problem with diagram B is that FUE proponents will say that no one would take 50% of available hairs from only the area where a “strip” would be taken. It is indeed one of the benefits of FUE vice strip.
My personal feeling is that the best approach for maximizing a hair transplant is a hybrid where strip (one or more) is performed first and then FUE session (one or more) afterwards. With a good strip and body hair (and obviously the right surgeon) transplanted into strip scar, one should be able to wear their hair 1/4 inch or so.
» Marco, I understand what you are trying to say and agree with your general
» premise. There is no question that the grouping of follicles is thinned
» (FU/CM2) when you take a strip. It is much more noticeable in the areas
» that are closest to the scar and may not be affected much if any farther
» away.
»
» The problem with diagram B is that FUE proponents will say that no one
» would take 50% of available hairs from only the area where a “strip” would
» be taken. It is indeed one of the benefits of FUE vice strip.
»
» My personal feeling is that the best approach for maximizing a hair
» transplant is a hybrid where strip (one or more) is performed first and
» then FUE session (one or more) afterwards. With a good strip and body
» hair (and obviously the right surgeon) transplanted into strip scar, one
» should be able to wear their hair 1/4 inch or so.
I agree although I was just trying to justify why it is so difficult to take 50% from FUE. The thought was that the FU donor cannot be evenly distributed compared with strip. Although you say that no one would take 50% in FUE, it is still being said by some surgeons that this is possible!
I am coming to the same conclusion as you regarding the mix of FUE and strip but then schmoe results were just posted and he used FUE and BHT only with results I would be happy with (it did take 3 sessions).
In my mind the jury s still out although I hope the jury in my mind comes to a decision before I am completely bald. I have to remember that the “journey” may be two years or so.
» I agree although I was just trying to justify why it is so difficult to
» take 50% from FUE. The thought was that the FU donor cannot be evenly
» distributed compared with strip. Although you say that no one would take
» 50% in FUE, it is still being said by some surgeons that this is
» possible!
»
» I am coming to the same conclusion as you regarding the mix of FUE and
» strip but then schmoe results were just posted and he used FUE and BHT
» only with results I would be happy with (it did take 3 sessions).
»
» In my mind the jury s still out although I hope the jury in my mind comes
» to a decision before I am completely bald. I have to remember that the
» “journey” may be two years or so.
Marco, I might be confusing you with someone else, but I believe you have very dark hair?? If so, the results on Schmoe (which are good) won’t look as good on someone like yourself because of the contrast between your hair color and skin color. There is still a fair amount of skin showing through Schmoe’s hair, but doesn’t look bad because of hair color. I’m in the same boat as you BTW.
» » Hi Marco, I am lost, I understand picture 1 and 2 but I don’t know why
» » picture 3 is trying to show.
»
» the last picture shows a horizontal scar from STRIP
» but it also illustrates the decrease in density that would result from
» strip, by the stretching of the scalp skin
Ok thanks. But I would assume the density would remain the same after a strip. The “stretching effect” really depends on the laxity of the scalp, and every person is different.
» Marco, I might be confusing you with someone else, but I believe you have
» very dark hair?? If so, the results on Schmoe (which are good) won’t look
» as good on someone like yourself because of the contrast between your hair
» color and skin color. There is still a fair amount of skin showing
» through Schmoe’s hair, but doesn’t look bad because of hair color. I’m in
» the same boat as you BTW.
Yeh, that is me but if you feel that schmoes results are good then you could think of two possibilities for us “darkys”. Use FUE/BHT only and get a thin look that can be enhanced with a bit of dermatch or go for the more numbers that requires a strip scar. My mental jury remains out.
» » » Hi Marco, I am lost, I understand picture 1 and 2 but I don’t know
» why
» » » picture 3 is trying to show.
» »
» » the last picture shows a horizontal scar from STRIP
» » but it also illustrates the decrease in density that would result from
» » strip, by the stretching of the scalp skin
»
» Ok thanks. But I would assume the density would remain the same after a
» strip. The “stretching effect” really depends on the laxity of the scalp,
» and every person is different.
It really is common sense. Short of looking like this little fella where you have excess skin falling all over itself, the laxity just means you have a better chance at not getting a scar that stretches.
For example, lets say you cut out a chunk of skin that measures 1 inch. That gap is closed from somewhere so usually the scalp is stretched from above and below the scar to make up that one inch when they sew the two ends together. That also stretches the distance between the follicular units that are closest to the scar.
» » Ok thanks. But I would assume the density would remain the same after a
» » strip. The “stretching effect” really depends on the laxity of the
» scalp,
» » and every person is different.
»
» It really is common sense. Short of looking like this little fella where
» you have excess skin falling all over itself, the laxity just means you
» have a better chance at not getting a scar that stretches.
»
» For example, lets say you cut out a chunk of skin that measures 1 inch.
» That gap is closed from somewhere so usually the scalp is stretched from
» above and below the scar to make up that one inch when they sew the two
» ends together. That also stretches the distance between the follicular
» units that are closest to the scar.
There is another possibility that deserves some thought even though I have not worked it through fully. I did do some calculations a while back though and it is interesting. This is going to sound weird possibly.
It is possible that when the scalp is lax and a strip is taken out then the head actually becomes smaller in circumference. It may only be by a millimeter or two but strangely this can result in an opportunity to take quite a lot of hair. I will redo the calculations when I sober up (sometime in 2008 I would think)
» » » » Hi Marco, I am lost, I understand picture 1 and 2 but I don’t know
» » why
» » » » picture 3 is trying to show.
» » »
» » » the last picture shows a horizontal scar from STRIP
» » » but it also illustrates the decrease in density that would result from
»
» » » strip, by the stretching of the scalp skin
» »
» » Ok thanks. But I would assume the density would remain the same after a
» » strip. The “stretching effect” really depends on the laxity of the
» scalp,
» » and every person is different.
»
» It really is common sense. Short of looking like this little fella where
» you have excess skin falling all over itself, the laxity just means you
» have a better chance at not getting a scar that stretches.
»
» For example, lets say you cut out a chunk of skin that measures 1 inch.
» That gap is closed from somewhere so usually the scalp is stretched from
» above and below the scar to make up that one inch when they sew the two
» ends together. That also stretches the distance between the follicular
» units that are closest to the scar.
»
Oh dear, the puppy is adorable. I forgot about my hair loss for a moment 
Dear Marco,
Thanks for posting this diagram.
I think another factor that is overlooked and needs to be mentioned.
The natural scalp donor area, in many individuals (not everyone), has a gradually tapering density when going from top towards the nape of the neck.
When a strip is excised and sutured close, there is a higher visible density differential on both sides of the strip scar.
As for the post strip density, that will diminish if significant number of grafts are extracted (in the best case scenario).
Regards,
Dr. A
» » Marco, I might be confusing you with someone else, but I believe you
» have
» » very dark hair?? If so, the results on Schmoe (which are good) won’t
» look
» » as good on someone like yourself because of the contrast between your
» hair
» » color and skin color. There is still a fair amount of skin showing
» » through Schmoe’s hair, but doesn’t look bad because of hair color. I’m
» in
» » the same boat as you BTW.
»
» Yeh, that is me but if you feel that schmoes results are good then you
» could think of two possibilities for us “darkys”. Use FUE/BHT only and get
» a thin look that can be enhanced with a bit of dermatch or go for the more
» numbers that requires a strip scar. My mental jury remains out.
To get the highest numbers i think you have to do a combination of strip and FUE.
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