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Which one should I get follicular unit extraction (FUE) or Strip? My surgeon is an expert in strip but has also been doing FUE. I am 19. Which one should I get: FUE or Strip? I have heard that strip has better results and damages donor area less than the FUE does. Advice needed. Thanks for your time! You guys have been of great help throughout. Thank you for your question! Your question is about FUE versus a strip method for hair transplant and you showed some really good photos of the level of your hair loss and you’re 19 years old. First just to answer the question about strip versus FUE, just for the sake of clarification, I think there is no single transplant surgeon who would not concede that the number of hairs and viable hairs are considerably greater, have a greater yield in the strip method versus the FUEs.
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FUEs are almost a cyclical return to the way that hair transplant was done in the 90s with punch grafts but now they’re just smaller punches. That being said, I just want to discuss with you a little bit about what we do in our practice in someone whose 19 years old comes to us with a degree of hair loss that you have. I do not want in any way, disrespect your transplant surgeon but I think that given what we can inform you about, I think you’ll find there is some value in learning about this.
So what I’m talking about is, someone like yourself who is lost so much hair by the age of 19, you have to wonder exactly where you will be a year from now, 2 years from now, 3 years from now. So I’m talking about age of onset which is early and the rate of progression which appears to be fast. Your hair transplant area is limited and therefore your donor area cannot meet the amount of hair needed to cover the scalp the amount of hair that has been last. We have to explore what are the options to slow down or stop the progression. Currently in the United States, finasteride and minoxidil are the two drugs used for male pattern hair loss. When you look at finasteride, finasteride is a drug that is taken orally, that essentially affects DHT or dihydrotestosterone sensitive hair follicles. Long story short, if your hairs are DHT sensitive, you will respond to finasteride.
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However, at the current time, so many people are concerned about the medical studies that showed a long term side effect or dysfunction from taking finasteride that in our practice, most men who come in are not interested in taking finasteride. Which means there is almost no medical intervention available. Topical minoxidil is not going to stop the progression of hair loss. it can prolong the appearance of thinning hair on the scalp so it looks like there is more hair but it will not reverse hair thinning. In our practice, someone like yourself, I would offer you the opportunity to do something called Hair Regeneration. Hair Regeneration is a method that we developed in our practice using a combination of extracellular matrix, platelet-rich plasma to stop and reverse hair thinning wherever there is existing hair. Now this is a very different from what is currently the standard of care for hair loss treatment. For most male pattern hair loss patients, who are doing research, they learn about hair transplant and then they look for the best possible transplant. But understand that no matter how old you are when you have a hair transplant, it is a limited solution and it is a temporary solution by virtue of the reality that you will progressively lose hair. Many people don’t even consider transplant because they don’t want a pluggy look.
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A pluggy look is a look we are all familiar with when someone looks like they have doll’s head hair where it looks like this plugs were placed in a way that’s very obvious.
The reality is a majority of these patients who have had these actually used to have more hair.
The problem was that the hair thinned and it caused the hair plugs to become obvious. So with that being said, in our practice, we do a microscopic evaluation of the scalp and we identify for our patients the potential hair that can thicken from Hair Regeneration. We have taken patients who are very advanced in their hair loss and we have been absolutely impressed by the amount of hair volume they have been able to achieve in spite of how far along they were. So basically, we believe strongly that as long as there is potential, there is opportunity to get improvement with Hair Regeneration. And we have reached a point where we would clearly be able to show the benefit of Hair Regeneration as outweighing the benefits of hair transplant in terms of volume of hair. Because if you think about it, Mother Nature already created hair in its natural orientation and because of the density that’s there, the potential for growth and the volume that’s created can never be duplicated by a surgeon. And so, with a every patient, even if they want to do a transplant and through their examination, we can determine whether or not how much they would probably benefit from Hair Regeneration.
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Even if they are a candidate for transplant, our strategy is to do first Hair Regeneration, allow 18 months to transpire and then see where they are at. And this treatment is a one-time treatment. And with 3-5 years of data, we can definitely stand behind the benefit lasting for at least 3 years and up to 5 years. And the reason why I say that is within the 2 years of this development, there weren’t that many patients so we can’t say definitely 5 years but we rarely seen anyone needing additional treatment, additional injection. So with that understanding, you can now consider an alternative to transplant or consider a strategy because wit Hair Regeneration, what are we doing? We are now reversing the thinning hair and creating more scalp coverage but we are stopping the progression. That means, that even when you choose a transplant, you can be more strategic and efficient and effective with the grafts because remember, you only have a limited donor area. The donor area is limited by the band of hair that you would see in the baldest man you’ll ever see because that is truly the genetic resistant area.
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Another disadvantage of FUEs is that by design, you have to go outside the genetically resistant hairs area and that’s FUEs are basically, as far as I’m concerned, is a ticking time bomb where people are not getting the density that they want, lose a lot of hair from transection of cutting of the grafts and not getting the yield that they were hopeful for and this has already been proven by the International Society for Hair Restoration survey of patients and doctors or members who cave conceded that 65% of patients want more density. So that being said, Hair Regeneration can be that strategy or strategic use of that method to stop the progression, restore volume and then consider hair transplantation. But I am very hesitant in my practice to transplant someone this young. I would rather Hair Regeneration, wait it out, watch and see if there’s any progression and then consider a transplant if appropriate understanding what the limitations are. So I know I’ve given you some new information so I hope that would guide you in your journey of treating your hair loss. So I hope that was helpful, I wish you the best of luck and thank you for your question!