Trying To Understand The Benefits of an FUE Hair Transplant

I really would like to have a hair transplant, but I’d prefer not to have long scar on the back of my head. My concern is if the back of my hair thins over time that the scar will become visible.

Does it make more sense to have FUE as opposed to a strip hair transplant, just in case I do thin out more in the back and the sides? I figure that if this does happen, I can always just shave my head to a #2 and go on with my life without the fear of having a visible scar. Is this a logical approach, or have I misunderstood the benefits of FUE?
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Thank you for taking the time to write. You question is astute in that you are trying to take into account future hair loss – something not every patient thinks about. Let me try to answer you as best I can without examining you.

If you have thin hair at the back of your head, FUE may be your best option. You definitely need to check with a hair surgeon though to make sure you don’t have a diffuse unpatterned alopecia (in which case surgery would be ill-advised). FUE is a viable option for you providing you have been tested and found to be a good candidate. The testing consists of actually trying to extract a few grafts and making sure they can be removed intact. In my experience, about half of the patients who are interested in this technique are candidates for it. Recall that the actual scarred AREA (cm2) in FUE is likely greater than in the traditional strip method – it is just in little dots all over the back of your head instead of a line!

That being said, it is unlikely with EITHER method that the hair in your donor area will thin visibly OR that you would have to worry about the scar being visible if you shave your head down to a #2. The average donor area does not thin that much over time which is what makes hair restoration possible in the first place. Also, most scars performed by careful surgeons using trichophytic and a double closure (sutures both above and below the skin to reduce tension) will become visible between #2 and #3 on the average barbershop clippers. FUE is more expensive (due to the time and effort involved) and yields fewer grafts than the strip method, but since it is not as commonly performed, we have less data on its benefits than we do for the more traditional methods.

In the final analysis, the decision is up to you. You present a logical approach to try to head off potential problems, but the problems you are trying to avoid are less likely than you think. My suggestion would be to consult an experienced surgeon to make certain you do not have abnormal donor area thinning, that you are a candidate for FUE, and to make your decision from there once you have all the data! Viewing the scars of some live patients can also help.

I hope that helps!

Warm Regards,
Dr. Sara Wasserbauer