Hi,

Does anyone know if you are getting both hair transplants and FFS (involving, among other procedures, brow work) whether it is necessary to do the hair transplants before or after FFS.  And if it is not a requirement to do them in any particular order, can anyone offer which order would be better, and explain to me why?

Thanks, everyone!!!

I think it's better to do it after FFS because you can then cover the scars of your scalp advancement with the hair transplant! I'm not an expert but I read this before.

In most cases it's ideal to do the FFS first , and if hairline advance is needed, doing it surgically so you are then able to take proper treatment of healing incision and scar. Also Its possible to surgically close the corners, usually not fully. In ideal scenario you don't need any hair transplants, or only to fill and shape the corners, and like Melanie said just to use very little transplant just to cover any parts of scar that remained visable, or to advance it little more if needed. You wouldn't spend much on such hair transplant. It can be very expensive if you want to create naturally full looking hairline advance in front. That's a lot of grafts and a lot of time and a lot of money. Doing FFS after such transplant could mean you lose part transplanted area due to incision for forehead, and cut away part for brow-lift, or so me transplanted hairs could fall out due to "trauma" if some hairs hasn't settled fully yet. But depends on personal case and what hairline you are starting with.

You can do FFS before hair transplant. When the face is done, it would maybe be easier to do the hair transplant since everybody has difference head shape and features. Some faces suit some hairlines better than others. I have no exactly ideas about this topic, but this is my theory.

Yea, I will need a lot of hair transplants, and perhaps it will become unaffordable.  But it makes sense what, you say, doing the FFS first.  Thanks for the input, everyone!

If you do a far head advancement after hair graphs then a lot of graphed hair will be lost. 

Quote from: Kara211 on February 09, 2016, 11:54:30 PM
Does anyone know if you are getting both hair transplants and FFS (involving, among other procedures, brow work) whether it is necessary to do the hair transplants before or after FFS.  And if it is not a requirement to do them in any particular order, can anyone offer which order would be better, and explain to me why?

Generally speaking, what others have said about doing transplants afterwards is the same as what I've heard.

Despite that being generally the case, I'd highly recommend you discuss with each surgeon you interview the particulars of your case, what surgical and transplant procedures you're considering, and all that, and get their input. The reason I say this is because there are various levels of hair loss and different techniques for approaching a hairline advancement both surgically and, perhaps, with transplants.

Dr. Ousterhout's book, "Facial Feminization Surgery: A Guide for the Transgendered Woman" offers very good treatment of the procedures surrounding a hairline advancement, related scarring which can occur, and transplants. Even if not entirely applicable to the exact approaches of other present-day surgeons, I found the information relevant in my general consideration of things. http://www.barnesandnoble.com/w/facial-feminization-surgery-douglas-k-ousterhout-md/1112966615

I'm not sure if you know, but FACIAL TEAM (http://facialteam.eu/) has a technique where they approach forehead work with a coronal incision (far behind the hairline, like ear to ear), and use the removed hair for transplants applied immediately after surgery, same day (see http://facialteam.eu/forehead-reconstruction-with-immediate-hairline-redesign/). You would have to check with them, but I believe some patients are a good candidate for that approach, while others may not be. The advantage if someone is a candidate is that there is no hairline scar. I've not heard of any US surgeons using this technique... I think they wrote a paper on it... perhaps even pioneering it, not sure, but I was impressed. Once again, though, you'd have to check with them if you're a good candidate. It also costs more. Others on this forum have posted before/after photos after having taken this approach with FACIAL TEAM... you might look.

Notable, I'd not known about the FACIAL TEAM technique until after a Virtual FFS assessment (http://www.virtualffs.co.uk/). If you haven't already, you might check out their site and get an assessment. As well, the following page discusses the FACIAL TEAM approach: http://www.virtualffs.co.uk/Hair_and_Hairline.html

Best of luck!

Facial team indeed promotes their coronal incision and try to make it seem like its something special, or even innovative. Truth is EVERY surgeon can make coronal or hairline incision or two combinations of both. Surgeon and well informed patient usually make the decision on which incision to choose together, based on what is desired result. Most surgeons use hairline incision approach because its more appropriate choice for most of patients. And usually most cost effective, with either patients not needing any hair transplants, or needing just a little to cover the scar, or fill out the corners. Facial team is trying to sell their hair transplant option, and there's nothing wrong with that. Smart businesses! In all honesty, coronal skin strip for donor transplant often isn't ideal due to hair density on top of scalp, and coronal incisions only work really good for patients with thick dense hair, otherwise those scars can end up being more noticeable  than healed hairline scar.

I'm pre-everything, but I've got transplants booked for next month. Most of my MPB is on the crown. So I'm keen to get that done and growing. If I want changes to my hairline later, I'll address that either as part of a larger FFS job, or just a second round of transplants.

Quote from: meganjames2 on February 11, 2016, 11:13:15 AM
I'm pre-everything, but I've got transplants booked for next month. Most of my MPB is on the crown...

Have you tried minoxidil and DHT blocker such as finasteride or dutasteride? I don't have my own experience but many people report of good regrowth exactly on crown area

I've been on both Min and Fin for over a year, they seem to have stopped the rot, but I've seen little regrowth. I think transplants are my only practical option to get a passable coverage.

So, tomorrow I fly out to Istanbul to have an FUE transplant by Cosmedica. I'm pretty nervous, I'm most of the way though my facial laser hair removal, but this feels like a a big step up. I'll follow up with how it goes for those who might be considering similar.

I wanted to give more time before jumping to forehead/bossing reduction / chin reduction surgery so I discussed options with all of the surgeons and arrived at an okay feeling about getting hairline transplants at this time. So I got hairline transplants... I'm about 2 months post, likely need a year to see the full results but so far so good. Even though it's early, the relative darkness created by the transplants creates a better appearing hairline... there's a subtle but important difference between bangs draping over bare receding hairline versus draping over non-receded transplanted hairline. In a year I'll revisit considerations with any next steps with forehead/chin.