Hey guys, I've had this question on my mind for awhile and figured I'd ask you all here. I'm really still in no place financially to afford either but I'd still like to start planning them more so than I have been. My main question is simply does it affect one or the other in regard to which is done first. In my own mind in made more sense to do ffs and then perhaps a hair transplant feeling that it could have an effect on it somehow if things like shifted. I have no idea lol. Really just more curious I guess. I'd really love to hopefully do both eventually but would debate potentially going for hair first over ffs for financial reasons. Also if anyone has recommendations for surgeons for either around New Jersey and surrounding areas lemme know, thanks! 

Cailin,

I am in the same position that your are except i have enough funds for a hair transplant which I will be doing first because AFAIK it takes about a year before the transplanted hair looks presentable.

Emily

Hi Cailin & Emily,

Despite being financially ready for both procedures, I decided that I'd go first with hair transplants, which I'll be doing in August at HairPalace Clinic in Budapest, Hungary (6000 transplants with FUE technique).

That's precisely because what you've said... It apparently takes a while until the transplanted area becomes natural-looking. I think that, at least in my case, it would be too weird to have a unmistakenly feminine facial structure (obtained through FFS) and at the same time clearly visible areas of androgenic alopecia... So I prefer to wait at least a good 6 months after hair restoration, before doing FFS.

I'd consider having a second series of hair transplants sometime after FFS, because I'll be having hairline lowering surgery (among others) and this often leaves a scar which may be covered with hair transplants. It would also serve as a means to increase hair density, if deemed desirable.

Anyways, my FFS (Dr. Bart Van De Ven, in Antwerp) is not yet scheduled, but I have good reasons to think that it will happen around the beginning of 2018 (during Spring, probably). This is something that must still be coordinated with my coming out at my job (boss, HR...) and with the bureaucracies of name change.

This also means that we still are a good 7 to 9 months from FFS and this will give even more time to my "hair super-combo" to work its magic... I've been using it for 5 months and the results are impressive (caveat: HRT also stops and sometimes reverses MPB, so I don't know how much of my response is to ascribe to HRT or to my combo).

So that's my plan concerning this... hope it's been helpful!

Peace & Hugs, Sarah

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Thank you both very much for your opinions on this. I probably will go ahead and plan to do that first before pursuing ffs and then I guess if needed go once again as Sarah stated if needed. My head as a whole lol is defitely still one of my most uncomfortable features even thou both my face and hair could be a lot worse. The main thing I hate is I feel I'm pretty much limited to having my hair pulled back on the sides to prevent my hairline from showing and even then I'm always so self conscience that my receding areas are showing. Hormones have helped some with regrowth but I don't think it will ever be enough for me to be truly confident. I tend to pass (or confused people lol) about at least half of the time as is even hardly wearing overly feminine clothing or makeup regularly. Anyways, that settles it I guess hair first it most likely is. Thank you both again! ^^

Hi Cailin,

I would really think this through some more. If you are planning on getting a scalp advance or any surgical procedure where you will be under general anesthesia for several hours it may be a problem, because of possible telogen effuvium of the hair follicles. If you are, definitely wait until several months afterward before considering a hair transplant.

I had a scalp advance and FFS other procedures done last year, and everything was good until about six months later, when I had big patches of hair fall out. I called my surgeon, Dr. Zukowski, but he blamed it on stopping finasteride, which I didn't agree with.  I consulted a dermatologist and another plastic surgeon, and they concluded it was probably telogen effluvium from surgical shock.  Sure enough, I had new hairs growing in two or three months later, but I sure wouldn't want to pay thousands of dollars for a hair transplant and then go through this, so be careful. 

With kindness,

Terri

I had hair implants in two sessions, the second in November last year...I cannot afford FFS and even if I could I would still have had my implants. They are rock solid and growing really well now...the hairs start off small and wiry but over a period of time they begin to thicken. I think it was Emily who said they take about a year to be "presentable" is right around the mark where mine lost the wiry look.

I am not familiar with he term FUE as a technique but am curious(probably the same as mine)...Sarah can you tell me what that stands for  Thanks

Good luck with whatever you decide

FUE is follicular unit extraction. It involves removing one to four hair follicles at a time from the scalp, as opposed to FUT, follicular unit transplantation, in which a strip of skin is removed and then the follicles taken from that.

~Terri

Thanks

So I had a strips of hair taken and each follicle was removed separately and implanted into my balding head so I guess that would be the second one...so is the FUE one kind of like "plugs" of hair technique?

Oh no, things have come a long way since then.  No more "doll head" look.  Individual hairs can be transplanted. Some clinics now use robotics to get very reproducible grafting with a natural dispersion to the transplanted follicles.  FUE is usually at least double the cost-per-follicle of FUT, though.

~Terri 

Cailin, to best assess this question it would help to know what you will need or are planning for hair transplants and FFS.  If you have only a small correction of hair planned it is a different thing than if you need a large area covered - also in respect to the technique of FFS. Generally, if you have a large area and are planning a forehead surgery that includes lowering the hairline because it is ver far recessed, it makes sense to first do that and later do the transplants to also cover the scars. If you have onl recession at the temples, you could try and get hair transplants in one go with FFS - Facialteam do them simultaneously to the FFS, others do it right in the week after FFS. I would not do the hair transplants before FFS unless you have a very large area to fill , so you can start filling the parts that are far from the face first and after FFS fill in the parts that are near the face.

After reading what you just said anjag I guess I probably will think it over more and most likely take your advice. My only concern really is around my temples so prolly best to go that route which I kind of assumed when I had asked. I'll have to look more into to facial team because I've always seen their name and heard great thing and had no idea having both done at the same time was even an option really. Thank you all again so much! ^^

Well, I think they do good work, but am not trying to promote anyone here. Its just that they are having this neat technique where they harvest the hair from the strip they take during FFS and transplant the hair after the FFS is done. Other surgeons also have the option to use transplants right after FFS but they will do it differently - I think usually the incision is done at the hairline then, which includes a hairline advance and no follicles are in that strip that is removed, the transplants then will be taken from a strip of hair on the head later and transplanted to the area with the scar, convering it... Both techniques have their advantages and disadvantages, I guess. Personally I like to hide the scar back on the head and not in the front, also because I think its less risk for sensation loss, but thats my opinion - others say the risks are low at the other approach as well and the Facialteam technique has the disadvantage of not giving a hairline advance with the surgery, but only with the transplants. So if a bigger advance is needed, they are limited and may also need additional transplants in a second session. They published a paper on that in a scientific journal.