Severn,
I agree with your assessment. It simply does not make any sense. Because of the lack of feed back that i have gotten from my surgeon and others on this issue, I am only left to assume that the hair transplant industry, as a whole, does not want to admit that hair transplant surgery is a complete and utter failure in a certain percent of the population. If you think about it, how many people would second guess an expensive and painfull hair transplant if they knew that there was a certain percentage of the population that experienced a complete and utter failure of a HT procedure. I have learned, from my own research, that there are countless others like me who are left with absolutely no explanation as to why their HT was a total failure even though there was absolutely no medical explanation for it. Think about it! If I told you i wanted to charge you 30 or 40 thousand dollars for a HT procedure and then told you that it simply does not work on a certain percentage of the population, How many people do you think would decide to roll the dice with that kind of money? In my estimation, not many! Go figure!
Prezident

Prezident,

I actually agree that there is a certain population (though minimal) where hair transplantation simply just doesn't work. I've seen a few cases like these and the reasons are unknown.

However, your case is different. Your hair GREW and then started to fall out. The question is why?

I did respond to you with a few possibilities, but you didn't reply.

Anyway, I do hope you and your doctor can get to the bottom of it.

Best wishes,

Bill

__________________
Managing Publisher of the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog and the Hair Loss Forum and Social Community

Follow us on Facebook | Twitter | YouTube

Subscribe to our Newsletters | How We Recommend Physicians

-----

To learn about how I restored my hair, view my my hair loss website.

Remember, true beauty radiates from within, not from the skin.

I am not a medical professional and my words should not be taken as medical advice. All opinions and views shared are my own.

Bill,
I did reply by thanking you and Thana for your very helpful and collective insights. I have forwarded my pics to Dr. Feller and hope to consult with him soon. Dr. Feller did not perform my 3500 FUE procedure. My procedure was performed by another surgeon whose clinic has advised me that they do not know why my transplanted hair is falling out. Hopefully Dr. Feller will find the answer to this mystery. I do find it interesting that the doubles have held better than the singles. This may simply be coincidence or it may be that the doubles are holding better because they contain more DHT resistent DNA! I obviously have not performed an exhaustive count to confirm this.
Prezident

Sorry to here about your results. One thing I will say as I said before. "NOT ALL FUE IS THE SAME" There are some doctors that have been performing this technique for a long time that will have different opinions on how they go about extractions. And results will vary between clinics. In my opinion Fue should not be rushed. Here is a post from an employee on how his doc goes about it.

"" Dr. Bisanga has adapted and improved his FUE punch technique over the years, one obvious example is the size of punch he uses has dropped in diameter to minimise traumatic impact on the scalp and surrounding follicular units. Another aspect is the technical ability and objective technique, the ability to feel the follicular unit and surrounding tissue when entering the scalp and gauging the depth and angles of each FU.

During my FUE sessions I was always aware of the changing positions Dr. Bisanga used to make, moving himself and adapting to changes in the angles and directions of the FU. Now watching FUE punching from the other side I have seen more.

FUE has and will always be technically a very difficult technique, the fact that each FU has to be removed individually and the average op is 1000 grafts plus obviously multiplies the room for error as each extraction can be different in some cases. Dependent on the area of the scalp,the angle the FU exits the scalp changes, dependent on the area it can be easier to extract the FU as the lay of the FU can be more consistent and also the position of the head when resting on the operating chair allows for easier extraction.

For example the back of the head, around the occipital area is much easier to punch. It is important the doc can understand his position needs to change otherwise there will be a greater scarring impact and potentially increased transection. The constant need to change position is not something that can be avoided regardless of tool size or the type of tool, this is about the technique itself.

Pressure control is also important to achieving minimum transaction and the least potential trauma to the surrounding FU. A largely forgotten aspect to FUE is the effects on the surrounding FU that are left in the donor. A FUE donor maybe be spread over the entire donor safe zone and if used well can leave minimal to almost no signs hair has been removed, but incorrect punch and extraction can greatly reduce the potential for future FUE and the graft numbers and even hinder Strip extraction.

The greater the friction created when the punch enters the skin the harder to balance the direction of the hair with any potential changes as there becomes less sensitivity between the fingers and the tip of the punch. The tension can be micro but Dr. Bisanga has found through changing his technique that even manually the tension can be reduced and this improves graft survival and collateral damage. The finger to punch pressure helps gauge the skin characteristics and even possible to feel the FU with practice. With this technique of punching Dr. Bisanga has minimised transaction to as little as 1-2% in most cases and even on demanding cases rarely increases to above 5%; this is only made possible by the touch sense gained through minimal transference of distance and resistance between his fingers and the punch.

The next aspect that is over looked much of the time is miniaturisation existing in the donor and the potential to create miniaturisation. Dr. Bisanga feels that anything near 20% miniaturisation in the donor can rule you out from surgery, certainly having FUE. Miniaturisation does not affect the density of the donor hair as such because that is just the calculation of FU per cm2 but it will affect the number of FU that can be removed. We have seen miniaturisation spread all over the donor and also just in isolated areas, either way it will reduce the numbers that can be extracted. By definition the miniaturised hair cannot be used so they must remain in the donor, this creates the problem of how close to the miniaturised FU can the extraction take place. Too close and the thickness of coverage will drop and could potentially traumatise the miniaturised hair and cause it to fall out.

So, the extraction pattern has to become wider thus less FU per cm2 are removed to retain the integrity of the donor, especially for the future. Miniaturisation can also be caused with the extraction, going back to the tension or resistance in the punch movement, this can create a ripple effect, like a 'skin quake', the punch hole being the epicentre and the vibrations moving out from the central point. As above Dr. Bisanga has minimised aspects of this by his punch motion technique, he has certainly found less resistance was caused creating obviously less contortion of the wound and the surrounding Follicular Units. This is very important, we have seen miniaturisation created post FUE surgery that has possibly rendered the areas non- harvestable due sometimes to over harvesting but also peripheral damage creating miniaturisation.

Dr. Bisanga's feeling on these problems is to lessen the motion when making the punch action, the least friction or motion allows for greater sensitivity and feel between punch and fingers and this in turn has reduced transection, decreased peripheral damage either to the skin or surrounding FU with changing directions as well as miniaturisation. With the many documented FUE cases he has to his name as well as the many more he has performed and internally documented he feels confident to say that in respect of physical technique he has reduced these negative factors a great deal but then research is obviously ongoing."
Posts: 199 | Location: New York | Registered: October 17, 2002