GNX1

Nowhere in Dr Charles statement does he say that FUE is bad for large procedures. You are getting paranoid.

if he stated "FUE is great, especially for larger procedures" people would assume FUE is reserved for larger procedures. it goes both ways and I would disagree with that as well.

Why have you felt the need to take a pop at Dr Charles?

 

I can think of one obvious small procedure where FUE is great: eyebrow reconstruction.

there are a lot a newbees that get on here all the time and if they were reading this they might think FUE is only reserved for smaller cases and may sway them away from FUE if they were needing several thousand grafts.

personally, I think Dr. Charles does great work but he doesnt perform large FUE procedures often. if he does I havent seen any evidence here or on his website.

when doctors make statements like "especially when performing smaller procedures" it gives others the impression that FUE is reserved for smaller procedures and not large procedures. I disagree and the evidence is there to support my opinion.

people take what doctors say as gospel and assume it is the absolute truth. maybe he didnt mean it that way but others could surely take it that way if they didnt know better.

if it was an eyebrow reconstruction thread I would agree but its not. its FUE performed on the scalp.

Very clean. Nice job. FUE is a great procedure especially for smaller cases.

in fact. as im sure ur aware there are doctors who only perform FUE who routinely perform 3000, 4000, 5000, 6000+ FUE cases and show no signs of visible scaring and some who perform both FUE and FUT.

Umar, Bhatti, Lorenzo, Feriduni, A, Reyes, Bisanga, etc....

If you are indeed experiencing MPB, then I'm afraid your only option is to get on finasteride. These pills rarely cause side effects, and the ones who claim to get sides tend to be extremely vocal in their opinion. I have a 10 year long study that demonstrates this.

impressive and creative hairline. nice work.

wow! wat more can I say? looks like two different ppl. good for him.

good decision imo. Dr. Bhatti consistantly does great work.

The problem with this debate about how many grafts are destroyed via strip excision vs. FUE extraction is based on too many variables and assumptions. Mickey85 and GNX1 are saying that strip excision automatically, by default, means that "several hundred" grafts are destroyed whereas with FUE this is not an issue. Let's examine this a bit closer.

 

1. It is assumed by the previous posts that when the scalpel is being directed through the donor zone there is a blatant disregard for the position of the follicular units in the path of said scalpel. Well, this depends on who's holding the scalpel, and in some cases, scalpels with an "s". Yes, some clinics use dual or even triple blade scalpels which will in fact destroy many viable follicular units. This is because the scalpels cannot be individually maneuvered to avoid any follicular unit groupings.

 

With a single blade scalpel the incision can be directed in between follicular units to avoid transection. When tumescence is utilized this becomes a fairly simple affair in that the spaces between the follicular bundles is increased. We've been doing it like this for years and even back in 2002 Dr. Feller was quoted as saying, after watching Dr. Hasson remove a donor strip, that he felt that "not a single hair was transected".

 

Does this negate the fact that many clinics take out donor strips in 20 minutes without concern for peripheral damage to the donor zone? Not even close but better clinics DO take time and effort to remove a donor strip properly. It takes us, both Dr. Hasson and Dr. Wong, at least one full hour to remove a virgin donor strip and many times up to 1.5 hours. Repair cases can take longer. Unfortunately, there are still clinics that use multi-blade scalpels for which there is NO excuse.

 

2. In one post earlier, Mickey85 states (in response to a post by GNX1)

 

 

 

This is incorrect.

 

At one point you state that the percentage refers to "hairs" then you correlate that percentage incorrectly to the number of "grafts". The correct reference is hairs, not grafts so your math is off. It is assumed in this thread that when telogen occurs it occurs to an entire follicular unit. This is not entirely true. Individual hairs in a follicular unit will go into telogen on a different time table than a neighboring hair in the same follicular unit. Therefore, the majority of the time, there is no issue with destroying follicular units due to the whole FU being invisible during telogen. In fact, this would indicate that FUE would have a higher transection rate of these telogen hairs BECAUSE they are in a visible grouping that is assumed to have fewer follicles than it really does. For instance, if a particular sized punch is chosen for a two hair grouping but that grouping is in reality a three hair grouping because of a follicle that is in telogen then it stands to reason that the follicle in telogen may be destroyed. Remember, we have to assume that the smallest punch safely possible is being used so any punch selection cannot take into account any individual hairs that may be invisible.

 

Mickey85,

 

 

 

Out of the before/after videos that Jose has posted there are 12 that have results of over 6000 grafts. Subtract three of those because there are multiple videos showing the same patient at various stages of their development going as far back as 2008 so I believe there are nine results out of the 247 videos he has posted that are over 6000 grafts. This is quite a feat to be sure. Keep in mind these are totals that take a long time to achieve and are not performed over the course of a few days. It's more like a few years.

 

You and I discussed how he was able to get so many grafts out of his patients and I said that it was because of his local (mainly Spanish only) pool of patients. We have found that the Spaniards typically have a higher donor density than patients we've worked on from other regions and countries. When I was having dinner with Jose just two weeks ago he confirmed this. Regardless, it sounds great knowing that there are cases of FUE that have been able to get big numbers however it cannot be disputed that FUT in the right hands will get more grafts over "x" number of procedures than FUE in equally skilled hands over "x" number of procedures. There will be exceptions to the rule of course but in life that is with anything.

the majority of patients are probably caucasion in general but latin patients surely do have more density then most. lucky them....

but the fact still remains that plenty of FUE surgeons can and do perform large sessions and the scaring is almost non existent with FUE. that cannot be said for FUT.

so when you factor in the number of grafts one would need to repair the stretched scar as well as the additional money, travel time, etc.... in the end IF an FUT patient receives more grafts then he might have vs. FUE it may be a wash considering the number of grafts needed to repair the patient. which could be 500 or so grafts. and they may or may not take due to the lack of blood flow to the graft when placed in the scar.

The problem with this debate about how many grafts are destroyed via strip excision vs. FUE extraction is based on too many variables and assumptions. Mickey85 and GNX1 are saying that strip excision automatically, by default, means that "several hundred" grafts are destroyed whereas with FUE this is not an issue. Let's examine this a bit closer.

 

1. It is assumed by the previous posts that when the scalpel is being directed through the donor zone there is a blatant disregard for the position of the follicular units in the path of said scalpel. Well, this depends on who's holding the scalpel, and in some cases, scalpels with an "s". Yes, some clinics use dual or even triple blade scalpels which will in fact destroy many viable follicular units. This is because the scalpels cannot be individually maneuvered to avoid any follicular unit groupings.

 

With a single blade scalpel the incision can be directed in between follicular units to avoid transection. When tumescence is utilized this becomes a fairly simple affair in that the spaces between the follicular bundles is increased. We've been doing it like this for years and even back in 2002 Dr. Feller was quoted as saying, after watching Dr. Hasson remove a donor strip, that he felt that "not a single hair was transected".

 

Does this negate the fact that many clinics take out donor strips in 20 minutes without concern for peripheral damage to the donor zone? Not even close but better clinics DO take time and effort to remove a donor strip properly. It takes us, both Dr. Hasson and Dr. Wong, at least one full hour to remove a virgin donor strip and many times up to 1.5 hours. Repair cases can take longer. Unfortunately, there are still clinics that use multi-blade scalpels for which there is NO excuse.

 

2. In one post earlier, Mickey85 states (in response to a post by GNX1)

 

 

 

This is incorrect.

 

At one point you state that the percentage refers to "hairs" then you correlate that percentage incorrectly to the number of "grafts". The correct reference is hairs, not grafts so your math is off. It is assumed in this thread that when telogen occurs it occurs to an entire follicular unit. This is not entirely true. Individual hairs in a follicular unit will go into telogen on a different time table than a neighboring hair in the same follicular unit. Therefore, the majority of the time, there is no issue with destroying follicular units due to the whole FU being invisible during telogen. In fact, this would indicate that FUE would have a higher transection rate of these telogen hairs BECAUSE they are in a visible grouping that is assumed to have fewer follicles than it really does. For instance, if a particular sized punch is chosen for a two hair grouping but that grouping is in reality a three hair grouping because of a follicle that is in telogen then it stands to reason that the follicle in telogen may be destroyed. Remember, we have to assume that the smallest punch safely possible is being used so any punch selection cannot take into account any individual hairs that may be invisible.

 

Mickey85,

 

 

 

Out of the before/after videos that Jose has posted there are 12 that have results of over 6000 grafts. Subtract three of those because there are multiple videos showing the same patient at various stages of their development going as far back as 2008 so I believe there are nine results out of the 247 videos he has posted that are over 6000 grafts. This is quite a feat to be sure. Keep in mind these are totals that take a long time to achieve and are not performed over the course of a few days. It's more like a few years.

 

You and I discussed how he was able to get so many grafts out of his patients and I said that it was because of his local (mainly Spanish only) pool of patients. We have found that the Spaniards typically have a higher donor density than patients we've worked on from other regions and countries. When I was having dinner with Jose just two weeks ago he confirmed this. Regardless, it sounds great knowing that there are cases of FUE that have been able to get big numbers however it cannot be disputed that FUT in the right hands will get more grafts over "x" number of procedures than FUE in equally skilled hands over "x" number of procedures. There will be exceptions to the rule of course but in life that is with anything.

the majority of patients are probably caucasion in general but latin patients surely do have more density then most. lucky them....

but the fact still remains that plenty of FUE surgeons can and do perform large sessions and the scaring is almost non existent with FUE. that cannot be said for FUT.

so when you factor in the number of grafts one would need to repair the stretched scar as well as the additional money, travel time, etc.... in the end IF an FUT patient receives more grafts then he might have vs. FUE it may be a wash considering the number of grafts needed to repair the patient. which could be 500 or so grafts. and they may or may not take due to the lack of blood flow to the graft when placed in the scar.

never heard of him Bill. I dont pay attention to every single HT doctor that comes along or posts results.

if you say he has done good work ill take ur word on it.

never once have I heard his name brought up in that group of world class HT surgeons when ppl ask who is the best if money was no option. have you?

ppl get all bent out of shape when someone states they havent heard of someone. like its some sort of sin to not have heard of one of the thousands of HT doctors around the world.

Hey your pics look great.*

 

I'm going to have an FUE done by Dr. Bhatti in 2 weeks, probably around 4000 grafts.

 

I was wondering if you could give me any advice/expectations for the first 2 weeks post-operation. I have to return to work 5 days after the procedure, and am hoping my scalp will appear somewhat normal by then.*

 

Alright thanks for anything you can tell me. I definitely appreciate it. Take care.

 

David

I plan on banking my vacation time and taking about a month off when I have the procedure. some look essentially normal at 3-4 weeks. others take far longer but ive yet to see a patient that didnt have obvious signs at the 2 week mark.

 

FUE has an important place in HT surgery, but it is not far superior.

 

FUE has an important place in HT surgery, but it is not far superior.

One concern is the potential damage to grafts.

 

Whereas in FUT, you can basically turn it into an assembly line where doctor extracts the strip, techs slice it up etc.

fatigue plays no role in that which is why FUE is far superior.

One concern is the potential damage to grafts.

 

Whereas in FUT, you can basically turn it into an assembly line where doctor extracts the strip, techs slice it up etc.

fatigue plays no role in that which is why FUE is far superior.

more great work from one of the worlds best. great lookn hairline. very natural.

there is definately plenty of HT doctors that can fix the less than satisfactory results.

where do you live?

soon im told. not sure on a date tho. moves like this rarely go as planned.

You're on this site 12 years and you've never heard of Dr. Gabel??

 

I'm here 3 months and have been very impressed with what I've seen. A poster called Othersyde has some great documentation of his hts. One was live.

Gabel or whoever he is aint one of em.

Both. Leaning towards FUT since high NW case.

Umar, Bhatti, A, all have done 6000+ FUE's with great success. FUT is certainly cheaper but you get what you pay for which is often a stretched disfigured scar.

never heard of him. from his site...."has been recognized internationally as a leader in the field of hair transplantation". lol

nice tight packing of hairline tho. looks good.

top 5 what? FUT or FUE? cause there are quite a few great doctors that perform one or the other but not the other.

he hasnt moved to his new clinic yet

the scar isnt gonna get any better lookn. only worse over time. I would look into FUE to fill it in. I really do wonder what percentage of FUT patients experience poor stretched scaring. ill bet its close to 20% if not more.

the money saved in FUT is only wasted paying for FUE to repair it.

looks a little thin for 5200 grafts. but with so few tripples its to be expected.