olmert

Explain your logic. I don't follow. FUT takes every graft, but then the space bordering the removed strip gets stretched. And yet this stretching does not result in visible lack of density. Maybe they are making the strip small enough so that the stretching is small. (I've heard a lot of places that the stretching does not reach far. In other words only the inch below and above the strip takes the stretching.) Assume, you take out an inch strip. Assume the inch above and below get stretched, and now what was covered by three inches of skin is covered by two stretched inches. So why can't you used FUE and pluck from the same three inch region? Why won't that yield the same number of grafts as strip? Why does combo FUT/FUE yield more than only FUE?

Under your logic, FUE alone should be able to get as many grafts as an FUE/FUT combo. Every corner that FUT can reach, can be reached also by FUE. So why should the combo get you more than FUE alone? FUT alone cannot max you out because there are corners that FUE can reach that a strip could not reach. The obvious answer is that getting the same graft from FUT (instead of FUE) is better. Maybe even today the survival rate is higher with FUT. The moderator says the combo can get you much more than FUE alone.

But why a 3K or 4K limit? According to SLA, you won't lose lifetime grafts with FUE before FUT. You will first punch out the grafts in FUE. Then you will take a strip with holes. No loss, he says.

But you are saying you would be a fool to do even one FUE graft first and then after take out a strip with a hole punched in it. You say to do the FUT before even one FUE. So why does the webinar say it does not matter which one you do first: a 4,000 graft FUE or an FUT? Why would you want the FUT strip to have even one hole punched in it?

But I don't understand. Why does the video say it does not matter whether you get FUT or FUE first? Why are there old posts on this forum that say you should do the FUT first, that say if you do FUE first, then the strip will simply have fewer grafts on it because they were plucked out from the FUE?

So when they take hair out for FUE, they don't take from the FUT donor region? I remember reading years back not to do FUE before FUT because the FUE would take hairs from the strip region, and then the strip would have fewer hairs.

But the posts above give the impression that 90% of doctors think combo will yield radically more lifetime grafts, like 2,000 more. This website always favored FUT over FUE. I wonder if the doctors favoring FUT somehow ended up here, or if legitimately 90% of the general experienced doctor pool believes the combo yields 2,000 more lifetime grafts.

Can you give a rough, unscientific estimate of how many more grafts it is generally believed you can get from combo? Are we talking 1,000 more grafts total on average? Also at what point do people generally stop getting FUT and move to FUE? Four FUT's and then to FUE? Is that decision made more by how many grafts another FUT can get, for instance once FUT can only get 1300 grafts, people generally go to FUE?

So give me a sense of what you think the approximate numbers are. Do 50% of doctors think you will get more lifetime grafts from an FUT/FUE combo, while 50% think you will get more from FUE alone? Do they also basically think that the lifetime grafts won't vary by more than 5% depending upon which you choose? What percent more are they making claims about?

Do most doctors currently believe you can get more lifetime grafts by first doing FUT until you can't anymore and then FUE? About how many more lifetime grafts on average? I think most patients' goal is maximizing lifetime grafts. (If this is not your goal, you probably don't even need one transplant.) So why are there so many doctors who only do FUE? The data is all the counts, but I am having a hard time envisioning why you would get more lifetime grafts with a FUT/FUE combo than with FUE alone. It used to be that more donors survive with FUT after being implanted, but this is no longer so. So why can you yank out more lifetime donor grafts with the combo?

Shapiro is exaggerating when gauged by medical convention. He says he did not test combo FUT/FUE. He only infers combo would yield more, while hiding in fuzzy language that is never used in medical literature. He is ridiculously vague. His implication is that more residual hair was left with FUT at the donor site. “A side-by-side study was done in which two patients had FUE only harvested from one side (half) of the head, and FUT only from the other side (half). This “side by side” harvesting was done two times one year apart. The number of hair (grafts) obtained per technique on each side (after two sessions) was recorded along with the “residual hair” density on both sides. From this data, the total amount of hair that FUE only, FUT only, and Combination FUT/FUE could potentially obtain. . . . Conclusion: More hair and grafts were obtained using combination FUT followed by FUE than by either technique alone.” Shapiro is de-emphasizing that he is inferring “potential” based upon residual hair at the donor spot. Why does he use the word "were obtained" by Combo if he says he didn't do any combo?

The conclusion that Dr. Shapiro gives makes no sense. He did not give an FUT/FUE combo to any patient. He gave one or the other, and found the result was similar. Where does he get the data to support that the combo is better?

Can MPB disclose the names of the doctors that opined that more grafts survive under FUT than under FUE? I myself would not rely upon logic, but would rely upon a doctor's opinion, even if the opinion is based merely on anecdotal evidence.

Does MPBsucks4545 have any citation or evidence that, when the transection rate is the same, more FUT grafts survive than FUE grafts?

I asked this about ten years ago. Back then there was this herd mentality against FUE and for FUT. FUE has improved since. Anyway, back then a few people who claimed they were the experts of this forum vouched you can get more grafts by (first Maxing out on FUT's and then doing FUE's) versus (doing FUE's only). But when you pressed them for a reason or for why they thought so, they got all defensive and would give ridiculous rationales that were basically in the nature of 1+1=3. Of course, they did not realize that was the logic they were offering. It may be they were correct, but if so, they had no idea why. It may be they were incorrect.

When I first started checking this forum 10 years ago, FUE had high transection rates, meaning you would lose 10% of donors. That was the big sell for FUT. I understand that now most surgeons say the transection rate for FUE and FUT is the same. 1. So what are the current advantages to FUT besides being cheaper? 2. Is it currently believed you can get more total donors by first maxing out on FUT before maxing out on FUE? (They were saying that too 10 years ago.)

Never disregard the disclaimer " IMHO" or "I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk." I am opposed to offering silly rationale that make no sense to someone with medical knowledge or with no studies or evidence supporting it, even when it seems to someone with no medical knowledge to make sense. This is why they do clinical trials.

I gave up on it. I hadn't taken enough of it to get any color yet, and then I saw a picture of someone who was doing it. He didn't look tan. He looked sickly orange. Then I tried an expensive liquid bronzer. It looked so phony that I stopped it quickly. I might try a powder bronzer.

Horrible. It is 3 months later. There was heavy, heavy internal bleeding in the recipient area. One guy believes the hair donation density was made higher than my scalp could handle, and that the doctor should have tested the area better to see if it could handle the density without bleeding because bleeding drowns and suffocates the donor grafts. I don't see much growth, and I see enormous shock loss. I will withhold judgment for another 6 months when the shock loss clears.

I believe in first stripping out, and then doing FUE.

I ended up going to Dr. Madhu for FUT.

How much did he charge before and after recommendation?

Yes on both. A consensus of veterans like me who have looked at a lot of pics and heard a lot of stories is what puts a doctor in the elite class. Now there is no per se requirement that an elite doctor be expensive, but the laws of economics will make it end up that way. It does not matter how cheap a country an elite doctor comes from. He will charge the most he can get away with. And an elite doctor will charge a lot because his elite reputation gets him business anyway. Therefore, there is one elite doctor in Brazil and one in Thailand. They charge as much as a western doctor even though their expenses are cheaper. That being said, the Indian and (one) Pakistani doctors are so much cheaper than the rest of the world, that if you aren't a millionaire, it may be your optimal choice to go to them. They are not so much inferior as to justify paying more for others doctors who are not so much better. There are definitely people in tax brackets that make choosing Indian doctors the best course. At the same time, if you are a billionaire, you should not go to Bhatti. It is common for veterans to bark if you bring up cost as a factor. This is because veterans are hobbyists. You will never find a car aficionado recommending a chevy, instead of a trans am, even though a chevy might be the optimal choice because of price. The hobbyists act as if the cheap doctors charge $20, while the expensive ones charge $500, and therefore even for the poorest person, price should not be a factor. But getting 4 HT's will cost $8K from Madhu, the cheapest decent doc, and cost like $100K from Lorenzo. And really the difference between them is not life and death. And really there are people in lower tax brackets. So really for a lot of people, price should matter.

LazyPirate, there was no need to look and see that your join date is within the past two weeks. Your posts make clear that as far as knowledge of HT goes, you are a newbie. Any veteran like me is aware that there are educated minds on both sides of the FUT/FUE debate. Anyone, such as you, claiming that that the debate is closed and settled is simply uninformed. This does not necessarily mean you made a mistake in getting FUE by Bhatti, though even among the most hard core FUE advocates there is a consensus that only the absolute top FUE doc's get a yield as high as FUT, and that Bhatti is not generally regarded as being in this elite physician class. If you did make the right decision, it happened by luck rather than through a studied analysis.

Bhatti's FUE is so cheap that it takes price out as a factor in the FUE/FUT debate. But the poster's goal is to maximize the total number of grafts. And even Scar, the biggest proponent of FUE says you will get more total grafts by first doing a few FUT's before doing FUE. Personally, I have not heard any reasoning why this would be true. There is the reasonable argument that doing a second FUE is hard because of the previous scarring, but I don't see why you couldn't do a one procedure FUE to take every last graft out of you. Bhatti does 6K FUE's. Or alternatively, if you were to do two FUE's, I don't see why you couldn't tell them to do the left side on the first FUE, and then the right side on the second one. But I am perplexed why even Scar thinks you can get more total grafts by starting out with FUT.