PupDaddy

Please first read my four (4) posts on page 2 of this thread, then please re-read my posts on this page (p. 3) of the thread (I apologize for the inadvertent double post on this page). The short answer is that much of the scalp hair transplanted in large numbers via FUE is at greater risk of thinning, miniaturizing, or dying in the ensuing years than scalp hair transplanted via FUT, and/or is at greater risk of doing so more quickly, because many of those grafts will have been taken from less optimal regions of the safe zone than grafts taken via strip. Why? Because for the same number of grafts, FUE will involve a much larger area of the donor than strip. The thousands of punch excisions must be spread out over a large area in order to avoid over-harvesting of any given area of the donor. That is how it was explained to me. I doubt whether the risk of more or faster DHT-related effects on FUE grafts v. FUT grafts under these circumstances can be quantified, but the risk is there. ALL head hair on males with MPB is susceptible to some effects of DHT over time, including hair in the safe zone. It is just that hair in the safe zone is more resistant to DHT and its worst effects and for a longer period of time than non-safe zone hair. And the best of the best, most robust and DHT-resistant hair in the safe zone is located in a relatively small channel of it, where FUT grafts are taken from. FUE in large numbers doesn't have the luxury of confining itself to that very best section of the donor. Whew!

That is a different topic altogether than the one I am discussing, GNX1. In his initial post to this thread, Mickey85 already listed the ability to take body hair and beard hair as one of the advantages of FUE. No one is disputing that. To the contrary, I think most people see that as a significant advantage of FUE, particularly for extreme repair cases where donor from the scalp has been compromised or depleted. (I also don't think anyone would dispute that body hair or beard hair transplanted to the scalp is not going to look as good cosmetically as scalp hair, but if body hair is all the surgeon has to work with, then FUE is the only way to get those hairs.) What we are now discussing as a disadvantage of FUE is the long-term survival and characteristics of FUE grafts taken from the scalp for large transplants relative to the long-term survival and characteristics of FUT grafts taken from the scalp for large transplants -- the disadvantage of FUE in this context stemming from the necessity to take many of such grafts from above and below the "sweetest" zone within the safe zone where the best quality, most DHT-resistant follicular units within the safe zone are found.

That is a different topic altogether than the one I am discussing, GNX1. In his initial post to this thread, Mickey85 already listed the ability to take body hair and beard hair as one of the advantages of FUE. No one is disputing that. To the contrary, I think most people see that as a significant advantage of FUE, particularly for extreme repair cases where donor from the scalp has been compromised or depleted. (I also don't think anyone would dispute that body hair or beard hair transplanted to the scalp is not going to look as good cosmetically as scalp hair, but if body hair is all the surgeon has to work with, then FUE is the only way to get those hairs.) What we are now discussing as a disadvantage of FUE is the long-term survival and characteristics of FUE grafts taken from the scalp for large transplants relative to the long-term survival and characteristics of FUT grafts taken from the scalp for large transplants -- the disadvantage of FUE in this context stemming from the necessity to take many of such grafts from above and below the "sweetest" zone within the safe zone where the best quality, most DHT-resistant follicular units within the safe zone are found.

No, no, no, Mickey. I'm not talking about FUE docs taking grafts outside the safe zone. I'm talking about FUE docs, when doing large transplants, necessarily taking many of the grafts from outside the BEST PART of the safe zone. The grafts still come from what is technically within the safe zone, but many don't come from that "sweet spot" of the safe zone -- the very best part of the safe zone, which is where the strip is taken from for FUT. That "sweet spot" within the safe zone is where the best, most robust, most DHT-resistant follicular units reside and comprises a rectangular "strip" about 1.5 inches or so high that runs smack across the part of the safe zone having the greatest density and thickest caliber hairs, which are the also the last hairs to be compromised by the effects of DHT over a lifetime. Above and below that sweet spot are areas still technically within the safe zone, but as it was explained to me, follicular units residing in those areas are less safe from being at least partially compromised by DHT over the long haul than those that come from the optimum part/best part/sweet spot of the safe zone. In other words, "safe" is a relative term when discussing the safe zone, and not all follicular units within the safe zone are equally safe. Think of the cartoon image of the bald guy with only a solid strip of hair remaining, running across the back of his head. That "strip" (I'm using that term differently than how we think of strip) is the sweet spot of the safe zone. That is where all follicular units are taken from for FUT, but you can't do take all the grafts from that "strip" for large FUE transplants because that would result in an obviously depleted "strip" of donor area that looked moth-eaten if not nearly devoid of hair with lots of very close together punctate scarring. In other words, over-harvesting of a confined area. That is why with every large session FUE transplant we see post-op excisions all over the back and sides, stopping north just shy of the crown and stopping south just shy of the nape. Even though all those grafts came from within the "safe zone," many came from above and below the sweetest part of the safe zone. Anyway, as it was explained to me by a Coalition doc, that is one of the "cons" of FUE. The grafts taken from above and below the sweetest part of the safe zone may never thin or die, but there is a greater chance they will than those taken from that sweetest spot -- which is where all FUT grafts are taken from. I hope all that made sense.

No, no, no, Mickey. I'm not talking about FUE docs taking grafts outside the safe zone. I'm talking about FUE docs, when doing large transplants, necessarily taking many of the grafts from outside the BEST PART of the safe zone. The grafts still come from what is technically within the safe zone, but many don't come from that "sweet spot" of the safe zone -- the very best part of the safe zone, which is where the strip is taken from for FUT. That "sweet spot" within the safe zone is where the best, most robust, most DHT-resistant follicular units reside and comprises a rectangular "strip" about 1.5 inches or so high that runs smack across the part of the safe zone having the greatest density and thickest caliber hairs, which are the also the last hairs to be compromised by the effects of DHT over a lifetime. Above and below that sweet spot are areas still technically within the safe zone, but as it was explained to me, follicular units residing in those areas are less safe from being at least partially compromised by DHT over the long haul than those that come from the optimum part/best part/sweet spot of the safe zone. In other words, "safe" is a relative term when discussing the safe zone, and not all follicular units within the safe zone are equally safe. Think of the cartoon image of the bald guy with only a solid strip of hair remaining, running across the back of his head. That "strip" (I'm using that term differently than how we think of strip) is the sweet spot of the safe zone. That is where all follicular units are taken from for FUT, but you can't do take all the grafts from that "strip" for large FUE transplants because that would result in an obviously depleted "strip" of donor area that looked moth-eaten if not nearly devoid of hair with lots of very close together punctate scarring. In other words, over-harvesting of a confined area. That is why with every large session FUE transplant we see post-op excisions all over the back and sides, stopping north just shy of the crown and stopping south just shy of the nape. Even though all those grafts came from within the "safe zone," many came from above and below the sweetest part of the safe zone. Anyway, as it was explained to me by a Coalition doc, that is one of the "cons" of FUE. The grafts taken from above and below the sweetest part of the safe zone may never thin or die, but there is a greater chance they will than those taken from that sweetest spot -- which is where all FUT grafts are taken from. I hope all that made sense.

No, no, no, Mickey. I'm not talking about FUE docs taking grafts outside the safe zone. I'm talking about FUE docs, when doing large transplants, necessarily taking many of the grafts from outside the BEST PART of the safe zone. The grafts still come from what is technically within the safe zone, but many don't come from that "sweet spot" of the safe zone -- the very best part of the safe zone, which is where the strip is taken from for FUT. That "sweet spot" within the safe zone is where the best, most robust, most DHT-resistant follicular units reside and comprises a rectangular "strip" about 1.5 inches or so high that runs smack across the part of the safe zone having the greatest density and thickest caliber hairs, which are the also the last hairs to be compromised by the effects of DHT over a lifetime. Above and below that sweet spot are areas still technically within the safe zone, but as it was explained to me, follicular units residing in those areas are less safe from being at least partially compromised by DHT over the long haul than those that come from the optimum part/best part/sweet spot of the safe zone. In other words, "safe" is a relative term when discussing the safe zone, and not all follicular units within the safe zone are equally safe. Think of the cartoon image of the bald guy with only a solid strip of hair remaining, running across the back of his head. That "strip" (I'm using that term differently than how we think of strip) is the sweet spot of the safe zone. That is where all follicular units are taken from for FUT, but you can't do that all the grafts from that "strip" for large FUE transplants because that would result in an obviously depleted "strip" of donor area that looked moth-eaten if not nearly devoid of hair with lots of very close together punctate scarring. In other words, over-harvesting of a confined area. That is why with every large session FUE transplant we see post-op excisions all over the back and sides, stopping north just shy of the crown and stopping south just shy of the nape. Even thought all those grafts came from within the "safe zone," many came from above and below the sweetest part of the safe zone. Anyway, as it was explained to me by a Coalition doc, that is one of the "cons" of FUE. The grafts taken from above and below the sweetest part of the safe zone may never thin or die, but there is a greater chance they will than those taken from that sweetest spot -- which is where all FUT grafts are taken from. I hope all that made sense.

No, no, no, Mickey. I'm not talking about FUE docs taking grafts outside the safe zone. I'm talking about FUE docs, when doing large transplants, necessarily taking many of the grafts from outside the BEST PART of the safe zone. The grafts still come from what is technically within the safe zone, but many don't come from that "sweet spot" of the safe zone -- the very best part of the safe zone, which is where the strip is taken from for FUT. That "sweet spot" within the safe zone is where the best, most robust, most DHT-resistant follicular units reside and comprises a rectangular "strip" about 1.5 inches or so high that runs smack across the part of the safe zone having the greatest density and thickest caliber hairs, which are the also the last hairs to be compromised by the effects of DHT over a lifetime. Above and below that sweet spot are areas still technically within the safe zone, but as it was explained to me, follicular units residing in those areas are less safe from being at least partially compromised by DHT over the long haul than those that come from the optimum part/best part/sweet spot of the safe zone. In other words, "safe" is a relative term when discussing the safe zone, and not all follicular units within the safe zone are equally safe. Think of the cartoon image of the bald guy with only a solid strip of hair remaining, running across the back of his head. That "strip" (I'm using that term differently than how we think of strip) is the sweet spot of the safe zone. That is where all follicular units are taken from for FUT, but you can't do that all the grafts from that "strip" for large FUE transplants because that would result in an obviously depleted "strip" of donor area that looked moth-eaten if not nearly devoid of hair with lots of very close together punctate scarring. In other words, over-harvesting of a confined area. That is why with every large session FUE transplant we see post-op excisions all over the back and sides, stopping north just shy of the crown and stopping south just shy of the nape. Even thought all those grafts came from within the "safe zone," many came from above and below the sweetest part of the safe zone. Anyway, as it was explained to me by a Coalition doc, that is one of the "cons" of FUE. The grafts taken from above and below the sweetest part of the safe zone may never thin or die, but there is a greater chance they will than those taken from that sweetest spot -- which is where all FUT grafts are taken from. I hope all that made sense.

If you're contending that good FUT docs routinely take strips from above or below the sweetest spot of the safe zone, I dare say that they all would reject that contention. For starters, there would be no reason to do that in most cases. By contrast, each and every large FUE transplant requires that many grafts be taken from above or below the sweetest spot of the safe zone. On that point we can all agree, yes? This very point was explained to me just yesterday by one of the most respected Coalition docs here, who does both FUT and FUE (no, his last name does not begin with "F"). This doesn't mean that the FUE grafts won't grow. It means there is a greater chance that, in the long run, many of the transplanted grafts will begin to thin (or possibly die) sooner than if the same number of grafts had been extracted via strip. As it was explained to me, not all "safe zone" follicular units are created equal. The follicular units in the sweet spot of the safe zone are the best of the best because they are the most robust and most resistant to the long-term effects of DHT. I am neither trashing FUE nor advocating for it. Nor am I trashing FUT or advocating for it. The point I raised is just one of the "cons" of FUE that should be considered by someone who is deciding between FUE or FUT for a large transplant (as I happen to be as we speak).

If you're contending that good FUT docs routinely take strips from above or below the sweetest spot of the safe zone, I dare say that they all would reject that contention. For starters, there would be no reason to do that in most cases. By contrast, each and every large FUE transplant requires that many grafts be taken from above or below the sweetest spot of the safe zone. On that point we can all agree, yes? This very point was explained to me just yesterday by one of the most respected Coalition docs here, who does both FUT and FUE (no, his last name does not begin with "F"). This doesn't mean that the FUE grafts won't grow. It means there is a greater chance that, in the long run, many of the transplanted grafts will begin to thin (or possibly die) sooner than if the same number of grafts had been extracted via strip. As it was explained to me, not all "safe zone" follicular units are created equal. The follicular units in the sweet spot of the safe zone are the best of the best because they are the most robust and most resistant to the long-term effects of DHT. I am neither trashing FUE nor advocating for it. Nor am I trashing FUT or advocating for it. The point I raised is just one of the "cons" of FUE that should be considered by someone who is deciding between FUE or FUT for a large transplant (as I happen to be as we speak).

You misunderstand my post. It isn't that reputable FUE docs routinely take grafts from outside the safe zone -- although we have seen some non-Coalition and non-recommended docs and their patients posting cases here where that appears to have happened. It is that the safe zone has a horizontal "sweet spot" running across it that is maybe (by my estimation) one and a half inches high, where the best, most robust, most DHT-resistant follicles within the safe zone reside.

You misunderstand my post. It isn't that reputable FUE docs routinely take grafts from outside the safe zone -- although we have seen some non-Coalition and non-recommended docs and their patients posting cases here where that appears to have happened. It is that the safe zone has a horizontal "sweet spot" running across it that is maybe (by my estimation) one and a half inches high, where the best, most robust, most DHT-resistant follicles within the safe zone reside.

As I recall, Jotronic explained that in the case you are referring to, it was an illusion that the strip was taken higher than normal. Personally, I've not seen any FUT cases performed by Coalition members here or recommended physicians here where strips were taken above or below the ideal area of the safe zone. There would be no need to, that I can think of. If it has happened, it would be an anomaly. By contrast, it is always the case with large-number FUE transplants that follicles are taken outside the sweetest spot of the safe zone. It just has to be that way.

As I recall, Jotronic explained that in the case you are referring to, it was an illusion that the strip was taken higher than normal. Personally, I've not seen any FUT cases performed by Coalition members here or recommended physicians here where strips were taken above or below the ideal area of the safe zone. There would be no need to, that I can think of. If it has happened, it would be an anomaly. By contrast, it is always the case with large-number FUE transplants that follicles are taken outside the sweetest spot of the safe zone. It just has to be that way.

An additional disadvantage of fue is: With large FUE transplants, many grafts will be taken from outside the "sweet spot" of the safe zone where the most DHT-resistant follicles reside. This is done to avoid over-harvesting a confined area, which would result in a moth-eaten appearance. With FUT, all grafts are taken from the sweet spot. The upshot is that there is a greater chance over time that some of the FUE grafts will thin or die.

An additional disadvantage of fue is: With large FUE transplants, many grafts will be taken from outside the "sweet spot" of the safe zone where the most DHT-resistant follicles reside. This is done to avoid over-harvesting a confined area, which would result in a moth-eaten appearance. With FUT, all grafts are taken from the sweet spot. The upshot is that there is a greater chance over time that some of the FUE grafts will thin or die.

Very well laid out, Mickey85, and very helpful! One point I might comment on concerns the issue of transection with FUT v. FUE. While I suppose it is true that when cutting the strip, some follicular units at the periphery of the strip, either at the edge of the strip itself or at the edge of the adjoining non-excised donor, could be (likely are?) transected. However, any such fu's won't be transplanted because they will be caught ahead of time by the techs dissecting the strip under their microscopes. In other words, there should be no surprises, which is why most excellent FUT docs achieve yield rates for transplanted grafts approaching 100%. Also, as you noted, the chances of transecting a graft during dissection of the strip itself into follicular units is nearly nil when you have skilled techs working with microscopes. Transection of follicular units in the context of FUE is something of a different animal. Every punch around, excision of (the "twiddle"), and extraction of (tweezing out) a graft risks transection of that graft or other injury to that graft for the reasons you stated: the doctor is working "blind" and can never be certain what twists, turns, or direction a follicular unit might be taking under the surface of the scalp; the doc is often using very small punches with little room for unseen deviation or error; stubborn grafts that want to "hold on" can be damaged when tweezing them out; and even when a graft is punched, excised, and extracted otherwise perfectly, the smaller amount of protective tissue around the graft (as you also noted) compared to a "chubby" FUT graft can leave the graft susceptible to non-growth or partial growth. The good news, however, is that more and more docs who are passionate and dedicated to FUE now appear more adept at mastering, or at least minimizing these challenges and are upping FUE graft survival and yields. Another "disadvantage" of FUE comes to mind, although it has nothing to do with the technique itself: Some of whom I consider to be the most skilled and artistic ht docs who consistently produce some of my favorite results have been slow to adopt and offer FUE. I won't name names here, but boy do I wish that a couple of the docs I have in mind (one in particular) were offering FUE.

Very well laid out, Mickey85, and very helpful! One point I might comment on concerns the issue of transection with FUT v. FUE. While I suppose it is true that when cutting the strip, some follicular units at the periphery of the strip, either at the edge of the strip itself or at the edge of the adjoining non-excised donor, could be (likely are?) transected. However, any such fu's won't be transplanted because they will be caught ahead of time by the techs dissecting the strip under their microscopes. In other words, there should be no surprises, which is why most excellent FUT docs achieve yield rates for transplanted grafts approaching 100%. Also, as you noted, the chances of transecting a graft during dissection of the strip itself into follicular units is nearly nil when you have skilled techs working with microscopes. Transection of follicular units in the context of FUE is something of a different animal. Every punch around, excision of (the "twiddle"), and extraction of (tweezing out) a graft risks transection of that graft or other injury to that graft for the reasons you stated: the doctor is working "blind" and can never be certain what twists, turns, or direction a follicular unit might be taking under the surface of the scalp; the doc is often using very small punches with little room for unseen deviation or error; stubborn grafts that want to "hold on" can be damaged when tweezing them out; and even when a graft is punched, excised, and extracted otherwise perfectly, the smaller amount of protective tissue around the graft (as you also noted) compared to a "chubby" FUT graft can leave the graft susceptible to non-growth or partial growth. The good news, however, is that more and more docs who are passionate and dedicated to FUE now appear more adept at mastering, or at least minimizing these challenges and are upping FUE graft survival and yields. Another "disadvantage" of FUE comes to mind, although it has nothing to do with the technique itself: Some of whom I consider to be the most skilled and artistic ht docs who consistently produce some of my favorite results have been slow to adopt and offer FUE. I won't name names here, but boy do I wish that a couple of the docs I have in mind (one in particular) were offering FUE.

And his scar must have turned out really well considering his relatively closely cropped hair. Nice!

This fellow looks SO much better! He looks decades younger and hipper, especially with his new hairstyle. It's great he found a doctor adept at both FUT and FUE and with the experience to make the call for a hybrid second pass so as not to risk a stretched scar. Kudos to Dr. B!

Just so readers of this thread will know, neither Hariri nor Mickey85 are ht docs. Nor, to my knowledge, have either undergone a hair transplant via fue. (Nor am I, or have I.) I only say this in case a new member reading this thread as part of their research into fue were to confuse their layman observations and opinions for those of physicians who actually perform fue, have tried both manual punches and motorized punches for extracting the follicular units, and can credibly compare graft survival/yield rates as between these two kinds of extraction tools. If the purpose of this thread is to poll ht physicians to determine which fue extraction tool they use and why (and, ideally, identify the make/model of the tools they have used, the number of procedures performed using each tool, transection rates with each, and the graft survival/yield rates achieved with each), then I submit that the thread is better served by leaving opinions about the comparative efficacy of these tools and ht physicians's reasons for choosing one over the other, to the physicians who have actually used them. That is, so long as the thread is intended as an objective effort to collect and collate this interesting and valuable information as opposed to an effort to push a preconceived notion or agenda. No offense, but why should anyone considering fue and reading this thread care that a non-physican, who has never extracted a graft from someone's donor or even had an fue transplant, "prefers that [a manual punch] retains the tactile feedback and has no moving parts that can create friction and heat," or believes, without evidentiary foundation or objective substantiation and in direct contravention of the statements of one of our Coalition member's representatives, that "manual FUE is the gold standard for a better yield" and that "motorized tools and ARTAS robot serves the surgeon rather than the patient?" When a Coalition physician or his representative says that they experienced no appreciable difference in fue graft survival/yield when using the SAFE motorized punch vs. manual punches, that the SAFE motorized punch in their experienced hands enhanced consistency of extracted graft quality and robustness and was chosen for that reason, or when an experienced fue doc with impressive, documented large-session results says that he prefers a particular motorized punch over manual punches because in his hands, the transection rate is the same (small) but the extra extraction speed offered by his motorized punch pays dividends with graft survival because the grafts are out of the body for a significantly shorter amount of time -- what, are they lying? We must assume so, and we must believe that a member here must have inside information from these clinics for him to nevertheless opine that nah, these reputable physicians with distinguished track records are only interested in "profits" at the expense of their patients if they have elected to use a motorized punch (or ARTAS) to execute their fue extractions. Really? This isn't my thread so I can't very well set the rules. But I think that this thread will be far more valuable if opinions, observations, and comments concerning the relative efficacy of these follicular extraction tools, transection rates, yield rates achieved with each, the benefits of one over the other, if any, and reasons a particular doctor has chosen to employ one or the other, should be left to the doctors and their representatives. Thanks again to Micky85 for starting this interesting and (potentially) valuable physician's fue survey.

Just so readers of this thread will know, neither Hariri nor Mickey85 are ht docs. Nor, to my knowledge, have either undergone a hair transplant via fue. (Nor am I, or have I.) I only say this in case a new member reading this thread as part of their research into fue were to confuse their layman observations and opinions for those of physicians who actually perform fue, have tried both manual punches and motorized punches for extracting the follicular units, and can credibly compare graft survival/yield rates as between these two kinds of extraction tools. If the purpose of this thread is to poll ht physicians to determine which fue extraction tool they use and why (and, ideally, identify the make/model of the tools they have used, the number of procedures performed using each tool, transection rates with each, and the graft survival/yield rates achieved with each), then I submit that the thread is better served by leaving opinions about the comparative efficacy of these tools and ht physicians's reasons for choosing one over the other, to the physicians who have actually used them. That is, so long as the thread is intended as an objective effort to collect and collate this interesting and valuable information as opposed to an effort to push a preconceived notion or agenda. No offense, but why should anyone considering fue and reading this thread care that a non-physican, who has never extracted a graft from someone's donor or even had an fue transplant, "prefers that [a manual punch] retains the tactile feedback and has no moving parts that can create friction and heat," or believes, without evidentiary foundation or objective substantiation and in direct contravention of the statements of one of our Coalition member's representatives, that "manual FUE is the gold standard for a better yield" and that "motorized tools and ARTAS robot serves the surgeon rather than the patient?" When a Coalition physician or his representative says that they experienced no appreciable difference in fue graft survival/yield when using the SAFE motorized punch vs. manual punches, that the SAFE motorized punch in their experienced hands enhanced consistency of extracted graft quality and robustness and was chosen for that reason, or when an experienced fue doc with impressive, documented large-session results says that he prefers a particular motorized punch over manual punches because in his hands, the transection rate is the same (small) but the extra extraction speed offered by his motorized punch pays dividends with graft survival because the grafts are out of the body for a significantly shorter amount of time -- what, are they lying? We must assume so, and we must believe that a member here must have inside information from these clinics for him to nevertheless opine that nah, these reputable physicians with distinguished track records are only interested in "profits" at the expense of their patients if they have elected to use a motorized punch (or ARTAS) to execute their fue extractions. Really? This isn't my thread so I can't very well set the rules. But I think that this thread will be far more valuable if opinions, observations, and comments concerning the relative efficacy of these follicular extraction tools, transection rates, yield rates achieved with each, the benefits of one over the other, if any, and reasons a particular doctor has chosen to employ one or the other, should be left to the doctors and their representatives. Thanks again to Micky85 for starting this interesting and (potentially) valuable physician's fue survey.

Congratulations on your recent hair transplant. Wishing you a great result from what is a relatively small number of grafts by today's standards. Do you know what Norwood level you were? Do you have any pe-op and post-op photos you could post? Regarding the robotic fue, do you know what make or brand it is? The two widely known fue "robots" are the NeoGraft and the ARTAS. They are very different from each other. The ARTAS is considered the more advanced of the two and without the graft-drying and graft-bruising problems associated with the suction-to-holding-tank system of the NeoGraft. The ARTAS has been the robotic fue mechanism of choice among top, established ht docs such as Dr. Rahal and the Shapiro brothers, whereas the NeoGraft seems to be marketed to dermatologists and plastic surgeons who want an "easy" way to expand their practice by offering hair transplants. Can you tell us the name of the doc you went to? Best luck on your growth and result.

Reproduced below is an informative post of Janna's on the subject of manual punches v. motorized punches for fue. She posted it in response to another member opining that fue using manual punches is universally superior to fue using motorized punches, and that only greedy or lazy docs would use motorized punches for fue. Besides pointing out the fallacy of this unsubstantiated opinion, Janna provided lots of information pertinent to this topic, including the critical functional distinctions among different makes/models/kinds of currently available motorized punches (e.g., sharp v. dull, turning velocity), the sharp v. dull distinction between currently available manual punches, and advances in motorized punch technology. In short, not all motorized punches are created equal. Nor or manual punches. Janna pointed out that a really meaningful assessment of motorized punch v. manual punch use by fue docs would include the make/model and characteristics of the manual or motorized punch used, why they chose that manual or motorized punch, and, in the case of fue docs who have used both, the number of procedures performed using each, and the yield rates achieved by that doc using the particular motorized punch v. the particular manual punch. I know that is way too much to ask of you, Micky85, but that kind of information would really enhance your survey. Anyway, here is Janna's post that I referenced. It was posted on December 8, 2012 and can be found in the thread at this link: http://www.hairrestorationnetwork.com/eve/165305-artas-hair-transplantation-system-fue-post2328021.html#post2328021 “It's interesting to read your posts because you have strong opinions that they often come across as if they are facts. Sometimes you speak on behalf of physicians as if you know them and have in depth conversations with them on a regular basis. Maybe you do with many of them but I know you haven't done so with Dr. Shapiro, yet you post as if you know why Dr. Shapiro acquired the Artas or why we switched from manual sharp punch to the motorised SAFE system. As I understand it, you don't like any motorised fue tools, and you have every right to your opinion. Are all docs using any type of motorised tool - sharp or dull punches put in the same category? While I believe there is only one dull punch, there are several variations of the sharp motorised punches. Do you remember the much hype about the Feller cordless sharp drill? Is he being lazy using motorised tool or is he innovative? Dr. Lorenzo, God bless him, is about the hardest working man I know who punches and takes all the grafts out himself not to mention planting all the grafts too. He works long hours and is quite passionate about his work. I know he's tried the Feller drill but I wasn't aware he's tried the SAFE system. Did all three purchase the SAFE system, try it for awhile then decided against it or just one of them? That part wasn't clear to me. How many patients did he/they try it on? When I visited all three clinics few years ago, they hadn't tried the SAFE system so it'd be interesting to get their opinion on it. I'm not disputing these top docs's reputation or their work or the fact that you like them. I like all of them too. When you speak to each of them, can you ask them about their yield? What is their percentage of patient satisfaction with their FUE? I know Feriduni has 4-5 techs that are skilled at punch/extracting, just as Dr. Feriduni is but I know yield can be compromised with any FUE procedure regardless of the technique. I'm sure they will tell you that while they strive for 100% yield on 100% of their patients, they don't have it. There's a fundamental difference between dull and sharp punches. You should find out the difference and why some choose dull as oppose to sharp. The top clinics tend to produce the most consistent results, thats why they are considered tops. For consistent results and for best yield at our practice, we converted to the SAFE system and acquired the Artas, not for anything else.”

Reproduced below is an informative post of Janna's on the subject of manual punches v. motorized punches for fue. She posted it in response to another member opining that fue using manual punches is universally superior to fue using motorized punches, and that only greedy or lazy docs would use motorized punches for fue. Besides pointing out the fallacy of this unsubstantiated opinion, Janna provided lots of information pertinent to this topic, including the critical functional distinctions among different makes/models/kinds of currently available motorized punches (e.g., sharp v. dull, turning velocity), the sharp v. dull distinction between currently available manual punches, and advances in motorized punch technology. In short, not all motorized punches are created equal. Nor or manual punches. Janna pointed out that a really meaningful assessment of motorized punch v. manual punch use by fue docs would include the make/model and characteristics of the manual or motorized punch used, why they chose that manual or motorized punch, and, in the case of fue docs who have used both, the number of procedures performed using each, and the yield rates achieved by that doc using the particular motorized punch v. the particular manual punch. I know that is way too much to ask of you, Micky85, but that kind of information would really enhance your survey. Anyway, here is Janna's post that I referenced. It was posted on December 8, 2012 and can be found in the thread at this link: http://www.hairrestorationnetwork.com/eve/165305-artas-hair-transplantation-system-fue-post2328021.html#post2328021 “It's interesting to read your posts because you have strong opinions that they often come across as if they are facts. Sometimes you speak on behalf of physicians as if you know them and have in depth conversations with them on a regular basis. Maybe you do with many of them but I know you haven't done so with Dr. Shapiro, yet you post as if you know why Dr. Shapiro acquired the Artas or why we switched from manual sharp punch to the motorised SAFE system. As I understand it, you don't like any motorised fue tools, and you have every right to your opinion. Are all docs using any type of motorised tool - sharp or dull punches put in the same category? While I believe there is only one dull punch, there are several variations of the sharp motorised punches. Do you remember the much hype about the Feller cordless sharp drill? Is he being lazy using motorised tool or is he innovative? Dr. Lorenzo, God bless him, is about the hardest working man I know who punches and takes all the grafts out himself not to mention planting all the grafts too. He works long hours and is quite passionate about his work. I know he's tried the Feller drill but I wasn't aware he's tried the SAFE system. Did all three purchase the SAFE system, try it for awhile then decided against it or just one of them? That part wasn't clear to me. How many patients did he/they try it on? When I visited all three clinics few years ago, they hadn't tried the SAFE system so it'd be interesting to get their opinion on it. I'm not disputing these top docs's reputation or their work or the fact that you like them. I like all of them too. When you speak to each of them, can you ask them about their yield? What is their percentage of patient satisfaction with their FUE? I know Feriduni has 4-5 techs that are skilled at punch/extracting, just as Dr. Feriduni is but I know yield can be compromised with any FUE procedure regardless of the technique. I'm sure they will tell you that while they strive for 100% yield on 100% of their patients, they don't have it. There's a fundamental difference between dull and sharp punches. You should find out the difference and why some choose dull as oppose to sharp. The top clinics tend to produce the most consistent results, thats why they are considered tops. For consistent results and for best yield at our practice, we converted to the SAFE system and acquired the Artas, not for anything else.”

That is incredible hairline work! One of the best I've seen. Dr. Paul is amazing.