Jump to content

PupDaddy

Senior Member
  • Posts

    610
  • Joined

  • Last visited

Everything posted by PupDaddy

  1. Thank you, David, for shutting down this obvious troll.
  2. GPS3, Congrats on pulling the trigger! You have every reason to expect a terrific result and, especially, a masterfully designed and executed hairline by Dr. Rahal. He has the gift. fueguy, Thank you for saying what you said and for reassuring GPS3. The "go to Turkey" bunch has grown tiresome here. I also agree with your opinion of the hairline work of the particular Turkish doc being pushed on GPS3.
  3. My thanks to Dr. Bhatti for addressing my questions about his "speed" approach to FUE extraction. Interestingly, after 139 pages (!!) of discussion, Drs. Feller and Bhatti seem not to be all that far apart in their opinions about FUT vs. FUE. Both have stated that FUT remains the gold standard for consistently high yield in hair restoration. Both have stated that FUE yield is more variable than FUT yield. Both have stated that FUT yield generally is better than FUE yield. And both have noted the negative effect of fibrosis on FUE yield in subsequent sessions. Where these two docs differ is in the quantification of FUT's yield advantage over FUE, whether this gap has been or can be diminished, and the degree to which it has been or can be diminished. I have learned a good bit more about both methods of extraction than I knew before. Thanks to both docs for sharing their knowledge, experience, opinions, and points of view.
  4. Very, very interesting, Dr. Feller. Thank you for the educational game. I recall Dr. Wesley commenting awhile back that he will more densely pack FUE hairline grafts for the same reasons you stated.
  5. One of the best SMP cases I've seen. A top-tier ht surgeon performing the sessions had to have greatly contributed to the artistry and naturalness.
  6. Personally, I’d still very much like to know the bases for Dr. Bhatti’s assertion that “speed is the singlemost essential factor which gives FUE in general and FUE megasessions in particular a higher yield almost comparable to FUT.” (Post #825, p. 83 of this thread.) Dr. Bhatti made that assertion in response to questions and concerns raised about the original version of the video he posted showing his FUE technique. When I questioned that assertion, which to me seemed counterintuitive (post #831, p. 83), Dr. Bhatti sent me an unsolicited message assuring me that he would publicly answer those questions in detail. That was on August 17th. The only reason I could think of for scoring (with a motorized punch) and extracting thousands of grafts at the breakneck speed demonstrated in Dr. Bhatti’s original, unedited video, would be to allow the clinic to churn out multiple FUE cases per day. Good for the clinic’s bottom line. Not so good, it would seem, for maximizing each patient’s yield. If preventing desiccation of the grafts were the objective of the speed approach demonstrated, it seems that this could be achieved with other strategies that would allow for a more measured pace of scoring, extraction, and implantation and a more careful and gentle handling of delicate FUE grafts. For example, grafts could be scored, extracted, and implanted in batches of, say, 600. In other words, carefully score and carefully extract 600 grafts (depositing them into an appropriate holding solution as they are extracted), sort them, implant them, then repeat this process with additional batches of 600 grafts until the total target number for the restoration had been extracted and implanted. If necessary, extreme megasession FUE cases could be executed over consecutive days or perhaps with an intervening day between surgical days to give the patient’s donor a day of rest between “assault” days. The “batch” approach to scoring, extraction, and implantation (described above) could still be employed, perhaps with somewhat larger batch numbers but which still would allow for more measured, careful, and gentle scoring, extraction, and implantation of these delicate, stripped down FUE grafts. Of course, these protocols likely would decrease the number of patients that could be worked on or completed per day, particularly if the “batch” approach were employed, which would require the surgeon to be present and participating during much or all of the surgery. But if the goal is to maximize FUE yield for each patient . . . . . Am I missing something? Dr. Bhatti? Again, I pose these questions in the interest of education, my own and that of other members interested in the science, art, and technique of hair restoration. I am neither pro nor anti FUE nor pro or anti FUT (or mFUE). I am pro exceptional hair restoration.
  7. In my opinion, smash, you are not a candidate for hair restoration surgery. Given your extensive hair loss at your young age (27) and your less-than-optimal hair characteristics (straight, dark, fine caliber hair), I really think you would be better served just keeping your hair buzzed relatively short and moving on. I know you don't want to hear this, but you asked. Hair restoration surgery can provided excellent cosmetic benefits for some guys, but not for others. Young guys with extensive male pattern baldness, high contrast between hair color and skin tone, average to below average donor density, and straight hair that is average to fine caliber (all of which describe you based on your photos), just don't make out so well with hair restoration. Keep this in mind: hair transplantation doesn't grow new hair or change one's hair characteristics. It only moves existing hair from the back of your head to a new location and attempts to arrange it in such a way as to create an illusion of more hair in the new location than there actually is. The less hair available to be moved (donor density), and the straighter and finer the caliber of that hair, and the greater the hair color-to- skin color contrast, and the larger the bald or thinning area(s) to be covered, and the greater the likelihood that the patient is likely to lose more hair going forward, the less likely that hair transplantation will provide long-term satisfactory cosmetic benefit. Unfortunately, you appear to possess all of the negative indicators. I'm really sorry to say this. Others may disagree.
  8. Although I'm not in love with the tell-tale look of implanter pen work along the hairline, the patient looks to have gotten good growth. Can you please post top down views pre-op and post op to give us a better sense of his restoration? Also, can you please post photos of your marked out design and of the patient immediately post-op? These kinds of photos are very helpful to understanding a ht doc's approach and technique and to assessing the outcome. They also help future ht patients get a handle on how drawn-in hairline paramaters translate to facial framing and cosmetic result, and how they can expect to appear immediately after surgery. Thanks!
  9. Another impressive FUE result by Dr. Diep. He kept graft count moderate by working with the patient's excellent hair characteristics. Nice!
  10. Stunning, natural, undetectable work by Dr. Cooley. No one could ever tell that this patient had been transplanted. Nice!
  11. Excellent point, Spanker, and seconded. At the very least, if technicians are doing the extractions, then I think the doc should identify the extracting technician(s) for each published case and should permit patients to book their procedures with those techs specified as the extracting techs.
  12. Bill, 1. I like the idea of the site designating which methods of extraction the physician has been screen for and is recommended for. I also like the idea of having physicians who originally were recommended based on one method having the opportunity to be recommended for the other. 2. I do not like the idea of rewarding "speed" of extraction or otherwise recognizing fast extraction as a standard, or even a factor, for recommendation or for Coalition status. Some very accomplished FUE docs believe that speed kills when it comes to FUE and therefore limit the number of grafts they will extract per day or per session. Others believe that extracting more than a certain number of grafts per day or per session is unwise in terms of injury to the donor, regardless of how quickly or slowly the grafts are extracted. So I don't think that docs who prefer to stagger large FUE restorations or who prefer to spread large FUE restorations out over consecutive days or with a day between each surgery day, should be considered lesser than docs who take a one-day-and-done approach to large FUE cases. In fact, I'm sure there are reputable docs who believe the opposite is true. Also, rewarding speed would tend to encourage the use of motorized punches over manual/non-motorized punches, which is a topic of disagreement and debate among reputable FUE docs. I think that if the physician and his team exhibit sound FUE technique and protocol and produce results that the publishers and members find worthy of recommendation or Coalition status, then how fast that doc extracts grafts or, stated differently, how many grafts the doc will extract and transplant per day, per session, or per multi-day session should simply be set out in that doc's profile when describing the doc's FUE protocol. My 2 cents.
  13. Well, at least there is now agreement between Dr. Bhatti and Dr. Feller on one fundamental point in this debate: Yield from FUE generally is not comparable to yield from FUT. Perhaps we'll even eventually get some semblance of agreement on the quantification of "almost." Dr. Feller has quantified his opinion: He places mode yield (most often repeated, most likely) from FUE megasessions performed by the most accomplished FUE docs at 75% and mode yield from FUT megassessions performed by the most accomplished FUT docs at 97%. I'd be interested to know whether Dr. Bhatti or Dr. Vories or other FUE docs have (a) quantified their personal mode yield from FUE megasessions and (b) could, as Dr. Feller has, render an opinion quantifying mode yields of FUE megassessions vs. FUT megasessions achieved by the most accomplished docs in these respective specialties. Dr. Bhatti? Also, Dr. Bhatti: Can you please elaborate on why "speed is the singlemost essential factor" to achieving higher yield for FUE megasessions? I assume you are referring to speed of scoring and extraction, as demonstrated in your surgery video? (By the way, was that you doing the scoring with the motorized punch? If so, do you execute the scoring for all the grafts in all your cases?) Are you saying that the faster the extraction the better so as to reduce out-of-body time of the thousands of grafts needed for the megasession? Would this objective not better be served by extracting and implanting in intervals, of, say, 500-1,000 grafts? Or by dividing the megasession into consecutive days or with an intervening day between partial sessions? Wouldn't these approaches achieve the desired reduction to graft out-of-body time while avoiding having to score and extract fragile FUE grafts at break-neck speed? I pose these questions respectfully and solely for educational purposes -- not to challenge. I admire the dedication, skill, perseverance, passion, and energy of all ht docs recommended here. Differing practices and opinions are to be expected. If they are discussed and debated honestly and without defensiveness or agenda, everyone benefits. Thank you, Dr. Bhatti.
  14. Lovely, refined work, especially considering the patient's straight hair and high contrast between skin tone and hair color!
  15. Translating those percentages into numbers (and assuming that Dr. Feller is correct), here is a comparison of the most likely results of various sized restorations if performed by the best of the best ht docs: 2,000 grafts FUT = 1,940 growing fu’s (60 wasted fu’s) 2,000 grafts FUE = 1,500 growing fu’s (500 wasted fu’s) 3,000 graft FUT transplant = 2,910 growing fu’s (90 wasted fu’s) 3,000 graft FUE transplant = 2,250 growing fu’s (750 wasted fu’s) 4,000 graft FUT transplant = 3,880 growing fu’s (120 wasted fu’s) 4,000 graft FUE transplant = 3,000 growing fu’s (1,000 wasted fu’s) 5,000 graft FUT transplant = 4,850 growing fu’s (150 wasted fu’s) 5,000 graft FUE transplant = 3,750 growing fu’s (1,250 wasted fu’s) Assuming that the average transplanted follicular unit contains 2 hairs, multiply the wasted fu’s per procedure x 2 to arrive at the number of hairs squandered by procedure: 2,000 graft transplant = 120 wasted hairs FUT vs. 1,000 wasted hairs FUE 3,000 graft transplant = 180 wasted hairs FUT vs. 1,500 wasted hairs FUE 4,000 graft transplant = 240 wasted hairs FUT vs. 2,000 wasted hairs FUE 5,000 graft transplant = 300 wasted hairs FUT vs. 2,500 wasted hairs FUE
  16. I am SO happy for you, Borromeo!! You've been through the ht wars and were fortunate to find a site like this one before irreparable damage was done. Dr. Dorin's work on you looks terrific. I think you are going to have a KILLER hairline and frontal third! After all you've been through, you've earned it. Skill + experience + transparency + ethical marketing + plenty of published results + screening and recommendation by a site like HRN = a greatly enhanced likelihood of a satisfactory hair restoration. GROW WELL, AND PLEASE KEEP US UPDATED!
  17. Swoop, Looking great! I somehow missed your thread and terrific writeup, which should be saved as a guide for the benefits of being an educated patient. Sending you a PM.
  18. Absolutely gorgeous, utterly natural hairline work by one of the greats. Dr. Ron outdid even himself with this one.
  19. Great planning and great work on this young man, Dr. Cooley! He's now, what, 27? You kept him from living the past decade as "that really young, really bald guy," and now he's got himself a cosmetically appealing head of hair going forward. I think his hair looks especially good in Photo #14.
  20. I see what you mean, Dr. V. His second procedure looks to have paid disproportionately large dividends. Thanks!
  21. Thank you for the updated photo and info, Dr. Vories. The patient is your rep, John Casper, yes? He's looking good! If I recall correctly, you did two large FUE procedures on him: 5,000+ grafts in 2012 and another 2,000 grafts nine months ago? Did you use suction assisted extraction, i.e. the Neograft machine, for his first procedure? And forceps placement? Do you have an “after” picture of similar angle and lighting as the "after" picture you posted, showing the fully matured result of his first procedure? This would give us a sense of his starting point prior to his second procedure so we can better appreciate the points you are making about earlier growth and increased hair caliber you are seeing under your current FUE protocol. Thanks!
×
×
  • Create New...