hairweare

After viewing Dr. Lindsey's case I thought a better name for the procedure should be "mFUSS". US docs will need to come up with something better if they want to stay competitive with the ROW. Perhaps Dr. Vories should start offering preceptorships?

How does it work on collecting cat hair? I am sure it has a niche somewhere!

Both along with Konior and Gabel appear to be excellent choices as long as you are ok with having a chunk of flesh hacked off the back of your head.

Claiming that he has not technically joined Dr. Feller until July is as they say in law a distinction without a difference. Nonetheless he has made his announcement public and for anyone to accept his advice now as objective is doing so after full disclosure...caveat emptor! I also don't have a problem with him announcing a new procedure but repeating misinformation such as Dr. L charging $9.61 a graft or needing 3-5 passes over 5 years, Dr. Vories use of Neograft, and subsequent FUE procedures having lower yields and poor hair quality are in need of a fact check and do more harm to his credibility than promote it.

Hopefully Dr. Lorenzo will NOT give you the hairline for which you desire. From what I know of him I doubt that he would.

Actually the argument against a dense hair line is that with the exception a few ethnicities it does not occur in nature. Based on your specific ethnicity and hair characteristics a skilled surgeon will place singles in the frontal zone to transition seamlessly to a zone which is more dense behind it. Proper placement and angulation is far more important that gross density per se.

Keyser you are spot on but perhaps more blunt than I was. To get a new medical technique acknowledged by ones peers as an advancement it is necessary to show an enhancement and at very minimum non-inferiority to what the mainstream view as state of the art. mFUE it would appear is quite aways from achieving that basic standard.

Blake, the burden is still to convince your professional peers that mFUE is not a "solution" in search of a problem. Presenting this on what is primarily a lay forum should be viewed as marketing and not a serious scientific hypothesis subject to professional review. Until you do so, it should be taken for what it is, an advertisement for your clinic.

Blake, it must be emphasized that your criticism and stated shortcomings of the current state of the art FUE are your personal opinions and not proven clinical science. Until your hypothesis is adequately exercised on a significant number of subjects and presented for peer review, it is prudent to remind readers that mFUE is merely an unproven hypothesis at this point and may turn out to be better or worse than what you are proposing.

The true challenge will to be able to present a multitude of mFUE cases at an international conference demonstrating at minimum non inferiority to what is now state of the art FUE which I believe is manual extraction and an implanter. It will also have to be priced competitively at between 3-5 USD per graft or why should anyone consider it seriously when there already is a proven alternative?

Pre -op views that are not shaved would be helpful to better judge the results.

I am complete agreement with your approach and am not convinced either that 5000K FUE procedures are advisable. I think the final result in this case will be very good and will help dispel the notion that subsequent FUE procedures are impeded by subcutaneous scarring in regard to both yield and quality of the grafts. Should the pt elect to address the linear scar I believe that 300 beard grafts would hide all traces of any previous HT.

Too many intra and inter operative variables to consider, but your procedure was done by one of the best so I wouldn't worry about it too much. Did you notice any gaps or area of non growth from your previous procedure?

Very likely caused by ingrown hairs, keeping your hair buzzed to the scalp may be exacerbating the situation. Warm moist compresses applied to the area for 20 mins 3-4 a day will help.

I understand a patient's desire for instant gratification, but that often comes at a cost. I would advise a conservative approach, one can always add later if necessary but once you go low you are committed to that hairline and may not have enough behind it to sustain the benefits. It has been often said or learned the hard way in my profession that "excellent can be the enemy of good".

The advancement of FUE has led to the successful use of punches so small that wounds heal quickly and with minimal to no visible scarring. Extractions that are so large as to require primary closure is a "solution" that is worse that the problem that it intended to address.

Sorry Blake but my first impression is that this is step backward using a larger punch in order to achieve what top FUE docs are getting with a .8mm punch. More work, less available donor, and no significant benefits in quality and yield at the expense of possibly unacceptable scarring. The healed donor area shown above is not a result I would be content with myself. I could be wrong but i don't see this method as going anywhere.

I have had 800 beard grafts myself so I do have some experience in this matter. Healing of the donor area is very rapid and I doubt scarring will be an issue. A major concern I would have is how well the beard hair will blend with your scalp hair. Both could have been measured in microns which can be predictive of how well they will match up in vivo. My impression is that Dr. B is somewhat more conservative in graft harvesting than Dr. Lorenzo who did my HTs. My feeling is that beard mixed in randomly at a maximally 1/3 ratio is not readily detectable particularly if the hair is kept relatively short. It is best utilized for the crown but in your case you do not have enough scalp donor to create a natural looking result. Mid-scalp if mixed with enough native and scalp grafts may end up looking satisfactory but I really believe that you will need a minimum of 1500 scalp grafts to make it work. You may want to consider a second opinion from Dr. L which is something as a physician I would never be opposed to.

Yes! Someone has been drinking the FUT Kool-Aid.

This patient appears to be blessed with an extraordinary dense donor area. When viewing "wow" results prospective patients need to take that into account rather than just the considering number of grafts. It would be interesting if Keller would provide the statistics similar to what Dr. Shapiro does for his case presentations.

When considering any FUE surgeon ask how many Afro-American cases they have done and study the results carefully. Keloid scars are more common with blacks which is another reason to look into FUE but the FUE is not with risks either. Keep in mind that if you choose a clinic where techs do the extractions you would have to know what that individuals experience is with African hair is. Dr. Vories does all of his own extractions and seems to have benefited from a learning curve as African follicles are more prone to transection which will drastically affect the ultimate yield.

Price should be a concern when shopping for a used car not a HT. The exception being only if you are considering an FUE procedure in the US.

When you run you finger tips over the recipient area to you notice a beard like stubble? At 6 months a fair percentage of the grafts should have at least broken the skin. As noted there have been well documented cases of late growth on this forum so there is not much else you can do but wait. Dr. A can view your recipient area under the scope and can provide further insight into your progress when you go in for follow up.

Yes, I agree some of those cases have achieved Lorenzo like results but at the cost of a permanent linear scar. Those that can't achieve FUSS like yields with FUE shouldn't be doing it but also shouldn't be criticizing those that can. 3-5 passes are the exception rather than the rules and are reserved for challenging higher NW cases with questionable donor reserve. No honest strip surgeon should touch those cases especially with a mega session.

You make some excellent points which I am in total agreement with.