hairweare

Pma's first frontal procedure results were posted not just the crown. 6Euros=6.61USD Where are you getting your math? Farjo's FUSS techs nicknamed Lorenzo the robot. I agree the moniker suites him well though. You didn't answer the question as to how many 2k FUE procedures you have done using both manual punches and all of the implantations. Comparing that to taking out a strip and sewing or stapling it up and then making knife slits is just not credible. Can you cite another surgeon who works as fast and accurately as Lorenzo? Other than Sunnycool's result are there any recent FUSS postings that I missed that are as impressive as the ones I mentioned above? Objectivity isn't being thrown out the window as long as we avoid hyperbole and just stick to the facts.

The recent case presentations by Dr. Vories, Pma, Maltese, Betterlate, and Shacked all look pretty good to me. Can't say other than SunnyCool's FUSS result from Dr. Shapiro that any recently posted strip case appear all that impressive. I am of course only referring to the recipient areas. Blake have you done many 2000K cases with manual punches and all the implants by yourself to be able to say that the procedure is not physically taxing? Despite your protests to the contrary, you do come off as a champion for strip which is fine because at 9 or !0 USD a graft I doubt realistically that you will be doing much FUE going forward.

If you are not impressed with the recent case presentations of Dr. Vories, or what Pma just posted then I don't think you are going to be much happier with a FUSS result either. Have you ever tried just shaving your head? For many high Norwoods particularly those who go back and forth unable to make a surgical decision this may be the best approach.

Well, I have coarse wavy mediterranean hair which is turning salt and pepper and I purposely chose a" low and slow" approach v. a 3 day 5K graft scalp and beard Hail Mary toss into the end zone procedure which was the alternative option presented to me in the US. Besides I like to travel and took two fun mini vacations while I was at it. My entire head was not shaved either time, I needed no pain meds and within two weeks I was looking and feeling normal again. I can't say that about my experience with FUSS. I know all about surgery and and hate the term "minor, which I believe is misleading. In my forties vanity left me with no other choice but if I had to do it over again the decision would be an easy one. I think you too have made it easy for yourself, go for the strip and don't look back. If you wouldn't be happy with Lorenzo like results I doubt any of the alternative FUE clinics would be satisfactory either. Now you only have to choose among your 4 doc short list so what is holding you back?

Lorenzo's fees are 6 Euros for the first 1K then 4 Euros for the next 1K and 2.5 Euros for all grafts thereafter. Other than for Dr. Vories I don't believe that anyone doing FUE in the US has competitive rates and arguably he is one of the best. I received a quote from a dedicated FUE doc on the West Coast for $8/graft but he later extended to me a $1/graft discount as a professional courtesy. KO, we must be viewing different videos because I find few posted FUSS cases graft for graft that look denser than his. I agree that Blake's comment about performing FUE to be a breeze is not credible. Lorenzo is somewhat of a freak, robotic in his rapid movements and is totally spent by the end of the procedure. Definitely not a walk in the park.

I experienced minimal shedding after both of my FUE procedures. You can tell which are grafted hairs as the tips will be thicker with typically a slightly bent appearance. Nothing to worry about unless you are not seeing any change in length.

If my FUE hair was any bouncier I could be a human pogo stick while doing headstands.

Lower the price of FUE to be comparable to Europe and the demand for it in the US will skyrocket. It is really as simple as that.

In fairness to Dr. Vories who can speak for himself, he no longer employs the Neografts system to extract follicles. I believe that he exclusively uses sharp Vortex punches of varying caliber. To my recollection he referenced a 10% not 20% stop loss transection rate and I believe this was also in reference to a Afro-American patient. I asked Dr Lorenzo how he keeps up at such a frenetic pace and when will he call it quits, to which he replied "when I can no longer improve upon what I am doing". I believe I also saw the video with a stated transection rate of 10% but it was from 5 years ago. Somehow I don't think that he would today accept that number as his standard of care. A very important point which seems to be missed and that Joe may have inadvertently made is that the "playing field" for FUE is much larger than it is for strip harvesting and that the surgeon can select 1,2 or multiple hair follicular groups at his discretion. Again, my strip surgeon who was an early advocate of FUE felt that at best he could get only another 500-800 strip grafts from my depleted occipital donor area whereas a skilled and conservative FUE doc having a much larger area to operate in was able to extract 2900 with probably another 750-1000 to spare. Unless you price your FUE procedures at the same rate as strip, your patients are really not getting a fair and balanced discussion as to which procedure to choose.

Blake, I looked at your references. As you know a 6 pt. study should not be construed as medical evidence and comparing transection rates from ARTAS to the best case scenario for FUSS is somewhat disingenuous is it not? None of the leading FUE surgeons use ARTAS so why not compare Dr. Vories transection rates to the average HRSN recommended FUSS doctor? Do you really believe that the difference in transection rates would be that far apart? I am anxious to hear about your new contribution to the refinement of FUE but it is only fair when critiquing it's efficacy one considers it's current state of the art or best practice techniques rather that cite dubious methods such as ARTAS of case reports where the methodology may not be the cutting edge (pun intended).

A very impressive result for only 2K grafts. I am sure his donor bank is still in great shape and should he elect for another procedure to refine the hairline and further fill in the crown, his final result would be nothing short of phenomenal.

On the contrary I doubt that it the perfect point you wanted to make! I don't want to lose this largely lay audience by getting too academic but suffice is say that in the late 70's if you had coronary disease your doctor was most likely going to refer you for an invasive operation because there was thought to be no other alternative. Skip ahead 40 years and the only patients being subjected to CABG are the two niche situations that you cited. The vast majority of heart patients are now treated with either medical therapy or a drug eluting stent. CV surgery programs are hurting for trainees and a lot of established CV surgeons are doing cosmetic vein stripping because they are unable to find work opening chests! Now granted this transition did not occur over night just because a Swiss doc figured he could open up a blocked artery with a balloon. Furthermore not all cardiologists performed the procedure the same way or produced the same stellar results as the leading institutions in Cleveland, Kansas City and Rochester. It took time for the technology to evolve and for docs to become better trained in order be first offer an alternative to CABG and then later to massively surpass it in gross volume. I believe we are at the same stage with FUE. The technology has evolved to reach parity but not all physicians use the same technique or utilize the best practices. True I selected Lorenzo based primarily on empiric evidence, but when one consistently sees the ho hum results frequently posted by the strip docs and compares it to his techniques using the same o less number of grafts, it is hard not to be impressed. I am convinced it is only a matter time before the science proves what we are now seeing with our "lying eyes"

Blake, I think your bias is showing through a bit. Sure when a patient is given the choice between $5 vs. $10 a graft "yield" very likely be higher with the former as who will want to pay $50K to in order to achieve the comparable full coverage? It is pretty much a Hobson's choice for that matter. One shouldn't categorically state that FUSS has an inherent better yield than FUE. Certainly the recent posted cases by Dr. Lorenzo's patients and the ones by Dr. Vories this month would offer a compelling refutation to that hypothesis which by no means is an established fact. I recall the days when docs argued that CABG for heart patients was a better treatment than angioplasty because it resulted in more complete revascularization and better outcomes. While perhaps that was the case during the primordial period of balloon angioplasty, when the technology and experience of the operators advanced that argument became moot allowing the vast majority of heart patients to avoid the knife and subsequent dreaded "zipper" chest. I see the same future for FUSS as patient education and demand will render FUSS obsolete in the near future since in the best of hands FUE has currently achieved credible parity.

Other than individual follicles being in different phases of the hair growth cycle or being "shocked" into prolonged telogen, there should be no difference in regional hair growth patterns.

I just scrolled through your progress and feel that your result so far is under par for what would be expected at 6 months. Things may of course change for the better in the next couple of months which is what we are all hoping for. Considering that your donor area looked very good and your FUSS scar was not that bad I really didn't understand the need for using beard grafts other than perhaps 200-250 to fill in the scar. Imo, beard grafts are a last resort after scalp donor hair has been exhausted and is best utilized for scars or mixed in with scalp hair for the crown. I have had 800 beard grafts used in this manner and they are now undetectable.

Sparky, perhaps in both cases it was your choice of surgeons rather than the technique that led to your results.

Considering your hair characteristics and previous results I suspect you will be very happy. You even have what appears to be a healthy reserve still left in your donor bank. Don't be influenced by the recent discussion claiming that FUE yields and quality on subsequent procedures decrease. This obviously is not the case for Lorenzo's patients. I experienced relatively little shedding following both procedures and the newly transplanted grafts seemed to resume their normal anagen phase without much pause. That said If the first procedure is any indication, I am probably 80% grown out at the 6th month mark. While there still was some later filling in, not much changed after the 8th month the first time around. Contrary to common belief, I can't think of any physiologic reason why the crown area grows slower. When it is time for a haircut your crown hair is just as long and in need of a trim as the rest of your head is it not?

Wow! that is amazing coverage and the pattern is very natural. It looks like you will have a grand slam result within 6 months. I had slightly less territory to cover but only got 1400 scalp and 500 beard FUEs but now at 6 months it is looking pretty good. My limited donor also looks pretty much the same as it did prior to the 2900 grafts so maybe I have another 500-750 along with another 500 beard grafts to get even better density. Greed is good? Recall that when I went back to my famous USA strip surgeon last year I had a bald crown, pluggy hair line and sparse top from late progression to a NW7. All he could offer was another strip, scar repair (maybe) but at best 500-800 grafts and SMP. I am grateful that I found this site instead and primarily due to Mickey85 posts started to look into Lorenzo's technique and decided to go for it. Like you I am glad that I did!

Stand on your head

My old FUSS scar is now well hidden after recently repaired by FUE, however my scalp has never felt entirely normal since my first operation in 1993 and likely never will. Think about that before having a large slice of flesh removed from the back of your head.

Hey Vox I am on the West Coast and willing to do your procedure for the relative bargain of $500,000. My schedule just happens to be open as well!

As far as the FUE in the US, I was not impressed with the published results of the dedicated FUE surgeons from either CA or GA and paying $8 or more/graft makes no sense when far less expensive and arguably equal of better facilities are available in Europe. I was not aware of Dr. Vories work when I chose to go to Europe for my two procedures but both in terms of quality and price he I believe belongs on anyone's short list. As a disclaimer while a physician and patient myself, I have never met Dr. Vories personally or have any affiliation with him or any other physician mentioned on this site.

Lower yield and variability is true for both FUSS and FUE. Choose your surgeon in either case wisely and this becomes a non factor in your decision making process.

Fibrotic tissue by definition is permanent, but I have my doubts that with state of the art techniques using small diameter sharp punches that this has much bearing on subsequent procedures. Again the strongest point in favor of this is that experienced FUE surgeons by intent choose to stage procedures and do not report this as a limitation. Lorenzo commented to me after both of my procedures how well the donor area had recovered. He did not know prior to the first procedure that 2900 grafts would be possible which ultimately was achieved safely by staging. That, not limited future harvesting should be the take home message in my opinion

Blake, rest assured that I will look at it both critically and objectively. We are all on the same team here.