scar5

Loags, I couldn't refute or agree with you. That would be a matter of you and your intuition. I would be interested, for the sake of argument, to ask where I am misguided. It almost suggests that I have been misled by something or someone. I am gullible if that is what you mean, and I have rationalized many HT decisions based on grasping at some idea, fact or assumption without looking at the bigger picture. Something an HT doc/rep takes as gratis in their business. However, looking back in this case, I think about how BHT works in the bigger scheme of things. As Dr. Bhatti says, it is ancillary but on the other hand, using beard in the areas he suggests might not be the best, and I definitely disagree with the 'Gold Standard' and empirical argument.

That is five hammer blows there...at least for a brown haired, fair skinned white boy like me. Forgetting about the economics entirely, for sake of argument, this is the classic way many docs prioritize empirical over aesthetic considerations. I have had BHT from every place known to man, as well as beard. My maxim has been 1 beard hair = two scalp follicles for density, and 4 chest hairs = 1 follicle - but those are only for my "incredible" body. More seriously, I have been told to 'leave the crown' in the final sit on more occasions than I can remember. As a result my crown is like a desert with a few shrubs. I don't recommend Dr. Bhatti's approach (although I admire his collection of data and input to the discussion) So let's go through the points. 1) Wrong..("gold standard" btw is a nonsense term.) What ever parameters you use, they are changing in the big picture. Sure, strip yields are good, but at what cost? No one wants a strip scar, especially a balding male. But it is the way a hair restoration is built around a strip scar that is another concern. It often means an empty crown and a wall of hair combed back over it- and thus, behind the crown, the flow is followed over the scar. Result, you are stuck with a combed back look with a thinning crown. Not bad, but hardly why you booked the HT in the first place. 2) Mid scalp 'fill' with beard hair?? Not for me. They stand out like to me. Sure, I am paranoid and over sensitive, but they look quite different to me. and they feel different too. Moreover, you get that sense that the disparity will not improve over time as the native hair weakens and these beard stalks continue. In digital photos they can be shocking ad the camera paints them like black dots against the natural diffused tones of scalp- hair They are dark and strong. Mid scalp is often light, weak and minaturized. Caveat - beard hairs often grey/gray much faster. 3) Accept low density for the crown? With a (gold standard) strip scar? I think no. Although I accept that in the days of social media, a wall of frontal hair can take a profile pic a long way. Guys, the crown is essential!! It is one of the tell-tale signs of balding. Remember balding itself is a nuisance and even a health risk (sun burn , facial wrinkles, etc) but what bothers us is the disqualifying nature of it's symbols. The first but weaker symbol is the receding hairline, but the killer punch is the empty crown. 4) I have seen some buzzed FUE heads with beard in the crown, that was very successful, especially salt 'n pepper color tones. Anyway, that is my 2 cents. I would consider these principles as an advocate of the nw3 25 yr old white male; 1) Don't neglect a long term strategy to cover the crown well - (and to be fair, Dr. Bhatti does state that conserving scalp hair for the crown is good) 2) Keep beard hair for when you are grey and only use it on the crown on scars. ..and keep you beard too if you are a hipster! 3) Consider what 1 BHT hair is worth to you in density and weigh up how odd it will look. Remember that top frontal scalp could be minaturized for a long time - a kind of sustained miniature state thanks to fin or other meds) 4) Remember what a famous FUE/BHT pioneer once said, "What you see is what you get"

Absolutely agree. You need a basic lattice of hair..I don't know how many grfts/cm in each zone or how it varies individual to individual, but it can be done and makes an enormous difference. -and some strategic hair cutting goes a long way too. You'll have to take my word for it. I must add, the SMP clinics don't encourage it. It suits them if you buzz to zero, but that doesn't mean it can't be done. In fact I think it almost always looks better once you get through the first two-four weeks of ugly/patchy growth.

He won't be playing golf; -with a sore back (from bending and twisting it. Holding it prone in awkward positions for hour after hour whilst doing the FUE) - sore eyes from straining to see for hours the same head - sore tendons in his fingers and wrists from hours of twisting and punching Economically FUE is a terrible waste for american docs - a wasted opportunity cost. It's a no brainer for them economically. The problem is the damage it does to their brand by persisting with strip, even with stellar results.

I would say Dr. Lindsay and Dr. Feller would be among the best (assuming you can get through the minefield of their strip rhetoric)...but why pay so much? Your best bet in the US is the airport. (international terminal)

Unfortunately I know why he did, and I don't even have to see your head. Rule no 1 If u ask docs to recommend fue-fut you have to check their history and examine the stakes under which they operate. i.e. America, no tech harvesting. Dr. Lindsay comes from that Feller school. Strip first and best evertime unless patient insists otherwise, and only then FUE for touch up or little boutique jobs. I'd avoid.

Apologies to Paceleb, sorry my friend. My above post was to the OP. My sentiments are with you, and your story sounds entirely plausible.

Yeah, but who's gonna know if you don't tell them, right? Misleading rhetoric Conflating the scarring of FUE/FUT ala- 'they both scar, nothing's for free in life, pick your posion..etc..etc.' This was the gold standard that kept strip profitable in the states for so long My donor is totally wrecked from over harvested FUE, and multiple strip scars, yet is only the strip scars that are the giveaway. (SMP has done well to hide the lines themselves at certain lengths but the buckled skin around them still draws the eye. )

Hey Clayton, Thanks man. Awesome post and I'm glad it changed your life. I was wondering if you would have a moment (I know it was only your first post, so I hope I'm not intruding) I was wondering if you could answer a few questions, as I am considering SMP myself. Why did you choose this company? Is it a permanent thing or will it fade in two years like the other temporary SMP chain's does? I mean who wants a two year fade? That means you only get a few months at the 'perfect match' (know what I mean?) Do they use color tones? - or do they use black/grey scale? Thanks. Does the ink turn blue?

Tootall, How could we say yeh or ney? (Seriously, as regular guys?) I hope Busa responds to your question, and I hope he/she/they (lol) does, but in the meantime, as a guy who has been through the mill, I gotta say, i wouldn't care if Shapiro and Konior have more x, y, and z than doctors in Europe/Asia. The key point is - laws prosecuted in their juristriction (and lawyers ready for action) , comparative economic advantage, hype/momentum. I think there is no way in the world, any of us could judge a doctor versus another doctor on any index that requires expertise knowledge. We have no yardstick except our crude interpretation of the protocols they seem to employ/use and those protocols could be blatant and obvious or completely random/ arbitrary factors beyond our awareness. And then there is their capability versus the probability that economic and legal pragmatism dictate. And even if we could calculate it down to the last follicle... ....we could never take anything for granted. The perceived risk factor viz-a-viz legal situations can change, as can the economic opportunities etc. Cracks and opportunities emerge. A doc could be doing manual extraction in May having interviewed potential extraction techs in April. Meanwhile a rep who is on his way out is briefing an incoming newbie all about us, these boards, the kinds of nutcases and casualties that inhabit them. I suppose those docs (a.b,c) are great. Why? Because I've heard a lot about them on these networks - more so Shapiro. Once upon a time a guy with an Italian name ran up a bunch of great strip results, went all FUE, built an empire then collapsed. Perhaps he has re-emerged in another guise, but his name and his chain was turned to mud in the world of these forums. He was the poster boy for the 'unscrupulous FUE hype' - the kind that the strip guys like (fill in the blank) etc. really needed to provide a bulwark for the progress of FUE. His reps were terrible, reeling off impossible numbers - it should serve as a caution to anyone that thinks that the FUE people are 'the good guys'. Nevertheless, it was part of inexorable trend that started. Strip - Manual FUE - Mechanical FUE- ??? ???- where does that end? Another famous doc in India, was a big early FUE star, but he has since reversed into strip - why? Economics. He is more experienced. So easy for him to say now, "Well, after a good deal of experience in FUE, I realised strip was better yield." But despite all this, I still think it is a fair question. There is no doubt that Shapiro and Konior operate in a libel trigger friendly environment and that they have their hands tied by laws that prohibit tech-harvesting? Does that make them better?

Personally, I think that you are making a bad decision. You are falling hook, line and sinker for the strip bait - based on the rationale that you are in poor shape, so you need every graft you can get, and strip delivers. Listen because this is really important. All of us need every last little graft. There is never enough. If you are already in bad shape, the last thing you need is an ear-to-ear strip scar. You should, IMO, aim to; 1) redistribute your hair carefully and conservatively via FUE. 2) Avoid US clinics if you are limited in funds 3) Avoid reading or listening to people/ reps/ docs trying to tell you that strip is your best option. (Strip is THEIR best option) 4) Maintain meds 5) Screen your overseas FUE options very carefully. They are not restricted by law like in the States and Canada. (Techs can't extract in America - know this and reflect on how the economics and legal implications of this trickles down into the lips of those white coats telling you that you need a strip scar. Best of luck

Zyzz, Are you a Yamaha motorbike? Are you a two-stroke? You ask a very good question. What are the biggest f-ups? I satisfy all four of your criteria. Unnatural angles. Well it was retrospectively (for who? patients who look stupid? Docs who are rich?) a massive mistake in the 80s - 90s. Hair transplantation was such a cavalier enterprise then, but it also had intelligent people at the helm. Firstly the physical situation. What do pragmatic smart people do when they know that their clients are dumb? They play safe. And safe to them was to plant deep - for blood supply. Result? Plantation. Also the the mid-80s had the dreadful punch grafting, which were basically like a 'drop-in garden' so they stood up straight. I remember as a teen, my mum (mom) laughing with her friends at the guy working at the grocery shop (store) with stalks. Little did she know her own son would be taken then, and God knows if she knew now. Unnatural hairline. It's better, much better. jigsaw hairline is better. Looks bad immediately post-op leading many docs to abandon it, but six months later, jigsaw rules, wall of hair sucks. Once upon a time, temples were not touched. Acute angles were not touched. Now we have natural temples with most clinics. Overharvested? Yep, absolutely. If you are a balding guy, you should thin out your donor site. But the patchy look with overharvested FUE is/will be common IMO. I am overharvested, but I don't care 'cause my crown is dying anyway. If you are talking about strip, I don't think there is such a thing. you are simply scarred. Low Yield Strip, I don't think yield is an issue. You can train a monkey to dissect. I wouldn't trust them or the doc, but percentage wise, they give you more fat grafts. But screw that. Who wants a strip scar? But Yep, with FUE mechanical, tech extracted rotary drills are my Academy Nomination for slashed and wasted grafts. Techs don't give a F&%&$. They are salaried and waiting for their pay check. It is a market situation. You must choose FUE if you are male and under 50 IMO, but it is the wild, wild west out there. to answer original question; Biggest mistake, Strip (FUT) = scar, overloading frontal zone, leaving crown sparse, forced to grow anyway FUE = transection, overharvesting

No, basically a('the scar') doesn't become wider b('in time'). The scar will stretch for about 8 months (in my experience. (1988-2009)) But what is 'A = the scar'? Once you do strip (..eh..sorry FUT - all FUE is FUT but WTF?) you are committed to it. You will do more strips to keep up with your hairloss. If you switch to FUE and you already have a huge ear-to-ear scar across the back of your head, (basically telling everybody that you have had a hair transplant and that you are desperately vain) ..why not just cut it open again? Why bother with FUE? Strip gives you a better yield. A better 'bang-for-buck' and that is always a good thing for you and your adversary. It is always good to know that your crown is balding everyday, but you cannot buzz your head because you have a strip scar. Know what I mean? With FUE you have less frontal 'bang' hair, but you might get more crown hair and an overall undetectable look as you age. You might be able to sit at the bar as a balding 50 year old and laugh at other people and their vanity. (On the other hand, you may be able o sit at home with your beautiful wife, kids fantastic salary - thanks to the strip job that saved you in the nick of time.. Now, the rep/doc/clinic will tell you there are no guarantees with the scar, either with the first, and especially with the second or third.

You are in a fantasy there my friend. I don't want to patronize you and you bring some good points - many, many grafts are wasted in strip. 1) Vacant follicles (telogen) 2) Loss along the line of linear incision- superior and interior sides of BOTH edges of the strip (beware the doc showing you the best side of the cut to show lack of transection) 3) On the bench in the slithering process 4) On the bench in the trimming process You get what you pay for - at least in theory. The best thing that can be said about strip, is that they might be inclined to use more good follicles, with fat around them that helps them survive. The price is just supply and demand with a bit of marketing strategy thrown in for good measure. You think the doc over charges? Maybe he/she "makes up for it" in another way. There is no holding these guys to account - it is part of the bargain we enter into.

Here is my sketchy and uneducated knowledge, if you coud call it that-maybe conjecture or hear say about the matter.SMP always looks a shade of blue, especially once the ink speeads a little,,aa it naturally does,. Even hair looks blue once it is completly shaven and under the skin. The problem is thta ink spreada to a much wider diameter than a hair shaft, and as it spreads out, morelight filters througj the skin around it. Black is made of red yellow amd blue, but the skin filters out the red spectrum leaving a blueish tinge. At first it is not obvios because the ink particles are concentrated and vertical. But soon the tops of the blobs shed off with epidermal slin layers, leaving the ink at the top of the dermal layer to spread and it looks blue. It isn't too bad if the hair buzzed to zero or grown to over 1cm, but thete is an inbetween stage whwrw it looks absolitely abnormal. The blue stripe can make you paranoid too. Try not to ley that happen., The SMP guys might point out that their inks are stable xolors etc. but that doesn't chage the physics aof light and skin. You can laser the ink off or you can use FUE to poke holes in it. Hopefully the holes will fill with white or skin tone scar tissue which will break up the blue stripe. Finally you could get another brand new strip scar and take out the lot, but that would be a shame IMO. Try q-switch laser first. I've been in precusely the same aituation. Not great. Nice to know the SMP guys are out there telling folks the truth, isn't it?

You know I almost got in trouble with a very nice poster called 'Questionmark' for "beating a dead horse" by discussing FUE vs strip. One shouldn't go over the same issues, right? Punters, Here we have an American doc - (with all due respect, our beloved and fine new doctor/moderator) telling us that in he had recently 'became convinced' that FUE was the golden goose, and only now, at this late hour, to have made fresh new discoveries. And guess what? Afterall, FUE is weaker! FUE grafts are vulnerable. It almost sounds as if it is something new and out of the box. Something Dr. Feller has been telling us for 8 years! Now before you say shut up scar5, the reason I post this rather rude, boorish and unpleasant post - and I mean no disrespect to the doc, not to mention I couldn't possibly judge him - ..the reason is simple, to remind you all. Never blame us humble posters for 're-igniting the embers' of the FUE-strip debate. What you see above is an example of how the professionals do it. Much nicer than the likes of me, but very effective nonetheless. People have said FUE grafts are more vulnerable for decades. Of course we all want FUE scarring and strip yield. So ask what the post is really about.

Don't tempt me! I'll say is something like, 'duh..surprise" and the strip guys will say, 'It's very rare'.. but as I have alluded to in this thread, the airspace gets filled up with info of one persuasion or the other. I'm glad strip is getting a hammering lately - much deserved IMO. Cudos for that guy posting

Yeah, its fine. I realise you are sincere, I just had to watch the strip clinics shut down or confine FUE for so long, I got tired of hearing, 'I'm tired of hearing this' Progress has been made.

It's OK. I think you have nice manners and I know nice manners help. When I was a kid I didn't understand advertising at all. If I saw a Coke sign or a message like 'Have a Coke' I just thought, why bother? Why tell us again and again about 'Coke'. We already know what Coke is! And why put up a big sign that says 'Have a Coke' ..such a daft expression. Nobody is gonna have a Coke when they read it, instead they are gonna hate on Coke for being so stupid as to assume so. That's what I thought. Let me ask you this. How many times did you read the same old stuff from Joe and Spex - stuff like FUE causes scarring? Did you tell them you were growing tired of hearing that? I mean that politely. Anyway, it is all changing rapidly through all the years we have had the same arguments.

I think I know precisely where you are coming from.

Precisely the mechanism reps exploit to shut down inquiring minds Who is we? Rest assured that many young men will wrestle with this issue in the coming year. Good thing we are past it. Been there done that.

I hear you but respectfully disagree - I mean, pure hypothetical of course. Once FUE was established and once a donor had been thinned out I don't see why anyone would slice and massive line right down the middle of it for the sake of more grafts. But to the OP - brilliant. Yes, ultimately FUE suits patients and strip suits surgeons. In the short term however, there is no denying the massive 'shock' results that strip had produced and continues to produce for some people in the front-on picture in the shorter term. But they'll need to go back for more and every scar is unpredictable. And if the meds hold out, maybe they'll be OK. Later as you age, you look at the thinning crown you start to wonder. When you realize it is time to buzz or 'rock the horse-shoe' you are beaten. There is also a psychological and social dimension to the strip scar. It is a symbol of something quite disturbing for some people. Even if you personally can cope, can you cope if the people around you judge you adversely for it? Will they ever know? Something at the back of your mind (and the back of your head). The FUE dots, meh, not so much, not by a long shot. FUE started in 1988. Strip started just a few years earlier. Previously, and even later, punch grafts and scalp-reductions dominated. FUE was immediately ostracized by the hair-medical community. Strip was a massive boon to the HT community because of its economics - just as the OP says. The road FUE had to take was incredibly slow. These days, these boards have opened up and let the sun shine in. It wasn't so long ago that you would be shunned and shouted down for suggesting that there should be FUE vs strip debates. 'Not that again' was the popular refrain. Finally we are moving!

A strip scar is the mark of a real man. That is why I am Scar5 . I know five times more than anybody else on this forum. However, I am humble enough to accept that it takes an expert to know this. What happens when you call the rep from your car wreck, and the car crash expert tells you their knowledge has evolved?

I don't see the word 'expert' written very often in HT forums. I see 'vets' more often. The knowledge one wants that speaks to the reality for any one patient/any one situation to help them make an educated guess is pretty nebulous because of the different viewpoints, experiences and practices of the pundits most likely to have it and the shifting sands of the HT business landscape. What are the inexorable, untouchable facts? - those that apply regardless of context? I don't think experience can answer that wholly satisfy that kind of question. You just have to skim through boards for the last fifteen years to see how these 'facts' have 'changed' or 'evolved'. Docs know best, but we can't expect to get their impartial expertise - that would be a fantasy. So we need to use triangulation, and that requires debate and argument of some sort - or at least 'contested facts' being ground up against one another. Being rational about hairloss is hard!

In my twenties it was day 30 to day 80. Nowadays, my ugly duckling phase is now pushing 21 years. Doldrums is internal and ugly-duckling is outside. The doldrums refer the psychological tension as your anticipation and hope tugs at your frustration and fear that you might have been stooged - and net effect is just a dull funk...you feel you are going nowhere.