scar5

Anyways I have opted for fut for giving me a cleaner overall hairline for now.

Congratulations..you've done it now, so I wish you the best.

Why does strip give one a 'cleaner hairline' ? I am very curious as to who told you this, and on what basis they justified the claim.

Wait for the two month point before looking critically at the scar, then don't panic if you have shock loss near it. Look for the fibrous white tissue and the widening gap. After 8-10 months I think you'll know the score. Of course you could go back for more hair in future and then it is another dice roll. Meantime, just make sure you have not got puss and blood, and don't move your neck.

Good luck.

Cleaner hairline? ..do tell!

 

The subjective argument...doctor’s training ...., ...his smartness.

 

...outside the US.....(docs).....migrate to more supervisory roles. Inside.... they...push to the point where they lose manual dexterity.

Docs will use hand held machines, feller machines, harris machines etc.

They won't persist with manual.

I think Blake having a bit of fun.

But even so, he is about to embark on a career as a doc in the states, where techs are banned from extraction, and where people are flying to Turkey instead. So any fun he is having has to be at the expense of the tech. (Politely avoiding the docs that employ them)

If you are going on about dexterity, there is the curious case of SMP at NHI, where docs actually do the SMP instead of SMP employees or proprietors.

Are they better? How would we know? They know the physiology of the skin better..Again, I think it is the stakes.

Docs can tell you information that techs can't mid-procedure. Docs have the power to control their speed where as employees are more likely to cover their asses and do their 'quota' regardless. Docs can act independently with confidence. Techs have the team/partner to worry about.

Docs are smart, and docs have patients lol.. patience..(good one scar) but will their brains be working 100% in such a mind numbing and boring pursuit as drilling thousands of tiny holes.

It comes back to the law and economics pretty quickly. If I were a doc based in the states, I'd trash FUE for as long as possible, then gradually concede yard-by-yard to small FUE procedures which I would do with hand held mechanical devices. I would consider ARTAS but consult carefully with an HT marketing company to see if patient ignorance was still strong enough or that the stigma of machines wasn't.

Just remember guys, no techs can drill in the states legally. Where does that leave an HT doc in a market that is flying itself overseas?

I still say if your don't like what your country is doing......Go somewhere else. I prefer a Dr. working on me. I prefer to stay warm in the winter with Natural gas. I'm not going to complain a Dr. is ripping me off for a job I agreed to have done. What's with the hostility with professionals. Most have sacrificed in life to get where they are at now. Do you guys think a so called "monkey" or some other derogatory name can do what you do better in your own profession? I bet we could give an example of one that could. Why can't the Dr. and the tech just be a well oiled machine/team?

I agree with about bitchin on professionals. They have made sacrifices and they desrve our respect. Ultimately, I look younger because of th ht industry.

I'm not so sure about the rest. We get what we pay for, rigjt? I think you will complain. I think you will get a lawyer to help you take care of problems and I think you will stay warm as long as you can payfor it.

Going to another country? That is precisely what is happening as we speak. How many patients on a plane to Turkey? More than five years ago, for sure. Strip is going down, and the HT industry in the states is doing its best to adapt.

My question assumes legalities are irrelevant. ....

 

.....there is some truth to paying a doctor a big premium to do what he cannot do as well as any tech

Well, sorry to say, that assumption turns makes the discussion into existential acrobatics.

The legal question is primary, fundamental and it is the backbone that holds all the other spin and BS together. The US is a libel-friendly environment and any lawyer will take your cash to put Dr. X in the local newspaper for having white-coats on $15 an hour drill holes in your head. So much flows from this. So many thousands of wasted hours on forums like this in the name of "HT education", in the name of objective science, all twisted around one striking fact, like moths circling a light bulb. Techs can't extract in The States. That's it. Simple. And so strip has an extended life-span, and so we go to Turkey, India etc..simple as that. Everything else is a rationalization aimed at disguising this.

As for Blake's comments, yes, I shudder at the thought etc...why do docs so often fall over themselves to tell me stuff like, "Well, to be frank, they (being the techs) are better than me at it" with an expression on their foreheads designed to impart a sense of "Wow, what do you know, I'm such a frank guy, I can't believe I just told you that, but it is because it's all about you...not me"

Now, steady on, you probably wanna say, "Scar 5, it is because you are a vain and you are immature and you are an HT victim with an HT victim complex - hence you stand ready to be manipulated and you want to be treated like a bitch..and anyway...I have kids and I want them to have a good life...and sorry buddy, ",

But none of that alters the facts.

In my last FUE, I was staggered, absolutely shocked beyond my comprehension, after all my experience, to see the techs do the extractions. I protested and what did the doc say? Again, with that familiar look in his eye brows, "Well, frankly, they do it better"

Medically trained, yes. Professional, yes. Ethical? Who am I to say? I am gaffed in the name of science.

Readers be aware - Techs can't extract in The States..it is a good thing, no? It makes America what it is. A place of freedom but a place where decent standards can be upheld..upheld in court - all for a price.

You can blow up mountains and poison the water table with natural gas fracking techniques, and the world will buy it. You make a stand for globalization at the expense of a lower middle class in the mid-West, but you can't allow techs to extract grafts, because that is fundamentally wrong. Bravo...no?

One rule about HT is that the landscape is changing...always. You can't establish the facts through education. By the time you realize it has changed. But somethings change faster than others.

How can we make an educated guess about the validity of,

a) Techs doing extractions generally

b) Tech A or tech B doing it?

c) Tech using device A or device B?

By the time you work it out, you are either bald, broke or so bent out of shape you don't even care.

It's always changing. Try to keep your eye on the bits that move less and the bits that move more. Techs can't extract in the states, so...use your head.

Nah,

I don't agree.

Choosing strip because of the economics of FUE - I mean assuming that docs and techs just cash in on the strip scar terror is BS.

The scum-bag techs, docs, sweet-smiling desk girls etc.. in the FUE clinic are just as bad as the strip shop correlates.

They are all in it for the $, so just look at trends, and the trend is FUE, and the trend is well-intentioned docs doing manual FUE but these docs are getting fatigued and morphing into either strip clinics (aka Dr (_)BC in Delhi) or moving into tech driven FUE, (Dr (_ _ _)in (__)

It is very difficult to tell the truth here, but use deductive learning and fill in the gaps.

FUE for sure, but manual FUE is only a docs friend for 4 years, if that.

But how am I, as a patient, to know who is the great technician on staff vs. the one who started performing extractions just yesterday?

You don't.

And how are you to know that Dr X just changed his extraction motion from a toggle and twist plus downward motion to a straight sharp punching action because of fatigue to his tendons.

Manual extraction is taxing. We should all be aware that a doc's life span is limited. The father of FUE - Dr. Dare-you-mention-my-name-on-HTN- suffered from this affliction and many FUE docs have given up manual extraction. Please do not assume that the doc you saw doing nice manual FUE on youtube is still doing it today.

Techs can be hacks.

i swear to you that I have had some techs on the payroll of clinics that are paying for these forum owners' kids college fees, that techs can be well-meaning robot hacks with drill in right hand and pay check in the left.

But docs get fatigue, so go figure!

scar5, I have you beat easy. I have 7 or 8 scars going from ear to ear. Why is your name scar5 if you only have 4? Exaggerating a bit? Or was it in anticipation of doing another surgery to correct some of the old ones?

.

OK Happy,

I gotta concede. You are the master. You make the Gods of Strip look down from heavens with pride. I gotta work on getting myself some more strip scars:confused:

i actually have a frontal scar to where I had a linear strip taken to remove the front which was impossibly dense compared to the barren interior.

Scar, can't you just grow your hair long enough so they can't pick out the scars?

I can, and I do, and I look decent - decently ugly, but decent.

I can even buzz quite close.

It is a case of which poison.

If I buzz close, I lose the illusion of density my weak HT gives to the face frame - (takes years off me), but I disguise the balding crown.

I have no donor, no time so I am cooked, as it were.

I look like a man my age, ironically, after all the BS. The lines have not come from a normal life of wife, kids and business pressure, but from years of wrestling with self-identity, poor self-image, desperate measures/ grasping at straws etc.

In terms of scars.

Two strip revisions one with trico, one without- different docs

SMP - three attempts, three providers

BHT - two docs

Gel inserted under the scars to flatten them out, twice

FUE into scars, twice, two different docs.

Gotta whole lotta mixed feelings about HT and the HT world, vanity and the need to look better, but I know the laws of nature and natural selection don't care about me for that, just as I don't care when i cast my sleazy eye over an attractive lady.

Now I just step up and into the mainstream, scars and all. Onwards..

...full donor capacity to pay for whatever BS we flog you balding dicks. What-a-loada-crap is just an expression and I wouldn't apply it here.

 

I value hair, and dignity. Unfortunately hair transplants and dignity are an awkward couple. How can I hide the fact?:mad:

But I agree again with Dr. K here...separate incisions are not good, so to is ONE incision. People now know what an HT scar looks like...just check Howard Stern Radio on youtube and hear them laughing (20 mil. audience) at scars, (including 'dot scars' = FUE scars from the 1990 - 2005 era) to realize what is up, or soon to be up.

That said, many women have seen my scars (strip - the FUE have never been questioned)) and not had a clue why I have them, but guys know and soon enough girls will too.

double

You get more hair, better yield and generally a more robust hair transplant if you cut a brand new scar far away from the original. Furthermore, you have less complications. Patients can't complain that you screwed up their 'good scars'.

That said, it is the most vile and disgusting piece of professional decision making in the canon of the strip doctor...as if strip is not vile enough.

It is appalling to get one ear-to-ear strip scar if you are relying on medications and are bound to lose more hair.

To create a second or third scar is beyond dumb.

Luckily, I am smart enough to outwit the system, and I have four scars, so I win....yeah!!

The only way this could be justified is if the patient attempts to create a montage, say ten strip scars from the neck to the crown. That would look cool, and in ten, twenty or thirty years time, multiple strip scars, shaven down, may be a sign of something much bigger and better than we imagined.

Well my preference is fue..

....should I go for FUT to maximize coverage for the hairline...FUT which is scheduled for 7th while my FUE is scheduled for 13th so I have yo decide...

You are rushing this, putting yourself under pressure and second-guessing yourself. All natural, but really, you will only add to your confusion asking people to enter the topic.

1) Medications

2) Calmness

IMO

FUE is better because you don't have a linear scar. This gives you choices as you age and respond to further loss, fall-of in medication effectiveness, hair colour changes etc.

Strip yields better in many cases, but that is not enough reason to give yourself the scar. Just consider a 3000 strip to pack as much punch as a 3500 FUE but the no scar.

If you go to a poor FUE clinic, you'll get no growth or sub-par growth and be angry, but you still won't have a strip scar.

I would suggest FUE but not just any old FUE doc.

Some of these FUE clinics or docs that do FUE are pretty shoddy.

Please, choose a well-respected FUE doc. Even if he/she doesn't have many published results. Use Dr. Lorenzo etc., or any of the several good FUE docs you see on this site as a yardstick (a reference) and compare your ideal doc to them.

Re: debate about strip and FUE. It is in a continuous state of flux, but the trend is an inexorable drift towards FUE. Trust nobody who acts as if it is all settled and a,b,c suits strip, and d,e,f suits FUE. Time proves them all wrong.

And medications.

Good stuff Olmert

All readers should be aware of why FUE has been uneconomic in The States (techs can't do initial extraction) and that this is fundamentally why such a rigorous defense of strip has prevailed in the face of progress.

I don't buy HT Doc's story here. He says he was initially skeptical about FUE, then after seeing great results, after hearing docs speak of great success, he became convinced FUE had arrived.

And now, after all that, he tells us about fat, torsion, heat friction etc..all facets of FUE he would have been initially aware of at the outset. Dr. Feller has been telling us about torsion, traction etc. for years. HT Doc speaks as if they are fresh revelations.

What he says is quite valid as far as points go, but why they are now all of a sudden swinging his vote is a little strange.

Ironically, FUE yields were probably higher 10-15 years ago, but so was the degree of scarring. Those were 1mm punch days.

I agree that older gents might like strip, and I think woman might suit it too. But then again, if women or older men never wanna buzz, then 1mm punch FUEs, which have a greater survival rate, but a larger scar, might do the trick.

Strip exists because techs can't drill follicles in The States legally and therefore it is uneconomical for clinics, not mention dangerous for docs and their tendons, to do the job day-in, day-out. The relatively recent ascent of ARTAS in an otherwise hostile world to FUE, is suggestive of this too.

But I think yield is better with strip because of the fat issue and visibility. Always said so, but if economics allowed for it, I believe people like Bisanga etc. could get yield pretty close for some clients. Once again, economics.

My Naive Idea

Re: Extraction, why can't they make/get some fat (synthetic?) and dip the follicles into them immediately upon extraction?

Now, few months after the procedure my hairline is in the same condition as it was before with NO improvement in hair growth.

Few people have good results after 'a few months', so wait. Otherwise, your story and others' just confirms the brutal reality. Hair Transplantation attracts the most mercenary doctors, and the most needy and pathetic clients - a marriage made in heaven.

thousands of tiny circles have more circumference than one long curved line --> more tissue is violated with FUE than with strip

.

My goodness.

My desperate, screwed up HT'd sorry ass.

More circumference? You can walk in circles after having FUE instead of walking straight to the taxi door from the clinic. What does this have to do with the issue at hand?

More tissue is violated? Do you wear a tie to a job interview? Do you have a hairy chest? The issue here is that FUE scarring is pixilated, like hair, so it is camouflaged. Strip leaves a line in the sand that tells everybody, 'I had a HT'.

What else could anyone care about? Good yield? Good yield plus HT scar = jerk, does it not?

More tissue is violated? (just adding it there) Dr. Feller's favorite line. And it is a good one. But it doesn't matter when you're looking at a strip scar or a horse shoe after ten years.

Bismark, what do you think it will take for strip to die out in America?

a) the internet to collapse

b) Propecia is proven to cause cancer

c) HTN gives a $10,000 cash back to any young guy who chooses strip

I don't understand why so many people have a difficult time understanding the density issue. You have to realize the amount of real estate lost with a strip is compensated for because the extracted grafts are implanted in a less dense pattern than from where they are harvesting.

?

There is no compensation. The virgin zone is thinned. Sure, your empty forehead gets some hairs, but the back stretches and thins, albeit in a nicer and more natural lie of hair than FUE, but then hen its the strip scar lottery means the hair must be strategically cut to cover it.

Some comments.

6000FUE and not starting to look thin is somewhat optimistic. The threshold seems to vary between 3000 - 6000 with an average of 4000.

 

I agree.

But thin is good. A thinned out donor is ideal for a balding man, because recipient density can never match native density, or a 'horse shoe'

I remind you that in these forums, it wasn't long ago that people said FUE was only suited for less than 1500 grafts.

Once Spex, a well-loved and respected poster, dared me to produce 10 pictures of FUE results over 3000 grafts. There were few available, thanks partially to FUE being uneconomic for American docs and his and Jotronic's efforts at maintaining the myths about FUE. But the results would come soon enough, thanks mainly to people like Lorenzo, operating and marketing outside the US and with clients not in the sphere of Amercan forums... and I think he knew this because he quickly rescinded.

But even so, there are limits and overharvesting is real.

In 2006, when I was even more naive than I am now, I marched into the pre-op consultation armed with my 'list of questions' I sourced from, I think, HLP or HTN, determined to make the clinic accountable proclaiming, "I want a complete list of all follicles, numbers of ones, twos, three etc., as well as a number of transected.

My wish was granted. I received an A4 piece of paper with gridlines drawn across it and columns indicating the numbers of grafts form respective regions, the number of hairs in it and the number of transected grafts. The transection rate was negligible. I think it was always only single digits, indicating less than 5%.

A year or two later, a leading FUE doc told me I probably got 50-60% yield!

To cut to the chase, I agree with Dr K here. It simply isn't worth their while to count and record transection, and if they did, they would fudge it. Furthermore, it is known that partially transected hairs can grow, even with less hairs. So they get planted too.

BTW

Later that day of the surgery, I asked to see the drill and from behind my back i heard the doctor disengage one chuck of the drill, remove it, place it on the table, and insert a different chuck, that he proceeded to show me.

Let me.....try not to generalise;

 

I have never had a previous FUT patient who had run out of donor hair ....

 

..FUE, especially when done by technicians, had depleted the donor area about 6000-7000 grafts while only giving a yield of 2000-3000 grafts.

There you have it folks.

Straight from the horse's mouth. **

**A recommended Hair Transplant Network Doctor no less.

Never had a strip patient run out of luck...(but that's just his experience)....on the other hand...

"FUE done.." (= not one case) "especially by technicians" (= not so always, but it tends to be so!)

"had depleted" (= ??? uh? One case? We are now talking of one case?)

.. Or are we using a sleight of tongue to conflate the effect...so that some of us walk away reading it as ...FUE = 35% (disclaimer #1 -tends to be more with technicians) (disclaimer #2 - I could be referring to just one case, but you don't know, so let's just assume it is all bad, where there is smoke there is fire)

Shocking post.

But I agree that yield is probably much lower than quoted, and yes, especially with technicians and drills.

Clarification, I mean it is wishful thinking in terms of expecting those weak hairs to live. It may be better to sacrifice them anyway, especially if it means you get a good balance of density.

Future,

Is this really your very first post?

Your question tells me that you done a fair amount of research and reflection and you are perfectly right to be suspicious of the answer you received.

Asking a rep this question is a bit vexing.

Say your meds are working and you are relatively stable,

Whilst they want your business, they often don't want to touch these areas deep behind or on the crown, concentrating on the hairline etc. Then, later, when these weak hairs finally croak theyll go in there.

I don't like this approach because it does not satisfy the initial desire to illiminate the bald zone, if anything it illuminates it and just prolongs the inevitable,

If they plant in the weak zones you might as well write off those dying hairs. Asking them to plant inbetween them is wishful thinking IMO. Even if you lost none to transection or post-trauma shickloss, you might not result in the density you need.

But you can't expect a rep to say they will willfully destroy your ailing weak hairs, rather they'll say that they deserve some love. But if you have been on meds, and they are still feeble, it isn't going to get better.

Assuming;

- you have a thin scar ear-to-ear scar and there are no 'fat patches'

- you are not looking for a scar revision, where a thin strip is taken and the wound is re-closed with the intention of thinning it.

All of the good FUE people should be able to help you. My advise would be to seek out;

a) doc-done manual extraction FUE

b) a doc-done mechanical extraction FUE

c) a tech-done mechanical extraction

in that order and see how the prices work out.

Some will suggest;

a) beard hair

b) body hair

It might not be a bad option, especially if you look good with a buzzed head and want to you use what remains of your precious grafts for further FUE work. However, growth with body hair might not be as good and beard hair extraction can cost more (heals extremely well, however)

Don't assume;

-that FUE into the scar can completely hide the scar...one strategy is to 'break up' the scar by heavily hitting certain patches but the problem with this is that growth is unpredictable.

-that the doc/reps will not try to talk you into another strip instead, in order to address the 'problem area'. I have first hand experience of this and paid the price.

- if this happens all bets are off, your scar will be better in patches and can be worse in others.

Have you done a trial buzz to assess the damage? If you have a lady in your life, you can get some of her eye-brow stuff and apply it to the area in advent of disaster.

I'm sure Turkey and India have options that could suit.

Good luck. Aussie is a bad place for HTs and to go bald! correction- any place sucks!

Look into SMP but wait at least 12 months post-HT

One thing I would do differently today is take a small umbrella.

Aussie men and sun umbrellas go hand-in-hand. Can of VB in the left hand, sun umbrella in the right!! Off to the footy! 'Don't you start no fight!' says Bon.

I think you'll have to ask the doc/rep that one. That is one thing they should be able to give you objective opinions about. I guess that sunblock creams have a variety of ingredients. They certainly use a variety of textures.

Detectability in recipient area and n the donor area for me is entirely down to the length and style of the hair.. Further more, grey hair is helping me, although I have brown temples and grey sides die to tje temples being filled with hair from the area destined to grey layer.