scar5

a buzz length is always great for a baldy - unless everyone tells you it isn't lol!

Ht density and native/horse shoe/donut density will be a mismatch at short length if you just use a buzz clipper and universally buzz. But..there are mant devious and natural ways that you can use artistry to prove otherwise.

1) make sure transplanted hair is planted flat! This is easy to say, easy to do, but almost impossible to achieve if the HT surgeon assumes you are shooting for the 'volume look' aka 'illusion of density'

or worse and probably more common, the HT surgeon just does his/her usual thing.

2) hair bleach or natural greying will do wonders.

3) Leave the HT hair longer than the buzzed native zones.

Even then it night not work because of color contrast and density.

i recommend a scissor cut until you become a charlaton with the clippers.

FUT is also called 'strip' . FUT stands for Follicular Unit Transplant.

It is a bit of a spin on words because all FUE transplants are FUT too, but "strip" sounds bad - it sounds a little like 'strip club', or something violent and repugnant (which it is IMO) so the strip industry invented an acronym to make it more palatable, hence FUT. lol

Strip is a hell of a lot more discomfort. It takes months to recover and your scalp nerves are rewired for life, giving you numbness and weird sensory input across your scalp for life. It literally takes all layers of your skin, down to the bone, chops it out of your scalp like a slab of steak, and then the surfaces are pulled together and stitched back. It is terrible for men IMO because they will lose hair in the 'male pattern baldness' pattern which really leaves them only with the option of buzzing or shaving once the crown is gone and the resulting scar, buckling or denting of the scalp plane, and misdirection of hair make that buzz shave impossible to pull off. But for women it is a different story.

Strip has a great advantage over FUE. The technicians can dissect the grafts from the slab of meat their employer (doc) takes out under microscopes and lighting, into wedges of cushioning fat that protect the follicles. Therefore, they can get what is called 'good yield'. In other words, the ratio of follicles they handle compared to the ratio of grafts that grow robustly on the scalp is higher (IMHO) than FUE. However, we must recognize that the docs may plant the hairs at ridiculous angles and those 'robust' hair just spell 'IDIOT' on the unsuspecting recipient.

Women lose hair in a different pattern. They rarely want to shave, although more and more and more will, as sexual/gender roles get progressively diluted (bravo). Nevertheless, assuming a girl doesn't want the option of shaving and buzz, and taking for granted the different pattern of female baldness, why wouldn't a woman not consider the cheaper rates and good yield strip has to offer?

 

Today''s FUT and repair work in the hands of a great doc can fix even the worst problems left by prior docs.

 

If you want it shorter than that and you did FUT, then you did not research enough...ok, big deal,.

They can't.

I've been to the best of the very best. They can't hide a strip scar and the dents and valleys around them.

Yes, if I grow to a 5 guard I am good, but what about my dying crown? And pluggy thinning top?

Right back to where you started, a horseshoe except you have less options than a virgin scalp.

Today's surgeons are yesterday's surgeons and tomorrow's surgeons.

My last strip was 2009, by the best again, trico closure, double layer. Not my worst scar, but far from good and stretched. Desperate bid to fix prior work and continuing loss. And guess what, that doc didn't even wanna go near the worst scarred area.

I think the 'today's surgeons' and 'today's techniques' line is always suspect. My doc in 1988 said precisely the same thing.

There are solutions to fix a bad scar to a 90-100% improvement level .

I don't want to discourage Aaron.

But, no there are not solutions that achieve 90-100% improvement in strip scars.

I would have found one by now if there were.

You can improve them aesthetically and significantly.

But there are tens of thousands of us with strip scars who regret them. So Aaron, you are not alone. And therapy or a mental health professional can help.

In the meantime, you wanna be working on a hairstyle that gives you dignity.

It's an ongoing saga and won't end until docs put down their scalpels and strip ends for good.

So what then are the 'correct' parameters? What is the correct ink? The correct needle size, cluster? The speed? The pressure?

Now before you say, "everyone is different", let's assume that that goes without even saying so.

And how does one know to trust an operator? I think none of us completely trusts them, and for good reason.

Regarding your story, I'm not trying be a wise ass but you seem to saying;

you should base your decision on results by extensively checking,

everybody is different so there is no telling what's gonna happen,

you studied the technical aspects really hard and,

studying the technical aspects is meaningless?

i think it is nigh impossible to do the results thing because you need to see these patients in the flesh over the course of several years - and quite a lot of them.

You can certainly dismiss a bad job, but how likely is it that they will be available for you?

I agree we are different.

I think study of the technical aspects is important. if you make the wrong call, you make the wrong call. The SMP operators are changing their stuff too, so you have to keep up, and whenever they innovate you lose what little evidence you would have gotten. Not to mention that they rotate, get better, get worse.

So what I am saying is that you compromise. You try to learn, you try to see and you know you get spin every step of the way.

Then it clearly isn't "permanent"...

...All of the pseudo-science and over analyzed bs you spouted is useless "knowledge" if u couldn't manage to apply it to your selection of a valid provider. .

Here is more spouting.

First

I think it is normal to make educated guesses and be wrong. I am sure you know that by now Ken. What you do is try to err on the side of caution taking in all your guesses, your knowledge etc., into account. Valid provider?? Who are you kidding? This is SMP right?

Second

I was told that it would significantly fade and I was happy about that and I am happy that it happened that way. I believe that the distinction between permanent and temp is more fuzzy than we are led to believe.

Third

It faded at least 30% within 30 days, again I was aware that it might be the case.

Fouthly

I believe that the ink that is remaining is more or less 'permanent' What I have left is a grey tint on my scalp that really helps the illusion of density.

Finally

All of that is science, just facts that you can look up. I guess you must already know that, hence...

Don't worry about being harsh, hard love on HTN is what it is all about.

However, I am not so proud of my choice as a consumer. I wouldn't dare to be so cocky. Most of us make decisions about these sorts of things quite tentatively and with a great deal of risk and hope. I am glad to say it really helped me and that SMP can be great for people who had strip transplants and kept losing their hair.

Scar5, if fut stretches up the neck and this leaves the donor region more dense looking, then this is a good reason to get fut instead of fue....

... I have heard 90% of the stretching is within 1 inch of the scar.

It doesn't leave the donor more dense looking. It is still thinner then before.

Moreover, the closure also draws the skin down from the crown, so you are making your balding crown look even more open.

re. the 90% . Yes, it depends who you ask in my experience. if you are worried about thinning they tell you it is around the scar. If you are worried about the crown getting stretched, or thinness around the scar, they tell you it is global stretching. I guess the truth lies somewhere in between.

If you had an FUE procedure you can do it after about 10 days.

If you had a strip (FUT) you should know that strip scars take 6 to 8 months to mature and that stretching you neck muscles is difficult to avoid in swimming and a host of other physical exercises.

Then the strip clinic reps and docs will tell you a whole different bunch of stories.

I've heard anything from ten days to ten months to a year before you should mess with exercises that involve even a slight risk of pulling at your neck muscles.

They say you must be selective and use your discretion when choosing the particular exercises you do. I personally find it almost impossible to avoid stretching the neck muscles entirely.

I'm guessing you did strip?

I know this has gone ARTAS, etc, and let it go on, but I'll squeeze this in.

 

Scar5,

 

....how do you explain the "economics" behind my own donor zone? I've had early 10,000 grafts taken out NOT COUNTING my previous two mini-micro sessions and my donor does not look "motheaten"

 

And if your speculation is correct it makes no difference since no more than an average of 3.5% of singles are in telogen

Because;

1) the strip stretch is a linear one. And the gaps are evened out. The FUE tries to strategically take pot shots here and there, bit the gaps will be uneven.

2) your neck line was stretched up, your crown stretched down.

But you still have the identical number of less hairs either FUE or strip. Strip actually takes out more skin but your skull being the same size and having less grafts to cover it is what determines the thinning.

PS> Thanks for explanation about ARTAS chuck. I think that is great info.

An interesting battle is now playing out in winemaking. Hand harvesting of the grapes vs machine harvesting. It has parallels to the ht industry except u if a certain kind of grape gets damaged n machine harvesting, that causes oxidation (bad) it is feasable to plant a different grape next season. Still, it is often said that hand harvesting producs finer wine, especially where subtlety is a factor. Yet the argument goes back and forth, with many variables and as economics of scale keeps encroaching, both sides find a way to push their case in new ways.

 

If ARTAS becomes the new gold standard, the top HT docs will be offering a product less distinguished form the worst HT docs. The premium they charge will go down.

 

 

We'll see if the price drops.

I am yet to see devices reduce prices like they are supposed to ( I believe Armanis prices dropped drastically about 8 years ago and that it coincided with a switch from him doing personal manual extraction to his docs (techs??) doing mechanized extraction)

Otherwise, stories like 'The Feller Punch' are the norm. Here a device is promoted on the basis that it reduces costs, and it doesn't reduce costs. I don't even think Feller himself dropped the price.

Clinics/Reps and Moderators always flog the same line;

"It doesn't matter about the device, all that matters is what the doctor is familiar with using"

This keeps the whole cartel pretty happy.

Scar5,

 

There was no bluff. FUT doesn't thin out the donor the way FUE does. Period.

 

With regards to actual graft dissection, it is easy to see hairs that are in telogen if they have not shed. .... With FUE these hairs are potentially transected

 

 

Joe,

Thanks. (You have a lot of fans here-- just like me )

re: Bluff.

Strip does thin out the donor the same.

Why?

Take 2000 units out of the back of your scalp, either FUE or strip, anyway you like.

Now you have 2000 less grafts to cover the identical surface area of scalp.

Now you can stretch up the neck - I'll give you that. That is not the spin that strip clinic sell however. They tell us it doesn't thin, magically like FUE. Your comments about FUE holes is completely irrelevant. I hope your (our lol) fans know that by now.

But!!

Economics dictates the equation, as always, and FUE just doesn't have the time and skill to create the extractions in a way to hide them as well. Nothing beats nature an here strip wins because the natural order of things looks pretty much the same, albeit thinner. FUE scars can also 'pop' out in terms of lightness. So yers, apart form buckling and misdirected planes of hair, strip donor scalp looks nicer and more natural. Further more, the FUE boundaries are blunt which forms a contrast. Also can look nasty. The tone of a buzzed strip donor area looks nicer than a FUE one, apart from the zone of incision and the buckling around it. (there are no guarantees)

Re: graft dissection

Of course you can see the hair if is still sitting in the bundle. No one ever said you couldn't. My speculation (and it is just speculation) Is that stretching exercises are bad in the sense that they might ease out these telegon hairs.

And in FUE transection is always a possibility, with or without telegon. But the telegon story works out in favour of FUE.

Even so I completely agree that aesthetics is all that counts.

And to the guy who says that planning for a contingency akin to a "massive failure" how does this story sound?

Slow and steady continuing loss over a period of ten to twenty years. Lower response to drugs. More and more dependence on hair styles that are purely to 'cover up' rather than what they should be for. Slow loss of confidence as you accept inevitably that you cannot shave and that you must keep the back longer even as the crown opens up. Is that massive failure? Sounds like a common story to me.

Joe,

Re; the ARTAS (and I know this is a billion dollar question, seriously) how adept is it at knowing and adjusting the diameter of extraction tools? Does it do it at all?

The pigment is deposited just .5mm in the upper part of the dermis.

I think temp SMP is great and all, but..

What do you mean here? .5mm into the dermis? or .5mm from the surface of the skin?

From what I understand, the depths of the dermal and epidermal layer vary in the body, and they also vary across any single person's scalp.

Then, to add to the complexity, the dermal layer is not smooth, it has a layer called the dermal papillae which is not flat, in fact it is made up of elongated protruding nodules that reach into the epidermis to oxygenate it, and to ventilate toxins into it.

So when an SMP practitioner starts banging away, she or he maybe hitting either or both the dermal layer or the epidermal layer and there is no way to tell which

is which. The response, I guess, is to go lower and hence 'permanent - although my 'permanent' is barely 50% after 30 months - or it is to go so shallow (temporary) that all of it is so superficial that it is extremely shallow. Even the mildest sunburn might compromise it.

I would like to see the industry issue a comprehensive study on FUE vs. FUT, with special focus on survival rates, but I doubt that can objectively happen now since camps for each have been firmly established, as demonstrated by this thread and the ongoing debate.

I don't think the camps are established.

It's a fluid situation as more and more clinics and patients move from strip to FUE.

Just 5 years ago, most people here said FUE is for small jobs.

Even three years.

What we have is inertia based on patient choices. People chose strip or chose FUE and then dug in their heels to defend their choice. But there is a lot of migration to FUE actually going on regardless.

KO is wrong if he believes that, same as Spanker and Joe etc.

The FUE holes and scar are due are irrelevant to the equation. If you read my earlier post, you know why.

Strip clinics have tried to bluff us for years that donor density wasn't depleted like FUE. Actually, tried no, DID bluff us, because nobody blinked. As late as June/July people on this board were arguing against it.

Only in recent months have they had to concede ground on the stretching issue (that yes, in fact, strip stretches out the scalp) and that has been only die to people like us banging on about it.

Next, you need to bring up linear incision transection. Joe addressed that in his last post, but there is no doubt loss.

In the last post Joe mentions that when bundles shed a single hair, FUE transection rates go up. He doesn't mention that these bundles will also be misidentified in strip dissection too.

I don't know about the ARTAS robot. Does it have a rotating chuck? So that various diameter punches are automatically rotated to extract various sized bundles it has identified? Does it even know the bundle size? Or does it just see a blob and then make a judgment based on the color density of that blob? Perhaps it is one-size-fits-all?

People don't choose strip for the reasons Joe suggests, IMHO. They choose it because they are told to do it by a strip clinic.

It is not just the linear line. It is the buckled scalp too and the prospect of having to undo all the 'good work' a second or third time for successive strips. Then there is the big question, if no drugs - no hair - no exit etc.

Agreed. Plenty of telogen follicles make it through. My bet is to avoid scalp stretching exercises that strip clinics advocate as you are easing out the last hairs.

In all my (paltry, it must be said) research, the term 'dormant follicle' has featured predominantly, suggesting that a follicle goes, well, 'dormant' and therefore either sheds all of its 1-2-3 or 4 hairs pretty much all together. But contrary to this, I have also seen pics that claim to show a follicle with a dormant hair within it. It is pretty confusing. One thing I will grant the strip clinics, is that dormant hairs do not necessarily fall out, and so if a hair is still identifiable, even if it is somewhat, for want of a better expression, 'on it's way out' of the follicle, at least the zone can be identified and then dissected.

But even so..it's no deal.

Don't forget about the linear transection factor too (the bit where they cut, and claim not to cut follicles) - big losses here too.

As someone who has actually stood next to a tech while she has been dissecting part of a strip, I can tell you that it is something of a Myth that 'a high number dormant follicles go in the bin'. Let me put it this way: Why would someone performing FUE stand a better chance of seeing dormant follicles better than someone performing FUT?

 

FUE is blind, FUT isn't.

Right, so you are standing next to a strip tech, in a strip clinic, the staff are all making a living performing strip, and the strip tech is going to tell you all about it, right?

You are going to walk away from a strip clinic with unbiased objective facts, right?

What did they tell you? That they can see an empty follicle?

FUE is blind? FUE can see from the surface, that's all. Strip doesn't even care. It is like an open cut coal mine. You get what you get.

But I am sure that FUE transection is brutal, but for the same reasons that strip is - economics!

Do I think FUE is clean and pure and honest? No way! It is disease ridden, corrupt etc. for all the same reasons strip is. It is simply that you don't end up with a line drawn across the back of your head. And that is the reason you should do FUE and meds first, if you are male and under 45, IMO.

the density, in terms of gr/cm2 should decrease by the same amount regardless of procedure, would you agree?

 

Of course there is no difference . ZERO! ziltch!

It is easy to get caught up in all this spin the strip guys try to throw a you.

Just remember the fact - you have twenty chairs in a room. Take out 5 - anyway you like.

Now there are fifteen chairs in the same room!

No amount of spin can disguise that.

The hole left by the FUE extraction is irrelevant.

 

c. Start with strip, undergo several strip procedures, realize they may be able to obtain some additional grafts via FUE far down the road, and utilize these instead of undergoing another strip surgery on, what is likely, a tighter scalp.

/QUOTE]

 

..and then lose the more hair as the effectiveness of Fin wears off, try your buzz your hair, and see the terrible strip scar, grow it back, hope for the best, realize the fantasy and that the joke is on you, buzz it again, looks even worse, grow it out again, seek out FUE in a desperate last ditch effort (because you can't do the dignified shave) , hope for the best again, and realize that strip surgery is for lucky guys.

 

Strip is big business. For two decades it has paraded its massive results. The losers, and there are many more than the winners, don't know, wouldn't bother, have given up, realize there is more to lose than gain etc... don't pore to the pond.

 

I recommend doing FUE and as much medication as you can tolerate before deciding to incriminate yourself with an ear-to-ear strip scar. (I don't car if it is "pencil thin" and 1mm, I will point it out to the girl you are courting if we ever meet.

Dear Matt,

 

That is just a perfect explanation

Indeed it is.

Here you have a strip doctor patting the back a poster peddling the 'good 'ol gospel"..What a croc of $%&!

All of it is rubbish beginning to end.

The reason FUT is better first is because it suits the strip industry and the strip industry owned the HT landscape for so, so long, that so many have invested in it emotionally and financially,

All of that Matt stuff is a pile of crap..., and the docs stuff is utter nonsense too.

This density does not decrease nonsense! What a load of... I have no words..no patience.. absolute rubbish.

Five more years will bury this for good!

1. I don't understand dr. karadeniz' excess skin argument. I don't see how it could be a way FUT could give grafts without decreasing donor density. If skin is bunched up - or in excess - I would thinking the bunching causes an appearance of greater hair density If you reduce the bunching — that is the skin excess — you will reduce hair density, I should think.

 

2. The neck stretching argument might be a way FUT gives grafts without decreasing donor density. Under this theory the hair line over your neck is raised up a bit. But how much is this hair line really raised? I thought almost all the skin stretching takes place within an inch of the scar. No?

 

3. I really wish I could get an answer to this: Why can’t you do FUE before FUT, and FUE harvest from areas no where near the FUT donor region?

All good points Ollie,

1) of course stretching decreases density, it is ridiculous to argue against otherwise, unless you argue that the diameter of the hair shaft itself 'stretches' too. Now that sounds unlikely.

2) The doc argues with you on this early in the thread (it's localized) , and then switches against you later. (it's global) So let's assume the neck accommodates 'some' stretch, the hair bearing zone 'some' stretch too. :confused:

3) It makes sense to do FUE first. You might get away with it (just FUE) for good. You might have a clean scalp (just look at the magnificent scalps we are now seeing regularly with heavy FUE harvesting) So why draw a dumb line across your head first?

The argument that fibrosis created in and around the FUE extraction sites makes strip sluicing or cutting tougher - who gives a #%&'! So do it hard! I don't care if the tech gets a sore hand, do you?

Multiple strip scars is butchery the doc says. Not so my doc, who was president of the ISHRS. One day, (and one day soon) they might say, strip is butchery, period.

A strip scar itself is a mark of intelligence, multiple strip scars more so, which is why I have four.

The total skin laxity of the scalp distributes forces so uniformly - using the above principles - that skin strip excision causes much less donor density decrease than we would expect.

This contradicts your earlier point that thinner distribution is localized near the incision.

But I think your point is key - it comes from the neck and outside the hair zone.

Strip is essentially a scalp reduction and was born from that protocol. Your skull still has identical dimensions to pre-op so the loss has to come from somewhere. If the area comes from the nape and neck, then there is no issue. But there is no issue to begin with because the stretch is small. Further to this, if we accept that stretch comes from the back, we must also expect it comes from the front and you are pulling back the hair line.

It is only a minor problem IMO, but one of those things strip clinics try to get by you. The natural distribution pattern that most of the remaining hair keeps after strip looks good, as long as it has not been squashed and buckled too much.

My hair looks mangy at the back from, I assume, overharvesting. The overharvested zones are obvious. But what is less obvious, apart from the blatant strip scars,

is the many strips I had done previously, and the stretching they caused and hence the thinning.

Remember, few people need just one HT, they may get three of four strips. In anycase, it does not make strip or FUT a bad thing. Plenty of other stuff does that.

There is no difference, except that FUE reveals the harvested zone, because they usually extract from predefined "zones" which they draw in les than 30 seconds- drawn crudely and bluntly. There is no transition. Strip doesn't have that affliction and you notice no transition.

Skin laxity has two components: glidability and elasticity....glidability gives grafts without significantly reducing the density around the donor area.

 

Don't you mean gullibilty? It makes no sense...who said this? ... a rep? ... a strip clinic's website?

If you remove hair bearing tissue containg x number of grafts then you have x less number of grafts left to cover the same surface area of scalp. The only way to avoid this is to remove the skull, and brain, chop the brain and squeeze it into a smaller rescepticle than the skull, and then reinsert that into the head cavity instead of the skull stitch it up, and glue the eyeballs onto the face.

Now that would make for awesome before and after pics, but even so.....