gillenator

While it is true that there are really no formal residency programs for HT surgery, some docs do offer internships including for FUE but they are far and few between. A good share of them do have formal training and education in the field of dermatology and you will see that if you read their respective biographies. But as KO stated, some come from a wide array of medical specialization. There is another thread in this forum entitled, "FUE: Extractions not done by the doctor" where I posted some comments. Interesting thread...:rolleyes:

Yes it is gone now but again, am left with a small scar the size of a pea. Still think it was a piece of staple that broke off. I keep the length at roughly 1 1/2 inches so you can't really see the small spot scar unless my hair is wet. One other possibility with these tiny pea size bumps is they are simply cysts. A cyst can develop at anytime and do not have to be related to having HT surgery. Cysts do not normally go away but can be surgically removed. If they are bothersome, usually a good dermatologist can look at it and determine what the problem is. And I'm referring to ones that are not directly on or adjacent to the strip scar. Anytime there is a bump or lump anywhere on the body, we should have it examined by a doctor. Sometimes they can be abnormal growth from a whole host of possibilities and why seeing a physician is the best thing to do.

I wore hair systems for 11 years before I had the nerve to pull the trigger in 1996, my first procedure. There was no internet when I started my research so all that was available was what I could find in the main library, and that was not much. In 1980, when I started research, most of the medical community regarded HT surgery as a renegade field of unscrupulous doctors who preyed upon desperate individuals. Almost every doctor I inquired with thought I was nuts to ever consider HT surgery. But of course back then, it was open donor methods and had no aesthetic appeal. I remember Dr. Bosley doing segments on public TV channels which set the stage for infomercials which came later. I got referred to Bosley a number of times, but did not want that type of result with plugs. I waited for the industry to begin doing micros and minis and did my first procedure in 1996 which came out reasonably well. It freed me from wearing hair systems which I desperately wanted. So in conclusion, it was not a matter of how long I spent doing research, it was a matter of waiting for the right techniques to arrive and then finding the best surgeon that I could find at the time.

There are many guys who would die to have a beard that thick and dense. And it's not unusual to have some sparse spots because that makes it look natural IMHO.

IMHO, running in itself does not put tension in the donor zone, but I would stay away from push-ups and sit-ups for at least 4 months post-op.

Roughly ten years ago, an experienced tech opened his own FUE clinic in the Jacksonville, FL area where he is from. I can't remember the name of the clinic but his first name is Larry. He was an independent tech and contracted with one of the clinics that I used to work for, and that's how I became acquainted with him. He decided to open and operate his own HT clinic, yet he has no formal education or training in the medical field. He held no license as far as I know because he told me this himself when I first met him. I then heard about him starting his own clinic and discovered that he shared office space with a licensed physician who was not a HT surgeon. This physician practiced in a completely different field of medicine that had no relation to the hair restoration field whatsoever. In other words, Larry was able to use the doctor's shingle (license) so-to-speak in order to meet the state's regulatory requirements to operate a medical facility. Yet Larry himself was performing the procedures...:rolleyes: And they put up some examples of their work and some of it looked good. The best work? Not in my opinion yet at the time, there were only a handful of North American surgeons performing FUE with very few examples to showcase. Some of you long term hair junkies may remember some of the controversy that occurred with this clinic in several of the online forums back then with the debate that if the work is good, "Who cares?" Others, like myself are of the opinion that an experienced licensed physician needs to be present in the OR whenever "surgery" is being performed no matter which individual is doing it. How in the world can anyone allow surgery to occur without an experienced licensed physician present?..:eek: Why am I of this opinion? Because people forget that various complications can arise during any surgical procedure. Individuals health conditions vary. They can be on medications or have sensitive medical issues/concerns that must be addressed before the procedure even takes place. Does the clinic take a complete medical history of every patient and have each and every one of them "cleared" for surgery? Things can change on a dime without notice. Things like a sudden drop in blood pressure, cardiac arrest, diabetic seizures, etc, etc...:eek: And I am not speaking exclusively about hair restoration surgery, it applies to any type of surgery including oral surgery and/or whenever anesthesia is applied. And how many of us also know that anesthesia (local or otherwise) should only be administered by someone who is legally licensed and experienced to administer it? That's the law in most states. And I could go on and on with numerous other violations but the real issue, "Is the patient at risk?" Are the patents' vitals being competently monitored throughout the procedure and by whom? Yes there are some very talented techs out there. But it's not just about the bottom line results or even the price. First and foremost, we cannot forget that the safety and the well being of every human being is imperative! Things like this can and do occur in an unregulated industry.

This is another phenomenon that is controversial regarding large procedures or the mega-session. In today's world, that is attainable with FUHT providing the individual has the accommodating scalp laxity for a strip that large, and of course the density level. Yet some docs do not like to do them because of the added level of trauma that the additional thousands of recipient incisions can cause. Some are of the opinion that yields and regrowth are better attained in smaller sessions of 2500-3,000 grafts for subsequent procedures. Initial procedures tend to have the best yields. So the impending question is, "Can a higher level of scalp trauma affect the overall yield?" I think that it can. There are many variables that can impact the regrowth or level of yield in mega-sessions. The first consideration is how the individual responds to the trauma. Some patients really experience inflammation and swelling, some do not. Some surgeons employ the use of custom blades to create their coronal incisions which lowers the level of trauma because they are in many cases, less invasive. If the mega-session is a subsequent procedure within the same surface area, then the recipient zone is already compromised with previous scar tissue and can affect yields in subsequent procedures. One of the other dilemmas is that a subsequent session does not appear to be as dense as we think it should be, visually speaking. If there is hair within the recipient area to begin with, how does one track the added level of density as per cm2? It can be done using a series of photos before and after the procedure using a scope but not too many clinics if any do this for the patient.

Yep, crunches, squats, shoulder and back routines all potentially create tension in the donor zone. Sit-ups especially create tension on the strip scar...:eek:

The industry is unregulated and so techs are not required to be licensed or regulated. Only nurses are regulated by licensure.

Lots of good information being provided...

Talk about popping out of the woodwork after 7 years...:rolleyes:

I remember a guy who started a thread on this hybrid hair replacement and he had rejection issues and had to have the grafts removed...:eek:

Good points by both PupDaddy and fisher4man...

IMHO, any type of activity that puts tension on the strip scar is not good. If you had strip, I would give it 12 weeks before doing any real "heavy" weightlifting.

You're welcome my friend. I was referring to the donor area (occipital zone) where the sutures are located. This is not an issue with FUE because there is no strip scar to potentially stretch.

Although the extractions in FUE are being performed more and more by the techs, the recipient incisions are almost always done by the surgeon. This is the area where the angulations, hairline design, and other artistry skills are demonstrated the most. Other than implanting the grafts, I do not agree with techs doing the extractions or any of the other incisions.

Forgot to add that I have even heard of surgeons learning the extraction process from techs, not another surgeon...:rolleyes:

IMHO, this is a controversial issue that needs to be addressed. And you are correct, depending on the clinic, some use techs to perform the extraction process. In most states within the USA, only a licensed physician can legally make incisions or perform "surgery" in its truest sense. Yet we continue to see the trend of using techs in the extraction process of the FUE procedure...:rolleyes: And yes, some docs see it this way and they make all of the extractions and also make 100% of the recipient incisions.

The local anesthesia that is used is generally applied in a series of injections. The first initial ones are targeted to block off certain larger nerves that encompasses the scalp. In other words, you should not feel the latter ones if the initial ones are given adequate time to take effect. Chances are, the techs and/or doctor will advise you to let them know if the anesthesia is wearing off. They also know ahead of time the general time frames that anesthesia lasts. But like anything else, we all respond differently to them. Again, once the initial numbing begins, the subsequent injections are a cake walk... You should not feel any of the recipient incisions that are made once the anesthesia takes full effect... I once read that approximately 60% of all men have a phobia regarding needles so you are not alone. Just keep reminding yourself that a teeny bit of discomfort is worth all of the new hair...

When it comes to producing the most natural results, it really comes down to the skill of the surgeon, not whether FUE or FUHT was the method.

A big part of the concern post-op is related to the strip scar if you have FUHT. The concern is putting undue strain, pressure, or tension in that area. Even though the outer layer of scalp is healed, the inside dermal layer takes longer to heal, up to eight weeks on average. Judo for example would be a huge no-no because of the various holds and throws that are involved. Lost grafts are of no concern at this point in time post-op.

There is a hybrid hair system which has a similar label.

I also agree that it really comes down to the skill of the surgeon and their proficiencies with whatever instruments they use whether they be sharp punches or the motorized tool. From my observation, there are more surgeons that use manual FUE for a whole number of reasons with control over transection being the primary concern. Control with the effects of torsion, traction, compression, dermal depth, and desiccation are other factors that are critical during the extraction process. I also favor manual methods when FUE is being initially learned by the surgeon. It is also true that there are more and more techs learning and performing the extraction process...:rolleyes:

Every one of the surgeons' comments have valid and legitimate points and can only be realized from them actually performing both techniques.

Your are welcome my friend. This condition can potentially be treated successfully and yet at the same time has different stages that are unpredictable. Because your situation is not severe, my premonition is that your procedure in terms of yield, etc., will be fine. You might IMHO experience some redness within the recipient and donor area post-op that may give you some challenges. Again, it's hard to say and no way to predict it. Just offering you some past observations from other guys that I have heard from over the years with a similar SD situation as yours. I wish you the best in your results...