England

Chris, I listed them but my post was censored. One of them I'm not allowed to mention, the other two were Feriduni and Bisanga.

As I already stated - both lean towards FUT - but both say yields are only slightly less, and both confirmed that the zone of extraction is widened and can in some people mean more grafts can be extracted with FUE. Both have excellent track records of achieving excellent yields with both, too.

Baldwhisky - honestly, I think your numbers are incorrect.

1 - The rich people would have to go to one of the 30 doctors for 'one doctor to stand out', So lets cut your odds by a factor of 30.

2 - The rich people would have to agree to have their pictures displayed. Lets cut your odds by a factor of 10? I reckon only 10% of very rich people would want to be made a public example, if that.

3 - The people you mention would have to choose FUE over FUT when considering the time too. This reduces your example by another factor of 10 (most rich people would prefer a single operation and 15 months to 2 operations over 4 years).

That's already 3 factors off the top of my head which reduce the odds you stated by a factor of 3000.

Lets put some sensible numbers around this.

You say that 1% of the men consider a hair transplant, that's 30 million people. Yet extrapolated worldwide, the number of hair restoration procedures in 2010 was approximately 279,381, 88.5% of which were FUT procedures (again, this is conservative because as the grafts increase, the % who select FUT increases too). This means that only 1% of the people considering a transplant have one at all, in any given year. By your own logic, lets say that 1% of them are rich enough to afford the large FUE. This leaves 279381*0.115*0.01 people, which is just 321 people. Lets then factor in the fact that probably 90% of those who get hair transplants don't need the massive 10,000 operations (it's actually probably closer to 95%). This leaves us with 3.21 people. How many hair replacement surgeons are there in the world? Again, lets use your numbers - you say an average surgeon can do 150 per year. If we take the 279,381, this means roughly 1862 doctors (assuming they are all fully booked all the time), of which 30 are 'top' doctors. This leaves 30/1862 * 3.21 people who go to a top doctor, which gives us 0.05 people . You might say that the top doctors attract more patients, but if this were true, the other surgeons wouldn't be fully booked so there would be more of them, so it all adds up the same either way

So, we're now left with 0.05 people who will have a HT, need a megasession, are rich enough to afford FUE, selected FUE over FUT, and went to one of the top 30 doctors.

This leaves 0.0061 patient per 'top doctor' per year, who wants and can afford an FUE megasession.

Then lets factor in the fact that only 10% of those want their pictures and story published on the internet. You can see how this leaves 0.00061 patients per 'top doctor' per year who have the FUE megasessions, as a conservative maximum.

Hair Transplant Statistics, Hair Restoration Surgery Info | Bernstein Medical - Center for Hair Restoration

Duplicate Post

Logically, if that is what I requested, but it is not. I said to take the top five clinics from each discipline over the past two years. This was to keep the comparison as close to equal as possible. This is graft for graft, case for case so logically, if we assume each practice is booking five days a week then the playing field is even.

The point is, you have to apply logic when making a logical point. You can only compare by looking at 'top 5' if the same number of surgeries are FUT and FUE. I already explained to you that most clinics who offer FUE also offer FUT, so each practice booking '5 days a week' isn't relevant at all. I think I read somewhere that only 10% of surgeries are FUE, mainly due to cost.

I don't buy the argument that we don't see 6000 to 10,000 graft cases of FUE due to financial limitations. If there is one thing I've learned in my ten years on this very forum and twenty years as a hair transplant patient, come Hell or high water, many men will find a way to finance their hair.

I completely disagree with this. If there's one thing I've learned simply by living and knowing people - the majority of people can't afford to spend 30-40k on their hair. To disregard this is a factor is... unsympathetic to the situation many patients find themselves in, in my view

If the only thing preventing this claim from being validated is a lack of financial means by most patients then I propose this counter point. If I were an FUE surgeon making the claim that 6000 to 10,000 grafts were routinely and commonly possible with little to no evidence of surgery or thinning etc, as you stated, then I would perform ten of these procedures at little to no cost in exchange for full marketing rights of the results. The onus would be on me to validate something this extraordinary and this would be the best way to do it. This would put the argument to rest once and for all and would open my practice up to bookings years in advance. "Studies" that cannot be validated hardly prove a thing. FUE has been in North America for ten years now so there has been ample time to show that this is what the average patient can achieve.

Firstly, I didn't say that 6,000 to 10,000 grafts are 'routinely and commonly possible' by FUE- so I don't know where that came from. That isn't even the case for strip. What I said, to be clear, is that some top doctors have told me that more grafts can be extracted in FUE in some patients, due to a larger available 'safe zone'.

Secondly - The top FUE doctors in question, as you said, are fully booked for months in advance, so why would they feel the need to prove anything at their own expense, which they haven't even claimed (as I said above)?

Thirdly - Since you're claiming FUE is so much worse, feel free to prove this or evidence it in any way in a double-blind study with a world class FUE doc. They have portfolios of results showing the success they have achieved, and first hand experience performing both FUE and FUT. Do H&W perform FUE?

You are correct, when a strip is taken the donor zone is thinned. However, it is magnitudes less donor thinning with strip than compared to FUE. With FUE there is a direct proportional reduction of density with each follicular unit extracted. Extract 3000 grafts then your donor zone is reduced in density by 3000 grafts. Remove 3000 grafts via strip then the area thinned is spread out over the entire donor zone by temporary tension that eventually returns. If the thinning was equal in strip compared to FUE then my donor zone would be a waste land after having over 10,000 grafts extracted. My donor zone is anything but.

Sorry, but again, I completely disagree with this. Mathematically, if you lose 3,000 grafts, whether that's with FUE or FUT - you still have 3,000 fewer grafts at the back of your head, with which to cover the same area. Unless your head has shrunk during the surgery - that means you will see the same loss in density in both. The only counter argument to this is if strip raises the bottom of the back of your hair, meaning that it has a lower area to cover, is this the case? The reduced density at the back of your head doesn't get resolved by 'temporary tension' subsiding - because the tension only subsides when the skin becomes accustomed to being stretched, not because the hairs become any more dense.

I have no idea what you refer to when you talk about "capping" so I cannot comment on this.

Capping for me, is the main disadvantage of FUE. It's when the doctor attempts to extract a graft unsuccessfully (typically by slicing the top off), which can leave the graft damaged, or with a reduced number of hairs. This decreases your donor without giving you increased hair in the recipient area.

One thing is clear to me however. These FUE experts you have been speaking to have been trying to validate FUE above and beyond the one advantage it does have.

The doctors in question are both FUE and FUT experts - so I respect their opinion on the comparison the most, given that they routinely perform both. That being said, they do suggest FUT is slightly more advisable in certain situations - due to the reasons I stated (less volatility - potentially higher yield, no capping, quicker, less expensive). To clarify - in my post I explained what advantages strip does and doesn't have, I didn't reach any conclusion that FUE is always better, or even better at all.

With a safe amount of grafts extracted you can cut your hair shorter than with strip. That is it, period. It is accepted and discussed among doctors, publicly and privately, that FUE does NOT offer the same survival rates across the board as strip (assuming top talent performing each procedure). The cost is greater, the sessions are smaller and this is not because of the cost overall. It is because of the inherent limitations imposed by a finite donor zone and the law of diminishing returns. Once you cross a certain threshold that is unique to each patient the visual benefits for the recipient zone are outweighed by the degradation of the donor zone.

I agree that the general consensus is that on average, FUE yields marginally lower. I also agree that not having a scar with FUE is a massive bonus - and it's enough of an advantage to make FUE desirable for many patients - particularly if yields are similar.

The cost is greater simply because FUE takes much longer, and arguably requires more skill. For example, for a 6,000 FUE, this would have to be spread over 2 surgeries of 3,000 each spread out ideally over 18 months, each of which taking 2 days (and would cost 30,000 EUR). Overall, to have and grow out both surgeries, it could take 4 years. Contrast to a strip surgery which could be done in a day and be grown out in 12-15 months, and the cost far less. It's obvious why such patients pick FUT for the larger procedures, but that of itself doesn't prove that FUE wouldn't work in such a case.

In summary, FUT clearly has advantages and disadvantages, and is often the preferred choice (even for experts of both FUE and FUT) - but claims of being able to extract hair without thinning the donor as much are not the reason for this.

I think that the vast majority of surgeries are FUT. Partly because some clinics don't offer FUE yet, partly because almost every clinic who offers FUE also offers FUT, and partly because it's cheaper. I also think that FUE can yield lower in the wrong hands.

Because so many more people get FUT - it would logically follow that there were more top results from FUT, but that of itself doesn't mean that FUE is less effective. Time and cost factors apply most to the cases who require the most grafts, which can distort the evidence because there are not many people who can afford 6,000 - 10,000 FUE grafts.

I have consulted with numerous top surgeons, many of whom have confirmed to me that given any one patient - it is possible to extract a higher number of grafts via FUE (without cosmetic problems). This is because FUE can be taken from 'safe zones' which ordinary strip cannot reach (such as further wide). I also believe that the best FUE surgeons can achieve yields which are as good as FUT.

People seem to have a mistaken perception that when you have a strip, the hair at the back isn't thinned. It is thinned exactly the same as an FUE result is - when your scar is closed, all of your existing hair is stretched over a larger area. This results in a % reduction in density which would be the same as if you had the same number of grafts removed by FUE (assuming no capping).

The advantage of strip, in my opinion, is that it reduces the risk of capping, can be handled by less expert doctors without reducing yield, and that all of the hair can be taken from one place (which is advantageous if other areas are thinning). I believe the majority of this advantage is removed when you go with a top FUE doctor. And of course, with FUE you leave yourself the option to shave down in the future or when you get very old and all of your hair thins, with scars which are barely visible.

Just a quick link for you to check out:

Topical Spironolactone for Women's Hair Loss: Does it Work?

The donor area is immaculate - you can't even tell anything was done.

I know people say that any hair surgery leaves scars but when they are completely undetectable like in this case, it's as good as scar-less IMO.

Hi Guys, I wanted to start the new thread on this topic. But couldn't find the link to new thread. Hence I am posting it to this thread.

 

I am a newbie and still doing research on FU transplantation and this forum is been very helpful with useful tips from experienced people.

I dont like scars and hence I thought I would go with FUE. But after sending my photos to few selected physicians, I was told that I am not a candidate for FUE because of less donor density. That means if I have to go with HT, it should be FU ( strip) transplant.

Yesterday when I was doing some research on patients who had already undergone HT, I noticed few people complaining about constant itching the donor scar area for a long time since the HT. That made me worry whether there could be any other long term side effects like head ache etc...etc...associated with HT which constantly reminds us that we had a HT.

 

My question is " Has anybody who had FU strip transplant suffering from itching scalp(donor and recepient area), head aches etc ....after the wounds are fully healed ? " May be people who have had transplant more than a year ago would be the best candidates to answer this question..

 

 

Your inputs are greatly appreciated.

Thanks

Hi Pranewbie,

I had an FUT surgery 7 years ago, and for me personally, even recently, I can occasionally feel that I have had something done back there. In the first couple of years you can sometimes feel it as a dull ache or a pulling (it doesn't hurt at all really after it's healed) - and this gets less and less with time (but in my case, never completely gone). It does subside enough that I never think about it though.

It may be the case that I had a particularly bad scar and I'm sure others on here may have better experiences - but that's my take on the situation - I would say you should make sure you go to a reputable doc who can probably close your scar far better than my original surgeon did. For me, however, the feeling was enough that my next procedure will be FUE. That being said, the result from the strip surgery was very good and I don't regret it at all. It's certainly a very small price to pay for getting a good head of hair.

Also, I didn't get any itching after it had healed.

Best of luck with your procedure if you decide to go ahead with it!

Has anyone noticed but me, but this seems to be the largest FUE procedure I've seen on the forum as quoted 2800 grafts. Even more amazing is that this is one day? Am I missing something? There are some large FUE sessions that I've seen from Dr. Ron Shapiro that are maybe 1800-2000 grafts. These sessions seem to have been done over 2-3 days. How is Dr. Rahal accomplishing this? Just curious. This equates to a graft being extracted and implanted every 15 seconds continuously for the 12 hours.

Hi,

First - there are some larger FUE surgeries on this forum. Most recently, Ben had 2968 FUE with Dr Feriduni (over 2 days). I've also seen a 3,029 FUE by Dr Feriduni done in one day. I'm sure there are larger FUE from other surgeons too.

Second - I am not a doctor and Matt will have to confirm this, but I believe that in most clinics it is not just the surgeon who extracts the grafts - typically this is handled in part or in full by multiple technicians. I think they can extract somewhere around 200 grafts / hour each and if they have two people on the go this would take 7 hours to extract 2,800. I believe the surgeon creates the incisions in the recipient area and then the majority of the grafts are inserted into the incisions by the technicians.

Hey j1j9j85 - I just wrote a long reply but was then asked for my password, so I'll keep this one short:

Don't worry, it doesn't sound silly at all. We all get hair transplants because we are aware of our looks and want to look good. Swollen skin and grafts on our head is like a nightmare!

The only thing I can think of is a cap which doesn't damage the grafts, so you can look down and cover yourself up - and maybe shades. The combination of both should cover up any swelling you have.

You have had a really unlucky time of it with your leg causing these extra problems - but just remember the end result will be the same, I wish you the best with that

Hey NewHairPlease,

Honestly, I'm quite excited for you. I'm sure, like me, before your surgery you've been viewing hundreds of other cases from dozens of doctors, and every time you've seen the cases progress from the 'ugly duckling' phase into a phase of growth and what turns out to be a brilliant result. Now - you are one of them, it's onwards and upwards from here. I can't wait to be in your situation right now.

Best of luck and keep us posted! :-)

If I was you I'd contact Matt from Rahal.

He's been a great point of contact for me throughout my research, top guy.

I would back up the lists from everyone else, H&W, Shapiro Medical Group & Rahal are probably my 3 favourites in the states.

A drastic improvement already - congrats, and you've got lots more to come!

Do you have to stop taking Propecia when you want to have kids?

Great result.

I think the characteristics of this patients hair help to achieve a good result with relatively few grafts.

LOL! Groupon is awesome.... for mobile phones, or restaurants.

Wouldn't personally use them for surgery!

I suggest you give up your deposit and take the channel tunnel over to Brussels!

Congrats and good luck, Jacob.

Pictures are nice and clear - will be great to watch your progress.

Are you having FUE or FUT?

Cheers

This result is outrageously good.

Phenomenal, the best I've ever seen.

Absolutely agree with Matt - never project your own issues onto other peoples opinions of you.

She may very well not give a damn about hair, and liked you for your eyes or personality. My own hairdresser of 1 year didn't even realise I'd had a hair transplant 7 years ago until I told her last week. My girlfriend also never notices any bad hair days even though I can obsess about them.

People just don't notice things in the same way that people who obsess over them do. Text the girl, and just be yourself. If there was great chemistry even with you wearing a cap obviously it's not that important to the dynamic what you have under there.

As Matt says - your personality and a simple smile are more powerful than any amount of hair will ever be - to the right girl. Give this one a chance.

I agree that this looks a little thinner than I would expect.

Particularly concerning as I am thinking about an FUE.

Hi Spex, the 5% was more of a figure I'd probably be happy to concede - not necessarily something I've had in writing or can evidence.

I know Dr Feriduni mentioned typical yield of 1.8 to 2.2 hairs per graft for FUE and 2.1 for FUT. I've seen a few numbers banded about on this forum saying 90% vs 95% (in the hands of a top surgeon, if it goes well etc.) - if you believe FUE is more than 5% worse on average, please tell me - I'd like to get it in writing too!

I know that with strip or FUE no surgeon can ever commit to a certain yield because there are too many unknowns - I guess I'd just like to know what a realistic reduction in yield is from FUT to FUE, for an average patient. That way I can choose which one is best for me.

I've not had any test patches for FUE done, no.

Cheers

Thanks Spex and ChrisDav.

Spex - both doctors I had face-to-face consultations with (Bisanga and Feriduni) recommended 2300-2400 grafts, over 2 days (both asked about my preference with FUT and FUE - I think it's fair to say both were slightly leaning towards FUT). The recipient area will be the hairline (adding density, filling in gaps), temples (same) and behind the hairline (where I receded after the first op). The end goal is to achieve a high density front third (zones 1, 2 & 3).

Donor density was measured as 60/70/70 by Bisanga, and 80/96 by Feriduni - both estimated roughly 6,000 grafts available in total, leaving me enough to cover more of the top in future but not enough to do the crown.

The yield of FUE and the ongoing debate over how much less it is than strip is what is causing me to hesitate. Obviously I want to maximise yield but I'm prepared to take a 5% hit if it means not having a longer scar. I can see the logic that since I already have a strip scar, strip makes sense for me - but I'm just very uncomfortable with that idea at the moment.

@chrisdav, yes indeed - they actually created an uneven hairline, went lower to one side (where a normal hairline would go higher) and ran out of grafts when they reached the right temple - leaving me a gap! I think I got lucky but agree they shouldn't be in operation still.

Hi all,

I've been on these forums for a long time, only recently have I started to post more as I have planned an FUE surgery for the end of next month.

I had a very small FUT surgery 7 years ago with Norton Clinic in the UK. Having seen some of their horror stories, I feel quite lucky that I managed to escape with a reasonable result. Due to my light hair, the hair line doesn't look pluggy, and the misplaced or mis-angled grafts don't show too much. My scar is also not very long and very thin, which again I think I was very fortunate with.

I chose FUE over FUT because I do not want to go down the FUT route again, for several reasons:

1 - I want to leave the option to FUE into the FUT scar at a later date to wear my hair shorter again, perhaps if I lose more hair in the future.

2 - I don't want to have an ear-to-ear scar (my current one is small and I don't want it to risk making it any worse)

3 - Over the past 7 years I have been able to very occasionally feel the strip scar tugging and it's an uncomfortable feeling.

4 - Psychologically, even through my first strip was fine at the time, and I had no issues with the actual surgery, FUE seems more appealing.

5 - Recovery time with strip seems to be longer

6 - I have no issues with being out of the 'public eye' for weeks or months, so I can shave my head.

My main question is, do you all think this is a good approach? Dr Feriduni mentioned to me that a prior strip surgery can alter the angle of the hairs and that if I had another FUT that FUE would become harder as a result. Does this potentially mean that the small FUT I've already had may reduce my yield with FUE? Obviously I've discussed this with the doctors I consulted with, but I wanted to get feedback on here. Have any of you had FUE after FUT, and can you share your thoughts on this?

Cheers all.

Some studies have shown that the yield of FUE is just as good as FUT - according to some doctors on forums such as this.

With FUE you can also extract from a wider area and so can actually achieve a greater number of grafts. You are also left with arguably less of a scar. Of course, it's more expensive.

With strip, you remove a strip of skin and hair, but this naturally means that the rest of your skin with hair on it has to stretch to cover the same area. As a result, in theory, you achieve exactly the same overall thinning in the donor area with strip as you do with FUE.

With strip there is no going back, FUE is a more conservative approach, IMHO.

http://www.baldtruthtalk.com/showpost.php?p=51097&postcount=17

Thought he looked older than 30!

Thanks Janna, great work

Hi all:) I just recieved my quote from Dr.Feridunis office and the emails I've been getting are from a gentleman called "Marraffa Cristian". He asks for a 1000 euro deposit to an account number and they dont take credit cards (huh?).

 

Is this a scam or is it real because I could be just depositing money into a random acount thats nothing to do with Dr.Feriduni. Has anyone paid this way before?

 

I'm sure this is all legit but taking cash only doesnt sound like the professional clinic that I assume Dr.Feriduni runs. Has anyone ever paid him like this?

 

Thanks:)

Hi littlemick,

Don't worry, Christian genuinely works at the Feriduni clinic. I had the pleasure of meeting him two weeks ago - he works on the reception. The deposit of 1,000 EUR per surgery day is also absolutely normal.

When I go back there I may offer to build Dr Feriduni an online credit card facility (my business is in software development)

Good luck with your procedure!