Dr. Alan Feller

You have been very vocal in your criticism of FUE, and for the most part I still don't have a reason to disagree with the position that you have laid out for us..

Thank you.

Yes I apologized and deleted the said posts just like I said I would. You demanded that I never come on your threads again, but I never ever promised to comply with that request. In a much earlier posting I said I would no longer address you, but subsequently changed my mind. I never promised anything. You see Dr Feller, you may think you have the right to go around and make demands of others, but you don't. I believe my posts comply with the terms of conditions of this site, and do not see any reason why you reserve the right to demand that I not post on your threads again. I am confident that my 1,000 odd posting history proves your allegations as baseless. Being a Dr certainly does not give you the right to go around and tell me what to to do.

No, you didn't simply change your mind. You agreed to not post on MY threads but "reserved" the right to comment as you wished on other threads not started by me. This thread was started by me.

And why do you follow me around online anyway ? I don't know you. We've never met nor have we ever spoken. But when you constantly harass me online and even tell viewers of this site to actively not consider me for surgery I don't think it's "telling you what to do" by demanding that you stop. I think any doctor targeted by you as I have been would demand the same thing and be justified in doing so.

Your focus on me is simply creepy and I have asked the moderators to step in.

Impressive effort on your reply.

But nope. None of the things you listed are advancements in FUE.

Not a single graft coming out of the scalp via FUE today is affected any less by the three detrimental forces than they were 17 years ago. It is this reality that cuts through all the noise and the hype.

The fact remains that each and every clinic you discuss in your post shows more FUT results than FUE results by a huge margin. And I ask again, if they believe FUE was the equivalent of FUT why would they keep performing FUT ? Why would there be any FUT presentations by them at all?

I can't speak to why any particular clinic would choose to jeopardize their good reputation by performing FUE but I can make an educated guess. Wishful thinking, internet hype, and shameless/illegal marketing schemes have misled potential patients into believing FUE is the equivalent of strip. I can see how this happened on this very website by the incredible rejection of reality by so many posters.

FUE has become a religion on this and other websites. So to keep the doors open these doctors believe they had better offer FUE or perhaps go out of business. They are just giving the public what they think it wants. The problem is that it is wrong and unethical and can't be justified when the realities of the procedure are compared to that of FUT.

That's why, at least in the United States, informed consent is where the BS stops. Failing to inform a patient of the differences between the two procedures and the specific disadvantages of FUE in particular is a violation of most if not all State Medical Board regulations. This can lead to medical license suspension or revocation. It can also lead to civil action. The medical boards of other countries, especially the third world ones, don't seem to give a damn. Physician accountability is non-existent especially when the procedure is elective.

You focus on all the "successes" posted online by FUE doctors in general. That's very nice, but how many failures and unhappy patients do you see on these doctors websites ? None, of course. No sane doctor would do that. But there are plenty of unhappy FUE patients on this very website that you completely ignored in your post. How many unhappy patients were given money back by their doctors in exchange for keeping their mouths and keyboards quiet? I can guarantee you they exist because such patients have come to my office and told me their silence was paid for by their doctor. You didn't mention them because you have no idea they exist. But they most certainly do.

Most or all of your entire field of view concerning FUE and hair transplants in general is from online reading. That is simply too narrow of a view for you to be truly informed. All I can say is trust me when I say there is much more to the picture than you can possibly be aware of.

"Not true and you know it.

 

1) Dr Lupanzula and Dr Bhatti have both come on to debate you"

 

AGREE.

 

LETS NOT FORGET DR. JIM HARRIS AS WELL WHO LATER RETRACTED HIS STATEMENT AFTER MANY FOLKS HAD ALREADY A CHANCE TO VIEW HIS OBJECTIVE OPINION.

 

DR MICHAEL VORIES ALSO HAS JOINED THE DEBATE AND HAS DISAGREED WITH BOTH DR. FELLER AND BLAKE ON MANY ACCOUNTS.

 

SO THERE HAVE BEEN FOUR WELL RESPECTED SURGEONS WHO HAVE DISAGREED, AND WE ARE STILL WAITING FOR ANOTHER FUT/FUE HT SURGEON TO JOIN THE DR. FELLER CRUSADE OTHER THAN BLAKE.........

These doctors have shown up. That's true. And I thanked and gave credit to each one in writing for doing so when their FUE colleagues would not.

However, not a single one of those doctors discussed nor demonstrated that they have addressed the three detrimental forces that afflict the FUE procedure-much less reduced or eliminated them. Until they do no claims of advancement in the FUE procedure can validly be made. And no claim of parity with FUT can reasonably be made either.

FUT/FUE surgeons do not need to come on here. They are not the ones making the FUE claims. But if you want to "hear" from the FUT/FUE surgical crowd they tell you every day where they stand on the FUE vs. FUT issue, all you need to do is know how to listen:

Look at their websites- H@W, Rahal, Shapiro, T@D, Cooley, Alexander, Gabel, Konior

All show mostly FUT procedure results and virtually no FUE results. Look at the cases they themselves choose to post on this site every month. You can be sure they pick the very best result they can find for the month because they know it will be scrutinized for years and become the basis upon which they are judged professionally-these results are almost always FUT results. Why do you think that is ?

Not true and you know it.

 

1) Dr Lupanzula and Dr Bhatti have both come on to debate you

2) When Dr Lupanzula recently did so on this very thread, you then proceeded to take copy-write protected video of the said Dr performing a procedure from another source, purposefully hide the JT logo, and then completely tear the thing apart when in my opinion was unfair and uncalled for. The backlash was so bad that you even took down the video.

 

FUE practioners do not not come on to debate these statements not because they can't, but because they don't want to be subjected to similar unprofesional treatment dished out to Dr Lupanzula. It's disappointing they don't join the debate, but I don't blame them for not wanting to engage in something that potentially ends up the same way the last one did.

Lupanzula and Bhatti did not debate me, they made claims I proved were false using their own video presentations and they fled the discussion. But I know you know that.

Sorry, no copyright violations under Fair Use, but I have no doubt you know that. You just love to spin things and harass me for some strange reason when you are not overtly cheerleading for your doctor and trying to send patients his way. Your agenda is obvious.

I went through your recent posting history and you only come on to cheerlead your doctor or denigrate me. No other doctor, just me. I don't know what your problem is but i have never met you nor even spoken with you and your consistent pattern of stalking is getting out of hand. I will report this to the moderator.

By the way, didn't you apologize and promise never to come onto one of my threads again when I proved you were very mistaken about another assumption you made about me and posted online ? You should demonstrate some honor and decency by holding up your end of the bargain by not posting in my threads again like you claimed you would.

Quite the contrary you've convinced me towards the reality of fue and I thank you for that, you've taught me much and I fully accept the reality of fut being the gold standard so it is not that I'm not getting the message, I'm just discussing the degree to which that is the case which I think is fair to do. I would love for the doctors to come on here and answer if they think that 3k fue grafts is = to 2k fut grafts, I just didn't think they would come on and answer so I left it to the members to discuss. In an ideal world, I'd love to see it put to the test, 2 patients similar needs, characteristics, 2k fut from Dr Bloxham/Feller and 3k fue from Dr Lupanzula who has argued for the merits of fue, lets put the numbers to the test but I understand too many variables and nobody is signing up for that but it'd be a fun little experiment.

 

I accept my that my lay view is limited but we've been presented with docs who also felt that the discrepancy between the 2 procedures isn't to the level you're stating, one is well known fut clinic Hasson and Wong...I respect your expertise but on what basis should I not accept there's as they too have thousands of operations under their belts. So I've got experts on both sides and I'm just trying to get to the truth in there and it helps to see it yourself ...I am trying to see what you're saying in terms of numbers in the results we're presented with, patient experiences come up all the time, these aren't hand picked best of clinic works I'm looking at.. At some point if the numbers are that one sided, the results and the numbers should meet even over a smaller sample size. I can see a difference, but 35% better on the low end better...I'm just not seeing it so far/yet.

 

I still thank you for all you've taught me and don't think it hasn't registered but even when you were educating, I still looked into every thing you said and concluded for myself if I believed it. That is the same process I am going thru now. I won't just accept every thing I'm told at face value, and neither would you.

If the difference between FUE and FUT were so small then FUT would no longer be offered or performed. Doesn't that make sense ?

Look at the videos of surgery posted by FUE doctors themselves on this site performing the FUE procedure.Anyone can plainly see that the grafts are being handled much more harshly and aggressively than in the FUT procedure. This isn't even debatable.

So why would doctors knowingly perform a surgical procedure they know, or should know, causes more damage to both the grafts and the donor area ? What do you think ?

This thread has been very helpful and has changed my thinking and approach. However, it also has reduced my hope in future options. I know what the doctors will say: FUE is still viable if you can't use FUT. One must just choose a reputable surgeon. But this video goes a bit too far in disparaging the only other option to FUT. After watching this, it's hard to be enthused for FUE, whatever surgeon one might go to.

The video can't be going a bit too far if it is telling the truth. The truth is simply the truth.

Notice no FUE practitioners have come on to debate these statements ? They never do.

There is a simple reason for it...they can't.

FUE is the option if you can't do strip, but the overwhelming percentage of the population can do FUT.

It is unethical to only offer FUE to a patient who is a candidate for FUT because these two procedures are NOT equivalents any more than ice cream and diet ice cream are equivalents.

http://www.fellermedical.com

 

I think Dr. Feller's point was that you can't see through the skin from the surface no matter what magnification you have. Cooley didn't really refute that in that quote. If he punches a 2 follicle graft out and it turns out to be a 4 he could very well have damaged the 2 hidden ones by using too small a punch.

 

Correct !

 

http://www.fellermedical.com

Mikey,

You definitely get the participation award. I think few watched the video as intently as you did, though they certainly should. Doctors, too. Just received a phone call from an HT doctor who viewed it said BRAVO to the video.

Unfortunately your observations and analysis are not on point. Not because you are not intelligent or

not dedicated to figuring things out, but because you don't live in the HT world as a profession- nor perform the procedures yourself. You only see it from the outside lay view which is a completely different view. The extent of your HT field of view is this forum. But imagine if you were a doctor who saw thousands of hair transplant patients every year. Don't you think your perspective might change just a little bit ?

Apparently I can't convince you, and many others, about the truth of FUE. All I can do is convey the facts and hope they take root before too many more patients become FUE victims.

We have been getting great feedback from patients who have read these posts and viewed our videos and were thankful to be given the realities of both procedures. In the end they almost always choose FUT.

Please keep viewing our videos and commenting. Thanks !

That quote from Cooley has nothing to do with "cherry picking" FUE grafts.

It's just saying that he uses magnification to help him extract the grafts as they are, and then uses microscopes to determine how many follicles those extracted grafts actually have in them AFTER they have been removed and are on the dissecting table.

The reason he is doing this is precisely because he can't cherry pick. You applied the word and the concept of cherry picking, Cooley (or whoever wrote that quote) did not. There is nothing about it in the quote.

The reason he looks at the grafts after they have been removed is because he doesn't know how many follicles are actually in it. There may have been one hair coming out of the skin before the extraction and yet there might be one or two more follicles in the graft in different phases of growth where the hairs could not be seen. There is no way for him to know before he targets it. That's what makes FUE is a blind procedure. It is also why so many FUE hairlines have multiple hairs coming out of a graft instead of just being pure singles.

Also, he may target a three hair graft, but one or two of the follicles and/or their bulbs may be torn off during the extraction process. The only way to know is to look under a microscope after the fact. We've been doing this since we started doing FUE 17 years ago. Problem is MOST FUE clinics do not inspect their grafts under a microscope- or at all. If the target graft had three hairs coming out of it yet two are torn away leaving just one possibly functioning follicle it is still counted as a three hair graft. If you want to know how they justify this, just ask me.

There is no cherry picking in FUE. It is a totally blind procedure.

Most FUE clinics claim that FUE is "the newest" and "latest"

procedure. It isn't. The procedure was reintroduced to North America 17 years ago. One can hardly call that "new". Would you call a car that was 17 years old "new"? Yet on the majority of FUE clinic websites they taut that they use the most "modern" method available of hair transplant. They claim it's "new" and "superior". The false implication that it is better than the "less-modern" procedure of FUT. Which of course it isn't.

Then there are the claims of "IMPROVED" FUE using robots, motorized punches and suction machines. Also untrue. In the end, these devices do not improve on simple manual FUE nor do they elevate the results of the FUE procedure to the level of FUT (the Gold Standard).

Nothing has changed since Dr. Rob Jones and I developed and shared North America's first revealed FUE procedure. This means we didn't pretend it was a State Secret like the few other doctors experimenting with FUE and use it as a marketing tool. Everything we figured out and developed we shared openly with the world. In fact, I performed the first FUE procedure that was video recorded and placed online back in 2002. And Dr. Jones and I performed the first FUE in a live surgical workshop during an ISHRS meeting back in 2003. Nothing has substantially changed that since time regarding the mechanics of the procedure itself. It is still exactly the same: A punch is used to score around the graft, a forceps is used to grab the graft, and the graft is ripped from the skin. Every clinic does it this way with the possible exception of one awful tool that tries to use suction instead of a forceps which injures the graft even more.

Here is the worlds first FUE procedure shown online in great detail and close up back in 2002. NOTHING HAS CHANGED SINCE THEN !

I called it a "perfect extraction" in the video because the graft LOOKED intact. But in reality it was significantly injured. There was just no way to see or measure the damage. But when you stop and look at what forces were inflicted on that graft compared to FUT it becomes clear to any rational physician that the FUE procedure is brutal by comparison. See how I had to grab that graft and hold pressure on the forceps as I pulled and pulled waiting for it to tear free ? THAT is what injures the FUE grafts and makes FUE outcomes very unreliable when compared to FUT. And of course the bigger the case the faster the doctor goes and the worse the compression and yanking forces become. There is no equivalent in the FUT procedure.

And here are videos shot specifically to present what FUT scars really look like. Not the rare and shocking scars that FUE clinics mislead people into believing are common.

The scar results we show are representative of the TRUE typical strip scar.

All of the skin above and below the scar are completely untouched and undamaged. When FUE is performed, in contrast, the entire donor area is damaged well beyond necessity and limits the numbers of grafts available for future use.

Feller and Bloxham Hair Transplant

Great Neck, NY

http://www.fellermedical.com

After reading Bverotti's post Dr. Bloxham and I began a discussion between ourselves about how confused people are about the realities of FUE surgery. So we decided to film it and share it online. If any FUE doctor cares to chime in, please do.

Dr. Alan Feller

Feller and Bloxham Medical, PC

Great Neck, NY

NYC Hair Transplant | NY Hair Restoration | Feller & Bloxham Medical

Hi Dr. Feller,

I respect your opinion, and I must assume that they are based your your skills.

 

I have personally witnessed many FUE sessions with no or less then 3 percent transections. And this not only at Prohairclinic, but also at other world class Belgian clinics.

 

So let's agree to disagree, that is fine.

 

I am not looking for the LW.

 

bart

I'm sorry Bart, I can't agree to disagree.

What I wrote was not opinion-but clinical fact based on 17 years experience in FUE and 23 years experience with FUT.

What you wrote was simply not true or confusing at best.

The word "transection" is used very loosely by the FUE community and it's time that it stopped.

FUE clinics seem to want the public to believe that transection is the only injury visited upon a graft during FUE surgery. But this is not true. The damage from the twisting, compression, and yanking of partially freed FUE grafts inflicts damage in far greater numbers than transection does AND it is invisible to the eye.

If it is your contention that all FUE grafts that appear intact (not transected) grow as well as FUT grafts then you are sadly mistaken. If you were a doctor and actually performed the FUE procedure you could appreciate the amount of force and trauma applied to the graft to get them out of MOST patients. When I say "most" I mean the vast majority of patients meaning 85%. Probably higher.

If FUE clinics started to use the more accurate "Damaged Graft" percentage instead of the so-called "Transected Graft" percentage the public would understand the true and unpredictable nature of the FUE procedure and few would take the gamble to have it performed on them if the gold standard of FUT were available.

In the United States patients must be given informed consent. Failure to disclose the" graft damage percentage" while offering only the "graft transection rate" would be failure to give informed consent and would seriously threaten that doctors license. It would also be grounds for civil action. This is why you don't see "hair mills" and "FUE mills" in the United States. In fact, you see almost no FUE- only clinics at all in the United States for this reason.

As I recall, years ago you sent a few doctors to Dr. Jones to learn the FUE techniques Dr. Jones and I developed together. I'm in contact with Dr. Jones on a regular basis and nothing significant has changed in that time on his end. Nor mine. Nor anybody else's as far as I know. Are you claiming that your current staff of doctors are performing FUE significantly different from what Dr. Jones and I developed and passed onto your doctors ? If so, how does it significantly differ ?

The statement is a non-starter. Sure, there can be donor thinning under the scar but it is usually just within the first weeks to months just after surgery and normally completely resolves on it's own. I may see this phenomenon once in every 30 surgeries and none have been permanent.

It is the donor thinning from FUE that is aggressive, permanent, and often the subject of online posts from unhappy FUE patients.

My experience as a Former FUT and FUE patient:

 

 

The best decision you can make is to have an FUE procedure.

 

An FUT will cause more damage to your donor area, period. Oh, just look beneath the scarline, you will very often see the remaining grafts are of FAR less quality because of FUT harvesting. So FUT often WEAKENS the donor area for future usage.

 

Forget about the internet hype and the trolling and look at the two procedures:

 

FUE is a blind procedure that rips the graft from the scalp. FUT is a equally blind as it destroys the FU along the cutting line.

 

FUT is a fully visualized procedure that allows for dissection of the grafts with the least amount of trauma known to man. Yes, but you would have to trust on a lot of techs getting it done right. No surgeon in the world can watch over all these techs at the same time. So in the end the Surgeon has NO idea how many grafts where damaged.

 

It's no contest. Indeed, FUE is least invasive method and should be prefered for this reason alone, along with many other reasons.

 

Oh, and all the records of most grafts transplanted are ... indeed all FUE cases!

 

 

FUT is the gold standard. Used to be, sorry. Diesel and petrol cars still the gold standard, only because it is cheaper .. but dirty at the same time. Take away cost and people will be driving electric cars forever.

 

 

 

FUE is internet hype. Yes, and there are so many good reasons it is hyped. ONe of the reasons is that many surgeons have done a lot of dammage using FUT (even the good docs out there).

 

FUE is not 'perfect', but it is really the best option available out there for the moment.

I'm afraid the entirety of your post is misinformed.

FUE does not hold the record for most grafts implanted, FUT does by a wide wide margin:

You are being fooled by the fact that FUE clinics misleadingly use the term "in one procedure" to refer to multiple days of surgery, whereas FUT clinics always mean a single day.

In order to approach the density and growth success of FUT, FUE doctors NEED to take more grafts to make up for the lower yields and thinner hair shafts. FUT doctors have no such disadvantage and thus fewer grafts are needed by comparison.

Furthermore, when FUE megasessions are performed almost all of them take hair from OUTSIDE the safe donor areas. FUT practitioners do not need to.

You are correct that there are bad FUT procedures out there. But almost all of them were performed by amateur practitioners seeking to perform HT on a part time basis. That's why patients NEED to look for clinics that perform FUT fulltime and have a full staff. Unfortunately, many patients find out AFTER their procedure that their clinic was amateur.

FUE has it's place, but only for smaller procedures or AFTER the strip procedure can no longer be performed.

And your statement about FUT techs is also incorrect. Of course there is some wastage during dissection, but orders of magnitude less than FUE. Furthermore, none of the FUT grafts get traumatized whereas ALL FUE grafts are traumatized all the time. Then you have to pray that the grafts tolerated the FUE procedure and hope they grow. This is why FUE yields and results are poorer compared to FUT and why so many more grafts are needed to achieve the same results.

The public is getting wise to the realities of FUE megasessions.

Why is it that FUE does not grow as well at FUT? For the sake of this question say you transplant 1000 graphs FUT, and 1000 graphs FUE, and you confirm all 1000 grow with each procedure type, 100% yield for the sake of this question, regardless if you think that could happen. Will the FUE grow thinner and more straggly? Or is this just a question of yield, and if so can't you just use more FUE graphs to get the same visual result if its say a difference of 9-20% growth yield. So you transplant 1200 graphs FUE and 1000 graphs FUT. What makes it look so much better?

Excellent question. Here's the answer.

1000 FUE will not look as good as a 1000 FUT in the recipient area even assuming 100% growth yield on both. The reason is the damage inflicted on the follicles by the FUE procedure. A follicle is composed of cells each of which contribute to the final thickness of the hair. If only part of the follicle is damaged it may still grow and thus be counted as a "successful" transplant, but the shaft diameter of the hair will be thinner and often kinky.

Depleting the donor area to make up for a poor yield of FUE, or the thinner hair shaft of FUE, is not an acceptable surgical protocol. If you were cutting fabric then that would be fine, but when you're dealing with human flesh ETHICAL doctors don't act this way.

The best decision you can make is to have an FUT procedure.

An FUE will not grow as well and it will cause more damage to your donor area.

Forget about the internet hype and the trolling and look at the two procedures:

FUE is a blind procedure that rips the graft from the scalp.

FUT is a fully visualized procedure that allows for dissection of the grafts with the least amount of trauma known to man.

It's no contest.

FUT is the gold standard.

FUE is internet hype.

Here is a video of an FUT scar from a typical patient of ours who received 3000 grafts:

Hairdew,

All politics and rhetoric aside I advise you in the STRONGEST terms to visit a local physician immediately as you may well be dealing with necrosis for which treatment with antibiotics and possibly professional wound care may be called for. I also read that you have not contacted your doctor's office as yet, I would recommend you do so immediately.

Dr. Feller

Great Neck, NY

----------

I know Dr Feller will say no matter how good a FUE transplant may be an FUT would have been better which is fair enough, but if in his opinion the best to hope for is say 60 percent as an average ,the question is was I just one of the lucky ones as no way

would 2520 grafts have given me the result that was achieved .

Indeed you were one of the lucky ones (luck of the Irish?).

Magnum stole my font.

We have to also consider the other factors here. A great doctor performing FUE with a patient with good donor and thick hair is probably going to end up looking better than FUT performed by a mediocre doctor with a patient with thin hair and poor donor. There are great/mediocre/bad doctors out there performing both techniques. So unless both the patient and the doctors are robots, tuned perfectly, we will never really be able to quantify these claims.

100% agree with this. That's why I focus on the differences between the two procedures themselves and not the doctors who perform them nor the patients they are performed on.

When you view it that way a mediocre FUT doctor will out perform a very experienced FUE doctor each and every time.

The doctor who moves the most grafts without damage wins. Everything else is secondary in an HT surgery.

Dr. Feller,

 

I have very limited time to discuss these issues as I have 12 hour work days as well as a young family to tend to so I will address what I can with the short window of time at my disposal. Before I do, I would remind you that my name is not “Dr. L”. My name is Dr. Lupanzula. Thank you.

 

 

 

I’m surprised to read this because I was not aware of any surgeons performing FUE 17 years ago with regularity except for one and he was not in North America. It wasn’t even introduced into North America until 2002 which was 15 years ago. Who else was performing FUE seventeen years ago? I do not see the connection between hearing these points before and their accuracy with regards to truth today. Logically, the points would be more valid today than they would have been 15 years ago (or 17) as there would be fifteen years of experience to back it up. In my opinion, this is the case with FUE as the early years could not have logically provided the view that we have today as such experience to give valid conclusions simply did not exist. This is not a slight in any way, but is a common sense. Is it not logical to understand something in life better with fifteen years of experience under one’s belt rather than having only six months of experience?

 

Regarding the studies you cite, I would like to address them both along with the contradictions. In the Beehner study it was noted that everyone involved in the procedure had eight years of experience however the total number of procedures having been performed in those eight years was ninety procedures. This is the equivalent of having performed less than nine FUE surgeries each year. Nine. I appreciate the information in this study but the experience level is not the same as one that does the same number of procedures in eight days as opposed to eight years. In addition, as you stated, a manual punch is and later yet this study you reference was using a motorized continuous rotation punch. Furthermore, the author stated

 

With regards to the FOX test, I think it is safe to say that this falls under the “experience” category that I referenced earlier and I disagree that a paper written with experience garnered from various small scale tests applies to an entire industry after fifteen years of discussion and sharing among peers. With all due respect, to believe that nothing has changed in fifteen years is paramount to walking with blinders. And this begs the question; if we have a study that shows something is problematic, do we simply give up, thereby creating a truth that validates the study through inaction and lack of effort to improve? I do not know you, but from your comments, you do not appear to be one that allows studies by third parties dictate how you run your practice.

 

My comment about torsion is not incorrect as you are assuming the follicle to be completely rigid, which it is not. I specifically said that torsion is not an issue if the distance traveled in the oscillation is short. This is why manual oscillation that is controlled from an experienced practitioner is the superior method compared to continuous rotation. There is a difference.

 

The “hand over hand” method you reference does not by definition require significant compression to be applied at all points of contact. In fact, your incorrect assumption is the point of contact itself. I can go into detail but I did not intend for this to turn into a tutorial and these are points that I teach to my students that must spend a minimum of six months in my clinic, many times up to a full year, learning the correct FUE method.

 

 

 

Interesting.

 

Comparison of survival of FU grafts trimmed chubby, medium, and skeletonized

Beehner-2010

 

(Their terminology, not my own)

 

In the spirit of sharing research I found this information to be particularly interesting.

 

- Dr. Feller, November 16, 2002

 

http://www.hairrestorationnetwork.com/eve/145487-another-question-dr-feller.html

 

 

What has changed since your own research showed a yield that is "higher" than "a dissected strip"? This is largely a rhetorical question.

 

 

Dr. Feller, I appreciate your passion in this subject and it is this type of vigor that translates well to believing in your craft as you present it to your patients. If you do not believe, you are not genuine and this is against our oath. However, I wish to be clear. I am not here to convince you of anything as it is clear that you are steadfast in your beliefs and I do not believe I am the one to change your mind, nor do I wish to be. I recently heard of you and of your position and comments and felt that some balance should be presented to the issue. Do we have enough raw data for conclusiveness across the field? No, because the field itself is rife with misrepresentation of the highest degree along with a multitude of inconsistencies for an equal multitude of reasons. In this absence we must rely on our own experiences and those of our colleagues that are willing and eager to share, and in turn learn themselves, and this is what I do with my own teachings to my students. I do not conduct weekend seminars and I do not hold video workshops. I take the art of FUE and my oath very seriously, and make no mistake, proper FUE is an art indeed. Physicians that wish to learn from me must reside in Brussels for a minimum of six months if they are already experienced hair restoration physicians, and one year if they are physicians that are not experienced in hair restoration surgery. This procedure is infinitely more difficult to perform compared to strip surgery thus it requires an understanding, dexterity and touch that cannot be achieved with anything short of extreme repetition, practice and passion and these are the forces that are , in my opinion and that of my colleagues, far more powerful than torsion, compression and traction. Good day.

Dr. Lupanzula,

Your response is disappointing.

You didn't address any of the substantive FUE issues. You simply attacked me.

But I will not take the bait and allow the thread to get off track.

Let me ask you this...

Which graft suffers less injury ?

A graft that was removed via strip that was divided under a microscope.

Or a graft that has been grabbed hand over hand along its length with a forceps while under compression and traction powerful enough to literally rip it free from the dermis ?

Thank you.

Well, yes, Dr. Bisanga does screen every patient meticulously. So if you are not a suitable FUE candidate he will tell you. Hence, I was only talking about the survival yield he has observed in all patients that were indeed suitable FUE patients and underwent surgery with him.

Then we are in fact mostly on the same page here and right back where we started.

The popular hype is that FUT is being replaced by FUE. However, if any doctor who can do both has to screen their patients for one or the other then obviously both procedures are not going anywhere. And, indeed, history has shown this to be the case as FUE has now been around for over 17 years and nobody has come up with a novel way to perform FUE of any significance.

The misinformation fired at me during these online discussions has always been that I am anti-FUE. This is false. I am pro-FUE but for SMALL cases that have been well screened. For everything else I prefer Strip and perhaps even a strip/FUE combo, or mFUE of course.

But physician competency, experience, and goodwill are not at the core of the issue here. The issue is the mechanics of the FUE procedure itself when compared to FUT. Not the doctor who performs it.

When you compare the two procedures independent of the doctor or even the patient, FUE is downright brutal to the grafts. Graft trauma is the number one predictable reason for graft growth failure. And if our textbooks and meetings and lectures emphasized one thing over and over it is that safe and delicate graft handling is essential to graft survival and overall result. Mishandling grafts is a sin. And the trauma inflicted on FUE grafts, no matter who performs it, is orders of magnitude greater than for FUT.

FUT does not inflict nearly the level of damage on grafts and donor area that FUE clearly does and has no analogue to FUE in terms of detrimental forces.

I know Dr. Bisanga. Lovely and genuine man and surgeon with great experience and skill, but even in his hands the disadvantage of FUE over FUT are simply not addressed. Is he better than the newbie FUE surgeon ? Of course. Does he have a better body of work because he meticulously screens patients for FUE instead of willy nilly taking anyone for FUE surgery who requests it ? No doubt. He has maximized the potential of FUE. And if you are going to have FUE done you better get it done with him or a surgeon like him. Of which there are not many. But the limitations of FUE still exist in frightening proportions are not something he can overcome as they are inherent to the very procedure itself.

Until and unless a doctor creates a brand new way of performing the FUE procedure that does not inflict the three detrimental forces of FUE ,and does not thin out the donor area, then they cannot claim parity with FUT. This isn't debatable.

A doctor can maximize their chances of getting a good yield with FUE, but in each and every circumstance, without exception, performing that same procedure with FUT will always end with a consistently better result. Not sometimes, EVERY time.

I don't have to look at any particular FUE doctor's photo gallery to know that no matter how good their results may look it was attained at a higher physiological price compared to FUT. Look at all of the poor FUE results posted on this site to date. All of them would have had a much greater chance of growing well if they had opted for and were given FUT first because their grafts would not have been injured nearly so much.

Gas,

I'm glad you like my passion. You've written that a few times and I appreciate it. This is my business and I happen to love what I do and enjoy sharing it. I volunteer my time on this site and take a lot of abuse because in the end I enjoy speaking my mind and cutting through the BS that get's thrown around far too often-especially when it comes to FUE.

You can chalk up the phone interview, or lack thereof, to a misunderstanding. I have no intention of going around and around. But it is all seems very clear to me.

Summary:

1.I asked for your name and phone number and you would not give them.

2. You made conditions I could not accept.

3. I never agreed to conditions in the first place.

Timeline:

I asked for your name and phone number. Plain and simple. But you didn't send them. Instead you posted online that you WOULD give them, but that I would have to agree to conditions that no reasonable person could accept especially if the goal was to do a recorded and transparent interview.

So already the games began.

I ignored your conditions and immediately posted what my questions would be limited to. Which were nothing sinister by the way. Just basic FUE questions.That should have been enough. But rather than PM me your information right away so we could move forward you PMd your conditions again saying you didn't want the call to turn heated and that if the doctors refused to participate that I couldn't report it.

First, how can I be expected to control which way the conversation goes ? In an interview the discussion goes where it goes. I certainly had no expectations of an emotional phone call, but apparently you did.

And second why should I not report online that the doctors refused to participate if that's what they choose to do ?

And third, if I posted the recording on a thread how can I control what other posters will say about the doctors? I am not a moderator.

Your conditions were unreasonable.

I immediately PM'd you back that I don't accept conditions. Either the call would be totally open and transparent or it would be pointless.

You should have dropped your conditions and let me make the call and just let it go where it goes. But you wouldn't do that. Instead you went back online and simply posted that Dr. Feller wouldn't accept your terms. That was disingenuous. I didn't agree to terms in the first place and I gave you no reason to believe that call would turn heated or that any thread built around it would become a "slugfest". That was the canard you created.

Again, this is game playing and time wasting.

I wanted to give you one more chance to allow the phone call to happen so I posted on May 22 that I would not use your name. And you vanished. Until I received a PM from you 9 days later on May 31. More game playing.

And in that third PM did I get your name and phone number ? No, only A name and no phone number. To get that I would have to use a linkln url that you attached. I put it into my browser and hit a wall that said I would have to sign up for an account. More game playing. I had enough and wrote you off.

If you were serious about the phone call happening you would not have stretched it out so long and you would have simply sent me a single PM saying "Hi Dr. Feller my name is Mr. John Doe and my phone number is XXX-XXXX I live in X country and I am available at XX:XX your time for the phone call"

But you didn't do that. You played games and wanted me to fish for every piece of information and then prevent me from using it if things didn't go according to your "conditions".

If you want to call that series of events a misunderstanding that's fine, I'm not going to continue going around and around with you, but the events seem clear to me.