Dr. Alan Feller

I think you mean "blinders" and you are projecting. The price of producing solar panels has not significantly dropped. Rather two things have happened to artificially make it seem like it has. The first is that the governments in these countries have bowed to the enviro crazies and SUBSIDIZE the purchasing and installation of these inefficient glass monsters. It had to be subsidized because nobody would want them otherwise. The second is that fuel prices have been driven up artificially due to over regulation and taxes which are in turn the direct result of socialist policies. The UK and Europe are infected with socialism and it shows in the price of energy. Your council buildings have solar panels as a showcase to demonstrate how "green" they are...and of course the council members don't have to pay for them themselves. YOU DO! There are hidden costs associated with solar panels as well. Ever try to get on the roof and clean them? Know how many visits to the ER there are from people falling off roofs because they went up there to clean their panels? That price is never factored in or advertised because it would ruin the illusion that it is "clean" "free" power. Over time the suns UV rays and the weather fog the glass cutting down the light that reaches the crystal. Oh, and the crystal breaks down as well. Always trust the market. If something really works people WANT it, and no government subsides or regulations are needed for people to want to buy it. Look at iPhones, everyone wanted one. No government intervention required. Now take solar panels. The Obama administration dumped BILLIONS into Solyndra, a solar panel start up, and it fell flat on it's face. The market didn't want it, the people didn't want it, so it was rejected. That's what a free society can do. Now in the UK they shove their socialist nightmare down everyones throats, so even if it is inferior and nobody wants it you will forced not only to have it, but PAY for it as well. One way or the other. Your government knows what's best for you. Sure, the UK and Europe are way ahead of the United States, that's why there are so many Americans running the borders to get in, right?

First, you need to look at how those statistics are gathered to understand why I don't believe them. They are NOT verified in any way, shape, or form. Most doctors will not admit in writing that they are not proficient in FUE and that they are not doing them for fear of loss of reputation and/or business. No doctor wants to think or have others believe they have fallen behind and can't do something a competing doctor in the next town can do. The joke, however, is that most likely that that doctor in the next town is no more proficient or experienced in FUE than himself. Second, most HT doctors do not perform FUE surgery. So who is doing all this skyrocketing FUE surgery? Third, most of the FUE reported by doctors are SMALL procedures of a few dozen to a few hundred in a session, not the megasessions being hyped on this and other chat forums. Only megasessions are considered legitimate for the FUE proponents I've been reading on this site. A doctor who only does a few dozen or hundred FUE in a session isn't considered "qualified". Forth, the number of patients with prior FUE cases that come into my office are minuscule compared to prior FUT. After 14 years there should be a lot more than that. Fifth, there was an increase in FUE procedures but this is as a direct result of the popularity and acceptance of FUT procedure. Over the past 14 years the popularity of FUT has SOARED. Look at how many clinics have popped up in that time. How many of them are FUE only? Want to know how many FUE only clinics have popped up in my town- and remember, I'm located one block from New York City? NONE ! How many have popped up in your town? So how and where are all these FUE procedures being performed? Simple, they are NOT being performed. Not in the numbers you seem to want to believe, and definitely not 30% of the HTs being performed in the United States.

It's also more interesting, seemingly high tech, and very expensive just like FUE compared to strip. It has it's place, but very very limited. An augmentation to our standard power sources, but certainly not an alternative.

It's been 14 years since FUE came on the scene, and in that time it hasn't made much of a dent. At the same time FUT has skyrocketed and continues to do so. Very similar to solar panels. They have been around since the seventies and experience periods of hype, but the king of energy production is still the much vilified fossil fuel power plants. Truth of the matter is if there were no FUT there would be no substantial HT industry for FUE to hang on to. Same thing with solar panels. If we didn't have the solid foundation of generator produced electricity we wouldn't be playing around with solar panels.

Thank you HairJo, more videos are coming.

Bill, It looks like we agree on the broad strokes, so that's good. Your issue is the nomenclature. The reason I wouldn't call it modified strip procedure is because it is not a strip. A strip conjures up a line running across the back of the scalp. mFUE is not that. But I also agree it is NOT FUE. But since it is not strip, and it is not FUE, and it is closer to FUE than strip I decided to call it mFUE instead of mStrip (or mFUT). But even FUE is not FUE because many times you get more than one follicular unit in a single extraction. I suppose we could have called it mPLUG since that is probably closer than FUE or Strip. However, we close the skin after extraction and the plug is divided up under microscopes, so you see that doesn't fit either. Probably the best name for it is non-linear scar. But nobody will remember that and we really don't need to add NLS to the alphabet soup of hair transplant names. So mFUE is the closest and that's what we call it.

KO, I think the best FUE doctors are the ones who are VERY selective and prescreen their patients along the lines you mentioned in your post. Excellent post by the way. Dr. Feller

ModernHair, Thank you for joining in. May I ask where in the world you got your information about how FUT dissection is performed? Because whoever told you was pulling your leg. I think I remember back about 17 years ago people talking about loss of dormant hairs during dissection but that was before ultra refined techniques were invented and microscopes were used routinely. But even then I don't believe the loss factor was more than perhaps 5%. Dormant follicle destruction would be much higher for FUE than it would be for FUT. While during FUT dissection a trained technician can easily see the well illuminated and magnified follicular grouping and delicately cut them apart. Even a dormant follicle can be easily visiualized with no problem. FUE, in sharp contrast, is completely blind and includes the necessary ripping of the follicle from the skin. Honestly, which procedure do you think would cause more damage to dormant follicles? By the way, you bring up "cherry picking grafts" during FUE. This is supposed to allow the practitioner to select one, two, or three hair groupings selectively. Many FUE practitioners make this claim as some sort of advantage over FUT. However, it is the presence of dormant follicles that lays waste to the claim. At the time of extraction all the doctor can see is the number of hairs at the surface. He has no idea how many dormant follicles lay below. So, going after a supposed one hair graft via FUE may actually result in a two or three hair graft when extracted ! So your understanding of FUE and FUT and which is safer for dormant follicles is reversed.

1. Absolutely incorrect. There are NOT as many "dud results"in FUT as FUE. Not even close. Love to know where you get your "data" from before you irresponsibly posted on this thread something that is blatantly untrue. 2. I didn't write that FUT results COULD look better, I wrote that they indisputably WILL look better. And for the reasons I've listed enough times in this thread already. 3. Your quote of Dr. Vories is interesting. So, you are saying that he's saying that IF an FUE graft survives it will grow as well as an FUT graft? That's if it survives, right?! This was a weak and disingenuous statement. 4. The "retreat" option is not an option at all. It is a self fulfilling prophecy of failure.If patients wish to fade buzz their donor area after a strip surgery, they can. So what's the problem? 5. "I even recall a recent FUT case from Dr Feller Taclinowest which was not a success." Another completely false statement. Putting aside the clear attempt at libel on your part, did you point out the indisputable failure of FUE results on the part of any FUE practitioners? Of course not, you singled me out. The last I saw Taclinowest was years ago, not recently, and he was growing and healing fine and his transplant was successful. I have had no contact from him to the contrary nor have I read anything of the sort online, so what are you talking about? Regardless, is it your position that he would have grown BETTER had he had an FUE instead of FUT? The problem is that the real and true reason that people want FUE is NOT the haircut options they may have afterward, nor the linear scar it leaves. Rather it is FEAR of the strip procedure itself. Fear is what's driving FUE and it's proponents, and there are no shortage of people who are willing to take advantage of that fear.

Tommy, "...there are amazing FUE results being posted almost daily". This is blatantly untrue. If it were true there would have been about 300 new "amazing" FUE cases on this board in the past year alone. There has been nothing even close to that number. Even cumulatively there haven't been that many in the past 14 years ! My statements about FUE are correct and true based on real world experience in both performing FUE and from seeing the results of multiple other FUE practitioners. I am the guy who writes the literature, and I've posted plenty of it on this very chat site since 2001. Every word has been correct and irrefutable since then. ****Notice no FUE practitioner has come on here to refute a single word I've written? **** Think about that when you decide which procedure to choose for your next procedure. Remember, it's your scalp and you only get one. Dr. Feller

Angelino, 99% of the hair loss community thinks and feels just as you do. The idea is to get as much hair with the BEST chance of growth with the LEAST amount of damage...and no HT procedure does that better than FUT (strip). You are in very good company. Since MOST people grow their donor area out a few inches the scar should and does mean absolutely nothing. I couldn't care less about my scar either as long as I get the most hair out with the least amount of damage possible. Thank you for joining in. Dr. Feller

Hi Bill, First, I truly appreciate you putting me in the "excellent physician" category. I work very hard to be worthy of a good reputation and maintain it. So it means a lot to have someone actually write it in a public forum. In the end, reputation is the currency of the internet and a part of it is being honest. Brutally honest at times. Even when it flies in the face of people who are convinced they are right. Even when it might affect my bottomline. I did not see your questions because this thread is so impossibly long at this point. I had no idea it would gain this much popularity and participation. I will check back and get to those questions later, but for now I will answer your immediate ones. Yes, there have been what SEEM like technical advances in FUE. I have contributed to these "advances" with my own cutting and motorized instruments and patents which I sold to a large company who now produces my instruments commercially. I no longer have any stake in them and can speak freely and without bias. While such inventions look technical and are sophisticated looking they do not actually change the dynamics of FUE. To do this they would have to overcome the three detrimental forces of FUE which are 1. Torsion 2. Traction 3. Compression NONE OF THEM DO! Instead, several of the inventions you mentioned were designed to allow the novice HT doctor to "get into the game" without the hardship of building up technique, experience, or a practice dedicated to state of the art HT. And to that end these technologies have failed. None of them have improved the procedure overall. Mine included. If they had, we wouldn't be having this discussion and this thread would not exist, much less after 28 pages! In the end a punch like tool must still be applied to the skin, pushed in and twisted, and then the graft has to be grasped, compressed, and literally ripped free of the dermis. No device you've mentioned or known gets around these basics. And until they do, there will have been no advancement in the field. Better to perform the procedure by hand as it is still a far better "machine" than anything yet devised or built by mankind. There are more FUE results out there because there are more doctors doing them and more patients requesting them. But the consistency of success and failure has NOT changed. Even a broken clock is right twice per day. But what about the rest of the day where it is completely wrong? Little is said about that. The same goes for FUE. The best results are reported and poor ones are under reported and buried. Think a clinic is going to post a poor result online? Think someone who feels foolish that they paid a fortune for a chewed up head with poor growth is going to post online? Not likely. A few do, but most don't want to face it any more than they have to. No matter how good an FUE case result looks, it would have looked better with strip AND have the added benefit of a less impacted donor area. Meaning more grafts available for future use after the strip case as compared to the FUE. Of course with anything the dedication of the practitioner is key. And there are a few out there that I know of. But even with all their hard work, good intentions, and experience their best work still can't compare to the benefits of strip. Mine included. I'll writ it again: NO MATTER HOW GOOD OR BAD AN FUE RESULT LOOKS, IT WOULD HAVE LOOKED BETTER HAD IT BEEN DONE AS A STRIP. I'm in the business and am balding. I've had only strip work done on myself and would not have FUE done on me even for FREE as long as I had a strip alternative. Which I do. FUE should be limited to those who are "stripped out" or are precluded from strip surgery for other reasons. FUE is not an alternative to strip, it is complimentary to strip and should be seen as such. You can put a patch on a pair of pants, even two patches. But you don't make an entire pair of pants with patches. You could, but it would be ridiculous. That's how I view FUE, as a patch. Of course you can do an entire HT with FUE, just like you can make a pair of pants from patches, but I can assure you a pair of pants made with patches comes with a higher price tag for something that isn't quite as good as a pair of pants and will not hold up as well. Dr. Feller

Thank you for joining in Home. FUE doesn't heal any quicker than strip. As for the recipient area the healing time and process is 100% identical. As for the donor area the healing time is also identical. The only difference being that in the strip procedure all the damage has been done along one thin line such that all the skin and follicles above and below the strip line are virgin. Whereas in the FUE procedure the damage is multiplied 13 times and distributed over large swathes of the donor area forever scarring and damaging them. I think you were really referring to post op PAIN in your question. Yes, strip is more uncomfortable due to the presence of the sutures. This concentrated area of healing is more uncomfortable, but usually only for the first night or two and easily dealt with by use of pain tablets. If you're strip experience was worse than that then that is the exception and not the norm. FUE may well be more pain free in the donor area because the damage has been distributed throughout a much larger area. HOWEVER, this benefit is a one time only freebie. Thereafter your next FUE surgery will be more painful. Just to numb the skin will take more time and be more painful because of all the fibrosis the first FUE will have caused throughout your donor area. Furthermore, your post op pain will not be similar to your first FUE, but rather quite painful and deep. A burning like feeling. This is common to most second time FUE patients. Not all, but MOST. And any FUE doctor will tell you second time FUE patients are harder to numb and keep numb in the donor area. The reason for this is that the skin is no longer like a sponge but rather fibrosed and hard and can't hold and distribute pain medication as it used to. Also, all that fibrosis causes an extra growth of nerve endings to compensate for the loss of normal sensitivity throughout the skin. Temporary or permanent donor neuralgia may follow. This is not nearly as much a problem in FUT. Dr. Feller

"It is a method that has been developed, improved upon, and grown in popularity as a result of the desire of the millennials to wear short(er) hair styles. When performed by and under the supervision of a qualified FUE Doctor and Technician(s), growth and quality shouldn't be compromised." Delancy, I understand this is just your perspective. But you need to understand that what you are writing publicly is simply not correct in the real world: 1. FUE has NOT been improved upon in any significant way since its inception in the 1930s and it's reintroduction in the 2000s. The same issues that plagued it then, plague it now. Absolutely nothing has changed. NOTHING ! For any clinic to claim otherwise is FRAUD and an engagement in the illegal act of failing to give INFORMED CONSENT to their patients. 2. FUE has not grown in popularity as a result of the desire of millennials to wear shorter hair styles. That has never really been the motivation of the overwhelming majority of patients who want FUE. The real reason is FEAR of having strip surgery. The thought of having a surgical procedure that includes the removal of a lengthy piece of skin is frightening to many people. It invokes such a deep phobia that they become almost hostile to the idea and openly vilify not just the procedure, but the surgeons who perform them as well. It is this fear that is at the base of the motivation of nearly every hardline FUE proponent on chat forums like this one. Claiming that it allows for shorter haircuts is merely a distraction. Make no mistake, millennials are not the first, nor the last, to want to be able to fade cut the back and sides of their heads. 3. "When performed by and under the supervision of a qualified FUE Doctor and Technician(s), growth and quality shouldn't be compromised. " This quote is colossally incorrect. How in the world do you support and justify this completely fallacious statement? I haven't met an FUE doctor to date who has made this claim. Delancy, if a doctor or clinic told you this PLEASE give me the name of that person or clinic. Then give me your name and address and I will call them on a three way call WITH YOU on the line. We will record the answer and discussion that follows and post it ONLINE for the world to hear. Fair enough? Dr. Alan Feller

The answer is ABSOLUTELY YES. Many patients who've come for an HT consult have already tried finasteride and reported sexual side effects.

London, I looked at your photos and your donor area is very very thinned out from the FUEs. I will be in London in October any chance of you meeting up with us there so I can just see for myself? Dr. Feller

Of course you can book a consultation. Yes, contact Spex, please. I look forward to seeing you!. Been a while.

London, I looked at your donor area and it is indeed very thinned out from the FUE. But photos aren't as good as seeing it in person. I'll be in London doing consults on OCT 3 and 4. See if you can visit me when I'm there so I can see the situation for myself. Dr. Feller

Back from vacation after two weeks off. I decided to post the scar photo of the very first post op patient I saw today. He is 7 months after one FUT (strip) procedure of 2,800 grafts. Here are pics of his scar. ALL the hair above and below the scar are perfectly intact and available for future procedures. Look at how small the scar line is. Unless he buzzed down to a two guard nobody would see it. I asked how likely it was that he would shave his hair down to the skin. His reply: "Are you crazy?! Why would I have just done a hair transplant if I was ever going to shave my head?! I love my new hair and want another procedure to fill the crown, please" His words... and I believe it says it all.

Agreed. Well done! He is a fast grower, his hairline looks ten times better already and he's just getting started. Excellent and undetectable scar as well. Good to know that above and below that tiny scar line is untouched skin with perfect virgin grafts. Be great to use in the crown to finish him up. Excellent work!

We see many before/after pictures and even videos, but very few with commentary as to what was done and why. Obviously it was to look good and fill in the balding areas, but to get to that place took a bit of planning. Like a game of Chess, a good HT looks forward to the next move. Here we present a standard 2,000 graft case before and after a year and our view toward the future of his hair loss. Enjoy!

Or influenced and mislead by anonymous online posters.

You know, Mick, you hit on something in your post. You wrote: "... in an ideal world maybe it shouldn't make any difference to one's self image or how people perceive us". I find HT is rarely for others as much as it is for the person himself. I believe HT is really about "identity" and not so much "vanity". And I don't mean vanity in a bad way. I have a friend who is as non-vane as you can get. He was already becoming a stage 5 hair loss sufferer but legitimately was not bothered by it. So when all my friends who needed transplants got them, he wouldn't even consider it. Until one day he came up to me and said he wanted one. I was truly floored. He had told other friends of ours that he wanted it and they were floored as well. What had changed? I had to ask. He told me. And I quote: " I really didn't care about my hair loss until I looked in the mirror and saw my father staring back at me. I wasn't me anymore. " I think that says it all and why the HT industry is huge. It is all about identity, not so much vanity. I feel the same way about myself. When I saw my forehead "growing" it wasn't "me" anymore. So I did something about it and that's how I got into the field. Unfortunately, the doctor who did my first transplant did not do a good job and wasted some of my donor area I sorely need now. Perhaps that is one reason why I am so sensitive about the donor area and that it not be wasted. You are born with as many follicles as you are ever going to have so make each and every one count! I wish I had back the estimated 800 that were destroyed during my first surgery. No internet back then, unfortunately. Best to you and your growth, Mick.

Yes, that is exactly what I am saying, Joe.

You got it Mick. Couldn't have said (written) it better myself. The very best growth to you. I hope you love your transplant and enjoy your new hair. I know EXACTLY how that feels. Feels like a million bucks. Joe, Nope. Strip grows better than FUE. Period. No parsing of words. Forune, I don't know the article, but what you wrote is dead on right. Thanks for joining the conversation.