Dr. Alan Feller

Thank you, Mike. Dr. Alan Feller Great Neck, NY

I've been calling out FUE doctors since 2003, Mike. I've made several "big" charges, not the least of which is it's unethical for doctors to solely offer FUE as it deprives the patient of the option of having the gold standard of hair transplant procedures which is FUT (Strip). It is every patients right to be offered the procedure that will give the best chance for the best results. FUE-only clinics deny lay patients this right. Please make sure you include that in that note you give to doctors when you consult with them. If any of them wish to come online and debate me publicly they are more than welcome to. As for my protocol: Let's say a patient comes for FUE but he is an FUT candidate: The highest number of grafts I will offer a patient via FUE is 1,500 grafts total for their lifetime. And this is IF and only IF they sign a consent form that expressly states they have been offered the FUT procedure and rejected it. The document will also state clearly that they are subjecting their donor area to a guaranteed greater level of damage, greater amount of scarring, and fewer grafts available for future procedures AND that the chances for growth in their recipient area is lower than for FUT. Anything above 1,500 FUE graft extractions increases confluences of scar in the donor area so precipitously that an ethical doctor could not justify it over that of a linear scar. Since you are a fan of writing things down I suggest you ask your FUE doctors to commit the following to writing: 1. My FUE grafts experience no more trauma than properly performed FUT grafts do. 2. My FUE grafts grow as well as my FUT grafts and I have no reason to think otherwise. 3. The damage to the grafts during the extraction process for FUE is the same as for FUT. 4. The amount of damage to the neighboring grafts in FUE is the same as for FUT. 5. The amount of scarring in the donor area produced by FUE is less than that for an equivalent sized FUT. 6. The expected growth for an FUE graft is the same as that for FUT grafts. 7. The general growth yields for FUE procedures are the same as that for FUT procedures. See if they will sign a document containing those 7 items before performing the procedure. Please get back to us with the names of those FUE doctors who will. Thank you, Dr. Feller Great Neck, NY

Arminius, If you have nothing positive to contribute, why bother at all ? Posting nasty comments and personal attacks helps nobody, least of all you. Dr. Feller Great Neck, NY

FUE should be reserved for patients who simply cannot have FUT. FUT should be the first line for any and all hair transplant procedures. Doing a 2,000 graft HT as an FUE when it could have been done as an FUT is irresponsible. FUE cases of about 500 to 1000 grafts TOTAL lifetime MAY cause minimal damage IF the donor is large enough, the grafts are cooperative enough, and the surgeon can stay within the safe donor area.

Thank you, Mick. Well said. Dr. Feller

Arminius, Believe me when I say I am on YOUR side and I want your hair to grow like gangbusters. That is my wish for ALL HT patients everywhere in the world no matter what procedure is used or which doctor performed it. However, what I have reported on this site about FUE is indisputable fact. It is not opinion, or bias, or based on a hidden agenda. Notice no FUE doctor has come on here to dispute any of it ? Including your own doctor who I guarantee reads these posts. Your harsh critique of me personally was uncalled for and, frankly, inappropriate. However, I understand what made you feel the need to do it: You don't want to believe or accept what I have been writing and reporting about FUE is the truth. And you are bothered by it. But you already committed yourself to an FUE procedure a few weeks ago, correct ? So to make yourself feel better you need to try to discredit me personally. This way you don't even have to explore or even understand the objective details of my reporting. It's just easier to "kill the messenger". I read your other posts and know you are worried about crops of pimples popping up in your FUE donor area. You know this is not normal. And now you are wondering if this may relate to the recipient area in some bad way which will affect your overall growth and final result. This is a very real and intelligent concern. It seems you don't know HOW they may be connected, but you are correct in assuming they may be. If you listen to what I have been saying in my videos and articles you would understand why your concerns are infact valid. I know you point to the good results of other FUE patients and clinics to find solace and to use as "proof" that Dr. Feller doesn't know what he's talking about. That's natural. But you are ignoring all the abject and inexcusable failures of FUE that have been published on this very forum alone. Not to mention the huge number of patients who, like you, have reported they just had an FUE, showed post op photos, and then fail to ever update the community with their results. Or, they post results that clearly don't compare to their FUT equivalents. You ignore all of this. It's my job not to. I am not some kind of ogre trying to sqwash the FUE industry. I perform FUE to this day, I have invented and patented FUE instrumentation and protocols. I have been cited in the aurhtorative HT textbook. I have taught other doctors how to perform FUE I was a true pioneer in the field. If FUT were outlawed today I would make a very nice living doing just FUE. But I would be conflicted knowing that a better way existed (FUT). A way that may not SEEM as attractive to lay patients, but nevertheless produces a superior result 100% of the time. It is to the shame of my colleagues who ignore, downplay, or deny the limitations of FUE and who refuse to discuss this reality on this forum. I believe most of them are mute on the subject because they: don't have enough personal FUE experience but don't want to admit it OR they don't want to criticize a cash cow and thus limit what they can ethically offer to their patients for a payday. It is they who should be embarrassed and whom you should be directing strident comments towards. I have no regrets sharing my surgical knowledge and intimate experience of FUE with lay patients so you really know what you are getting yourselves into, and will continue to do so. If my expose of FUE saves even one patient from an FUE megasession then I know I did my job. Dr. Feller

This presentation is an excellent example of why FUE should be used in limited numbers and in limited cases. The photos Dr. Cooley shows of the donor area thinning is extremely common in FUE patients. In fact, Dr. Paul Rose recently gave a lecture and wrote an excellent article as to why even relatively small sessions of FUE can cause pathological thinnig out the donor area. This is a case of excellent patient evaluation and management. Well done Dr. Cooley and Staff. Dr. Alan Feller Great Neck, NY

Unfortunately, the issues facing FUE are not just opinion. They are factually observed, well documented/recorded, have already been named and classified, and are immutable. More and more ethical doctors are coming out and speaking publicly about the disadvantages and detriments of FUE despite the fact that these honest doctors stand to lose tremendous amounts of money while telling the truth. It is simple: The damage to the grafts during the procedure are markedly and demonstrably higher than that for FUT (the gold standard). There is no avoiding this, there is no debating this. It is established and observable fact. Here, Dr. Lam gives a lecture that clearly demonstrates not opinion, but observable fact concerning the FUE procedure and the damage it inflicts on the grafts.

And remember to look for consistently produced results like these:

If you understand and agree that FUT gives better results on average and is the best for all bigger hair transplant surgeries, then I have done my job. Best of luck to you. If you say you are not a covert FUE rep, then I believe you and do apologize. It seems we are on the same page. Forgive me as I am just used to being attacked subtly and viciously by FUE cheerleaders, chest beaters, and zealots -several of whom have been banned.

1. I have provided scientific data. You just choose to ignore it: a. The FOX test. b. Dr. Beehner's studies. c. Dr. Wesley's studies. d. The consensus of all HT doctors I've ever met save one. e. The position statement of the ishrs declaring the primacy of FUT over FUE. f. My 17 years of having performed FUE, offered the first live demonstration, and patented tools. Finally, do you really need "scientific data" to know that if someone smashes down on your foot it will be damaged ? Because that is the "proof" and the "data" you are asking for. You are layman, so you have no idea what is and is not out of proportion. 2. Your second question is a statement, more of an attack, than a question. It doesn't matter how smart or educated someone is any field. If a physicist doesn't also perform hair transplants, why should I care what they think? And if their rational and logic is wrong, it's wrong, no matter what their background. All I've ever heard from the FUE doctors who have tried to defend the graft mauling they engage in include the rejection of common sense thinking with regards to the involved physical forces on the graft; and the most convenient and self serving inability to see a plainly injured graft sitting right in front of their faces in the form of skeletonization. Of course you can't appreciate this because you are a laymen. So this is not necessarily your fault. The FUE doctors know better, or should know better. At least most of the HT doctors who perform both will, for the most part, admit the truth that FUE grafts are traumatized more than FUT grafts. Even if they try to downplay this reality. 3. You are a laymen and can't understand any studies that are presented. They are not written for you, they are written for practicing surgeons. It doesn't matter if the doctor performing the FUE perform FUE only or FUE/ FUT. The reality and physics of the situation are the same. No doctor, no matter his focus of specialty, utilizes a method that address and decreases the three detrimental forces that injure FUE grafts: Traction, Torsion, and Compression. 4. Yes, grafts will grow worse if they are injured. Just as your eyes will work worse if I squeeze, pull, and twist them them with a forcepts. Just as your foot will work worse if you drop a couch on it. No further analysis is needed. FUE is worse on the grafts than the analogies I just gave you, but you couldn't understand that because you've never held a graft or performed surgery. 5. Simple: Dead grafts don't grow. Injured grafts produce poorer hairs. - No, stick and place will not bring dead grafts back to life or "uninjure" traumatized grafts. -Damage to FUT grafts are negligible. When compared to FUE it is non-existent. -Fast extraction causes more damage because all the detrimental forces are increased. When I see fast extraction I see medical malpractice. It's just a matter of time before a failed FUE patient takes his doctor to court and shows the carelessness with which the "fast harvest" FUE doctors engaged in to perform the surgery. That doctor will be toast, which is why you don't see this kind of doctor in the United States. In the third world, anything goes. -As for the speed of the punch during surgery, you wouldn't understand because you don't perform them. Gas, you sound like an FUE clinic representative to me. Why don't you just admit it and have your doctor come on here and debate me ? Let the world see the kind of work he is doing. In fact, I would love a video of your doctor quickly harvesting grafts. Another FUE-only doctor did that and it didn't work out too well for him. When the public posted how aghast they were at seeing this doctor literally and carelessly ripping grafts out indiscriminately he quickly tried to edited the video to cover up what he was doing. You will rarely ever see such a blatant demonstration of the consciousness of guilt as that one. But perhaps your FUE doctor will stand more firmly behind his own work. Perhaps he can educate me. I'd love to be wrong.

I did not make any special effort to choose my words. I don't know what you are getting at there. There are no technicians or nurses worldwide who are qualified to do the scoring (cutting). It doesn't matter if they are licensed in their fields or not. What is the point of having doctors (referred to as surgeons) if just anybody can perform surgery? In the United States, the center of the modern world and modern surgery, the "First Surgeon" must be a physician. Not a tech, not an assistant, not a nurse, not a PA. No non-doctor is qualified to perform the cutting. These ancillary staff may ASSIST the first surgeon, but not take his place. Thus, when the first surgeon leaves the surgical field, much less the room, the staff member becomes the first surgeon and that is against the law. Look at it from a moral perspective. If living human tissue is going to be cut it should be cut by the most qualified person in existence. By the person at the top of the pyramid of: skill, responsibility, and accountability. That person is the doctor. The others are just hired hands with no overarching responsibility for the patient. That lays purely with the licensed physician. If the doctor leaves the room he may be blamed for a poor job being performed by a subordinate, but that doesn't help the patient on whom the poor job was inflicted. Had the doctor done this job himself, as proscribed by law in the Unites States, the poor job might not have happened in the first place.

This is why I say hair loss is similar to losing an arm and why it's different than people who seek plastic surgery like facelifts. The former no longer see themselves, the latter do see themselves just older. Here is a recent patient of ours whose identity we were able to recover in just one transplant session:

Jean, As I've written many times before: I don't debate laymen. You are not qualified to debate me.

Davis, you are good. Damn good. If we had just five more posters like you online the internet FUE hype would be stopped dead in it's tracks. Thank you for posting. You are extremely lucid and articulate.

I am only being one sided because that's what the facts and experience dictate. If you do not perform the surgery then you can't understand the realities that these facts are based on. People, such as yourself, see this as "arrogant". I am not an egalitarian. Doctors know more than laymen. That's just how it is. This reality rubs some people the wrong way so they lash out and call me arrogant. But this doesn't change the truth. The numbers you are looking for do exist. The popularly accepted growth yield for FUE is 75%. I believe it is lower because these figures do not include the number of grafts killed during the extraction attempt. The number only relate sto the grafts that were actually removed SEEMINGLY intact. There are tons of data out there that support the failure or retardation of growth of FUE grafts vs. FUT grafts. Just look at the results posted on this site alone. Also look at the results those doctors who are capable of performing both choose to present on their websites and this site. They are overwhelmingly FUT results for a reason. Sure, there are poor FUT doctors and poor FUE doctors. But that doesn't make the procedures equivalent. A poor FUT will likely grow better than a poor FUE. And if X factor negatively affects FUT then you can bet your last dollar it affects FUE to the same extent or worse. We do not need to set up studies to know with scientific certainty that a graft that has been compressed, twisted, and literally RIPPED from the skin will grow poorly compared to one that has not. We do not need to perform physiological tests on a graft that has been skeletonized to know it is not going to grow as well as one with all the necessary tissue still wrapped around it. Despite the obviousness of it all, the scientific method was applied to quantify and qualify the damage inflicted on FUE grafts during extraction. It was called the FOX test and it showed that fully 80% of grafts are damaged during extraction. I believe the number is actually higher because even grafts that LOOK intact are not. Amazingly, however, as the internet hype of FUE ratcheted up the FOX test became conveniently forgotten. The acceptance of FUE has been anything but scientific. The proof is in the pudding. When photos of "successful" FUE procedures are presented as "evidence" that FUE works as well as FUT I say on it's face this claim is misleading. If you show only people who won at Casinos and ignore those who lost their shirts one would come to the conclusion that most people win in Vegas. But of course it isn't true. Every patient, and I mean every human being, has a right to the procedure that offers them the best chance of growth in the recipient area. Offering FUE to the exclusion of FUT denies them this right. I believe it is highly unethical to offer FUE to the exclusion of FUT in almost all cases. It is just wrong. But people are making money doing it so you don't hear much fuss about it. I, for one, will not accept making money this way. I want to do it right or not at all. Many of my colleagues, unfortunately, do not feel the same way. One cannot produce a skeletonized graft via FUE and ethically reinsert it into that persons scalp while all along knowing had the procedure been performed as an FUT instead that graft would not have been skeletonized at all.

Jean, Your posts are very malicious and the tone is uncalled for. HLS2015 is correct. You are incorrect.

Davis, your post is dead on. Really well written. Good to see someone is using their brain and thinking things through.

Andy, No hostility at all. And I fully agree with you to go for strip then FUE. That's exactly how it should be. We are on the same page. I'm glad doug said patients would have more grafts in a lifetime if they go for FUT. You didn't include that in the original quote.

Jean, you are offensive. And you mean to be. I do not appeal to authority, I am the authority. You are just a loud layman who simply doesn't know what he doesn't know. You embarrass yourself and confuse well meaning people. You really should stop assuming to speak for the doctors who perform the actual surgeries. They didn't ask you to. You have no idea of how many procedures they are performing nor what their success and failure ratio is. You also should stop trying to suppress the views and posts of those you don't agree with. I've already had at least one your phony posts deleted by the moderator. But by all means keep commenting on my Youtube videos, you boost their rankings.

Amen.

I can't speak for what other people say or why they say it. Nor does it matter. The facts are the facts. FUE causes more trauma to the grafts and therefore do not grow as well as their FUT counterparts. Dr. Hasson firmly understands this and has always agreed with this reality. If he has changed his position on this he certainly never shared his reasons with me or anyone else that I know of. It would be nice if he shared his revelations with the public. That would make for a great forum topic. What I do reject is the reasoning that because Dr. Hasson (or anyone else) is an excellent and world class leader in FUT that this somehow makes him an expert on FUE. It doesn't. Nor did Dr. Hasson or Doug make this claim for themselves. The inference was entirely made up by anonymous online lay posters.

It's not a "big statement" it is what it is. I take exception to anyone who delegates surgery to unlicensed unqualified personnel. It doesn't matter who they are. You as the public should as well.

Yes, he did. I did the bulk of his repair using manual FUE.