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Dr. Alan Feller

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  1. Spex is a showcase for me but I do not own him. He may express any opinions he wishes to, even if they are the opposite of mine, or are dead wrong. If everyone knows the beautiful head of hair he now possess came out of my clinic, that's good enough for me. - Our relationship changed a few years ago when he decided to make a business out representing multiple doctors. He is a non-medical layman like the rest of you and his views and positions are not necessary correct nor can he be held legally accountable for them as he is not a qualified medical doctor. Many things make sense until you learn more and get the bigger picture. Then they stop making sense. Like FUE. If you want a qualified opinion of the ARTAS you should look to doctors like myself, not laymen. Personally, I find that machine to be pointless. There is nothing I would welcome more than an ARTAS - using doctor to come onto this chat forum and debate me about its efficacy and usefulness. I know when comparing results I and my FUT megasession colleagues would wipe the floor with them. Or how about the ARTAS company itself. Perhaps they can tell me why every doctor I know who has purchased their machine chooses not to use them. Let's use some commons sense here. If that machine really worked, wouldn't I buy five of them and do five surgeries at the same time and make a fortune ? Until Spex started working for another doctor his views on FUE paralleled mine. Then, overnight, they changed. Perhaps you should be asking him how he reconciles this instead of me. Andy, you refer to FUE and FUT as "philosophies" . They are not. They are two different real world procedures not abstract viewpoints, and one (FUE) is being applied inappropriately all too often.
  2. I think you mean "lay" not "lame". You are certainly anything but "lame" from how well you write. But you are right. You have no surgical experience and unfortunately no amount of online reading, participation, or enthusiasm can give you the insight you need to truly understand the surgical differences between FUE and FUT. And in my opinion you are getting precious little genuine advice from the professionals on this site who should be giving it to you. I give lengthy responses because, unfortunately, virtually none of my colleagues chime in on the online forums to educate patients due to fear of being attacked or perhaps simply because the truth may affect their bottom line. FUE can be quite good for business, can't it ? Your conclusion that yields between FUE and FUT are similar is just not true. I'm telling you this as an experienced hair transplant physician. It's not your fault, though, you have been misled intentionally and unintentionally to this very false conclusion. The variation in success between the two procedure are often VAST. If the results between FUT and FUE were THAT close there would not be an FUT procedure anymore. Yet this is clearly not the case. Please look at the results posted by all the doctors that do both FUT and FUE on this site alone. They are required to post results in their profile section. Look there right now. Virtually none of the posted results are of their FUE patients, much less megasession patients. And not a single doctor, Dr. Hasson included, has given up their FUT practice in favor of FUE. Why do you suppose that is ? Because FUT grows better and more reliably and they know it. Their results demonstrate that reality. Doctors in this country and others are performing FUE because that's what the patient wants. Simple as that. The marketing campaign of some clinics and equipment manufacturers along with massive online FUE hype has made the public believe they can have their cake and eat it too. Doctors who perform FUE are progressive and capable, and doctors who perform FUT are antiquated. That is the online lie that has been pedaled since 2010 or so. It is incorrect to claim you have seen "failed" FUTs because you have seen stretched scars in the donor area. The PRIMARY measure of the success or failure of a hair transplant is in how well the hairs grow in the recipient area. And in this arena, FUT is the undisputed king. Your observation also completely ignores the massive amounts of scarring inherent to the FUE procedure. Just look at this post by a worried FUE patient made on April 9: http://www.hairrestorationnetwork.com/eve/186691-1500-grafts-donor-square-patch-visible-after-fue.html Most patients seeking FUE are scared to death of having the strip procedure performed. Many CLAIM they don't want the strip because of the line left in the donor area, but this isn't so. Most are just afraid of having a strip surgically excised from the back of their head but publicly claim it is the linear scar that they object to simply because they are embarrassed to admit their fear. It's actually understandable and probably represents millions of potential patients. Patients want to believe that they can have a "non-surgery" surgery. And way too many doctors allow them to believe that is the case. Hence claims of "scar free" surgery or "scalpel free" surgery. Both lies which will get a doctors license yanked in the United States. Third world doctors may say whatever they want in their advertising with little to no reprisal. And many certainly do either directly or through surrogates. You said "in the right hands" FUE is as good or better than FUT. I have no doubt you have read many make that claim about a select few hair transplant practitioners. Yet never once have I seen the actual practitioners who can do BOTH ever make this claim. Not even once. Doesn't that make you think? I tried to have a debate on here with two other doctors who only perform FUE. The thread got corrupted by trolls and troublemakers of the like in their effort to shut it down. Perhaps that should tell you something. The bottom line was I asked them to write and stand behind their belief that the FUE graft procedure does not cause MORE graft trauma then the FUT procedure- and both balked. As they always will. To claim otherwise is to deny informed consent to your patient. At least the doctors in the United States know that and will not make a false claim that will jeopardize their medical license. Is it any coincidence you don't see FUE "heroes" and mills in the United States ? Do you honestly think that is due to the genetic incompetence of the American doctor ? So the world looks to America for advanced surgical technique in everything except hair transplantation ? Come on. Does that make common sense ? Let's face it. You WANT a surgery that is good as strip but without a strip. I get it. But few patients will get that. Instead they will most likely get a poorer final result with more damage to their donor area. Instead of ignoring the bad FUE stories on this and other websites, read them and think why they are unhappy. The know they will never get back the hairs that FUE killed. You never hear that coming from an FUT patient. Make hair growth your PRIMARY concern. Don't be misled by wishful anonymous online posters and the doctors who are only too willing to service them. If your primary concern is successful hair growth go with a proven FUT doctor knowing your chances of regret are FAR lower than it would be for FUE. And conversely, where you chances of a great result are higher. Best of luck in your choice. Dr. Feller
  3. From the photos I think it is obvious that this patient has been over harvested using the FUE method. What we are seeing is scar tissue and shock loss from the FUE procedure extending through the safe donor area into non-safe areas like the crown. The grafts were taken from too close together and the result is damage to the underlying blood supply as well as confluence of scar where the scar tissue from each extraction hole connects to that of the next extraction hole creating sheets of obvious scar tissue. That scar tissue is now permanent and the patient will have to wear their donor area hair longer to conceal it. This is representative of what has become all too common in the FUE side of the hair transplant field.
  4. HairDew, It is posts like these that confuse the public about FUE. I know you want FUE to work as well if not better than FUT. We ALL do, including me. But such is not the case- not yet- and not ever unless a revolutionary new method of skin incision is invented. Yet nothing significantly new has been invented since the introduction of FUE to North America in 2002. This is demonstrably provable. I think cherry picking postings from websites, like that from Dr. Hasson, is inappropriate and disingenuous. You excluded the majority of websites wherein the doctors make it clear that FUE yields and results are not on par with FUT and include this reality in their surgical consent forms. Dr. Hasson is not an FUE expert. Nor does he claim to be. He is an uber FUT expert, but this does not lend itself to FUE expertise. By his own words he has only been experimenting and studying FUE for just the past few years and is now coming to conclusions I had already made and published over 10 years ago: that the only FUE worth doing is MANUAL FUE. As he continues performing the procedure regularly, as I did, he will find more and more that his FUE results will pale next to his FUT results. In a phone conversation I had with Dr. Hasson about 10 years ago he himself noted how viciously FUE procedures destroyed the donor area and told me in detail how he had been seeing the patients of a particular FUE-only doctor and how destroyed their donor areas were. I'll never forget him using the saying "it causes follicular holocaust." He also used another term to describe the procedure that I will not write here. Nothing from then to now has changed in terms of harvesting from the donor area. HairDew, You put a red box around a particular quote of Dr. Hasson: "I never imaged that FUE grafts, if extracted properly, could look so close to those of strip" I don't know why he said that. There have been great examples of excellent looking grafts offered online since at least 2002. Pay close attention to words he chose to use. He wrote how FUE grafts: "could LOOK so close to those of strip". The problem with FUE has never been that the grafts could or couldn't look like those of strip grafts, but that even when they DO look like strip grafts they simply don't grow as well. And this is due to the extra trauma FUE inflicts on the graft compared to FUT. Just because an FUE graft "looks" good doesn't mean it is. Dr. Hasson knows and understands this. In your red box Dr. Hasson also mentions that he couldn't have predicted that a donor area could look so pristine one week after an FUE. Again, I don't know why he couldn't have predicted this. It is not new, nor is it a secret that tiny punctures of the scalp heal well. Examples have been posted many times online. In fact the majority of FUE "cases" posted online are of the donor area 1 week after surgery- usually to the exclusion of the final growth results. Again, the issue is not how the donor area LOOKS but rather the amount of subdermal damage inflicted along with the pathological remodeling the dermis undergoes in the months following the FUE. After all, all linear FUT scars look awesome one week after the procedure. It is only in the following months that the scars may widen and the skin remodels itself. It is the very FUE damage, scaring, and remodeling that he himself objected to time and time again years ago when performing an FUT to repair and finish such patients. Nothing has changed in the arena of FUE. The same amount of damage is still inflicted on the graft in 2017 as compared to 2001. Naturally, the more experienced and caring the doctor and staff, the better the result will be. The smaller the case, the better the result will be. I do take issue with non-doctors performing the scoring (cutting) part of any surgical procedure. In the United States it is illegal and considered an inappropriate delegation of surgical responsibility. Even an RN and a PA-very highly trained, licensed, and competent medical professionals- cannot perform the scoring (cutting) around the graft as they may not act as the Primary surgeon. They may Assist in the scoring, but it must be the attending surgeon who actually has his hands on the cutting tool. If the primary surgeon leaves the room, then the RN or PA becomes the primary surgeon and that is simply illegal. Recently, a number of FUE doctors left the ISHRS because they were allowing their staff to perform the entirety of the FUE extraction process themselves as the primary surgeons. The ISHRS took the position that this was not a practice the Society should stand behind. I think this was good and juste position on the part of the ISHRS and I stand behind their decision completely - as do the other 1,000 plus members who waved goodbye to these FUE practitioners. Allowing technicians to perform an entire procedure is inexcusable. And, in the United States, absolutely illegal. Unfortunately, many other countries offer their citizens no such protection under law. And there is no shortage of clinics willing to benefit from it. Patients travel to these clinics at their own risk. Despite how disingenuously anonymous online posters try repeatedly to re-frame my position on FUE into a procedure "that doesn't work" ,I have always proclaimed FUE can and does work on occasion and in the right patients. Or else why would I ever perform them? Teach them? Invent patented instrumentation for them? Write on them ? And contribute to the authoritative text on HT? That said, it is painfully obvious to any objective person or practitioner that FUE does not serve the patient as well as FUT in terms of consistent HAIR GROWTH, which is the entire point of getting a hair transplant in the first place. If your goal is to get as many uninjured hair follicles as possible for transplantation while leaving as much hair as possible in the donor area then go with FUT. If not, then go with FUE. Dr. Alan Feller
  5. Trix: You've got it inverted. The chances of donor numbness and permanent pain are much higher with FUE than FUT. In fact the term "donor neuropathy" was coined to describe FUE pain. I have never seen it applied to FUT. The reasons for this are simple. In FUT there is only one plain of cutting and virtually no neurological or vascular damage so thees wounds heal extraordinarily well. FUE, by contrast, inflicts thousands of damaging holes in the donor area that disrupt nerves, nerve endings and vascularity throughout every plain. In fact, the damage inflicted by FUE is 7 to 13 times greater. The real neuropathies, however, don't show up until a second FUE procedure is attempted. It is at that time numbing is harder to achieve and maintain and postoperatively an increase in pain in the form of "burning" occurs. There is no analogue for FUT surgery. Below is a video I made a while ago that explains the damage caused by FUE compared to FUT.
  6. Chris wrote: "Granted , I have never performed a surgical procedure , but why would that make me ignorant of the procedure ?" Wow.
  7. I'm sorry you find my mention of your ignorance in surgical experience vitriolic. It's not meant to be, it's just a fact and shouldn't affect your feelings one way or another.
  8. Chris wrote: "This is loudest case of God Syndrome I've come across " There you go Chris. Pretty vitriolic. I don't debate with laymen posters like yourself. I inform you and the community as to the realities of surgical procedure because you have no idea or experience. I do. You may either accept the information or ignore it. It's completely up to you.
  9. Mick and Chris, You both immediately descend to name calling and vitriol. That doesn't add to your credibility or your position. So I ask again, with 60 HTN recommended surgeons, worldwide, contributing to this website every month as a requirement, why are there virtually NO examples of megasession FUE ? The answer is because they are not being performed OR the ones that are being performed are producing results no doctor wants to post online to be seen by the world. Trix took the time to watch my videos about FUE myths and facts. You both should, too. If you have any questions I'm happy to answer them.
  10. Trix: This is absolutely correct and an immutable fact that many in the online community simply can't and won't accept. In fact they will reject it loudly. Until an online poster can get a medical license, perform the FUE procedure and take responsibility for it they are uninformed. Being the recipient of a hair transplant procedure does not make a laymen into an expert-no matter how bright, motivated, and enthused he may be. And, no matter how much time he spends on a lay hair transplant forum. So you should weight their input accordingly. If you are rejecting FUT for whatever reason. This means you are putting the actual growth of the graft secondary to some other concern. That is your business and it is fine in my book IF and only IF you have been properly informed about the risks of FUE compared to FUT. I am not a hair transplant cop, so you do what you think is in your own best interest. May I ask, Trix, why you are interested in FUE over FUT ?
  11. I'm glad they received good results from their FUE megasessions and are happy but they are in the severe minority. If you want to go by FUE cases that "show up" on this site, don't exclude those FUE posters who are very upset with their growth rates and final results. They are legion and they are not likely to come onto a thread like this one. If you want purely scientific evidence of the FUE procedure as compared to FUT look to Drs. Rassman and Bernsteins seminal paper where they introduced the FOX test. Fewer than 20% of patients produce grafts intact enough to be expected to perform as well as FUT grafts. Identifying these patients is impossible prior to actually performing the procedure. So, let's say 1,000 people get FUE surgery. 200 will have good looking results. That seems like a lot, until you take into account the other 800 patients who got poor results and can't get those grafts back. Think of standing outside of Las Vegas Casino. How many people do you have to interview before you find someone who beat the house ? But if you only advertise the winners you can mislead the public into thinking just about everyone will be a winner. There is no difference between the skill level of European FUE doctors over American ones. The only difference is the brute force European doctors are willing to apply. Brute force means simply going as fast as you can. Score the graft and rip it out quickly. This has been going on since 2002. To call this "progressive" is naive. As I said, lay posters don't know what they don't know. There is absolutely no significant difference between the different manual FUE procedures across the world. The only real difference are the individual physiology of the patients and the NUMBER of patients they perform the procedure on. The more patients you perform the procedure on, the more good results you can present. But make no mistake, most results are poor compared to FUT. By far. When you read that an FUE clinic got out 4,000 FUE grafts, what you don't know is how many ATTEMPTS were made to get that number. If it was 5,000 attempts you just lost 1,000 grafts you could have used in the future forever. It also explains the massive donor damage associated with FUE as well as donor hair thinning. See Dr. Paul Rose's article in the last publication of the International Hair Transplant Forum. The documentation and evidence against large FUE sessions is unequivocal. A "progressive" clinic would offer BOTH FUE and FUT. Most of the European FUE mills do not offer both because an FUT clinic requires more staff and overhead. Simple as that. Also, the medical malpractice laws are far more lax outside of the United States allowing European clinics to allow unlicensed technicians to perform entire procedures in practice or de facto.
  12. Trix Thank you for watching our videos. If they made you think twice about having a large session of FUE then we did our job. I would advise you stay away from FUE megasessions and avoid looking to lay online posters for guidance or confirmation of FUE. While their intentions may be good, they simply don’t know what they don’t know. The professional consensus by the experts that perform BOTH procedures is that FUE is an inferior procedure that should be used sparingly and on a limited basis. Consider this: On HTN the 60 member doctors are required to post one patient case study per month. This means before/after photos. Yet, when you look at the photos the doctors themselves chose to post you almost never see any megasession FUE cases. Instead their large cases are almost exclusively FUT. You may confirm this for yourself by picking any doctor that claims to do both FUT and FUE and go to their Profile page. There you will see their submissions over at least the past five years. Virtually none are of FUE megasessions. To expand on this, note that the International Society of Hair Restoration Surgeons (ISHRS) has over 1,000 hair surgeons within its ranks. Pick any random ten and you will see the same thing: almost no megasession results to present. Dr. Alan Feller
  13. You are far from the only one to have these feelings prior to your procedure. I felt the same way before mine but realized these feeling were very misplaced. Dr. Bloxham and I made a video about this very issue a few weeks ago. I think you'll feel a bit better about your decision after watching it. Dr. Feller
  14. Excellent choice for recommendation. Of course I give Dr. Bloxham my highest recommendation and put my personal reputation AND my Great Neck practice behind it. As the "Wiseguys" would say: "I vouch for him". The back story of how Dr. Bloxham got to this point is much more in depth and competitive than most people realize. I started my search for a partner over ten years ago. I had tried out over a dozen doctors but none of them made the grade. These included: General Practitioners, Family Practitioners, General Surgeon, ENT/Facial Plastics, an Orthopedic surgeon, two E.R. specialists, an Ob/Gyn, and even a Bariatric Surgeon. They either didn't have the natural talent required, or the dedication required, or just that "something" that makes a doctor "click" with patients. I let them all go after spending a week or more with me to evaluate them. Then Dr. Blake Bloxham came along. A diamond in the rough if I ever saw one. The interesting thing is that his initial visits and externship with me were not in anticipation of him working with me nor for me. He was a California guy so it never even occurred to me he would want to practice in NY. He just wanted more exposure to the field and I enjoyed the visits of someone who was so well versed in the details and language of the modern HT industry. His visits were always a pleasure and I looked forward to them. When he visited he would watch the entire surgery from start to finish. Every visit. He NEVER left the room no matter how boring and repetitive the process became (ever watch a doctor make 3,000 recipient sites ? It is not entertaining passed the first 100 I assure you.) But he would stay for every slit. He asked intelligent questions. Then he would ask even more questions when we stepped out of the procedure room. None of the other prospects showed that degree of interest. I could see that Blake was not only watching the techniques, he was processing the information actively in his mind. The same words would always form in my mind during his visits: "This guy is dedicated." Every other doctor I brought in would walk in and out of the room during the procedure. They got bored quickly. They THOUGHT they already knew what I was doing, figured it was easy, and didn't need to watch for long.They would call their wives or friends from the other room to pass the time while I worked. In doing so they missed crucial techniques I was using. So I would quiz them at the end of the day as to how I performed certain details of the operation. They would either try to BS the answer or simply didn't know. Even when I would give them multiple days to watch, they would do the same thing. They never learned that they weren't learning. I realized they were too set in their ways to allow themselves to learn something new. Worse, they would not see themselves as students. Their confidence in areas of medicine outside of HT worked against them. By the way, this is the problem with clinics who just buy FUE machines and try to add HT to their practices. They are over confident. They believe they know what they are doing but really don't know what they don't know. They refuse to become students again. Blake, however WAS a student when he first started visiting. He had no pride to wound, no old habits to break, and no chip on his shoulder about admitting he was a blank slate. Then I realized a few more things about him: 1. He is very smart. He is intellectual, but not socially off putting. I "tested" his range of knowledge and I was impressed. He could also quote movie lines and jokes A good sense of humor and culturally tuned in. 2. He is used to working with his hands and is gifted with excellent hand/eye coordination. I had him perform dexterity tests in my office and he passed them all easily. Few of my other prospects could. Those who did have excellent dexterity had terrible consultation skills and visa versa. But, Blake had both skills - and they obviously came naturally. 3. I had him join me in consultation and invited him to interact. Because he was the moderator on this site a few patients actually knew him. They would get into deep conversations and I would just watch the interplay. He was a natural consultant, no doubt about that. 4. He was very motivated and responsible. Usually I start my surgeries at 7:45am which means he needed to be at the office no later than 7:30am. But I decided to test him and told him I needed him in at 6:30am instead. he was there at 6:10am. Then I told him to be in at 9am one day to see if he would allow for the traffic. He was there by 8:30. He was the only doctor who ALWAYS made it to the office on time, or before time. NONE of the others had the 100% score he did. By the way, he came in from Pennsylvania ! So as he finished his first year in residency I offered him to come on board. He had proved himself over and over again and I figured I was just seeing the tip of the iceberg. I realized he was young, but I was even younger than him when I started in HT and I came to realize that was an advantage. And I was right. His work product is second to NONE. He can not only handle the surgical side of HT, but the business side as well. So I offered him a partnership right off the bat. I know a great investment when I see one. And again, I was right. He is a dynamo and the embodiment of what the future of HT will be. Indeed, he is the future of HT and a rising star. I believe Dr. Bloxham is BY FAR the most vetted, well known, and transparent HTN candidate to date. His recommendation would be an asset to the HTN community and the HT industry at large. Dr. Feller Great Neck, NY
  15. Simply leave the hair in the donor area ABOVE the planned FUT incision a bit longer than usual and simply let it drape down over the area after the procedure.
  16. This video should help you actually see what parts of the procedure the doctor should be performing himself. He should also do everything on your list except graft placement. The clinic should use full time in-house technicians and each should use a microscope for dissection. Make sure, also, they are cutting true follicular units and not minigrafts that they are calling follicular units. Look at the implanted grafts at the end of the video, that is top notch hair transplanting and the clinic you are considering should be able to show you, literally, a hundred of these in past patients. Good luck and growth.
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