Dr. Alan Feller

So you have never actually performed either procedure.

Ever do either my friend?

FUE has proven results, just not on the same level of FUT. 80% growth of FUE is the generally agreed upon average. In many cases far far worse. If a person had an FUE, the best result expected would be equal to FUT. However, the opposite is never said and never true. Think about that. Nobody ever says "hey, that FUT worked as well as that FUE". Agreed too many FUE mills have sprung up. Not in the U.S. however due to regulations and lawsuits. And justifiably so. To claim FUT is far less labor intensive than FUE is to have never performed either.

Disagree. All things being equal, FUT produces the most consistent and reliable results due to the order of magnitude decrease in extraction trauma compared to FUE. To claim it is the FUE surgeons experience rather than the increased trauma of the procedure is to ignore the elephant in the room. And we're talking BIG pachyderm here.

It's funny you write that because I have had several patients tell me that when others would compliment the improvement of their hair after an HT they gave the credit to a new shampoo rather than admit they went for the procedure. In the early nineties most patients wouldn't even admit their hairless bothered them publicly. Now with the marketing of Minoxidil and Propecia people talk about it more openly. In that vane, even the use of HT is becoming more sociably acceptable these days. It is truly interesting to note that people feel less self conscious admitting to using a medicine to restore their hair rather than having a procedure. As opposed as I am to hair mill clinics that spend millions on advertising and aggressive marketing by robot 'turnkey" device manufacturers, they do raise public awareness of HT through their broad marketing campaigns and by frequently inserting their message into the culture, HT in general becomes more accepted and less derided. I would imagine eyeglasses when first used by the public came with some derision. Even today it is considered weakness to wear them and users are still referred to as "four eyes" making many get contact lenses so nobody would know. Human vanity is a force to be reckoned with.

Thank you. Cases like this are extremely satisfying as it finishes what the other doctor started and lends naturalness and thickness. We get patients like this all the time, and I mean every week. This case represents the striking contrast between the old world of plugs and mini grafts and the modern world of TRUE follicular units. I say TRUE because way too many clinics are STILL performing mini/micrografts and CALLING it follicular unit surgery when it clearly is not.

Why should there be bad blood? If they indeed said it and you believe it has merit, why any hesitation in listing their names here ? The best and easiest way to cut through the FUE hype and misdirection is simply to have any doctor claiming that their FUE grows as well as FUT simply put it in writing. This way it is documented and they can be held accountable for what they are telling patients to get them to sign on the dotted line. Should the results be a dismal failure you would then have grounds for a civil lawsuit. You can also report them to their state medical board for failing to offer the primary treatment and for fraud by falsely claiming that FUE is expected to grow as well as FUT. In my office ALL FUE patients must sign a document that clearly states that to have an FUE performed in my clinic they acknowledge that FUT was discussed and either ruled out by the doctor for various reasons, or not desired by the patient with the understanding that the growth yields for an equivalent FUE procedure and subsequent donor damage is expected to be worse than FUT. But I encourage you to post the names of the doctors who made the claim that their FUE grows the same as their FUT if that is in fact what they said. In the United States I highly doubt it. When I've heard these claims in the past usually the doctor didn't say it, but rather it was what the patient wanted to hear and simply embellished it or made it up outright.

Think about this for a moment: If FUE is the same as FUT, then why does FUT still exist? Why hasn't it been completely abandoned? It's been 15 years since the introduction of FUE into North America, so why do we still primarily perform this procedure? As for those you claim told you that there is no difference in result between FUT and FUE: 1. Please list the names of the doctors who claimed to you that FUE produces the same results as FUT in terms of consistency and yield. I was surprised you didn't already list them. 2. Get that statement, in no uncertain terms, in writing if you are going to have an FUE procedure. That is my best advice to you and anyone. Dr. Feller

It is incorrect to call it a "current trend" of poor FUE results, but rather a "continuing" trend that reflects the true reality of FUE results in the general population for the past 15 years.

Front loading is when a disproportionate amount of donor grafts are used to create or thicken a hairline that is too low to connect to the top should more hair loss occur in the future. The front loaded patient can look absolutely stunning for the first few years after transplant, but as the patient loses more hair behind the front loaded hairline the gap can't be filled because too much donor area was used in the first surgery so it looks unbalanced. That's why more conservative hairlines are the better choice. Unfortunately, so many young men demand lower hairlines that some doctors accommodate them even though it most certainly is not in the patient's best interest years down the line.

Most failures are the result of amateur clinics or poor graft handling. And this seems to be the case most of the time so I suspect one or the other with him prior to us. Thank you for the comments. Dr. Feller

Just returned from a whirlwind visit to London. Arrived at 6:30am Saturday morning London time and had a full house waiting for us by 8:30 am. No sleep for the hair doctors. Two days of back to back consults followed during which we saw almost 70 patients. Clearly the UK is thirsting for hair transplantation. Several prior patients also took the opportunity to stop by and say hello. Here is one of them. We performed 5,500 grafts over two procedures with the last procedure being over a year ago. Complete rebuild of the front and top. Hail Britannia!

Agreed, an excellent FUT result. He also clearly has a very silky fine hair which must have made this even more of a challenge. Well done.

Thank you for the kind words. They mean a lot to us and the patient himself. Interestingly, his hair is still maturing and we will update this thread after his next visit. But mission accomplished even at this point as we achieved two things: The first is that we covered bald and balding areas. That was the primary goal. The second was to cover the patchy growth of his first failed procedure (performed elsewhere I'm happy to say). And we succeeded in doing that in spades. All HT is a gamble in a sense. But as long as all the variables are maximized as much as possible there is a greater chance of a pleasing result for all patients, not just this one. More results on the way. Dr. Feller

Getting a hair transplant to support a particular hair style or even a range of styles is not the point of getting a hair transplant. The sole point is to be able to cover bald areas of the scalp so that you can use the most optimal style to get coverage. Reduce or eliminate the balding, that is the first and foremost goal. Sure, it would be nice to have "options" but not at the expense of the "mission" which is to move as much hair as possible with the best chance to grow as possible. For this Strip (FUT) is the clear choice. And without the consistent successes that FUT has produced since the early 1990s there would be no HT industry and no FUE "option". FUE should be limited to: 1. Patients who have been stripped out 2. Small cases where anticipation of further loss is minimal 3. Patients with thick hair shafts 4. Patients who simply can't psychologically allow themselves to submit to strip surgery with the proviso that they are informed thoroughly of the risks of poor growth with FUE in writing.

Joe's photo clearly shows a recent FUE patient who simply cannot shave his head, which flies in the face of every claim made by the uninformed and agenda driven FUE crowd. Clearly the scarring is massive and he will have to grow his hair to cover it. Not quite what FUE was advertised to be, is it? 911s photo shows a recent patient who had three prior strip procedures who healed beautifully and then properly utilized FUE to grab even more hair out. Want to bet who has a better result in the recipient area? To simply comment on the difference between the visible scarring is ridiculous as both patients will have to grow their hair long. The fact is, the patient in the first photo should have done what the patient in the second photo did. That is, to have several strip procedures then finish up with FUE. This approach is the safest and most responsible. A claim that the patient in the first photo would have had an even worse FUT scar by virtue of the fact that he had poor FUE scarring is uninformed and a clear distraction The fact that he has poor FUE scarring is all that matters here. Why not ask why he has so much FUE scarring?

Dr. Bloxham answers the question: Can an HT stand on it's own?

You win a virtual Ferrari. Congratulations! Happy virtual driving

The issue of front loading was the "hot debate" of it's time in the late 1900s and early early 2000s. When 3,000 grafts are packed into the front on someone with questionable hair loss potential in the top and back this can lead to an unbalanced look and not enough hair left in the donor to cover it years down the road. In some patients it can be done, but by and large should be avoided. I'm seeing a lot of FUE-only doctors "front loading" because they attract a very young patient population and that's what they want, but that doesn't mean it should be performed.

Give that man a cigar. You got it, Destorius . It doesn't matter one bit what he had done, the point is that the donor area can't be seen. A simple concept, but one that has been lost, purposefully in many cases, on this and other chat sites. 99.9% of patients couldn't care less about being able to shave their donor area because they never intend to shave their hair down...especially after they've spent their hard earned money on a hair transplant. That's what makes the FUT vs. FUE "debate" invalid. So Destorius you not only got it, but you "get it". Well done. More to come. Here's the link to the patient by the way: http://www.hairrestorationnetwork.com/eve/180969-video-3000-grafts-10-months-feller-bloxham-great-neck-ny.html

Nope. No hair systems. That's his real hair. Here is a link to the full case: http://www.hairrestorationnetwork.com/eve/180969-video-3000-grafts-10-months-feller-bloxham-great-neck-ny.html

Multiple choice question: What's the story with the person in the photo ? A. Photo taken just before HT surgery B. Photo taken just after HT surgery C. Photo taken 10 months after FUT surgery D. Photo taken 10 months after FUE surgery E. Person is my mailman who never had HT surgery All are welcome to play.

Thank you for the kind words HairJo. I have invented, patented and commercially produced both manual and FUE instruments. When I first started I preferred manual tools. But then I put a punch on a rotary tool, basically a hobby motor, and thought it might speed up the process. Others had done this on their own as well. But it was large and more powerful than necessary so I looked into reducing the size and weight. While doing that I realized that the torsion force created by the drill spinning in one direction might be doing harm. I also felt that too much heat was being created at the tip. So I sought to build an oscillating motorized tool that cut slower and with a small degree of arc, which I did. It has it's place in certain kinds of patients, but it's main strength is that it allowed novices the ability to score grafts better than they could manually. I showed the tool off at a booth in Amsterdam in 2010 and was made an offer for my company that I couldn't refuse. So I sold it lock, stock, and barrel. They continued improving the design and the last I saw it looked more sleek, light, and sleeker. But I found that with practice and having worked on a number of different kinds of scalps over the years that I was more proficient with a manual punch and even faster. So I haven't used a motorized punch in years because I haven't needed to. If, however, I find too many grafts are being damaged during scoring I may pull out the motorized tool and give it a try. So to me a very sharp, thin walled punch with gradations inscribed on the tip for depth measurement is the best tool for FUE. This along with either the two forceps method of Lorenzo for delivery, or the one forceps and needle perforation technique that I developed years ago for delivery.

Thank you.

I don't understand how me saying I haven't overcome them can be confused with me saying they CAN'T be overcome. So why are you pulling this quote? But to answer your question the answer is YES I believe the three detrimental forces CAN be overcome. Just that nobody has overcome them to date. No physician and no technology. TO DATE. This, however, has not stopped unscrupulous or clueless doctors from saying they have or implying they have. I myself am still working on reducing these forces, so obviously I believe it can be done. My general philosophy is that if it can be imagined it can be done. In fact I'm going to start another thread that asks the public for their ideas. Sort of an inventors meeting. All will be able to participate. Whoever can eliminate or reduce these forces to FUT levels will become a billionaire. No joke.