bverotti

Let me try to explain some points. First of all it is important which extraction instruments are used. Anything above 0,8 increases the chances of visible scarring. Also important is that the patient must be willing to shave the donor area completely during each procedure. This will help to spread out the extractions and thus minimize the number of grafts taken per cm2. Given that most donor areas are between 150 and 200 cm2 : For 2000 grafts extracted it means a reduction of about 10 to 13 grafts per cm2, not likely to be visible unless very close inspection. The more grafts are extracted the more likely the donor area starts to appear less dense. I guess as of about 4000 grafts extracted the donor area might start showing some signs of missing grafts at very short hairlenght. There are no miracles, not even with FUE. However I would still go as far as to say that 4000 grafts FUE extracted donor area at 1 or 2 mm will be much less visible than after a 4000 grafts strip scar at the same lenght. BArt

Once the transplants are producing hair again they are doing that in such a way that they did in their previous location. As a funny note I also tell people that if your kids pull your transplanted hairs it will hurt in the same way they would pull native hairs.

Sometimes there is just too much hair in the recipient area to provide the best possible quality work. It is like asking the doc and the techs to perform top quality with the lights down. But again, it needs to be evaluated patient by patient. sometimes it is possible to perform good work implanting between existing hairs, sometimes it is better not to.

Both FUT (also called strip) and FUE (some name it FIT) are BOTH surgical procedures. FUT and FUE is about how grafts are harvested from the donor area, it has nothing to do with the method that is used for the recipient site. FUT is based on surgery whereas FUE is based on microsurgery. Since BOTH are considered surgical procedures we feel that a surgeon needs to have full responsibilty during the procedure. Extractions during an FUE procedure are best left at the hands of a doctor. He is responsible for harvesting the grafts correctly. Some may disagree, but we feel that it is in the patients best interest.

Indeed, M and M IMHO start out with a conservative hairline aproach. It is easy to lower the hairline if desired, the opposite is much more difficult.

This looks almost like a female hairline to me, sooo low.

I am not sure I U understand your question. You want to do 2k strip and then a small FUE ? Why would you not either go for a bigger strip session or do all using FUE in 1 session?

Wether FUE or FUT, both technique could claim to perform 'hair stem cell transplant'. Obviously by transplanting FU the stem cells are transplanted along.

WTH, Bill, please take it easy, I took great caution not to enter a debate in this thread, yet you attack me as if I did. I am working on getting pics, no need to get into discussions. The proof will make any discussion pointless.

I agree with dr. Feller that at ISHRS there seems to be a almost general dislike for FUE. I know this first hand as I was a showcase patient in 2003. The discussions between panel member and the audience where quite agressive of tone at certain times. It is also true that procedures are to be limited to maximum 12 hours. Therefore we work hard for the patient, even using seperate morning and afternoon teams to avoid fatique. FUE is hard for the surgeon, but it is just sooo rewarding for the patient.

You need as many grafts as you can possibly get. Most likely in your case a combo of strip and FUE is going to get you anywhere 5000-7000 grafts.

I dont think that anyone know exactly why some hairs are dht resistant and other not. Fact however is that HT work.

Yeah ... that road ... been there with you. I just wish Pat had been able to witness a procedure during his visit with us. Surely that road would have been much much shorter :-)

Bill, I can understand that you doubt my words, no problem with that. At one point in time everyone believed the earth was flat. However there was a guy who disputed this fact, he bluntly claimed it was round. Although he was right, he was never ever in a position to proof himselve. Now, I don't want to die before it has been proven beyond doubt that FUE megassesions work for anyone that wants to have FUE. Let me however ask you in return why it is that you have never contacted dedicated FUE docs for their opinion ? Understandably you turn to coalition docs with great strip experience if you want information about strip. Why is it that we have never seen any interviews with full time FUE docs ?

As you know I prefer FUE over strip. However I doubt we are ever going to see a 7000 grafts FUE case, one pass. Looking at donor areas (safe zoned) immediately after extracting 3000 in 1 go I can't think of how to aim for double that amount or more in one pass. I believe it makes more sense to talk about averages. IMHO FUE averages are 4000-5000 grafts on most patients, regardless of laxity, 2 sessions. Furthermore I would like to point out that the FUE vs strip article by Bill is his view and the view of the docs that contributed. I believe none of the contributing docs are FUE dedicated however (meaning they only perform FUE, no strip). However Bills article does NOT reflect the experiences and opinions of other docs who have been doing FUE exclusively for many years. In fact some of the contents is incorrect in our opinion. Thanks for letting me post opinions that differ from the mods view.

You are going to spend a lot of money. You want the best possible results. Let them shave the area that is going to be worked in. This way the doc and his assistants can see better what they are doing. BV

I was treated by laser about 6 years ago. A laser was used to create the little holes. I was a newbie at the time and attracted to the word "laser". However knowing what I know now I must state that lasers do not offer any advantage during hair surgery. On the contrary, lasers are using heat. Heat and skin leads to burns and scarring. I would not recommend the use of lasers.

If you want to get the best value for you money you want to shave. Give the doc and the assistants a clear view of the work area. Only this way you will get the best possible result.

I am a propecia believer as well. The people we know that are on propecia are almost all responding very well.

If you are looking for FUE then you could give dr. Ilter (Sweden) a visit. BV

Mrjb that is a very good comment indeed ! Do NOT bet on family hairloss to predict future hairloss, it really means little IMHO.

I believe patients healing characteristics are by far the most important healing factor. Some patients just heal very quick or sometimes very slow. Today I saw a patient we did exactly 9 days ago and there was virtually no more redness at all. On the other side of the line there are patient recipient area that take 7 months to go back to normal.

Well, I can only talk about our experience. To answer your question : During the first 10 minutes or so the procedure is as you decribe in your point 1. The surgeon then has figured out the angle and depth. From then on he only uses your point 2 Average extraction speed is about 350 grafts an hour. Extremes are 250 and about 500 an hour. Yes, taking 1500 grafts is usually finished around lunch time. Hard to believe ? Sure it is, I would like to make an analogy with giga strip sessions ... they where kinda hard to believe too. THC, I do not want to start an issue over speed. Fact is that we are doing FUE, every day (or almost) for several years now. Some may see this as a marketing statement, however I must stress that doing FUE once in a while is not the same as doing it every day. In our office the surgeon is doing all the extractions by himselve with the help of assistants. Obviously breaks are needed, no question. When the patient pays for XXX grafts he will receive that amount of intact grafts. We hope to present more cases soon, showing more evidence that mega FUE sessions in the hands of an experienced team works on a consistant base.

Ps PJ, I have no idea how 2 docs could be extracting simultaniously, at least using our routines. You can find good FUE video coverage on youtube. Interesting to see how FUE routines vary from doc to doc!

PJ, can run a marathon ? I can not, nor can a whole bunch of people. However if people would practice and train hard enough for extensive time than most people would be able to run a marathon. Same goes for FUE. No doc has started by doing 1000 FUE per day, not a single one. Heck, I remember that during the first 6 months we where proud to have pulled of 500-700 graft cases. Today anything under 1500 grafts is a small to regular session. Mind that we have docs who perform it almost EVERY day for the last 2 to 4 years. (Patients are asked if they want to count grafts during the lunch break so that there is no doubt about about the numbers, these are facts.) We believe that in the comming months and years many more docs will come forward, not necesarely the 'known' ones on the board, and achieve mega sessions FUE. Strip and FUE will coexist for sure, but IMHO the balance will tip. Greetz