Franklin

"Just as it wouldn't be appropriate to use a bad strip scar as the example for all strip procedures, we shouldn't use this example of poor FUE as indicative of all FUE" Absolutely agree. I had Fue going on almost 8 years ago . This doc has no idea here what he is doing. Research any type of surgery from a specific doc with meeting several patients before you let them put 1 hair on your head.

Well it's called thickening thinning areas. And I am happy I did the 1100 grafts money well spent imo. Got rid of the toppik in 2003. And have my hairloss in check for now at age 46. I had small procedures without shaving and it was a failure earlier. Just wanted to make the odds better this time around.

Exactly. I never got caught up in all this tool talk attention grabbing headlines. I am only concerned (as I think we all should be)is in the results and the effect it has on the donor area for further procedures.

Exactly. I was never caught up in all this tool talk. To me it's just a headline grabber. I am only concerned(which we all should be) about long term results and the effect it will have on the donor afterward for future procedures.

I agree!

I agree 100% with this staement.

"" Dr. Bisanga has adapted and improved his FUE punch technique over the years, one obvious example is the size of punch he uses has dropped in diameter to minimise traumatic impact on the scalp and surrounding follicular units. Another aspect is the technical ability and objective technique, the ability to feel the follicular unit and surrounding tissue when entering the scalp and gauging the depth and angles of each FU. During my FUE sessions I was always aware of the changing positions Dr. Bisanga used to make, moving himself and adapting to changes in the angles and directions of the FU. Now watching FUE punching from the other side I have seen more. FUE has and will always be technically a very difficult technique, the fact that each FU has to be removed individually and the average op is 1000 grafts plus obviously multiplies the room for error as each extraction can be different in some cases. Dependent on the area of the scalp,the angle the FU exits the scalp changes, dependent on the area it can be easier to extract the FU as the lay of the FU can be more consistent and also the position of the head when resting on the operating chair allows for easier extraction. For example the back of the head, around the occipital area is much easier to punch. It is important the doc can understand his position needs to change otherwise there will be a greater scarring impact and potentially increased transection. The constant need to change position is not something that can be avoided regardless of tool size or the type of tool, this is about the technique itself. Pressure control is also important to achieving minimum transaction and the least potential trauma to the surrounding FU. A largely forgotten aspect to FUE is the effects on the surrounding FU that are left in the donor. A FUE donor maybe be spread over the entire donor safe zone and if used well can leave minimal to almost no signs hair has been removed, but incorrect punch and extraction can greatly reduce the potential for future FUE and the graft numbers and even hinder Strip extraction. The greater the friction created when the punch enters the skin the harder to balance the direction of the hair with any potential changes as there becomes less sensitivity between the fingers and the tip of the punch. The tension can be micro but Dr. Bisanga has found through changing his technique that even manually the tension can be reduced and this improves graft survival and collateral damage. The finger to punch pressure helps gauge the skin characteristics and even possible to feel the FU with practice. With this technique of punching Dr. Bisanga has minimised transaction to as little as 1-2% in most cases and even on demanding cases rarely increases to above 5%; this is only made possible by the touch sense gained through minimal transference of distance and resistance between his fingers and the punch. The next aspect that is over looked much of the time is miniaturisation existing in the donor and the potential to create miniaturisation. Dr. Bisanga feels that anything near 20% miniaturisation in the donor can rule you out from surgery, certainly having FUE. Miniaturisation does not affect the density of the donor hair as such because that is just the calculation of FU per cm2 but it will affect the number of FU that can be removed. We have seen miniaturisation spread all over the donor and also just in isolated areas, either way it will reduce the numbers that can be extracted. By definition the miniaturised hair cannot be used so they must remain in the donor, this creates the problem of how close to the miniaturised FU can the extraction take place. Too close and the thickness of coverage will drop and could potentially traumatise the miniaturised hair and cause it to fall out. So, the extraction pattern has to become wider thus less FU per cm2 are removed to retain the integrity of the donor, especially for the future. Miniaturisation can also be caused with the extraction, going back to the tension or resistance in the punch movement, this can create a ripple effect, like a 'skin quake', the punch hole being the epicentre and the vibrations moving out from the central point. As above Dr. Bisanga has minimised aspects of this by his punch motion technique, he has certainly found less resistance was caused creating obviously less contortion of the wound and the surrounding Follicular Units. This is very important, we have seen miniaturisation created post FUE surgery that has possibly rendered the areas non- harvestable due sometimes to over harvesting but also peripheral damage creating miniaturisation. Dr. Bisanga's feeling on these problems is to lessen the motion when making the punch action, the least friction or motion allows for greater sensitivity and feel between punch and fingers and this in turn has reduced transection, decreased peripheral damage either to the skin or surrounding FU with changing directions as well as miniaturisation. With the many documented FUE cases he has to his name as well as the many more he has performed and internally documented he feels confident to say that in respect of physical technique he has reduced these negative factors a great deal but then research is obviously ongoing." Posts: 199 | Location: New York | Registered: October 17, 2002

Sorry to here about your results. One thing I will say as I said before. "NOT ALL FUE IS THE SAME" There are some doctors that have been performing this technique for a long time that will have different opinions on how they go about extractions. And results will vary between clinics. In my opinion Fue should not be rushed. Here is a post from an employee on how his doc goes about it.

I will agree 100% with this!

Make sure you get a few cosultations before doing bht. It should be only used as a last resort. And make sure whatever doc that would be doing bht on you has a few patients to see in person.

Pain is common after Fue? The most you should have is maybe the donor becomes a little itchy after few days for some a little aloe vera on that does the trick. But nerve damage from Fue?? If this doc is going around saying it is "quite common" then he is only speaking from his experience. It's why I say just because someone offers Fue does not mean it's all the same and they follow the same protocol as others offering Fue. I hope you recover soon.

N-6. What you need to do is compare a Fue procedure from a Top doc that offers it with the same number of grafts from a strip procedure from a top doc. Then you can compare yield. I have been saying this for years and will stick to it to this day. Since I had a horrible yield with strip 10 years ago(But I will not say strip is producing poor yield just the one who performed it in my case) Conclusion bad doc poor technique. Went a head had more grafts than my original strip procedures and had excellent yield with Fue. No matter what procedure you choose research yourself some clinics in person and compare yields with graft counts. Myself I was never to worried about speed of a procedure only in the end results. If we have to pay a little more so be it it's a cosmetic procedure and our choice to get it done as long as we have the best chance on getting the results we expect. Good luck on your research. And may I point out. I am not talking about Fue megasessions in my summary of the procedures. Just final graft counts when everything is said and done.

I had Fue in jan 2003. They are growing just fine to this day. If done correctly they should last just as long as a correctly done strip procedure would.

For the clinic then yes. On a side note for me personally. I want the doc involved as much as possble even if it takes a bit longer. I would be curious to know which states this is legal in since over the last 5 years or so it seems more and more are offering Fue procedures.

PGP. I am only talking from a legal aspect. If it turns out to possibly have a bad outcome if a tech does it then it opens up to a bigger problem for docs practice. There are laws and should be followed. But as far as tools used. I am now and allways were only concerned about results.

Stay away from any clinic that does not follow this!

Bad idea imo. It's about yield. And until I see steady consistent yield for quite some time and patient reviews I will stick to this opinion. Docs can write up whatever they want on the internet but it's up to us patients to see the results in person to see if he can achieve it.

Hi yes I can see the gap. So you had no grafts planted in that area? Sorry if I missed any other posts you made showing how you were before your ht and post op graft implantation.

And this is exactly what you have to do. 6 months is nothing near the final result and all patients grow at different rates post op. I understand your fustration at the moment but I would wait another 6 months make sure you document all with photos to start with then come back and post your concerns here. Good luck and try and be patient.

100% Agree with this post. I have been researching ht's since my first one back in 1999. I did not see past patients from my first strip doc back then. After that I made it my business to get in contact with former patients and go see what a hairtrasplant looks like from the doc of my choice in person. It's not easy a lot of times to set this up but really what's the rush? It's your head and you have to live with the results the rest of your life. I think hairloss forums are great for a start of your research. But nothing replaces in person evaluation. I really to this day do not understand how anyone gets a ht without doing this final research.

Could not agree with you more!!

Ceasar08 I remember this case also. He was a n/w 5A the work is just fine and he is happy with it.

Doug while hearing technical aspects of a new invention are good as a start. I would really be interested if some past patients came on the internet and showed there own results and talked about there yield along with some pics. Then eventually have a chance to meet up with them to see there results. This is the only way imo to really see if it is advancement or not in overall Fue.

I agree with this statement "LARGE Fue Sessions" like B-Spot has also stated "I think once you start talking about doing 2-3-4-5K of FUE per day, the yield/transection rate is logically going to go up"can lead to more transections But from what I have seen and depending on Doctor clinic on how long they been doing this procedure you can get several thousand in a weeks time. I am not a supporter of the one day Fue meggasession.

Huh?? Where is the proof for for this (blanket)statement? I had strip bad yield. Maybe 20% growth if I was lucky. Bad doctor is what it came down too. Then Fue after percentage growth mid to high 90's I would say been wearing on my head for over 6 years still looks great. It all comes down to doctors skill and technique.