Problems with FUE

[leborv]

Hi,

 

During my consultation visit with Dr. Sword, I was advised that there are problmes/concerns with FUE, namely that when the hair is extracted, there is no way to ensure that the follicle is undamaged. Dr. Sword's assistant claims that this is the reason that he does not use this technique. I wanted to see if anyone else has heard the same story, or can shed some light on whether this is fact or fiction...

[Pat - Community Publisher]

Leborv,

 

Having seen the FUE procedure come on to the hair restoration scene from day one, I have always had serious reservations about its effectiveness and the way it was marketed online.

 

Below is a post I posted on this forum a while back regarding the FUE procedure and its marketing -

 

 

"This post may upset some patients and physicians. In fact in the past I have not only been berated as a "shill for strip excision doctors" for raising concerns about the FUE procedure but been sued for openly expressing my views. But I feel the need to add my two cents regarding the follicular unit extraction (FUE) procedure for the benefit of potential patients.

 

I have followed this procedure's development and promotion from early on and I have created video and written content to the Hair Loss Learning Center about this FUE procedure. I even considered having it performed my self last year when I did surgery with Dr. Paul Rose.

 

But in my opinion, when all the pros and cons are calculated, the FUE procedure is over rated, over hyped and no where close to being a substitute for the ultra refined follicular unit strip excision procedure now being performed by leading physicians.

 

The FUE procedure is really a child of Internet promotion. It was introduced several years ago not to the medical hair restoration community, where it could be tested and shared with other surgeons, but rather on the Internet where it was heavily promoted.

 

This promotion on web sites and on certain forums presented its originator, a physician in Australia, as a champion of hair loss sufferers who would save them from the strip excision "butchers". His promotions often included prominent pictures of horrible donor scars and claims that his procedure was a "scarless" procedure.

 

Posts of questionable authenticity claiming remarkable, yet most often unsubstantiated results were then proliferated on many forums. Some were led to believe that this FUE procedure was an important advance and flew to Australia to have this very expensive and secretive procedure done.

 

Yet myself and many others, including many physicians had numerous reservations about this untested and unknown procedure such as the rate of transaction (severing/damaging) of the follicles being extracted sight unseen under the skin using small punches. In addition, this procedure was by no means "scarless" as the actual cumulative surface scaring in the donor area of hundreds of little punch holes is considerably more than one long and typically thin donor scar resulting from strip excision. In some cases the FUE procedure can even produce donor areas that have a thinned out mouth eaten look.

 

This self promoting Australian physician's unwillingness to submit his procedure to evaluation and peer review also raised suspicions. In time, while interest in the FUE procedure that was generated online was running high, this physician decided to teach other physicians his secret Australian technique at workshops costing over $100,000 per physician. There were very few if any takers for this "workshop".

 

Since that time several North American and European physicians, seeing some combination of medical and marketing potential, began offering their own FUE procedures. I believe that some physicians, given the nearly hysterical level of interest generated in FUE, felt compelled to experiment with and refine this procedure in order to offer it to patients on a limited and responsible basis when appropriate. I believe that other physicians jumped on the FUE bandwagon to capitalize on the consumer interest generated in FUE and to differentiate themselves from other hair transplant physicians.

 

The many leading hair restoration physicians who did not embrace the FUE procedure have continued to refine their follicular unit strip excision procedure. Today, leading surgeons are very careful to use closure techniques that now close the donor area under minimal tension. They also typically are taking donor tissue in longer more narrow strips to minimize potential tension. These advances in strip excision donor closure make this procedure ideal for maximizing patient graft yield efficiently and cost effectively, while minimizing the actual cosmetic scarring in the donor area.

 

Based on all the evidence I have seen and having worked and promoted physicians offer both FUE and strip excision surgery, I believe that the FUE procedure is no where close to being a viable replacement to state of the art strip excision surgery.

 

I do believe that the FUE surgery does have the advantage of more rapid healing in the donor area. In addition, it may be a viable option for those who want to only do limited grafting in small areas."

[markcia]

I met w/ DR BEEHENER in the Hudson Valley and he has similar views.

DR B is a 20 yr veteran in the HT world,and is a very solid guy.

[damo]

Markcia i have had 2 procedures now the last one being only months ago and opted to have strip again like i did with my 1st procedure.As Pat said i have weighed up the pros and cons and its far superior to have the strip proecdure performed.You definately get bigger bang for your buck with strip and its a hell of alot less labour intensive and also costs alot less money too.Many of the top surgeons today you will find do the far superior follicular unit strip excision.I think the only time you would get FUE is if you needed a very limited amount of grafts required for example in the temple area.But as for maximising patient graft yield and the cost strip takes the cake in my opinion.

 

Rgds

Damo

[harryben]

what about if we re not living in the US ?

if we still want to go through one of the best Doc for a Strip, we then need at least a 2 weeks stay right ? it will then be almost more expensive for the 2 weeks stay than for the HT ? are they any deals ?

[Gorpy]

The only reason you would stay much after the surgery is for the suture removal a week to 10 days later. Otherwise you could fly back as soon as you feel like it. Even the next day. I have heard of situations where an agreement was made where you could get a local doc to remove the sutures. That way you don't have to stick around.

[arfy]

FUE does work. There are only a few doctors doing it. Some doctors do both Strip and FUE, and have a valuable perespective on the pros and cons.

 

NO hair transplant is perfect or without limitations. FUE does work but ultimately it is still a hair transplant with all the same issues that all hair transplants have... You still have to be careful and think it over carefully... be a good candidate first. Pick a good doctor. Know the limitations. Have a long term sensible plan. And so on.

 

If a doctor doesn't offer FUE then it isn't realistic to expect them to recommend it. To put it nicely, don't look to Pepsi for accurate information about Coke.

[Smoothy]

It was a novelty when first come out being used by doctors, but now that many cases have been done, we are starting to see the problems associated with this type of techinque.

[harryben]

Smoothy, What kinda problems ?

[Pat - Community Publisher]

I've been told and I've read in the official European hair transplant societies journal that Dr. Minotakis, who was one of the most prominent FUE surgeons in Europe for the past few years, gave a scathing critique of FUE surgery at the annual European hair transplant meeting in Beligium this year.

 

Apparently he, like many others now, feel that FUE was oversold to the public as a "scarless" replacement for strip surgery and is now falling short in many areas such as high folicle transection, poor growth and increased cosmetic scarring in the donor area.

 

My understanding is that due to these short falls Dr. Minotakis no longer provides FUE surgeries.

[Franklin]

Ok once again it all depends who is doing a particular surgery. With Fue ok . This Dr. Minotakis. Here is a little quick backround of who he is from a websearch.Dr. Minotakis is the Medical Directory of DHI in Athens, Greece.I found this on a site when doing a search for Dr. Minotakis. Now this was taken from the 2003 ageans masters meeting. Maybe he is no longer with Dhi I am not sure. And at that time Dhi what was doing Fue for a few months maybe?????? and where is Dhi now? Their Fue really has no long backround to it so maybe I am not surprised if he was talking about how DHI does their version of Fue.Please do not take all statements on any procedure until you had a chance to see for yourself. I have seen a few different styles of strip and they do not produce the same results. And I have seen a few of the different Fue techniques and they are not getting the same results as other.I was not lured into to any salesmenship when I decided on getting my Fue. And if it was not for me going to seminars being in touch with former patients that had it done years before.And seeing real close up results I would have not gone through with it.I don't want to peruade others thinking but everytime I see comments on Fue like it is being performed the same by every doctor and those are the results you expect to get. I feel I have to give my opinion on this open forum as otherwise.That is just like saying going for a strip with this doctor and going with a strip with that doctor you are insured great results. Not true at all . Some strip docs are still using triple bladed knives to cut the donor strip and 18 guage needles. Just like certain Fue doctors are using different tools for there extractions.And different placing techniques.I would also like to add the following.Dr. Minotakis has never been a

prominent FUE surgeon.? Who trained him? and how many procedures did he

assist on before he began to practice FUE on patients?

[Loren]

This is an interesting topic and it's good to see dialogue on the subject. For the record Dr Minotakis is not with DHI, he is a STRIP surgeon.

 

At DHI we have been doing the DHI method of follicular hair extraction for three years now. We too performed strip surgery for many years but should medicine not progress and offer the patient more up to date techniques? Should we all rest on our dusty laurels and keep offering a method that's pretty dated when something is available with a number of great benefits and advancements to the patients?

 

The fact of the matter is that if a doctor can do good extraction AND placement, then this technique is by far the way to go for as many hair surgeons and clinics who have the stamina and guts to get into it. The technique is much more tedious, time consuming and less cost effective for the surgeon and clinic and for these sole reasons few doctors are offering their patients FUE. For a strip surgeon who needs just 20 short minutes to extract and suture a strip to suddenly adopt a technique which demands he spend perhaps 3 hours on extraction, it doesn't take a genius to understand why strip surgeons are not going full steam ahead towards FUE.

 

We have great results and the healing in the donor site is exactly as we say it is but let's not try to get into self promotion. Our strategy is just to pass enquirers onto the patients themselves to see their results up close.

 

 

 

Lorraine ??“ DHI.

[EastCoast]

I went to Dr. Jones in Canada for about 2k of fue grafts. Growth was average.

[Franklin]

East sorry to here that. I went to Woods excellent yield. It is in the technique I keep saying. Just like great strip and average strip.These post should not be about strip vs. Fue. It should be about finding a great doc. And once you do. Then you can decide which route to take in your hair restoration.

[hairbegone]

are you aying that fu transplants have an issue or just the extraction process? what's the difference between fue and strip excision? what does Shapiro use? thanks. new to the forum and doing research.

[EastCoast]

I am not saying no growth or poor yield. I had 3 small surgeries, 350 fue, 1000 fue, 700 fue. A total of 2k grafts does not appear dense over the front and mid scalp. I don't have any gaps, everthing filled in, but as with all HT's density is sparce even with my Elvis density.

 

Does any one know the cuurent prices of FUE. I need about 700 more grafts.

[Franklin]

I am not saying no growth or poor yield. I had 3 small surgeries, 350 fue, 1000 fue, 700 fue. A total of 2k grafts does not appear dense over the front and mid scalp. I don't have any gaps, everthing filled in, but as with all HT's density is sparce even with my Elvis density.

East thanks for clearing this up. Because as you know newbies are allways comming into the sites like the question above. It is good that you made it clear. Like all ht's it is about numbers for a indivduals required density.