FUE Extraction Patterns

[zenmunk]

In some small FUE cases, I've noticed pics where it doesn't appear as if the entire safe zone was utilized; instead, only the back was used, and the extractions seem to be grouped unnecessarily close together. Take a look at the donor extraction pattern in this thread:

 

http://www.hairrestorationnetwork.com/eve/142984-fue-patient-1-year-post-op-also-**update**-2-year-post-ops-dr-feller-patient.html

 

Couldn't the doc have utilized the safe zone on the sides of the patient's head as well?

 

 

Theoretically, wouldn't a better cosmetic result be achieved in the donor area by spreading out the extractions as much as possible, even in small cases?

 

 

Are there any valid reasons for keeping the extractions grouped together in such a way?

I'm not suggesting this patient's donor result is bad at all (and, the overall results of the HT are obviously amazing); just wondering if spreading the extractions out more may have been even better (particularly if the patient chooses to wear his hair buzzed down to a #1 or less on the clippers).

 

Thanks.

[Blake Bloxham]

In some small FUE cases, I've noticed pics where it doesn't appear as if the entire safe zone was utilized; instead, only the back was used, and the extractions seem to be grouped unnecessarily close together. Take a look at the donor extraction pattern in this thread:

 

http://www.hairrestorationnetwork.com/eve/142984-fue-patient-1-year-post-op-also-**update**-2-year-post-ops-dr-feller-patient.html

 

Couldn't the doc have utilized the safe zone on the sides of the patient's head as well?

 

 

Theoretically, wouldn't a better cosmetic result be achieved in the donor area by spreading out the extractions as much as possible, even in small cases?

 

 

Are there any valid reasons for keeping the extractions grouped together in such a way?

I'm not suggesting this patient's donor result is bad at all (and, the overall results of the HT are obviously amazing); just wondering if spreading the extractions out more may have been even better (particularly if the patient chooses to wear his hair buzzed down to a #1 or less on the clippers).

 

Thanks.

 

Zen,

 

I understand what you're saying, and I think in small follicular unit extraction (FUE) cases it comes down to the surgeon's experience/preference. In theory, I see how spreading out the extraction sites (within the universal safe zone) would lead to less potential scarring, but I can also see how it could create additional trauma, more difficultly camouflaging the procedure in the recovery period, and also scarring in sites where it normally would not have occurred.

 

Altogether, I think skilled FUE surgeons know how to extract the most viable grafts while creating minimal scarring. As long as the physician stays within the universal safe zone, I'm uncertain whether or not there are really any advantages or disadvantages to utilizing one part of the region versus extracting grafts from various areas.

[gillenator]

Future HT Doc makes some very good points. I have read comments from FUE docs before which explain the collateral damage that unskilled sugeons can cause during the extraction process, or using inappropriate sized punches much too large in diameter, and the neighboring FUs can potentially sustain damage. This is especially true for patients with above average density in FUs in the donor region (safe zone).

 

Some docs would advocate strip harvest because although yes it does leave the patient with a fine linear scar, but the surrounding area is not damaged or compromised from the (extraction) punch sites.

 

That is where I believe Robotic tools will facilitate and refine each extraction site in the future.

[zenmunk]

Thank you both for your replies.

 

How willing do you think HT docs are about extracting outside of the universal safe zone if a patient requests it? I know that's a strange question, but if I go forward with a relatively small FUE procedure to restore my hairline (1200-1300 grafts), and, if necessary, a follow-up procedure to touch-up what doesn't grow from the first procedure, I don't want to chase my future hair loss with additional surgeries.

 

If it were possible, I'd have non-DHT resistant hairs cloned and used exclusively as the hairs to restore my hair line, and if/when the meds quit working, just let nature take its course and allow the transplanted hair to fall out with the rest. Alas, that's not possible, and I'll be left with two transplanted "triangles" of hair at my temples, but with FUE I'd at least have the option to shave down providing the scarring is not too noticeable.

 

That's why I'd prefer my doc to extract from the ENTIRE safe zone, spreading them out as much as possible, to minimize the appearance of scarring. Of course, a lot will depend on how I heal, but that's outside of anyone's control. I realize the doc with be extracting from the safe zone no matter what, but if I were explain the above, do you think a doc would venture outside of the safe zone somewhat in order to spread out the extractions as much as possible?

 

Thanks.

[gillenator]

I understand your philosophy behind your thinking and planning. I want to encourage you to think in terms of the work you will need over your lifetime.

 

Yet I am hearing from you that when your destined advanced level of hairloss catches up with you in the next several decades or so, you will just want the transplants to fall out with the rest?

 

Well, if that is what is in your cards, your future, you must be basing that viewpoint from the fact that there are men on either side of your family history that are Norwood class 6, 7 right?

 

Listen to me my friend. IMHO, FUE is okay in general terms "if" you DO NOT have advanced hairloss in your future. Your approach is okay as long as you won't need much work done.

 

By the way, have you started finasteride? Is it working? Some guys refuse to take Propecia for their own reasons yet have advanced hairloss in their destiny and still want to start HT surgery. NOT a good formula for success.

 

Back to FUE. If you do need lots of work, then spreading out the many thousands of extractions can start to present a problem for some people because of the collateral damage that can be done throughout one's donor zone(s).

 

Not everyone are ideal candidates for extraction methods of harvesting hair as compared to say a 1 to 1.5 cm wide X 20 cm strip excision. Hypothetical example.

 

Please understand that I am not saying this is your situation, but it is the potential effects in the extraction process such as torsion (twisting force), compression (squeezing force), and traction (pulling force), that is involved in removing every FU and FU grouping. Every doc has a varying level of experience and expertise and can compound the damage to the surrounding areas if proficiency is on the lower side of things. And the larger the punch diameter, the more invasive it becomes (collateral damage) and especially when reaching above 1mm in size. I am referring to the manual means of extractions being done, one by one, all human effort and "feel".

 

This situation is now changing rapidly with the awesome advancement of technology in extraction tools. There is new technology with powered "robotic" extraction engineering such as the one that Dr. Jim Harris is known for developing and successful use. A number of reputable HT docs are now using various extraction instrumentation developed by Dr. Harris.

 

Also, my understanding is that most FUE docs also rate the degree of "mush" or play in the layers of scalp tissue that can vary between patients like everything else. This is another factor to consider when evaluating how many extractions can be safely removed in any proposed donor area of the scalp.

 

That is why I feel that for most people who cannot afford the newer FUE extraction methods with robotics, yet still need lots of work over a lifetime are better off with strip.

Edited September 6, 2011 by gillenator

[aaron1234]

Zenmunk,

 

Are you implying that you'd like FUE extractions that go past and above the ears - like on the sides of the head? Some docs have done that. I believe Dr. Lindsey did that with Spex's 100,000th hair transplant. But it was a smaller session of about 200 grafts. Some docs might be wary of going out that far on the sides because it might not exactly be a safe zone. Depends on the patient. You do see a lot of temple point reconstructions for very good reason.

[zenmunk]

Firstly, thank you for your thoughtful reply, gillenator.

 

Yet I am hearing from you that when your destined advanced level of hairloss catches up with you in the next several decades or so, you will just want the transplants to fall out with the rest?

 

Yes, I would prefer the transplants to fall out with the rest. I believe that would allow me to maintain the most natural look possible as my hairloss progresses. The alternative is being left with two patches of transplanted hair near the temple regions with bald or thinning areas surrounding them - not too attractive and not a natural balding pattern. However, I know that's not possible, because most, if not all, of the grafts will be extracted from the safe zone. That scenario will only be achieved when cloning is a viable option someday.

 

So, back to present-day reality... My only HT options are chasing my hairloss for the rest of my life with multiple surgeries (which I'd rather not do) or getting one FUE procedure of around 1300 grafts to conservatively restore my hairline (and perhaps a follow-up procedure to touch-up areas where the first procedure fell short), and if my native hair falls out around the transplanted hair, just shave down. However, shaving becomes a problem if the scarring left in the donor area is unsightly. Therefore, I've been researching the best methods to reduce the appearance of obvious donor scarring and hairless patterns, especially when the hair is very short or shaved. I've found one article by Dr. Bisanga, and other info by one of his reps on another forum, regarding FUE and extraction patterns in particular to be quite educational. Dr. Bisanga emphasizes, "spread[ing] the extraction pattern over the largest area possible, try[ing] not to limit the surface area whenever possible." That's what I'd want my doc to do, including sides of the head and even venturing outside of the safe zone to get the best grafts and minimize donor problems.

 

Well, if that is what is in your cards, your future, you must be basing that viewpoint from the fact that there are men on either side of your family history that are Norwood class 6, 7 right?

 

Actually, my dad still has a fairly decent amount of hair, perhaps a Norwood 3A with slight crown thinning, and he's 74. I didn't know my maternal or paternal grandfathers, but my maternal uncle is 60-ish, and he's probably a Norwood 3V with some diffuse thinning on top. So, all in all, I don't think Norwood 6 or 7 is in my future, but you never know.

 

By the way, have you started finasteride? Is it working? Some guys refuse to take Propecia for their own reasons yet have advanced hairloss in their destiny and still want to start HT surgery. NOT a good formula for success.

 

Yes, I've faithfully taken propecia almost every day for 13 years. It's pretty much frozen my hair loss with the exception of a very little bit of loss at the left side of my hairline over the years, but that hair was more diffuse when I started started taking the meds, so it's been fighting extra hard just to hang on.

 

Currently, I'm around a Norwood 3, perhaps a little less (2.5?); it's hard to tell, because the Norwood scale charts vary. My crown is intact, and I have no diffuse thinning (other than my left hairline which would be addressed by a HT). I've been very fortunate with the meds so far, and 13 years is a long time, but who can say if/when they will stop working me; hence, I've been factoring that into my HT plans. I'm soon-to-be 39 y.o., by the way.

 

Not everyone are ideal candidates for extraction methods of harvesting hair as compared to say a 1 to 1.5 cm wide X 20 cm strip excision. Hypothetical example.

 

Please understand that I am not saying this is your situation, but it is the potential effects in the extraction process such as torsion (twisting force), compression (squeezing force), and traction (pulling force), that is involved in removing every FU and FU grouping. Every doc has a varying level of experience and expertise and can compound the damage to the surrounding areas if proficiency is on the lower side of things. And the larger the punch diameter, the more invasive it becomes (collateral damage) and especially when reaching above 1mm in size. I am referring to the manual means of extractions being done, one by one, all human effort and "feel".

 

All good points. I've consulted Dr. Feller in-person (I'm based in NYC). He feels I'm a good candidate for FUE. He quoted 1300 grafts being necessary to restore my hairline. He said he can never tell for sure if someone is a good candidate for FUE until he actually begins extracting. He added that if he discovered I wasn't a good candidate during surgery, he would stop the procedure. I find that approach quite ethical.

 

Of course, I would insist that he use the smallest punches possible, and I'd make it known that I'd prefer that he take Dr. Bisanga's approach in my case and, "spread the extraction pattern over the largest area possible." I'd even sign something giving him permission to extract from outside of the safe zone if it would make for a more successful donor and recipient result. I have fine, straight hair, so extracting outside of the safe zone as well may increase the odds of matching hair shaft thickness at the hairline, and I don't have a problem with any of the transplanted hair falling out if the propecia stops working for me in the future.

 

Having said that, I still haven't settled on a surgeon yet. I also had a phone consultation with Matt from SMG. I think the next step is to try and arrange in-person meetings with FUE patients of Dr. Feller and Dr. Ron Shapiro who share my hair characteristics and degree of hair loss. You can only get so much from photographs.

 

This situation is now changing rapidly with the awesome advancement of technology in extraction tools. There is new technology with powered "robotic" extraction engineering such as the one that Dr. Jim Harris is known for developing and successful use. A number of reputable HT docs are now using various extraction instrumentation developed by Dr. Harris.

 

Also, my understanding is that most FUE docs also rate the degree of "mush" or play in the layers of scalp tissue that can vary between patients like everything else. This is another factor to consider when evaluating how many extractions can be safely removed in any proposed donor area of the scalp.

 

That is why I feel that for most people who cannot afford the newer FUE extraction methods with robotics, yet still need lots of work over a lifetime are better off with strip.

 

Do you think robotic extractions are superior to manual? If so, why?

 

Yes, I'm aware of the "mush" factor. That's a good point, because donor tissue quality may vary throughout the entire donor area.

 

 

Are you implying that you'd like FUE extractions that go past and above the ears - like on the sides of the head? Some docs have done that. I believe Dr. Lindsey did that with Spex's 100,000th hair transplant. But it was a smaller session of about 200 grafts. Some docs might be wary of going out that far on the sides because it might not exactly be a safe zone. Depends on the patient. You do see a lot of temple point reconstructions for very good reason.

 

Exactly, aaron1234. I'd like the FUE extractions to go past and above the areas on the sides of the head as well as the back of the head. Like I was telling gillenator, I really appreciate the logic in Dr. Bisanga's approach regarding spreading out the extractions as much as possible. Of course, the ability to do that successfully depends not only on the doctor's skill, but the patient's physiology.

Edited September 6, 2011 by zenmunk

[Sean]

Pretty interesting topic. What do you think of the extraction pattern on my scalp, etc safe zone? I just had a 3016 Graft FUE procedure on August 31st.

Edited September 6, 2011 by Sean

[zenmunk]

Pretty interesting topic. What do you think of the extraction pattern on my scalp, etc safe zone? I just had a 3016 Graft FUE procedure on August 31st.

 

I'm a relative newbie, but according to my research an average donor can safely give approximately 4500 FUE with proper planning and execution. Regarding extraction patterns, I think you'd have to present pics of your post-operative donor (with extraction wounds still fresh) to learned members of the forum, including docs of course, to get some accurate opinions of your case.

 

Do you feel that the FUs were extracted in a manner that minimizes obvious patterns especially when the hair is very short or buzzed?

[Sean]

I'm a relative newbie, but according to my research an average donor can safely give approximately 4500 FUE with proper planning and execution. Regarding extraction patterns, I think you'd have to present pics of your post-operative donor (with extraction wounds still fresh) to learned members of the forum, including docs of course, to get some accurate opinions of your case.

 

Do you feel that the FUs were extracted in a manner that minimizes obvious patterns especially when the hair is very short or buzzed?

 

 

Zenmunk, I posted my pics on my hairlosswebsite link at the bottom of my post. If you go to my post op photos, you'll see the extraction area. I just wanted to see if my extraction was in accordance to what you were saying. I had 3,016 FUE with 5,000 FUE remaining in the bank for future use. I feel my FUs were extracted in a safe way but I can always use a second opinion or multiple opinions rather from users like yourself and others. It definitely helps us all. My plan is keep my hair really short on the sides, buzzed close to the skin. Your post made me wonder about the safe zone and extraction sites. A lot of doctors use different extraction sites and methods. I think this also depends on the punch size used too, if you are to keep it very short or buzzed.

[zenmunk]

Zenmunk, I posted my pics on my hairloss website link at the bottom of my post. If you go to my post op photos, you'll see the extraction area. I just wanted to see if my extraction was in accordance to what you were saying. I had 3,016 FUE with 5,000 FUE remaining in the bank for future use. I feel my FUs were extracted in a safe way but I can always use a second opinion or multiple opinions rather from users like yourself and others. It definitely helps us all. My plan is keep my hair really short on the sides, buzzed close to the skin. Your post made me wonder about the safe zone and extraction sites. A lot of doctors use different extraction sites and methods. I think this also depends on the punch size used too, if you are to keep it very short or buzzed.

 

Sean,

 

Each extraction has to allow for FU’s to surround that point; you cannot punch two points adjacent to each other. In larger FUE cases it becomes more challenging for the doctor to not leave visible “hair less” areas as the extraction pattern becomes more confined.

 

The pics of your donor are not close enough for me to see the extraction pattern in detail. However, it appears as if Dr. Rahal stayed well within the "safe zone" if that is one of your concerns.

 

I think a key may be to buzz your donor, and surrounding native hair, down to a #1 or less on the clippers and try your best to notice if any obvious thinning patterns emerge. If the differences in density between the donor area and untouched native areas surrounding it are not noticeable or hardly noticeable, then you're good to go, especially considering 3,016 is no small number for FUE.

 

But at the end of the day, what's done is done, and I wouldn't worry too much about it at this point. Stay positive, and concentrate on a successful overall outcome.

 

[gillenator]

Pretty interesting topic. What do you think of the extraction pattern on my scalp, etc safe zone? I just had a 3016 Graft FUE procedure on August 31st.

 

Hi Sean,

 

Well thanks for sharing your pics from your recent FUE procedure. I would consider your procedure as mid-range for the graft count. You also appear fairly young and wondering if you also are taking Propecia with good stabilization results. Also wondering what is the most advanced class of hairloss on either side of your family history.

 

You and I share the same wider color contrast of dark hair on a fairer complexion. It can be diificult to make an evaluation regarding each person's safe zone based on pics only. I always advocate the use of either a video telescope or at the least, a densiometer or use of lighted magnification to compare hair shaft diameter when determing the boundaries of each patients' safe zone. It can be tricky with guys under 30 years of age because miniturization can spread and decrease the safe zone primarily in the occipital area. IMHO, some of the extractions look a little high just below your crown into the coronet area. Again, I base this on the fact that you appear under 30 and will the progression of MPB creep into the areas that some of your extractions were taken. Only time will tell.

 

A strip would allow the doc to harvest a thinner sample just as long, but no where near as wide as the area of extractions needed for a FUE procedure. In other words, a strip excision most of the time do not exceed 1.5 cm in width and can be safely taken within the safe zone.

 

Now, let's say the worst happens and you continue to diffuse and now you want more coverage in the frontal to mid scalp zone. The question now becomes, how many more extractions can your occipital zone or even the sides give up before the thinning begins to become noticable or what some refer to as beginning to look moth-eaten?

 

If your color contrast was more narrow, blonde hair on a fair complexion, the whiter dots from the healed extraction sites do not contrast as much as white scar dots against dark hair like us.

 

So let's say if you do end up needing another 3,000 - 5,000 grafts in coverage, and I know you were informed that you have another 5,000 extractions available, where do they plan to extract them. From the same area?

 

I cannot tell the degree of coarsness that you have in the donor zones, but the higher level of caliber, the better coverage. You appear to have a higher than average degree of coarseness to your hair.

 

Yet most guys forget that when they buzz their hair or wear it it very short, they lose the benefit of visual coverage because there is no length to the existing hair to hide the extraction sites (scarring). I am referring to the donor areas where the extractions are taken.

 

Believe me, I have talked to enough guys over the years who had larger FUE procedures done with the idea or goal of being able to buzz their scalps. Because of their thinned out donor zones, they can no longer do this and end up growing more length in the back to hide the FUE scarring.

 

Some of them had 1mm or larger punches used and also had their extractions confined to a smaller surface area so that their entire scalp would not have to be buzzed.

 

IMHO, you and your doctor were wise in having your entire scalp buzzed so that the extractions were indeed uniformily spread out.

 

For guys who do not have advanced hairloss classes in their family histories, and those who do not need tons of work, FUE is fine, providing the doctor is skilled in extractions and collateral damage is held to a minimum.

 

My two cents for whatever it's worth. I do think your result is going to look fine, again it is the issue of future work that you may end up needing that I see as the issue.

 

We must remember at all times that MPB is progressive and that very, very few patients can get by with a solo procedure in their lifetimes.

[gillenator]

Sean,

 

Each extraction has to allow for FU’s to surround that point; you cannot punch two points adjacent to each other. In larger FUE cases it becomes more challenging for the doctor to not leave visible “hair less” areas as the extraction pattern becomes more confined.

 

The pics of your donor are not close enough for me to see the extraction pattern in detail. However, it appears as if Dr. Rahal stayed well within the "safe zone" if that is one of your concerns.

 

I think a key may be to buzz your donor, and surrounding native hair, down to a #1 or less on the clippers and try your best to notice if any obvious thinning patterns emerge. If the differences in density between the donor area and untouched native areas surrounding it are not noticeable or hardly noticeable, then you're good to go, especially considering 3,016 is no small number for FUE.

 

But at the end of the day, what's done is done, and I wouldn't worry too much about it at this point. Stay positive, and concentrate on a successful overall outcome.

 

 

 

Good points Zen. One of my larger concerns for younger men is that what looks like a well defined safe zone to the naked eye can be deceiving. We all know that MPB is progressive so the question becomes, will a patient's safe zone decrease or condense with time and age?

 

And that is exactly why some guys who had HTs 10-15 years ago are now beginning to lose some of their coverage because their strips were taken too high or too low when they were in their twenties.

 

Microscopic evaluation of one's donor regions are impeccably inportant IMHO. Miniturization can be too minute to notice with the naked eye.

[Sean]

Zenmunk, Thanks for your response and message. I think you created a great thread and it his helping a lot of people that are researching or underwent surgery learn more about procedures and things not discussed as much. I took into consideration what you said, hair does not define us. You are right, i'll try not to worry and hope for the best. Thanks for the words of encouragement. By the way, I posted more photos of the donor areas on my hair loss website, I hope they are clearer. I just got them the other day from the clinic when I requested them. I know your thread is all about extraction sites. By the way, I wanted to let you know the punch size used on me were .8 and .9, that is less than the 1mm ones used by most clinics. I hope that is an important factor to consider regarding extraction sites.

 

---------------------------------------------------------------------------------------------------------------

 

Gillenator, hello and thank you for such an in depth thoughtful response. I believe the most advanced baldness class is 4v if anything. I don't even think my father is pushing past or touching a 5, he has to be a 4v by looking at his scalp and evaluating it myself. My mother's side of the family, no one is bald. Everyone has a really thick head of hair.

 

I am taking propecia since January 2011 I believe. I did miss a month of it I believe in between sometime around March. If you look at my one year photos before surgery, that is around the time when I started taking propecia, then if you look at my preop photos, you may see some changes, with some hair regrown or hair stabilised, rather in the front. I don't think I lost hair since using propecia, but it has definitely helped I feel, especially the crown area. I haven't even touched rogaine foam yet. Just have been taking Proscar (1.25mg estimated per day). I do feel I am responsive to Propecia, maybe you can check and see if you think so by looking at the pictures, I can always use a second opinion.

 

I wish I had a video telescope or densiometer to show the donor, but im trying to make the best of it with the pictures taken by the clinic. I do understand what you are saying though, regarding the dark hair on fairer complexion.

 

You feel that my extractions seem a little high just below my crown into the coronet area, that does concern me. I hope progression wont creep into those areas. Only time can tell, but I hope medications can stabilize it.

 

I am not sure how many extractions my zone can give up before thinning becomes noticeable. That is a good question. I really hope I do not have a moth eaten look. I am following all instructions carefully. Maybe this matters, a punch size of .8 and .9 were used in combination. So, it was less than 1mm most other clinics use. I do have a wider area in the back to extract from, due to the shape of my head. I think if an extraction were to occur in the future, it maybe in from areas other then the already extracted zone?

 

I was told I had really good density, hairs, when I was getting the procedure done, so I guess that may help with better coverage.

 

Thank you for such a valuable opinion and answer. I am taking what you said into consideration for any future treatments if needed. I completely understand though, that in my case, solo procedure may not be the case, i'll need more later on in life. I just hope, I don't need them soon.

[gillenator]

Zenmonk,

 

Interesting that you comment on Dr. Bisanga's opinion. We use to work togethor in the clinic some years ago.

 

I do agree with alot of what he states unless the patient has too much mush factor throughout the scalp. Supposedly there was a FOXX test developed to evaluate the candidacy for FUE.

 

Some FUE docs state that everyone is a candidate for FUE. I disagree! Some strip docs state that everyone is a candidate for strip. I disagree with that statement as well. Few docs truly understand that some folks just are not good candiates for HT surgery.

 

On to your next question my friend. The robotic tool is great for those surgeons who take transection and collateral damage issues seriously like Dr. Harris does.

 

I still believe that most docs doing FUE should develop their own level of expertise and feel for the extraction tools when done manually.

 

But that's where I believe that robotics will help to minimize extraction error and truly improve transection rates to improve the overall yield across the board with FUE technology. Again, both manual expertise and tooling have their place.

 

I also believe that surgeons will naturally lean towards the larger punches IF they lack experience in manual extraction methods. That's where again robotics will help the doctor in preventing the damage I referred to in torsion, compression, etc. It will help greatly in preserving their grafts and minimizing the collateral damage to the surrounding tissue.

 

Are you by chance considering the use of Acell to minimize the formation and subsequent appearance of scarring to the extraction sites?

 

I wish all of you guys the very best with your results!:cool:

[gillenator]

Hey Sean,

 

You are very welcome my friend. So glad to hear that the punches were under 1mm. Your surgeon is ethical and reputable IMHO.

 

If I had a brick for every FUE patient that had been told exactly where their "future" extractions would be taken, I could build a skyscraper.

 

Many guys tell me, the doc said I have X,XXX grafts left for future extractions. BUT they rarely if ever tell them "where" they will be harvested. Again I am referring to the larger cases.

 

The other good thing Sean is that there does not sound like there are any advanced classes of hairloss in your family. KNOCK ON WOOD!

 

And you are also successful with Propecia, more good news. I cut Proscar myself and have been doing so since 1996.

 

Because the hairloss in you family is not real advanced, you may not need another procedure for some time. How old are you?

 

Take care my friend!

[ej]

Interesting topic , Fue is a tough skill to acquire ! .. I heard a lot of Dr Harris ` safe extraction scribe `and the many Drs who bought it ,.. however now he has, and uses a robotic device !

 

does this mean that the safe scribe isnt really that safe anymore ??

 

ej

Edited September 10, 2011 by ej
grammar

[gillenator]

Rather than make irrational conclusions, the best thing for you to do is visit his website and read for yourself.

[ej]

Im sorry you think I was irrational with my question as there was no offence intended, and I didnt conclude anything ,thus the question in the first place .

 

I did check out the website I assume that the fue ` tools`and robotic system are used in conjunction with one another to obtain optimum results , I fear though that some Drs can just ` buy` the equipment and open up shop so to speak which brings me to my own conclusion that the equipment being used is only as good as the Dr using it therefore very important to conduct a reasonable amount of research

 

ej

[zenmunk]

Are you by chance considering the use of Acell to minimize the formation and subsequent appearance of scarring to the extraction sites?

 

Well, I've narrowed down the choice of surgeons to two: Dr. Feller & Dr. Ron Shapiro. Matt from SMG told me that they use Acell. I'm not sure if Dr. Feller uses it - I couldn't find any info. to that effect on the forum, and he didn't mention it during our in-office consultation.

 

Do you know if Dr. Feller uses Acell? Also, any general opinions on both doctors specifically regarding FUE?

 

Thanks.

[gillenator]

MY suggestion would be to ask Dr. Feller directly if he uses Acell. I do not hink that he does.

 

Dr Shapiro has a very long history of doing strip but still has not been doing FUE for very long. No offense but not sure why you are considering him for FUE verses strip.

[galtsglutch]

Fascinating topic.

 

Thanks for posting this thread. This has been very educational. There really are a lot of variables to consider in deciding between FUE and FUT... and many to consider as well once you've made your choice.

[zenmunk]

MY suggestion would be to ask Dr. Feller directly if he uses Acell. I do not hink that he does.

 

Good advice. Unfortunately, I didn't know about Acell when I had my consultation with Dr. Feller, and he didn't volunteer any info. about it. I plan to schedule another consultation with him to ask a series of questions I've thought of since our last meeting, and I'll be sure to include asking about Acell. I'm in NYC, so it's convenient for me to do so. Hopefully he won't mind meeting with me again gratis.

 

Dr Shapiro has a very long history of doing strip but still has not been doing FUE for very long. No offense but not sure why you are considering him for FUE verses strip.

 

No offense taken. I'm aware of Dr. Shapiro's impeccable reputation regarding FUT, and he's been recommended numerous times in this forum for FUE as well, his relative inexperience with FUE notwithstanding. SMG's prices are also much more attractive. Having said that, I wouldn't even consider FUE with him or any surgeon unless I've corresponded with numerous patients about their experiences. I also insist on meeting as many patients in-person as I can. To be honest, I'm leaning toward Dr. Feller, because of his greater experience with FUE, but I like to keep my options open and research as much as possible.

[gillenator]

zen, I am so impressed with your approach and all of the research that you are doing.

 

Yes Dr. Shapiro is an awesome strip doc, I could not agree more.

[zenmunk]

Thanks very much, gillenator. I appreciate the support and all of your advice.

 

That's what makes a forum like this so valuable to hair loss sufferers, providing they take the time to delve into it and make connections with caring HT vets and docs who can help them make educated decisions. There are many wise people posting here with rather sad stories. They learned the hard way, and it would be foolish not to heed their collective advice.