The pros/cons of FUE. Myths dispelled.

[Mickey85]

I will also say that the ability to cherry pick multi hair grafts with FUE over strip is a definite advantage.

 

Greatjob, I also have no problem with you and respect and like you as a poster and wish you the very best with your results. You can have a debate with me anytime but I will reply in kind when I see inaccuracies about my postings.

 

In regards to the scalp tension. It is common knowledge that strip does diminish the amount of scalp laxity that exists. Patients that have had more than one strip procedure know this because the quantity of grafts in the second(or third etc) procedure is less than the one before it due to the tightened scalp. Many patients have noted a permanent numbness, dull pain, itchiness etc that never subsides. Now that does not mean every patient will sustain those effects, but it is worth mentioning because it is a 'potential' drawback which I noted many times. Taken from Dr. Umar's website:

 

"Patients may suffer from numbness, pain and problems of forever trying to hide the scar and being conscious of it"

 

In terms of this photo:

 

I specifically state "He/she can select finer hair to use in the hairline" and that cherry picking did allow for a more refined result. Density was never mention. It was not intentional to even imply multi-hair grafts would be beneficial in the hairline because that would be an un-natural result. This photo used is to demonstrate the ability to cherry pick finer hairs from outside the strip zone to mimic a natural hairline. You can see that the initial strip result looks un-natural with coarse hair used because the surgeon cannot select finer hair from outside the strip zone. Dr Feriduni even used the term "cherry picking" in his description and spoke of its benefits in that case.

 

Now for the change in hair direction. I don't see how Jotronic disproved it, in actual fact he did agree to some extent:

 

"When you have a strip this flow is interrupted and you can have more abrupt changes in direction of the hairs above and below the incision line. I personally do not believe it is a big issue and it is more visible when shaved than when grown out"

 

And also:

 

"Now Mickey, no where did I disagree with you so you don't have to try and debate me on this."

 

The part where Joe and I disagree is in the photo I used because the guy had crazy whorls going on in the donor. Strip was not blamed for that but it was blamed for the eradication of smooth change in direction as you can see. It not longer flowed smoothly. I have since taken that photo off the "change in direction" list and moved it to "change of hair caliber gradation" list.

 

Look at this photo:

 

 

You can clearly see that change in direction here compared to the untouched section in green. Also Dr. Umar and other FUE surgeons reiterate that strip does change the direction of hair flow:

 

"Additionally, strip surgery will destroy the natural geometry of the donor region by obliterating the natural linear arrangement of follicular groups along the consecutive spirals"

 

Anyone is free to believe whomever and whatever they choose, but I will defend myself and my statements. Peace.

[Bill - Seemiller]

You can clearly see that change in direction here compared to the untouched section in green. Also Dr. Umar and other FUE surgeons reiterate that strip does change the direction of hair flow:

 

Mickey,

 

The above photo showing the change in direction of donor hair after FUSS can occur but is rare. Also, the above is an extreme and exceptionally rare example and if it's going to occur, it typically only happens after multiple procedures. In many cases, it's not noticeable when the hair is grown out.

 

While I'm a proponent of both FUSS (strip harvesting) and FUE (follicular unit extraction) since both come with their own distinct advantages, there are equally as many unpredictabilities with FUE as there is with FUSS. Some of these can be found in the "disadvantages" section of our web content on follicular unit extraction. Another is possible damage to tissue surrounding an extracted follicular unit, making the surrounding follicles weaker and less viable for transplanting in future procedures.

 

Mickey, I truly respect you and appreciate all the work you've put into creating these educational topics and discussions. My only criticism is that you've openly admitted to a personal bias towards FUE based on a bad experience with FUSS. Thus, while you do an excellent job citing the advantages and disadvantages of FUE clearly and intelligently, you don't always provide the same level of unbiased insight towards FUSS.

 

It's difficult to see beyond personal experience at times however, the best educators can move beyond personal bias and let statistics and consistency do the talking.

 

Best wishes,

 

Bill

[Mickey85]

Mickey,

 

The above photo showing the change in direction of donor hair after FUSS can occur but is rare. Also, the above is an extreme and exceptionally rare example and if it's going to occur, it typically only happens after multiple procedures. In many cases, it's not noticeable when the hair is grown out.

 

 

While I'm a proponent of both FUSS (strip harvesting) and FUE (follicular unit extraction) since both come with their own distinct advantages, there are equally as many unpredictabilities with FUE as there is with FUSS. Some of these can be found in the "disadvantages" section of our web content on follicular unit extraction. Another is possible damage to tissue surrounding an extracted follicular unit, making the surrounding follicles weaker and less viable for transplanting in future procedures.

 

Mickey, I truly respect you and appreciate all the work you've put into creating these educational topics and discussions. My only criticism is that you've openly admitted to a personal bias towards FUE based on a bad experience with FUSS. Thus, while you do an excellent job citing the advantages and disadvantages of FUE clearly and intelligently, you don't always provide the same level of unbiased insight towards FUSS.

 

It's difficult to see beyond personal experience at times however, the best educators can move beyond personal bias and let statistics and consistency do the talking.

 

Best wishes,

 

Bill

 

Hey Bill,

 

Like I say at the start of the thread, all the factors are potential. Even if they are rare, they are listed. I have photos of the change of direction happening after just one procedure. I'll be happy to add them. Something not being noticeable when the hair is grown out is still worth mentioning.

 

After one strip procedure. Noticeable difference in direction.

 

I personally do not believe there are(one for one) an equal amount disadvantages for FUE as there are for strip. I even added things like cost(which is not inherent in the FUE method itself and an external factor) and having to shave to donor down(very trivial) just to be unbiased. I could have listed body hair as a means of obtaining more hair out of FUE instead of strip, but did not. I could have countered shaving the donor via FUE with having to grow hair out for strip to cover the strip site, but did not. While I was aggressive in naming all the negative factors of strip, I made sure every factor was also listed for FUE. There are 17 advantages FUE has over strip and 9 disadvantages. Far from there being an equal amount.

 

I am pro-FUE due to the disadvantages that are inherent with strip and are non-existent with FUE. Who is not biased? The guy with a good strip procedure will praise strip. The guy with bad FUE will bag FUE. The rep who works for a strip clinic will promote strip, as will the doctor. I have presented evidence that shows the pros/cons for both while Dr Carmen merely called my posts ridiculous and nonsense.

 

Does my bad experience with strip give me a bias? Or does it make me that much more credible? Would I have more credence if I had not have had strip surgery at all then? That is upto the individual to answer but I want people to really think about that, along with the evidence I have presented on top.

 

The way the word 'biased' is used in that if an individual does not see strip and FUE as equals, then they are biased. It has a negative connotion to it and can be used to discredit someone who stops and thinks "No, this method is better due to this, this and that" and has presented evidence to back those sentiments.

 

When an ex-porn actress leaves the industry and preaches about the maltreatment and atrocities of the porn industry and brings up testimonials, statistics, evidence to reinforce her sentiments, is she biased? Is she rendered wrong simply because she doesn't see things in a neutral perspective? I'm not equating the hair industry to the porn industry but showing that labelling someone as biased when they have evidence to at least support their claims is wrong. Being biased is a moot point when one has evidence to substantiate WHY they think that way.

 

You say I don't always provide the same unbiased insight toward strip, that is because I think FUE is superior and have backed up why I think it is superior. No one has to believe this, if someone who is informed wants to go strip, I wish them all the very best. I presented ALL the disadvantages of FUE that I know, that was my obligation in being unbiased when it came to the pros/cons list. If I left anything out it was due to me not knowing about it at the time. Outside of the pros/cons list, I did not think I had to be neutral.

 

I can't see them as equals Bill, because to me, strip has more disadvantages. I do not see them as adjuncts. I see them as Drs. Lorenzo, Umar, Hakan, Reddy, Erdogan, De Reys etc see them. If they genuinely did have the same amount(and severity) of pros and cons, then my conclusion would be that they are mutual or equals. Due to strip having more drawbacks, I have chosen to be pro-FUE. The pros/cons list that is on this website lacks many things that are inherent in strip such as the tightening of the scalp or the higher potential for nerve damage. These factors do happen and yet they are omitted. The ability to return to weightlifting or exercise is also omitted, as is the exact graft count.

 

These are my feelings on the subject, it is not to challenge you or anyone else, but to back up my sentiments and to show why my opinion is this way. I hope you don't take offense to any of this, it is just me explaining myself and clearing up misconceptions. I'm not talking in a heated or aggressive way, I just like to voice my thoughts, and I have alot of thoughts hehe.

Edited July 1, 2013 by Mickey85

[Mickey85]

Have merged "Allows for shorter hairstyles" into "No linear scar" in the Advantages section and have also added "No sutures or staples" in the Advantages section.

[M1A1]

Mickey,

I have read the complete thread and I have to say, I am impressed with your representation of FUE & FIT and their advantages and disadvantages...You seem to provide a logical perspective.

 

What I find fascinating is that you have opened the eyes of many readers on JUST this forum about FUE and lets just say that, well, the BEST FUE doctors in the world will be incredibly busy. It's simple, the market demands it-supply side econ 101.

 

You know when I first saw the results of the Turkish doctors, Dr. Lorenzo, and the others from Belgium, I couldn't believe it, NO- the truth of the matter is that I didn't want to believe it. Now I know, the best FUE doctors in the world are in EUROPE. And the BEST FUE doctor arguably may currently be in Spain. North American doctors on average have a long way to go to equal their FUR peers in Europe and Turkey.

 

Keep up the good work...

[M1A1]

Whoops, I meant FUE-LOL...

[Mickey85]

Mickey,

I have read the complete thread and I have to say, I am impressed with your representation of FUE & FIT and their advantages and disadvantages...You seem to provide a logical perspective.

 

What I find fascinating is that you have opened the eyes of many readers on JUST this forum about FUE and lets just say that, well, the BEST FUE doctors in the world will be incredibly busy. It's simple, the market demands it-supply side econ 101.

 

You know when I first saw the results of the Turkish doctors, Dr. Lorenzo, and the others from Belgium, I couldn't believe it, NO- the truth of the matter is that I didn't want to believe it. Now I know, the best FUE doctors in the world are in EUROPE. And the BEST FUE doctor arguably may currently be in Spain. North American doctors on average have a long way to go to equal their FUR peers in Europe and Turkey.

 

Keep up the good work...

 

Thank you so much for that M1A1, I appreciate it so much and I agree with everything you said

[Questionmark]

I don`t want to comment specifically on Dr. Carmans criticism, as I was totally surprised to read such from a coalition doc, but in general, attacking this thread and insinuating that the pro/con section is biased and led by a personal bad FUT experience is amazingly unfair and entirely unfounded imo.

 

I don`t think I have to back this claim up, as everybody can read the initial post for himself and evaluate whether it is one sided or not, whether it contains "ridicoulous" or "nonsense" claims or not, whether it deserves to be attributed to such terms or not...

 

Actually I think we can`t find a more well-balanced compendium about the pros and cons of FUT and FUE in the whole internet (so far), and as Mickey pointed out, he even had abstained from naming some more adavantages of FUE in comparison to FUT, while he listed all advantages of FUT in the necessary manner.

Mickey does not blindly crusade for FUE. In fact Mickey is a strong advocate of FUE, but he has reasons for that, and he is offering them in the most substantiated way possible. His attitude and position originally had been rooted in his personal experience, yes, but deriving from this that he is one sided and biased would be totally wrong and ignoring the circumstance that his experience was only the jump start for a then clinical, exhaustive research into the general advantages and disadvantages of FUT in comparison to FUT.

 

Of course the initial post has to be constantly overhauled, updated and maybe some claims altered in one or the other way,and I always welcome criticism, especially on such an important and controversial topic - and I am sure the same goes for Mickey - but it should always be polite and constructive.

[Mickey85]

I don`t want to comment specifically on Dr. Carmans criticism, as I was totally surprised to read such from a coalition doc, but in general, attacking this thread and insinuating that the pro/con section is biased and led by a personal bad FUT experience is amazingly unfair and entirely unfounded imo.

 

I don`t think I have to back this claim up, as everybody can read the initial post for himself and evaluate whether it is one sided or not, whether it contains "ridicoulous" or "nonsense" claims or not, whether it deserves to be attributed to such terms or not...

 

Actually I think we can`t find a more well-balanced compendium about the pros and cons of FUT and FUE in the whole internet (so far), and as Mickey pointed out, he even had abstained from naming some more adavantages of FUE in comparison to FUT, while he listed all advantages of FUT in the necessary manner.

Mickey does not blindly crusade for FUE. In fact Mickey is a strong advocate of FUE, but he has reasons for that, and he is offering them in the most substantiated way possible. His attitude and position originally had been rooted in his personal experience, yes, but deriving from this that he is one sided and biased would be totally wrong and ignoring the circumstance that his experience was only the jump start for a then clinical, exhaustive research into the general advantages and disadvantages of FUT in comparison to FUT.

 

Of course the initial post has to be constantly overhauled, updated and maybe some claims altered in one or the other way,and I always welcome criticism, especially on such an important and controversial topic - and I am sure the same goes for Mickey - but it should always be polite and constructive.

 

I wanna give you the biggest bro-hug right now champ hehehe.

[hairshopeing]

Agreed!!! Mickey has done an excellent, balanced and educational thread that anyone intending to have a procedure done should read!!! Hats off to you mickey! I'm sure you've helped hundreds of potential ht patients already!!!!

[Mickey85]

Agreed!!! Mickey has done an excellent, balanced and educational thread that anyone intending to have a procedure done should read!!! Hats off to you mickey! I'm sure you've helped hundreds of potential ht patients already!!!!

 

You guys sure know how to make a guy blush

[Mickey85]

15,000 views!!!

[MAGNUMpi]

15,000 views!!!

Well deserved.

[Mickey85]

Well deserved.

 

Thanks champ, hope you have been well. This forum has an excellent selection of amazing FUE surgeons, Bisanga, Reddy, Lorenzo, Mwamba, Hakan and Maras have all been recommended within the last 12 months or so and the likes of De Reys and Erdogan are showing a strong possibility

[M1A1]

Mickey,

Something else that is of interest to me is that some of the FUE doctors in Europe, Turkey, & Belgium tell their patients to use the Laser Comb after their procedure- any thoughts on that???

[Mickey85]

Hmmmm I'm on the fence when it comes to the laser comb in general. I'm not sure if it can stimulate the new follicles into a better yield or by simply growing out faster(much like Rogaine is recommended due to increased blood flow to the grafts) but I don't think it does much on a natural, non-HT scalp. Would be interesting to see why these FUE surgeons recommend the laser comb post-op...

[M1A1]

Actually, I am having some moderate success on it after 9 months. It has definitely naturalized my hair transplanted hairline especially in the transition zone.

Though, I have been on Propecia since 1998... My understanding of Rogaine and the comb are that they are both Anagen inductors, however, they have different mechanisms at play that ultimately achieve somewhat of a cosmetic improvement-it's all relative...

[Mickey85]

Actually, I am having some moderate success on it after 9 months. It has definitely naturalized my hair transplanted hairline especially in the transition zone.

Though, I have been on Propecia since 1998... My understanding of Rogaine and the comb are that they are both Anagen inductors, however, they have different mechanisms at play that ultimately achieve somewhat of a cosmetic improvement-it's all relative...

 

Oh wow, that is awesome. I have not looked into laser combs much but read they light they emit can re-awaken follicles but it's not something I have in depth knowledge of.

[BaldingBogger]

Mickey has done a great job on here. I think some Dr's nose will be put out of joint if they just offer FUT but they they need to evolve.!

 

FUT and FUE both have their place but a LOT of guys will now realise FUE will fit their needs with FUT catering mainly for higher norwoods .

[Mickey85]

Thanks champ Much appreciated.

[KO]

I think Mickey will like this article.

 

Slow Ideas

 

by Atul Gawande

 

 

Atul Gawande: How Do Good Ideas Spread? : The New Yorker

 

 

I know outside links are banned, but it is a magazine article, so I can't think of another way to display it...

[Mickey85]

Checking it out now KO!!

[Mickey85]

Wow.. 20,000 views.

[Mickey85]

Been a while since I have visited this thread

[romanino]

Hello Mickey,how are u? Hope u doing good...

I just want to thank u for all your work on this thread,u really really knowledge me about lot's things that I didn't even know.

You help me to choose my Dr. for my repair, I'm 7th day post op now and everything seem to be find...

Thank u again,love and lot's respect...!!!