Are we there yet?

[PupDaddy]

QUESTION:

 

As of March 2013, and solely from the perspective of fully matured cosmetic result, are we at a point where a 3,000 graft FUE transplant performed by a premier FUE doc will consistently be indistinguishable from a 3,000 graft FUT performed by a premier strip doc, all other things being equal?

 

I chose 3,000 for two reasons: (1) it is a substantial session size for either FUE or FUT, and (2) some of the premier FUE docs currently put a 3,000 graft upper limit for any one FUE transplant, whether performed in a single day or divided or two or more days.

 

Here are the assumptions underlying the question:

 

1. Fifty (50) NW3A patients, all in their early 40’s with essentially the same hair characteristics (medium caliber, straight to slight wave), donor density (average), and skin to hair color contrast (medium). All are non-smokers. All are on finasteride.

 

2. All the patients are good candidates for a 3,000 FUE transplant (FOX test approved) or a 3,000 FUT transplant (sufficient donor laxity).

 

3. By random drawing, half the patients receive an FUT transplant and the other half receive an FUE transplant.

 

4. The doctors performing these hypothetical transplants on these hypothetical patients are the three currently "best" FUT docs in the world and the three currently "best" FUE docs in the world, each at their own clinics with the assistance of their regular techs.

 

5. All transplanted hair is scalp hair.

 

6. All the patients were compliant post operatively and are now 18 months post op.

 

7. All the patients have cut their hair to a length of approximately one and three-quarters inches.

 

Given these assumptions, would the FUE results, generally speaking, be cosmetically indistinguishable from the FUT results? In other words, as kids on a long family car trip might say, “Are we there yet?”

[Mickey85]

I wish I could give you a definite 'yes', but sadly, any method could have bad yield. I had FUT and the result was as bad as the bad FUE megasessions you see(given I only had minimal loss, my density should have been great). Some FUE sessions do fail however. It is unfortunately the roll of the dice. I know you gave stipulations with all factors being equal etc but relieve the chance that it may not go right. I say if you compare most Lorenzo results to most Hasson and Wong results, the difference would be negligible, in that there would not be a discernible difference, maybe a minimal. Doctor choice is crucial however. This is just my opinion.

 

Over the years many have come to a compromise in that they will accept a lower yield in exchange for no strip scar. However I have seen patients of failed FUE state "I should have just gone FUT instead, the scar is no detectable anyway". It all depends on what YOU would feel would be easier to deal with, the strip scar and it's potential to stretch that is associated with FUT or the weaker yield that is associated with FUE? What 'failure' would you be more willing to accept? This may lend you more questions than answers but you have got to go in fully aware that no surgeon or method is guaranteed, Doctors make you read, copy and sign many statements and contracts stating this.

 

I could easily tell you who to go to or could recommend one method over another(my sentiments are pretty well known) but instead I ask you to ask yourself what is important to you. Can you live with a strip scar? Can you live with a stretched strip scar? Can you handle the yield not being close to what you expect and accept? These are questions that barely NO surgeon or rep ask and are questions I feel should be standard and enforced in determining the best possible procedure for the patient.

 

My sentiments anyway. It's great that you are doing thorough research.

[PupDaddy]

The question isn't specifically for my benefit. Rather, it is designed for general ht knowledge and discussion, to see if there is a consensus whether, as of today, large-session FUE as practiced by the best FUE docs produces (a) equally good cosmetic results (yield, density, and appearance/caliber/characteristics of the fully matured transplanted follicles) as those produced by the best FUT docs practicing today with (b) equal consistency as those produced by the best FUT docs practicing today, all else being equal. Granted, "all else being equal" is unrealistic in a pure sense, but for the question to be of any use, we have to set some parameters and assumptions.

 

The keys to this question are QUALITY of result (appearance of the transplanted frontal region and hairline once fully matured) and CONSISTENCY with which that quality is achieved. In framing my original question, I assumed a sample size of 50 patients so that the work as a whole could fairly be judged as being REPRESENTATIVE of the six hypothetical doctors' work and the extraction method they used, while allowing for anomalous results (good and bad) that might well occur in the practice of a premier ht surgeon. Perhaps the sample size should be larger, but I trust you catch my drift.

 

This isn't about guarantees (which, my opinion, are empty anyway), whether poor yield could occur in any given case or with either FUE or FUT, whether a strip scar could stretch, the ramifications of poor yield or other failure -- all of which, and much more, should be considered by anyone contemplating a hair transplant. The question is about trying to take stock of where we are in the practice of relatively large session, frontal restoration, scalp hair FUE in the hands of the very best, compared to where we are in the practice of relatively large session, frontal restoration, scalp hair FUT in the hands of the very best, solely in terms of consistently achievable (representative, albeit not 100% and not without a possible anomalous result in any given case) cosmetic result (appearance of the transplanted frontal region and hairline). Thus, returning to my hypothetical, if we attended a cocktail party honoring the 25 FUE patients and 25 FUT patients (or make it 50 and 50, or 100 and 100), would we likely say, "That group's hair, on average, looks better than that group's hair?"

 

The question might well not be answerable in a meaningful way, but I pose it anyway.

[moopookoo]

all 'FUE only clinics' claim/advertize that FUE yield is 95%+, it includes recommended doctors as well

 

 

but if you ask FUT only Dr or Dr who performs both you will get different answer, which is that FUE is unpredictable and generally does not yield as good as strip

 

IS Dr Rassman the only surgeon who does 'fue test' , fox test, before surgery?

[Mickey85]

all 'FUE only clinics' claim/advertize that FUE yield is 95%+, it includes recommended doctors as well

 

 

but if you ask FUT only Dr or Dr who performs both you will get different answer, which is that FUE is unpredictable and generally does not yield as good as strip

 

IS Dr Rassman the only surgeon who does 'fue test' , fox test, before surgery?

 

arent too many fue only clinics globally. umar, armani(is he retired? he should), de reys lorenzo, dr jc, and alot in turkey and parts of europe and india but i think that's it?

 

fut only doctors will always say fut yield is better. composite docs like feriduni have said there is usaully a 5 percent discretion between methods.

[Mickey85]

The question isn't specifically for my benefit. Rather, it is designed for general ht knowledge and discussion, to see if there is a consensus whether, as of today, large-session FUE as practiced by the best FUE docs produces (a) equally good cosmetic results (yield, density, and appearance/caliber/characteristics of the fully matured transplanted follicles) as those produced by the best FUT docs practicing today with (b) equal consistency as those produced by the best FUT docs practicing today, all else being equal. Granted, "all else being equal" is unrealistic in a pure sense, but for the question to be of any use, we have to set some parameters and assumptions.

 

The keys to this question are QUALITY of result (appearance of the transplanted frontal region and hairline once fully matured) and CONSISTENCY with which that quality is achieved. In framing my original question, I assumed a sample size of 50 patients so that the work as a whole could fairly be judged as being REPRESENTATIVE of the six hypothetical doctors' work and the extraction method they used, while allowing for anomalous results (good and bad) that might well occur in the practice of a premier ht surgeon. Perhaps the sample size should be larger, but I trust you catch my drift.

 

This isn't about guarantees (which, my opinion, are empty anyway), whether poor yield could occur in any given case or with either FUE or FUT, whether a strip scar could stretch, the ramifications of poor yield or other failure -- all of which, and much more, should be considered by anyone contemplating a hair transplant. The question is about trying to take stock of where we are in the practice of relatively large session, frontal restoration, scalp hair FUE in the hands of the very best, compared to where we are in the practice of relatively large session, frontal restoration, scalp hair FUT in the hands of the very best, solely in terms of consistently achievable (representative, albeit not 100% and not without a possible anomalous result in any given case) cosmetic result (appearance of the transplanted frontal region and hairline). Thus, returning to my hypothetical, if we attended a cocktail party honoring the 25 FUE patients and 25 FUT patients (or make it 50 and 50, or 100 and 100), would we likely say, "That group's hair, on average, looks better than that group's hair?"

 

The question might well not be answerable in a meaningful way, but I pose it anyway.

 

i think that if you compared 25 results from lorenzo bisanga and feriduni all fue with 25 results from hasson, wong and shapiro the difference would be slight taking into account they were all nw3s as you said. you may get some that would look equal and some that would look slightly better. all in all i do believe that for anything upto a norwood 4(if they have the donor for it) fue has arrived to a stage where it has evolved to a very respectable level and can definitely be an option opposed to strip. thats not to say it matches or exceeds it but i think it is within the vicinity.