Should there be mandatory FUE test before having FUE HT?

[moopookoo]

Reading though different forums and browsing through results it appers that FUT yields better results and its more consistent in comparison .

In theory if shouldnt be the case as FUE allows you to extract any kind of graft you want whereas strip is limited and you only got whats in a strip of skin thats been cut off.

 

FUE results vary, some results are on par ith fut some are not so great.Many surgeons dont do any testing, I think the only one who does it is Dr Rassman(not sure if he still does t), many dont even test BHT and move to the large sessions without knowing what % of grafts will grow.. and we all know how unpredictable BHT can be

 

Distrubing part is a lot of fue clinics advertise 100% growth or close to it. Truth is they cant predict that even if they are the best in the field. Also, excuses such as hair color, scalp contrast.curl is the reason why some results look better than others, yes these are the factors but they are often used to cover up for poor yield.

 

 

Should there be mandatory fue testing before moving on to larger sessions, that way you know exacty what to expect, once you have 4-6000 transplanted you really dont know if growth was 60 or 90%, imo its a big difference

[michaeljames]

Hello MooPooKoo,

 

There is a bit of confusion about the types of HT surgery and the efficacy of them. First note is that both 'Strip Method' and FUE are forms of FUT surgery. As you indicate the harvesting of donor grafts is the main variation. The facti is that FUE is a more time consuming and therefore a more costly procedure. However, those surgeons who are well skilled get good results with both forms.

 

The issue is if FUE is the best choice for a patient. The primary reason is will the patient have a high rate of transection (damaged follilicular units) via FUE harvesting. The surgeons skill and the patients genetic predispositon are the critcal factors here. I have the benefit of working with the Chairman of the ISHRS FUE research committee and know that FUE can give great results. Dr Mohebi a surgeon well recommended on this forum routinely performs the FOX test. There is really no reason why this test cannot be performed for all FUE patients before doing the procedure. I hope this helps, All the Best; Michael

[Atticus]

The link below touches upon the subject of FUE vs FUT;

 

 

What is the best type of Hair Transplant? FUE vs. Strip

 

Dr. Umar does do test areas if the patient wishes. To me the real test should the Doctor and his documented skills.

 

Atticus

 

 

Reading though different forums and browsing through results it appers that FUT yields better results and its more consistent in comparison .

In theory if shouldnt be the case as FUE allows you to extract any kind of graft you want whereas strip is limited and you only got whats in a strip of skin thats been cut off.

 

FUE results vary, some results are on par ith fut some are not so great.Many surgeons dont do any testing, I think the only one who does it is Dr Rassman(not sure if he still does t), many dont even test BHT and move to the large sessions without knowing what % of grafts will grow.. and we all know how unpredictable BHT can be

 

Distrubing part is a lot of fue clinics advertise 100% growth or close to it. Truth is they cant predict that even if they are the best in the field. Also, excuses such as hair color, scalp contrast.curl is the reason why some results look better than others, yes these are the factors but they are often used to cover up for poor yield.

 

 

Should there be mandatory fue testing before moving on to larger sessions, that way you know exacty what to expect, once you have 4-6000 transplanted you really dont know if growth was 60 or 90%, imo its a big difference

[jfables]

Atticus, Of course most clinics are going to tell you there is no need for testing because yield in their masterful hands is the same whether FUE or Strip. If it's true that yield could be less with FUE why would the clinic admit it and risk losing business?

 

The best thing to do to protect your money and your donor is get a small test done of a couple hundred grafts even if you have to pay for the test.

 

By the way "Chairman of the ISHRS FUE research committee" sounds like a big friggin' deal, man. Maybe you should listen to whatever he says.

[Atticus]

Hey jfables,

 

I probably didn't explain properly. Dr. Umar does do test FUE, but the question of " should it be mandatory" is the question asked. I don't think it can be mandatory.

 

As far as this:

 

jfables:

 

By the way "Chairman of the ISHRS FUE research committee" sounds like a big friggin' deal, man. Maybe you should listen to whatever he says.

 

Atticus:

 

I listen to many different opinons and observations. But I am just a good ol boy who fell of the turnip truck, shucks, I only possess an MBA. If I recall correctly, my Doctor, Dr. Umar is a very big deal man! He frequently speaks/presents at ISHRS conferences. Plus, he has several publishing in different medical journals.

 

Take it easy,

 

Atticus, MBA :cool:

 

 

Atticus, Of course most clinics are going to tell you there is no need for testing because yield in their masterful hands is the same whether FUE or Strip. If it's true that yield could be less with FUE why would the clinic admit it and risk losing business?

 

The best thing to do to protect your money and your donor is get a small test done of a couple hundred grafts even if you have to pay for the test.

 

By the way "Chairman of the ISHRS FUE research committee" sounds like a big friggin' deal, man. Maybe you should listen to whatever he says.

Edited March 23, 2013 by Atticus

[moopookoo]

I never met any of Dr Umars patients but I heard of some cases of poor growth where patient spent 100K and got poor growth.

This could have been avoided by small test.

 

 

When I consulted Dr Umar he never suggested testing even though he quoted 2-3000 BHT/beard,

 

I ve seen other so called pioneers with the same issue, these cases dont end up on forums or surgeons websites

 

 

IMO FUE growth issue is white elephant in the room and performing smll test prior to large session is no brainer

[michaeljames]

I never met any of Dr Umars patients but I heard of some cases of poor growth where patient spent 100K and got poor growth.

This could have been avoided by small test.

 

 

When I consulted Dr Umar he never suggested testing even though he quoted 2-3000 BHT/beard,

 

I ve seen other so called pioneers with the same issue, these cases dont end up on forums or surgeons websites

 

 

IMO FUE growth issue is white elephant in the room and performing smll test prior to large session is no brainer

 

Hello Again,

 

Dr. Umar and Dr. Mohebi are both well recommended and recognized HT surgeons. Dr. Umar serves on the committee with Dr. Mohebi. FUE is still a new enough medical procedure that has growing success. The point I am making is that the FOX Test is available and though it is not mandatory. As a patient advocate I simply suggest that those considering FUE request their physician to do the test. It provides verifiable information directly to the particular patient as to the likelihood of low levels of transection, the healing of the puncture wounds and how well the grafts may take. This is much more preferable then assuming or basing the decision on previous experience.

 

As I am not a physician I base my opinion on my several years working with Dr. Mohebi and observing his practice. Perhaps you could message him and get a direct response.

 

FUE is relatively new but it is my understanding the full distinguished members of the ISHRS FUE Committee are charged with leading the efforts of suggested research and to work towards greater efficacy of the procedure and suggestions for standardization.

 

All the Best, Michael

[Atticus]

I guess the question would be, what doctor has 100% success rate. No. This applies to all facets of surgery. Any Doctor who tells someone that ALL of his surgerries have been success would be suspect. Honestly, there is no Doctor that can guarantee 100% success in any type of surgery. It is just not humanly possible. To single out one Doctor is simply not fair.

 

Monopookoo:

 

When I consulted Dr Umar he never suggested testing even though he quoted 2-3000 BHT/beard,

 

Atticus:

 

Did you actually have surgery by him?

 

Just wondering.

 

 

I never met any of Dr Umars patients but I heard of some cases of poor growth where patient spent 100K and got poor growth.

This could have been avoided by small test.

 

 

When I consulted Dr Umar he never suggested testing even though he quoted 2-3000 BHT/beard,

 

I ve seen other so called pioneers with the same issue, these cases dont end up on forums or surgeons websites

 

 

IMO FUE growth issue is white elephant in the room and performing smll test prior to large session is no brainer

[Mickey85]

there are alot of 'shoulds' that could be implemented that would greatly benefit the patient. why are they not you ask? because it is deterimental to the surgeon. can you imagine every patient being required to have a small fue tesr prior to the full surgery? they would have to wait a whole year before the result blooms and then they could have the full session.... many would just say 'forget it'. and who is to say that if a small test works, that a full session will work? fatigue and human error would be less of a factor in implanting 100 grafts compared to 2000 grafts. i wouldnt ve happy if i waited 2 years, one for the test and one for the full session, just to have the procedure fail anyway.

 

the yield factor of fue is brought up alot but you could easily find the similar amount of failed fut procedures from hasson and wong, rahal, feller, shapiro etc as dr umar. what precautions are taken fior fut patients? a basic 'scalp exercise' and alot of luck. then if the scar stretches they blame your racial background("asian/black/european people tend to stretch" i kid you not i was told this after my scar stretched) or your physiology. but hold on? what about the state of the art dual layer, minimal tension, trico closure that clinics proudly showcases? guess it only works when the procedure goes right. how fitting.

 

i apologize for my tone, it is not directed at you at all. just trying to hammer the point home that surgeons could certainly do alot more, but dont. surgeons could be much more ethical, but wont. because thay would mean turning away more patients which would eventually lead to a decline in clients. i would know. i went to a 'world class clinic' and was absolutely shattered by what i saw, heard and personally experienced... from a world class clinic...

[jfables]

Hey jfables,

 

I probably didn't explain properly. Dr. Umar does do test FUE, but the question of " should it be mandatory" is the question asked. I don't think it can be mandatory.

 

As far as this:

 

jfables:

 

By the way "Chairman of the ISHRS FUE research committee" sounds like a big friggin' deal, man. Maybe you should listen to whatever he says.

 

Atticus:

 

I listen to many different opinons and observations. But I am just a good ol boy who fell of the turnip truck, shucks, I only possess an MBA. If I recall correctly, my Doctor, Dr. Umar is a very big deal man! He frequently speaks/presents at ISHRS conferences. Plus, he has several publishing in different medical journals.

 

Take it easy,

 

Atticus, MBA :cool:

 

My point is "ISHRS" shouldn't impress anyone. The entire HT industry is a circus (and I mean industry -- not medical field, in case anyone thinks it is).

[Mickey85]

Michaeljames has subtle(and sometimes obvious) methods of boasting about the doctor he works FOR whilst offering very little in terms of substance to the topic on hand. I for one dislike this kind of tactic and I do hope it stops.

[moopookoo]

I didnt have procedure with Dr Umar, just consultation.

 

i would rather wait 6-12 months to see results of the test than have large scale FUE?BHT and have disapointing results.

after large session is always hard to argue with HT surgeon if you had poor result or not,

does patient know if there are 7000 growing or 4500...?

 

everytime someone gets poor yield its always patients hair color, texture,scalp/hair contrast, curl, race, patient unrealistic expectations, etc etc...its never surgeon fault and poor growth

[Mickey85]

it is true that surgeons never own up to the poor yield or bad scar etc which is a shame. the most they will.do is take a neutral approach and simply say the result was not good, that they are sorry and offer a repair but they never blame themselves or their techs...

 

we shouldnt forget that even some mega fut sessions fail, upwards of 6000 scalp grafts so their donor is basically depleted. if you are going for a massive fue/bht then it would be wise to request a test, especially when talking about the quantity of grafts, the cost associated with fue and bht and the irregular consistenxy of body hair transplantation.

[AGL77]

After 2 strip procedures I'm considering fue and/or BHT but would want to do a very small test before committing to smothering larger. How small a procedure could one do....100, 200.... to be able to conclude on the success or failure and what doc would do such a small procedure? Wouldn't it be a waste of time for them since the most desirable docs are the busier docs and they can fill that chair with much larger/profitable patients?

[moopookoo]

100 grafts is ok

 

I know famous BHT Dr from Atlanta does BHT test, at least in my case he recommended it, since he couldnt guarantee growth

 

Out of 100 if you get 70+growing is very good...most of times only 20-40% grows..best kept secret

[Dr. Sanusi Umar]

I never met any of Dr Umars patients but I heard of some cases of poor growth where patient spent 100K and got poor growth.

 

 

 

Mr Moopookoo,

 

These assertions are not true. If another clinic tells you this, then you are being misled. This is a healthy debate to have in the forum. It is also good to use facts when making such allegations.

 

The video introduced by Atticus explains instances where I have required a test. Before seeing me, the patient in the video had a failed strip surgery, followed by a failed FUE procedure in 2 separate clinics.

 

There are different methods and techniques to FUE and all clinics do not adhere to the same protocols neither are they all with the same level of competence and experience in FUE or Strip surgery. As such a blanket test requirement cannot be reasonably required of every clinic. Poor yield can occur in all HT procedures. A cursory search of this forum would reveal cases of poor yield at the hands of both FUE and FUT clinics. A test requirement might as well be applied to FUT surgeries since the majority of patient presenting to my clinic with complaints of poor yield have had FUT surgery and not FUE. This of course is a reflection of the fact that there are many more strip procedures being performed worldwide than there are FUE.

 

 

 

I do not require a test procedure in the majority of patients presenting to my clinic. I do however for patients with tightly curled afro-textured hair. That said, a patient should have the option to request for a test procedure (whether it is an FUE or Strip procedure). They should have a low threshold for such requests if the clinic they are dealing with is new to the field (FUE or FUT). There should be no good reason for a clinic to refuse a test request since the test procedures are done at a fee.

Edited March 25, 2013 by Dr Umar

[Mickey85]

Mr Moopookoo,

 

These assertions are not true. If another clinic tells you this, then you are being misled. This is a healthy debate to have in the forum. It is also good to use facts when making such allegations.

 

The video introduced by Atticus explains instances where I have required a test. Before seeing me, the patient in the video had a failed strip surgery, followed by a failed FUE procedure in 2 separate clinics.

 

There are different methods and techniques to FUE and all clinics do not adhere to the same protocols neither are they all with the same level of competence and experience in FUE or Strip surgery. As such a blanket test requirement cannot be reasonably required of every clinic. Poor yield can occur in all HT procedures. A cursory search of this forum would reveal cases of poor yield at the hands of both FUE and FUT clinics. A test requirement might as well be applied to FUT surgeries since the majority of patient presenting to my clinic with complaints of poor yield have had FUT surgery and not FUE. This of course is a reflection of the fact that there are many more strip procedures being performed worldwide than there are FUE.

 

 

 

I do not require a test procedure in the majority of patients presenting to my clinic. I do however for patients with tightly curled afro-textured hair. That said, a patient should have the option to request for a test procedure (whether it is an FUE or Strip procedure). They should have a low threshold for such requests if the clinic they are dealing with is new to the field (FUE or FUT). There should be no good reason for a clinic to refuse a test request since the test procedures are done at a fee.

 

always a class act and a gentlemen Dr Umar. i commend you for being one of the few surgeons in north america who broke away from conformity and comfort by performing only fue.

[michaeljames]

After 2 strip procedures I'm considering fue and/or BHT but would want to do a very small test before committing to smothering larger. How small a procedure could one do....100, 200.... to be able to conclude on the success or failure and what doc would do such a small procedure? Wouldn't it be a waste of time for them since the most desirable docs are the busier docs and they can fill that chair with much larger/profitable patients?

 

Hello AGL,

 

The nature of FUE is that it is a slower procedure and tedious particularly if non robotic extraction is being used. I think that many of the recommended surgeons here could take such a case if warranted. In the end it is providing the service for the patient and to meet there needs.

 

I always encourage professional evaluation and all HTN surgeons as they have been evaluated thoroughly by the providers of this forum.

[michaeljames]

Michaeljames has subtle(and sometimes obvious) methods of boasting about the doctor he works FOR whilst offering very little in terms of substance to the topic on hand. I for one dislike this kind of tactic and I do hope it stops.

 

Hello Mickey,

 

Yes, I am most familiar with the work at the centers in which I actually serve as a patient advocate. My biggest advice is always that the surgeons recommended here are some of the leading experts in HT. I always encourage professional evaluation and all HTN surgeons as they have been evaluated thoroughly by the providers of this forum.

 

My greatest concern is that at times in this forum patients take their personal experience and extrapolate that for the whole. As a patient advocate I do not shy away that this is an injustice. Each case is unique and when it comes to medical advice; then in the end a professional consult is the best option. This is not necessarily to guide people towards HT but to have them act with the best information from professionals as well as the experiential reporting of forum members.

 

HTN forum is invaluable and I thoroughly agree that there are surgeries that don't go well as with all things human. The bottom line is for me to direct towards help which the recommended surgeons here can provide.

 

The context of my comments are in that regard and anyone who reads my posts can clearly see in my signature my position and interpret the integrity of my comments. Categorically, I support all the recommended doctors because of my trust in the HTN Forum providers.

[GNX1]

FUE is still a new enough medical procedure that has growing success.

new procedure? its been around for 15 years now.:rolleyes:

[Mickey85]

new procedure? its been around for 15 years now.:rolleyes:

 

It certainly is no longer a 'new' procedure. Clinics who are mainly FUT dominant or FUT exclusive will bring up that 'fact' but it really is fallacy. Surgeons like Feriduni, Hakan, the Doc from Georgia etc have been practicing for about 10 years now whilst others have caught on more recently due to patient demand whilst some have not caught on at all. To the composite and FUE exclusive clinics, it is not a new procedure and has not been new for quite some time as they have begun to master it.

[Atticus]

Michaeljames has subtle(and sometimes obvious) methods of boasting about the doctor he works FOR whilst offering very little in terms of substance to the topic on hand. I for one dislike this kind of tactic and I do hope it stops.

 

Mickey,

 

I think it is great that you have this discussions regarding fUE, as the are very educational. Before coming to this forum, I consulted with a guy who wanted to cut a huge strip of of scalsp flesh of the the back of my skull just to do a little hairliner, temple work. Thus, I would have ended up with a huge strip scar, when there would have been no need for this .

 

Luckily, I started doing my research and leaned toward FUE. When I was a newbie, the slant seems to have been towards FUT. I thank you and all the others who thought out side of the box and helped me make a great choice. - I chose dr. umar for FUE, could not have made a better choice.

 

Keep up the good work,

 

Atticus

[Mickey85]

Mickey,

 

I think it is great that you have this discussions regarding fUE, as the are very educational. Before coming to this forum, I consulted with a guy who wanted to cut a huge strip of of scalsp flesh of the the back of my skull just to do a little hairliner, temple work. Thus, I would have ended up with a huge strip scar, when there would have been no need for this .

 

Luckily, I started doing my research and leaned toward FUE. When I was a newbie, the slant seems to have been towards FUT. I thank you and all the others who thought out side of the box and helped me make a great choice. - I chose dr. umar for FUE, could not have made a better choice.

 

Keep up the good work,

 

Atticus

 

Thank you Atticus, you don't know how much your compliments mean and how much they help me. After being swayed to FUT for minimal recession and experienced the complications that can arise from FUT, I went into a deep depression. Whilst I'm not totally out of the haze just yet, the fact that people are being educated on the pros and cons of both procedures and personally thank me for making them aware helps ease the torment I live with. Thank you again for your graciousness.

[Atticus]

Thank you Atticus, you don't know how much your compliments mean and how much they help me. After being swayed to FUT for minimal recession and experienced the complications that can arise from FUT, I went into a deep depression. Whilst I'm not totally out of the haze just yet, the fact that people are being educated on the pros and cons of both procedures and personally thank me for making them aware helps ease the torment I live with. Thank you again for your graciousness.

 

 

You are quite welcome Mickey. I applaud you for making it through your depression and forging ahead. This takes true courage. I was born with MDD (my brain doesn't make enough dopamine) and I imagine that if the hack that wanted to cut out a huge piece of sclap from the back of my head via FUT had done so for a few hairline and temple grafts, I would have probably have become unnconsulable. Plus, now that I think of it, what would this hack HT doc have done with all my extra grafts, thrown them away?

[Mickey85]

[/b]

 

 

You are quite welcome Mickey. I applaud you for making it through your depression and forging ahead. This takes true courage. I was born with MDD (my brain doesn't make enough dopamine) and I imagine that if the hack that wanted to cut out a huge piece of sclap from the back of my head via FUT had done so for a few hairline and temple grafts, I would have probably have become unnconsulable. Plus, now that I think of it, what would this hack HT doc have done with all my extra grafts, thrown them away?

 

Thanks again for the support and kind words. I really would have preferred not to go through this journey even if it meant I would not be as strong after it. It really has been hell.

 

If you did end up with extra grafts, the surgeon would have either discarded them or done what my incompetent surgeon did(due to his carelessness and largely underestimating my donor by almost 20%) and packed them inbetween dense native hair resulting in permanent shockloss....