Practical and Theoretical FUE

[Michael Vories, MD]

Why did our clinic switch exclusively to FUE?

 

The advantages of FUE, compared to FUT, are easily discerned. The lack of a visible donor scar (with punches smaller than 1.0 mm) is the most common reason patients come to our office. But is the theoretical advantage of FUE that is the most exciting. Many clinics like to quote that FUE should delegated to small sessions only, and they can't move as much hair as FUT. This is simply not true. The real power behind FUE is the enormous flexibility over the size of cases. With the extraction devices we have now (which will only improve over time), we can extract between 0% and 100% of the donor bank. Our current understanding is the donor bank becomes noticeably thinner at 50% depletion, so theoretically this flexibility leads to the potential of large cases. We recently finished a 5125 graft session (over 11,000 hairs) in a patient, whom is documenting his experience in a blog. With the possibility of performing large cases with FUE, the last drawback was removed, and for this reason we stopped doing FUT cases. Many on this forum may not agree with our reasoning, but we simply felt the benefits of FUE outweighed FUT.

Edited March 24, 2013 by Vories

[Spanker]

Here is a single FUT case that yielded 15112 hairs and 8402 grafts, so, it can happen. I haven't see a single FUE session that big before.

 

I think people will gravitate more to FUE when the yield is consistent on big cases, but to be honest, the big FUE cases followed from beginning to end had not been great yield for the most part, but I am looking forward to seeing things develop.

 

 

http://www.hairrestorationnetwork.com/eve/165656-dr-hasson-8402-grafts-one-session-11-months.html

[Mickey85]

Hmmmm I am a FUE advocate as many around here know, but I personally wouldn't say that the real power behind FUE is the enormous flexibility over the size of cases, certainly not in the upper parameters. Again I'm not saying this is wrong but I do not think it has been substantiated enough to where it is the general consensus. FUE has many glaring advantages over FUT which would be more evident but I don't think it can supersede FUT just yet in terms of total hairs/grafts achievable. Sure you could go past 50% extraction on the donor, but I think it would be left cosmetically barren in most cases. Part of the reason people want FUE is to avoid the linear scar and other complications(visual and other) on the donor of FUT so going past 50% via FUE would in a way be reverting back to the unacceptable donor result that lead people away from FUT in the first place.

 

There is a 10,000 graft FUE result and to me, it does not look convincing at all. The patient was basically a NW7 and the result after several operations was average at best. Maybe the patient was happy with the result but I certainly would not be. And that is not a flaw of the surgeon as he is one of the best FUE surgeons in the world, but a limitation of hair transplantation and particularly FUE. In most cases there just is not enough donor hair to cover a NW6 or 7 with enough coverage and density... Even with FUT the surgeons have to compromise with an unnaturally high hairline and spare crown density.

 

All in all I like that you have embraced FUE and I do see this trend continuing but I do not see FUE transcending FUT in terms of total graft/hair quantity. Maybe sporadically but not consistently. Just my opinion for what it is worth.

[jfables]

Why did our clinic switch exclusively to FUE?

 

The advantages of FUE, compared to FUT, are easily discerned. The lack of a visible donor scar (with punches smaller than 1.0 mm) is the most common reason patients come to our office. But is the theoretical advantage of FUE that is the most exciting. Many clinics like to quote that FUE should delegated to small sessions only, and they can't move as much hair as FUT. This is simply not true. The real power behind FUE is the enormous flexibility over the size of cases. With the extraction devices we have now (which will only improve over time), we can extract between 0% and 100% of the donor bank. Typically the donor bank becomes noticeably thinner at 50% depletion, but this flexibility leads to the potential of much larger cases. We recently finished a 5125 graft session (over 11,000 hairs) in a patient. I am not aware of an FUT single session that can do this. (To compare you must look at the hair count, 6000 FUT grafts may well be close to 6000 follicles if they are all cut down to singles).

 

These are the reason we switched to FUE sessions. My suspicion is we will joined by many others in the near future, and I welcome all of them!

 

You're not "aware" of a single FUT case of over 5,125 grafts? Really? Did you just join the HT business? Were you doing microdermabrasion or acupuncture previously? I've had less than 50% removed from my donor via FUE and it looks quite thin when cut short. Let's focus less on the donor for a moment though, so please show us some of your results (as in recipient hair growth).

[Mickey85]

You're not "aware" of a single FUT case of over 5,125 grafts? Really? Did you just join the HT business? Were you doing microdermabrasion or acupuncture previously? I've had less than 50% removed from my donor via FUE and it looks quite thin when cut short. Let's focus less on the donor for a moment though, so please show us some of your results (as in recipient hair growth).

 

it may be possible that he was talking about the graft to hair ratio. however i do find some of his claims lofty.

[Michael Vories, MD]

Wow- I stand corrected. 15,000 follicles in a single session, FUE or FUT, is larger than anything I have heard of- and I have been doing specifically HRT for the past 10 years. I do agree that 10,000 grafts in a typical donor bank of a NW7 is unreasonable and would result in a depleted donor. As a general rule we do not cross the 50% barrier, and in most cases we don't come close to 50%.

 

There is a separate discussion revolving around these big FUE cases. Factors that need to be included are the size of the punch, the depth of the extractions- which affect transections, and how this changes the growth of the donor area.

 

This discussion revolves around the lack of enough large FUE cases to give patients assurance that the donor area will not be cosmetically depleted. As these cases are submitted on this forum or others, patients will become as comfortable accepting these cases as they have with large FUT cases.

[Michael Vories, MD]

I just looked up that 8000 graft case. I did not see a hair count- but the results are incredible. How many hours did it take to place 8000 grafts? The thought of having to place that many grafts makes me dizzy. (I place all grafts myself)

[moopookoo]

Dr Umar had some 20 000 grafts case

is that the world record ?

[Spanker]

I just looked up that 8000 graft case. I did not see a hair count- but the results are incredible. How many hours did it take to place 8000 grafts? The thought of having to place that many grafts makes me dizzy. (I place all grafts myself)

 

I totaled the hair count from the graft count of single, doubles, and triples. The graft count breakdown is in one of the pictures on the left side.

[GNX1]

Why did our clinic switch exclusively to FUE?

 

The advantages of FUE, compared to FUT, are easily discerned. The lack of a visible donor scar (with punches smaller than 1.0 mm) is the most common reason patients come to our office. But is the theoretical advantage of FUE that is the most exciting. Many clinics like to quote that FUE should delegated to small sessions only, and they can't move as much hair as FUT. This is simply not true. The real power behind FUE is the enormous flexibility over the size of cases. With the extraction devices we have now (which will only improve over time), we can extract between 0% and 100% of the donor bank. Our current understanding is the donor bank becomes noticeably thinner at 50% depletion, so theoretically this flexibility leads to the potential of large cases. We recently finished a 5125 graft session (over 11,000 hairs) in a patient, whom is documenting his experience in a blog. With the possibility of performing large cases with FUE, the last drawback was removed, and for this reason we stopped doing FUT cases. Many on this forum may not agree with our reasoning, but we simply felt the benefits of FUE outweighed FUT.

I dont agree with everything you said but most. the scar from FUT is the primary reason most do not want to opt for FUT. grafts from the HEAD hair will on average result in far more grafts being transplanted then FUE on average from the head.

 

but, when u incorporate the beard/body the grafts may be unlimited so FUE does have a huge advantage there. as time goes on FUT will likely only be reserved for very large cases with limited beard/body hair. that is the direction we are seeing these days.

 

who is ur clinic?

[Blake Bloxham]

Dr. Vories,

 

Was the 5k graft FUE case performed in a single day?

 

Also, can you share some more information regarding your implantation device? From what I recall, it's similar to a "Choi Implanter" pen, but offers several advantages over the traditional model? How many do you use concurrently during a procedure?

 

Also, like GNX pointed out, one of the advantages of FUE is the ability to extract body hair grafts (especially in situations like repair cases), and I'm wondering if you perform BHT in the clinic? If so, any thoughts on how the NeoGraft handles the body extractions?