Donor scar options

[CaddyTad77]

Dr Lorenzo is getting FUT like results via FUE. He has hundreds of videos on youtube. For me FUT is not an option because I cannot take time off coaching and playing hockey. Also, I have a very tight scalp and do not want to risk permanent scalp tightness or numbness. FUE can give me results just as good as FUT can. I might have to go overseas to get it done, but there are doctors practicing manual FUE at the same level of "Gold Standard" strip surgery. It's what you feel is right for you that matters, thats all.

[s2thoudriver]

For answers to this on-going debate, simply use the ‘search’ facility on here as it’s been done a million times

 

I have to admit it’s getting a little tiring now and although I now mostly sit and observe on them now, sometimes I can’t just sit on my hands. As it’s a bit ‘repeating parrot fashion’, my responses and comments are starting to get more blunt and direct (so apologies in advance, no offense intended to anyone, the on-going comments on this subject just winds me up these days)

So here goes….., in essence, there are still supporters of the old strip method and also supporters of the FUE method too and until the strip surgeons become masters of their game in the FUE market, it will remain a highly debateable topic. The golden rule is this… as long as you go for a surgeon who has experience and good results and you are happy with your choice, then go for it. However,….. in 2013, with FUE where it is now and with the results from surgeons and procedures from people on this great forum, it seems crazy (to me) that anyone would you ever consider a strip procedure and scar over FUE.

To add to this with some comments on posts I have read on here (purely my opinion, not necessarily correct, but food for thought)…….

“Exactly, one size does not fit all. So why does Dr. Lindsay draw upon the 2mm FUE punch job to illustrate the folly of FUE” – Because he, like many other US surgeons is mostly experience in strip and continues to practice his preferred technique (his choice if that’s where he gets his best results), especially after supporting it for so long and having good results from it.

“Dr. Lindsey was referring to the fact that you will always have more donor available via strip no matter who the doctor is” –You have the same amount of grafts in your head whether strip or FUE, so it still baffles me why people keep bringing this up.

“growth yield appears to be often on par with the strip harvesting technique in experienced hands” – Agreed, and sometimes even better if the technicians dissecting the strip are inexperienced and transect grafts etc (the surgeons never get involved in this part, unlike FUE where they are the ones punching the grafts!)

“That said, I think it's unfair to assert that physicians who have mastered strip harvesting are giving poor advice because of income and/or a refusal to adopt FUE into their practice. While some may still resist incorporating FUE for their own reasons, today's strip excision technique in skilled hands often produces pencil thin scarring and unquestionaby stellar results. Furthermore, incorporating FUE into a physicians practice would actually increase overall revenue, so to argue that physicians are financially gaining by offering only strip excision is illogical. “ – Ok, a few things here, firstly, you have to question why certain surgeons don’t evolve from strip methods practiced over a decade into practicing and mastering the latest FUE techniques……………….

Most I have seen/spoken to used to do strip but stopped the strip method many years ago and have moved on to advanced FUE methods. I have never…and I really mean NEVER, seen or heard of an experienced FUE surgeon who has been producing good FUE say “you know what, whilst FUE is ok, I’m going to learn and practice the strip method and stop doing FUE as I feel it is far superior”, not one, zero. Feel free to voice if you have heard anything to the contrary, as I haven’t and I think it would add a lot of clarity to this discussion to find out why they went from FUE to strip.

The revenue question/comments… ok, overall, FUE is more expensive, so to the unbusiness-like mind, it may appear that all surgeons should go to FUE if they want to get more profit. From what I have seen, this is wrong as there is a big difference between revenue and profit. Based on videos, discussions and feedback I have received, a surgeons involvement in strip is usually the cut of the strip and closure, which takes very little time all grafts are harvested from the strip by a team of technicians. With FUE, the surgeon does the graft harvesting themselves, with technicians simply pulling them out carefully…therefore it is more time consuming for the surgeon. Time = money and surgeons time is big money, hence higher revenue but lower profit due to the cost per hour factor for the surgeons salary. This is further supported by the timescales for the overall procedures, FUE takes a lot longer to perform, therefore increasing the cost of the facilities, supporting staff and also tools etc. Again, reducing profit margins. So, yes, although FUE would generate more revenue, surgeons often get higher profit out of strip method and often work less hours with less overheads. Also, lets not forget, strip surgery is cheaper, so by continuing to do strip procedures at less than FUE prices, surgeons can capture the market for those patients on a lower budget.

“In my opinion, there is nothing wrong with undergoing strip excision for an 1800 to 2000 graft case. My first hair transplant (and this was back in 2004)” – kind of sums up my view very well… it was good in its day as there were no viable alternatives. We are now in 2013 and FUE has, in my opinion, rendered strip surgery unnecessary.

“anybody thats a norwood 4 and up needs to do FUT, that we can all agree on , yes?” – Absolutely not. This is the kind of statement that keeps getting thrown about. It might have been a viable statement in 2003 but not 2013.

"recommended surgeons" – People get hung up on the surgeons “recommended” on here… please keep it in mind that they are “recommended” by a web forum, not a medical body or medical proffessionals.

“FUE is hard and less predictable than strip” – It is hard yes, but it is not less predictable at all. In fact strip is less predictable as it’s a gamble as to whether the scar will stretch or not.

“saying that some people have mushy skin, and therefore shouldn't get FUE is a croc” – absolutely, surely if the skin was ‘mushy’ a strip HT would be more of a gamble.

My sole intention on this forum is to try and help people learn and choose the right method for them. I have received many personal emails and always offer my opinions based on both my HT research and experience. If I can help anyone reduce the risk of doing something they might regret, choosing a surgeon or technique that could have detrimental results, then I will do so.

I’ll probably get jumped on by various strip supporters and so be it. I have never said that strip is bad as over the years it has produced some stellar results, I am just of the opinion that now, today, in the right hands, with the right experience (there are enough great FUE surgeons and experiences on here for all of these factors), I feel (and it is just my opinion) that strip is no longer required.

 

 

Regards

Rob

[gillenator]

scar5,

 

If you think my comments were a selling point for strip than you definitely misunderstood me.

 

Either technique leaves scarring, period. I have seen some strip cases that were far more invasive than FUE and then some FUE cases that completely devastated the patient's donor zone.

 

Yet IMHO, strip is still a better approach "IF" the individual has advanced classes of hairloss in their genetic profile (family history) and knows they will need more procedures in the future. It's the overall yield across the board compared to FUE and obviously the surgeon's skills and proficiency are critical either way.

 

Hopefully this may change in the years to come but for now, manual FUE proficiency has only been mastered by a handful of doctors.

 

Another thing. I did not say mushy skin, I said mushy "scalp tissue" which is completely different than the outer epidermis layer. I am referring to the underlying dermis soft tissue that can be "mushy" in some individuals and subject to collateral damage from the punches used. This is exactly what Dr. Feller was warning about.

 

And I never said that those individuals then are lent to strip. You said that. A strip excision does not do the collateral damage that the forces of FUE can potentially do to the donor zone. This is one of the points that Dr. Lindsey made. I do agree that either method obviously has its own issues of scarring and risks.

 

Yet some individuals do have a more mushy much softer dermis layer and it is not a "croc" as you insinuate. It's a fact. And my post was not referring to you, myself, nor anyone specific. I was referring to the individuals that had their donor zones whacked from FUE extractions...:eek:

[scar5]

scar5,

 

...Either technique leaves scarring, period.

 

...strip is still a better approach "IF" the individual has advanced classes of hairloss in their genetic profile (family history)

 

...And I never said that those individuals then are lent to strip. You said that.

 

 

 

Yes, it's the old story, "either, both, whichever, case-by-case" etc., ...we end of up 'choosing' what our rep tells us, and quite often, frankly, feeling like an imbecile, when we realize we'll have to 'hide' that strip scar later in life, hoping that the meds won't stop working, knowing we have cut off our line of retreat.

 

Dr. Feller, Spex, Dr. Lindsay as a collective group have successfully maintained this torsion, traction story..all I can say is that it's a good thing Lorenzo an co. aren't listening, and I mean that for the sake of all young guys out there with advanced hairloss and a ticket to NW 6-7.

 

I am the perfect candidate for strip according to your story, and strip has been a massive complication in my life. Oh how I wish I had access to Lorenzo etc. back then. My scalp has been plundered by FUE, goos and bad and the scarring is of no consequence. The strip scars I have, on the otherhand, have been a source of massive problems for me. The world I walk in is not terrible, but it is competitive, and people's identities are not off limits to those looking for an edge. That strip scar is written across my head, a walking advertisement for them. Not good.

 

Sure, I can cover the strip scar quite adequately by allowing a 12 - 15 weeks of growth. That also allows my front to grow nicely and I can create a fullish NW2 from front on, which is impressive to say the least, on my mediocre head - I almost look decent looking!. But look on top, you see a balding crown and a vague bit of scrub on top behind the front line. Perhaps, I should accept and move on. Too hard for me that. I know some people wouldn't mind.

 

To hear a doc say, sorry son, your dermis is mushy, your loss is extensive, it's strip for you, bang-for-buck etc. is still wrong.

 

PS. I shouldn't have said , 'croc' . It's a boorish thing to say, and I don't wanna create that image, that I just shoot off like that. I like your posts Gil, and I truely believe that these guys are selling us a fable. FUE is the only resort for big advanced loss, because it offers a line-of-retreat. Sure, strip will give you fast and big results, no doubt, and if you only have five years to live (sans hat), I say do it, that's me, but I know some people can happily compromise where I can't.

Edited October 3, 2013 by scar5
I can cover part.

[Mickey85]

As I observed, FUT is 95% guarantee than FUE but it depends with the Physicians and technicians.

 

95% guarantee? Yield cannot be guaranteed in hair transplantation friend.

[Mickey85]

scar5,

 

 

Either technique leaves scarring, period.

 

I'm sorry but this is a total blanket statement used by those who desire to alleviate any concerns people may have about strip. "Oh it's just a different kind of scar". Yet it totally omits the other discerning factors that are inherent in strip and non-evident in FUE. Why not mention that strip is more likely to leave the donor with permanent numbness? Why not mention that strip eradicates the natural geometry and direction of hair growth? That is disrupts the gradual progression of thick caliber multi-grafts to finer single-hair grafts? Does the patient(or forum members) not need to be informed about ALL the factors? Do surgeons and reps simply and arbitrarily deem it negligible or unnecessary? Where is the informed consent?

 

When talking about strip in comparison to FUE, people always bring up that they both leave scars but never venture into the territory they know they cannot debunk. It's not just about the visible linear scar. People defending strip never bring up those drawbacks because they cannot debunk it and it would turn people away from strip. I openly acknowledge that FUE has drawbacks and even made a thread about it. FUE thins the donor? Sure. FUE grafts are more susceptible to damage? Dam right. But the number of disadvantages inherent in strip far outweigh those in FUE in severity and quantity. My donor still feels foreign almost 2 years post-op via strip by a top strip surgeon. I can't cut my hair shorter than a high 5 clipper. There is a noticeable 'change where the strip scar is due to the obliteration in hair caliber gradation. No one mentioned that could happen when I was emailing consultants, they all filled me up with hope that the result would look amazing(which is did not) and acted like I was buying a Mercedes instead of telling me the serious details.

 

I like gillenator and alot of his posts, but the part about "both leave scars" omits so many other factors and I feel the need to express that it is much more than just the linear scar left behind.

[Mickey85]

In any case...I don't know everything but I do know that FUE is hard and less predictable than strip. I

 

In your hands maybe. I'm sure surgeons that left strip behind like Lorenzo, Reddy, Hakan Erdogan, De Reys and Umar disagree. Why would they switch to FUE if they felt their results would worsen to a negligible level?

[gillenator]

Thanks for your posts scar5 and you have learned a volume since your journey first started. Not everyone has the strip scarring issues that you and some others have experienced. For example, I had four separate strip procedures (6917 grafts) and still have one thin strip scar. Years later I was diagnosed with late stage lung cancer, went through massive chemo and lost 100% of all my hair. I was able for the first time see my strip scar completely bare of any hair. It goes ear-to-ear. I have no regrets. I have often wondered what my scalp would have looked liked if there had been 6917 extractions from FUE! :eek:

 

If an individual cannot live with a strip scar, and still wants surgical hair restoration, then FUE is the only other option. But that in itself does not imply the scarring will not be an issue. It may not be a linear strip scar but the scarring is still there, just in a different pattern and look. I wish you could see some of the pics that I have received over the years since roughly 2003 and you might have a different opinion.

 

It's not that I am against FUE or not that I do not support that technique. Each has it's place. Or, if the individual does not have advanced classes of hair loss in family history, then FUE makes sense over strip.

 

I am not advocating that anyone with a mushy scalp should do strip. What I am saying is that the negative forces of FUE do not apply with strip surgery. Each of these techniques present their own unique challenges, some of which you pointed out. They both have their advantages and disadvantages and why each and every individual needs to do much research before ever making a decision.

 

You can choose to believe that FUE offers "a line of retreat" and that may be true for some but not for all. Many of the guys who regretted doing sizable FUE procedures cannot shave or buzz their scalps and regret it for that reason. And yet they were "sold" into believing that FUE was a "scar less technique". So not only are they angry that their donor zones are moth-eaten, they paid three times the price of strip to have it done! :confused:

 

Finally, there are a number of individuals who get sold either way, strip or FUE, when they are "clearly not candidates" or are marginal candidates at best for HT surgery. Yet as long as they carry their credit cards to the clinic, someone will be willing to do their procedure. It's a shame. They should be counseled and explained why before they leave.

 

It angers me when I see some reps/clinics come on these forums with their campaigns calling/labeling their FUE something new such as a scarless technique and many of the newbies buy into it. Or they insist and make claims that FUE will not leave any scarring for those who want to shave/buzz their scalps post-op.

 

Even the scalps that are not mushy can have issues of healing or may be prone to scarring FUE or strip. And the more extractions that are done (large sessions), the more potential for the scarring to show.

 

Either way, I wish you the best as you continue your journey my friend...

[gillenator]

Mickey,

 

Well please tell me a better more direct way to state it because I really do not know a more direct and honest way to state that both techniques leaves scarring. Whenever tissue is cut, the body creates scar tissue in the healing process. It's a scientific fact, not my opinion or campaign as you suggest.

 

And my statement was not intended to downplay nor omit the other negative factors of strip methods including the tri-closure which in some cases totally ruined the appearance of the donor zone. I thought that I mentioned that both techniques have their disadvantages as well as advantages.

 

Let's talk about it then. Both techniques can leave the donor zone numb post-op. It's not just strip. I know some guys who had sizable FUE and even smaller FUE sessions that still have numbness like you since their procedures. Some for several years. The scalp is enriched with blood vessels and nerves. Both can be severed with excisions or extractions. I know an endless number of guys who had strip and did not have issues of numbing and guys who had FUE and are still numb to this day. Either group have some who have experienced recipient area numbing as well. It happens. I experienced it on two of my four procedures.

 

Don't think that I am this big advocate of strip over FUE. I have counseled and recommended a number of guys to do FUE instead of strip, because their situation warranted that recommendation. It has nothing to do with favoring one technique over the other. And nothing to do with price either.

 

If you really want to know my opinion, I do not favor "any type of surgery"! If possible, I wish everyone suffering from hair loss could get it back without any type of surgery period.

 

I frequently tell guys who are ready to just jump into surgery to wait and do their research because surgery "should be the last resort", strip or FUE. Especially the young guys who are just beginning to see their hair loss and have never given the meds the opportunity to stabilize and even regrow some of their native hair back. They want the quick fix and have no clue what the trade-offs are such as the risk of ending up with visible scarring.

 

It is the guys like yourself who had a horrible experience with strip that hold to their sole opinions of FUE. I understand that and had my four strip procedures turned out terrible, I honestly have to say that I would probably have the same opinion.

 

You never see guys that had good experiences with strip come on the forums and slam strip. Their strip scars are pencil thin with considerable donor left for the future. Their yields are top end and they are happy and end up leaving these forums and go on with their lives.

 

And at the same time I see other guys go on with their lives after FUE. Do they have anything in common? Yes. They all went to top rated surgeons, they have no other medical issues, and are not more prone to scarring. Yet I have seen some cases where the patient went to a top notch surgeon and the result including yield was horrific! :eek:

 

Does that mean strip is better? Not always. Does it mean that FUE is better? Not always. Nothing is a perfect method. Either technique as I have said many times presents their own risks and benefits. Everyone responds differently and heals differently. You only really appreciate what I am saying once you have seen virtually hundreds of post-op photos like I have.

 

So it's not an issue that I think strip or FUE is better. My opinions are based on endless clinical observations and countless photos over the past three decades.

[gillenator]

In your hands maybe. I'm sure surgeons that left strip behind like Lorenzo, Reddy, Hakan Erdogan, De Reys and Umar disagree. Why would they switch to FUE if they felt their results would worsen to a negligible level?

 

Have you ever given thought that it might just have to do with price? :rolleyes:

 

Not judging these fine doctors but the price of FUE as you know is much higher.

[Mickey85]

Have you ever given thought that it might just have to do with price? :rolleyes:

 

Not judging these fine doctors but the price of FUE as you know is much higher.

 

I will reply to your posts soon.

[greatjob]

The problem I see most often with the fue vs. strip debate is most fue advocates compare the best fue cases to the worst strip cases, and likewise most strip advocates compare the best strip cases to the worst fue cases.

 

I came to an understanding with mickey the last time we had this debate. That understanding was that both procedures have their place. Fue can never totally replace strip without regeneration because it cannot be the best option for 100% of patients. I have stayed out of all the battles because I feel I came to a resolution with mickey and other members involved in the debate.

 

As long as someone is not blatantly misrepresenting the facts I don't see the need to argue with each other. I have no doubt Mickey, Gillinator, and scar5 have patients best interest in mind and all are very knowledgeable advocates. At this point you guys are just arguing semantics, which I have been guilty of multiple times.

[s2thoudriver]

Still waiting to hear about a surgeon who has been performing FUE for a few years then stopped doing it in favour of learning and practicing the 'better' strip technique......

 

 

How about any surgeons who used to do strip, then started doing FUE, then decided that the results with strip were better for the patient (not financially for the surgeon), so stopped doing FUE and returned back to the strip method....

 

I suspect non :rolleyes:

[1978matt]

Still waiting to hear about a surgeon who has been performing FUE for a few years then stopped doing it in favour of learning and practicing the 'better' strip technique......

 

 

How about any surgeons who used to do strip, then started doing FUE, then decided that the results with strip were better for the patient (not financially for the surgeon), so stopped doing FUE and returned back to the strip method....

 

I suspect non :rolleyes:

 

 

 

Pretty much every HTN strip surgeon on here does FUE although they do not feel the need to heavily advertise it. Perhaps they came to the conclusion that both methods have their place :-)

 

Its only really Turkey, Umar, Lorenzo, Vories and that crazy guy in Atlanta who have ditched Strip. Hardly a massive 'non' to the strip method.

 

Didnt Bisanga learn FUE in Atlanta and yet he does both at his own practice.

 

Lorenzo also believes not everyone is an FUE candidate and wont agree to a procedure if that's the case.

[scar5]

Perhaps they came to the conclusion that both methods have their place :-)

.

The 'have their place' thing just means that your money will always have a place in the doc's wallet, that's all it means.

 

Are you saying Hasson and Wong believe that FUE is bogus becuase they don't have a place for it? Of course they don't believe it is wrong. Right from the start, the docs understood about FUE. As market pressure built up, through these forums and through the walking strip scars on parade around the world, the spin had to change, but underneath the facts were always pretty clear.

 

Now some docs made a big deal of doing FUE and some have already gone back to strip, why? Because it's not worth the effort, the risk, and the opportunity cost. Doesn't change the facts.

 

Do you swim or jog? Both swimming and jogging 'have their place', right? Some people shouldn't jog because they have bad backs etc.,but if you are going to make a chain of gyms, and you have to make some business decisions. So its pool or no pool and let the advertising begin.

 

As a consumer, will there ever be a place for an ear-to-ear scar? Of course, if you believe it is worth the risk and are willing to pay for

 

. Nevertheless, the facts speak for themselves. Strip is on the way out, and FUE is coming in. Everyday , every week, every year, more people are asking for FUE. And it will continue. You can say, both have their place, and all. It means nothing, absolutely nothing. The HT world is moving. There is no agreed balance, no treaty, no lines drawn in the sand. it's an open market between consumers information and the supply side economics.

[Spanker]

Anyone that says that strip is completely on its way out has not concept of supply and demand and the difference between taking 90 percent (taking into account the dormant hairs) of an area and 30 percent of an area. As long as people want maximum harvest to hair to the top of their head, there will be a need for strip. This will only not be true when donor doubling or other cures/treatments come available.

[Mickey85]

Have you ever given thought that it might just have to do with price? :rolleyes:

 

Not judging these fine doctors but the price of FUE as you know is much higher.

 

I'll start with this post and work backwards.

 

FUE is not as lucrative in comparison to strip as one(ie you) may assume. It is true that the average price of FUE per graft is double that of strip. No qualms from me there. However when a surgeon discards strip and begins to practice FUE exclusively, he forgoes the ability to perform 4,000, 5,000, 6,000, 7,000+ graft(ie megasessions)procedures. This important detail mitigates the potential financial gain of FUE. Lorenzo caps his sessions off at 3,000 grafts. De Reys only does 1,500 to 1,800 grafts per day. Hasson and Wong can do 5,000+ graft sessions in one day with absolute ease. Feller, Konior, Rahal, Arocha etc frequently do 5,000+ sessions in one day. I really doubt that when they were performing strip Lorenzo, Hakan, Erdogan etc thought "I need more income, I will learn a difficult, unproven and inconsistent technique that will only allow me to harvest half the grafts instead of the safe, proven and reliable method(strip)". I really doubt that. I believe they ditched strip because they thought FUE in general was a better procedure for the patient, a more efficient means to obtain hair and less invasive.

[Mickey85]

Mickey,

 

Well please tell me a better more direct way to state it because I really do not know a more direct and honest way to state that both techniques leaves scarring. Whenever tissue is cut, the body creates scar tissue in the healing process. It's a scientific fact, not my opinion or campaign as you suggest.

 

And my statement was not intended to downplay nor omit the other negative factors of strip methods including the tri-closure which in some cases totally ruined the appearance of the donor zone. I thought that I mentioned that both techniques have their disadvantages as well as advantages.

 

Let's talk about it then. Both techniques can leave the donor zone numb post-op. It's not just strip. I know some guys who had sizable FUE and even smaller FUE sessions that still have numbness like you since their procedures. Some for several years. The scalp is enriched with blood vessels and nerves. Both can be severed with excisions or extractions. I know an endless number of guys who had strip and did not have issues of numbing and guys who had FUE and are still numb to this day. Either group have some who have experienced recipient area numbing as well. It happens. I experienced it on two of my four procedures.

 

Don't think that I am this big advocate of strip over FUE. I have counseled and recommended a number of guys to do FUE instead of strip, because their situation warranted that recommendation. It has nothing to do with favoring one technique over the other. And nothing to do with price either.

 

If you really want to know my opinion, I do not favor "any type of surgery"! If possible, I wish everyone suffering from hair loss could get it back without any type of surgery period.

 

I frequently tell guys who are ready to just jump into surgery to wait and do their research because surgery "should be the last resort", strip or FUE. Especially the young guys who are just beginning to see their hair loss and have never given the meds the opportunity to stabilize and even regrow some of their native hair back. They want the quick fix and have no clue what the trade-offs are such as the risk of ending up with visible scarring.

 

It is the guys like yourself who had a horrible experience with strip that hold to their sole opinions of FUE. I understand that and had my four strip procedures turned out terrible, I honestly have to say that I would probably have the same opinion.

 

You never see guys that had good experiences with strip come on the forums and slam strip. Their strip scars are pencil thin with considerable donor left for the future. Their yields are top end and they are happy and end up leaving these forums and go on with their lives.

 

And at the same time I see other guys go on with their lives after FUE. Do they have anything in common? Yes. They all went to top rated surgeons, they have no other medical issues, and are not more prone to scarring. Yet I have seen some cases where the patient went to a top notch surgeon and the result including yield was horrific! :eek:

 

Does that mean strip is better? Not always. Does it mean that FUE is better? Not always. Nothing is a perfect method. Either technique as I have said many times presents their own risks and benefits. Everyone responds differently and heals differently. You only really appreciate what I am saying once you have seen virtually hundreds of post-op photos like I have.

 

So it's not an issue that I think strip or FUE is better. My opinions are based on endless clinical observations and countless photos over the past three decades.

 

Gillenator, I don't have a more direct or better way to say it. I have a problem with the phrase itself because while it is generally true, it is not an accurate depiction. It is like saying "Hair transplants work" where we all know they work but it is given the idea that hair transplantation works for everyone, which it does not. That is the problem I have with that statement, it gives the idea that the scarring is the only difference. A man of your smarts, knowledge and history should know that and inform members rather than rule it down to a few words.

 

I acknowledge both procedures can numb the donor, however I specifically and intentionally said "strip is more likely to leave the donor with permanent numbness" given that the strip incision goes down far deeper than the punches in FUE. Not to mention the larger gap(1cm+) between the edges of the strip mean a smaller chance of the nerves correcting themselves. With FUE it is only a 1mm gap.

 

I see plenty of guys who had great results with strip but are unhappy with the strip scar and ask about FUE grafting into it as a remedy. Conversely I don't see many guys who have had FUE being unhappy with the donor. My problem with strip is mainly the unpredictable nature of the scar result. The amount of people I have seen complain about their FUE scarring could be counted on one hand. The amount of people complaining about their strip scars(even from top end surgeons) , I have lost count.

 

I had a bad experience with strip due to the unpredictable nature of it. FUE happens to have less surprises and fewer drawbacks. I don't care if people don't sympathize or empathize with MY situation, I have gone out of my way not to be vocal about my case. People should look at the facts and the information. Black and white. It doesn't matter WHY I write what I write. What matters WHAT we write. My opinion is not solely based on my bad experience with strip. My pros/cons thread says it all in black and white(and color) . My bad experience was a catalyst to actively research the differences between the two and then I came to a conclusion that FUE was a superior(but not perfect) technique when compared to strip.

[scar5]

As long as people want maximum harvest to hair to the top of their head, there will be a need for strip. .

 

As long as you keep convincing people that FUE can't get them to the promised land, they'll keep buying in, but I'm (not) afraid, your assumption is just plain wrong (whether you like it or not! - that's a Farrell line!)

 

There will be FUEs so big, and so good in the next ten years, that these guys with strip scars will ask for their money back.

 

Just turn the clock back two years and hear all the strip guys saying FUE is for small jobs.

Edited October 4, 2013 by scar5
Here is not hear

[Mickey85]

Pretty much every HTN strip surgeon on here does FUE although they do not feel the need to heavily advertise it. Perhaps they came to the conclusion that both methods have their place :-)

 

Its only really Turkey, Umar, Lorenzo, Vories and that crazy guy in Atlanta who have ditched Strip. Hardly a massive 'non' to the strip method.

 

Didnt Bisanga learn FUE in Atlanta and yet he does both at his own practice.

 

Lorenzo also believes not everyone is an FUE candidate and wont agree to a procedure if that's the case.

 

The vast majority of surgeons on HTN actually rarely practice FUE. Where are Konior's FUE results? Where are Arocha's? Where are Carman's? Wong's? Hasson's? Feller's? Farjo's? They predominantly perform strip. I find it funny that surgeons like Lorenzo have proved that FUE's place is far larger where surgeon's like Feller and Konior relegate it to minor recession at best. So if Lorenzo, Erdogan, Hakan, De Reys, Umar etc have proved that FUE can treat Norwood 5s(donor dependent) then why are the North American doctors not using it to treat norwood 3s and 4s? I believe it comes down to laziness and not wanting to learn a new method.

 

Lorenzo might not think FUE is for everyone but he believes anyone who is a candidate for strip, is a candidate for FUE. Eligibility for strip is actually harder than FUE due to laxity AND density being a factor, where with FUE, it is only density that matters. Now I can understand a norwood 5 or 6 going for strip if the density and laxity is there.

 

I find it ethically wrong for strip surgeons to perform strip on guys who are norwood 1,2 and 3 really, when a less invasive method can usually treat them.

[Mickey85]

90 percent (taking into account the dormant hairs) of an area and 30 percent of an area. .

 

Bit inaccurate. Strip takes 90% of AN area, where FUE takes 35% of a much larger area.

[Spanker]

Bit inaccurate. Strip takes 90% of AN area, where FUE takes 35% of a much larger area.

 

Right, that is why it is reasonable to say that there will always be room for both for those that are looking for maximum harvest.

[Mickey85]

Right, that is why it is reasonable to say that there will always be room for both for those that are looking for maximum harvest.

 

Agreed. You never mentioned FUE and strip being used in unison however. Made it sound like strip alone would obtain the most grafts possible.

[Spanker]

As long as you keep convincing people that FUE can't get them to the promised land, they'll keep buying in, but I'm (not) afraid, your assumption is just plain wrong (whether you like it or not! - that's a Farrell line!)

 

There will be FUEs so big, and so good in the next ten years, that these guys with strip scars will ask for their money back.

 

Just turn the clock back two years and hear all the strip guys saying FUE is for small jobs.

 

I hope you are right, but why will the total FUE available harvest change in the next 10 years? Supply is supply, unless you are talking about bigger surgeries in the future in one sitting and that may be true, but you are still always going to be able to get the most grafts, and the most quality grafts especially by using both methods. This point is not debatable to me. It simple math. People are going to always want more on the top of their head.

[1978matt]

"The vast majority of surgeons on HTN actually rarely practice FUE. Where are Konior's FUE results? Where are Arocha's? Where are Carman's? Wong's? Hasson's? Feller's? Farjo's? They predominantly perform strip."

 

I didn't know you had a mole in their operations as you seem to know a lot about the work these docs are doing day to day and the proportion of FUE procedures they are performing. Is his one of those 'blanket statements' I keep reading about? Was there not a statistic somewhere saying that 40% of procedure last year were FUE? If it's not HTN doctors who are doing them then who exactly is???!

 

The only Drs I know for sure who are FUT exclusive are H&W and that is because Jotronic has stated it in other threads.

 

Do you not think the reason they dont post FUE results is that there general philospophy is that strip delivers more consistent results? That is their belief based on 10 years at medical school and 10+ years practicing hair transplants, learning about the latest techniques and research etc.

 

I know my Dr's general views on FUE/Strip but I'm not going to attempt to state them here but you can email him and ask if you like! He's very accessible and I'm sure would be delighted to reply and give his opinion based on his 30 years experience:).

 

"I find it funny that surgeons like Lorenzo have proved that FUE's place is far larger where surgeon's like Feller and Konior relegate it to minor recession at best. So if Lorenzo, Erdogan, Hakan, De Reys, Umar etc have proved that FUE can treat Norwood 5s(donor dependent) then why are the North American doctors not using it to treat norwood 3s and 4s? I believe it comes down to laziness and not wanting to learn a new method."

 

The results they post are great but show me 10 dramatic transformations (NW6 to NW2) on people who are not Spanish or Turkish. There just aren't many out there. The fact remains that a lot of Spaniards/Turks have much better hair/skin characteristics for 6000+ FUE to work. Where are all the pale faced Norweigns and Swedes who have had great multiple FUE restorations with these doctors?

 

"I find it ethically wrong for strip surgeons to perform strip on guys who are norwood 1,2 and 3 really, when a less invasive method can usually treat them."

 

You say that but I'm sure, like me, you object to surgeons like Armani who dense pack average hair NW2-4 patients with 3000+ FUE leaving them very sparse donor for future recession. Yes, it might work for some people if they are lucky and don't lose further hair, and that's the whole point: FUE is great for some and not for others.

 

There's nothing fundamentally wrong with doing strip on any norwood number as long as the patient knows that head-shaving will be out of the question. In fact it would be far better if the said patient is likely to turn out a NW5 or 6, otherwise you end up with the Armani situation of expending all you FUE donor, then having to move on to BHT.

 

Yes, they could throw the towel in and 'shave their head' but as Gillenator said there is no guarantees that the FUE scars are invisible.

 

Unfortunatley as Spanker has said, until the holy grail of cloning can be found there will always be a place for strip surgeries amongst some patients.