Donor scar options

[Mickey85]

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.

 

So you are using pure conjecture now. Nice. The onus is on YOU to show that those surgeons regularly perform FUE. They 'rarely' perform it because they almost never post results. In fact, I have never seen one FUE result from Konior. Or Arocha. Or Carman. Or Radha, or Frank or Farjo. Do you want me to keep going? Please point out several FUE results from those surgeons. If you cannot, then you are using pure conjecture. You think if these guys were doing FUE procedures they wouldn't be showing results? With the demand for FUE these days, they would be insane NOT to promote themselves for doing FUE.

 

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???

 

Erdogan(100%), Lorenzo(100%), Hakan(100%), Eser(100%), Keser(100%), De Reys(100%), Umar(100%), Bisanga(70-80%), Feriduni(60%), Mwamba(90-95%), Reddy(100%), Atlanta doc(100%) Diep(circa 50%), Vories(100%). The demand for FUE is growing. Hence why more and more people are flocking to surgeons who perform FUE. Feriduni is booked out til April. Bisanga booked out til January. Erdogan booked out til January. A top tier strip surgeon(I'm talking top 3, won't say who) has dates open in the next 2 weeks. The aforementioned FUE surgeons are performing most of the FUE work, not the majority of the HTN surgeons. Please show me an FUE result in the last 6 months from Feller, Konior, Arocha and Frank and Farjo and I will Paypal you $100 US dollars.

 

Do you not think the reason they dont post FUE results is that there general philospophy is that strip delivers more consistent results?

 

That has been debunked by the likes of Lorenzo, Erdogan, Hakan etc. Their results alone are much more impressive than the likes of Carman, Lindsey, Bernstein, Feller etc. I think the reason they don't post results is because they perform poor FUE or they don't perform it at all. Doctors like Lorenzo, Hakan, Erdogan, De Reys etc have much more skill at FUE than the North American surgeons. But keep blaming the method and not the surgeon if it makes you feel better.

The results they post are great but show me 10 dramatic transformations (NW6 to NW2) on people who are not Spanish or Turkish.

 

Keep reaching. 12 months ago before these Turkish surgeons came to prominence it was "only Spanish people had good donor densities". Now it has expanded to Turkish. I see a pattern here. Years before that it was "FUE is only good for minor recession. Before that it was "FUE is like plugs but smaller". Lo and behold! Only Spanish and Turkish people have high density! Strip for everyone who is not Spanish and Turkish!

 

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.

 

Of course I object to that. I don't like Rahal dense packing 2,000 grafts on Norwood 2s either. But I'm not sure how that pertains to surgeons performing strip on Norwood 2s when FUE can handle it.

 

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.

 

Nice blanket statement

 

It is more invasive and an inefficient means of obtaining hair especially if a low quantity is needed. It is worse for the patient. Why go through a more invasive procedure? What is a better situation? Go through a more invasive procedure to obtain 2,000 grafts? Or to go through a less invasive procedure to obtain 2,000 grafts? Why take out a whole strip of skin and deep tissue just to get to the grafts? That is an inefficient means of obtaining hair.

[Spanker]

"The aforementioned FUE surgeons are performing most of the FUE work, not the majority of the HTN surgeons. Please show me an FUE result in the last 6 months from Feller, Konior, Arocha and Frank and Farjo and I will Paypal you $100 US dollars."

 

Am I in this for 100 bucks too? I may be able to come up with something

[Mickey85]

"The aforementioned FUE surgeons are performing most of the FUE work, not the majority of the HTN surgeons. Please show me an FUE result in the last 6 months from Feller, Konior, Arocha and Frank and Farjo and I will Paypal you $100 US dollars."

 

Am I in this for 100 bucks too? I may be able to come up with something

 

Offer was for Matt only. From 6 months ago til TODAY(10/4/13). From all the mentioned surgeons(Mrs Farjo included, Lorenzo excluded). I don't feel it is fair to include anyone other than Matt because I won't be receiving anything if he cannot prove me wrong.

[Spanker]

 

1. I believe it comes down to laziness and not wanting to learn a new method.

 

2. 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.

 

3. 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.

 

 

1). That is bold claim. You can say whatever you want to, but that is blind opinion based on pure conjecture. I am pretty disappointed in that. I don't think that anyone that knows Dr. Konior would describe him as lazy. He does do FUE, but I do think that he feels that strip offers the most consistent results. I am not speaking directly for him on this, just from the conversations that I have had. He's not lazy.

 

2). Where are you getting this? Eligibility for strip is harder than FUE? How do you know that? Where did you get that? Man has been living on Mars for years. Saying things like they are factual for not make them factual.

 

3). That is your right to believe that, but I disagree. I was about a 2.5 and elected strip after 2 years of research because I felt the most comfortable that I would get a favorable outcome that way. Is a doctor unethical for giving a person that is educated on the subject what he wants I don't think so.

[scar5]

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.[/

 

Meh...

 

1) It's not a numbers game anymore, but speaking of numbers,

 

Over 10,000 fUEs will be become common. Is that enough? NO? Then then the gu y with 10000 FUE gets a strip scar at the eleventh hour for another 1000? That, I grant you, is possible given the diabolical mental affects of hairloss and investment we pour into it (at the expense of having a normal life)

 

2) FUE scalps , free of a strip scar (warning guys, don't get a strip scar) need less hair in the donor in the final analysis. In fact you want the horse shoe much thinner, to blend in with the weaker recipient. The scope for FUE extraction artistry to develop is wide open. Strip, of course, thins the donor by stretching the remaining surface area over the scalp, but you have no choice about how it looks. In fact, what you end up doing is having to grow, and grow, often well past the optimal length for a look to balance a tinning crown. This is where the strip guys who tell us, 'Unless you want to shave, you'll be OK with strip" are missing the point. It's not about shaving, it is about having to have bulk at the back when you are thin in the crown. Very underwhelming feeling.

 

3) Strip transplants need the big volume, combed-back things if loss progresses. It's nice for frontal photos and news readers, but it isn't the global thing.

 

4) FUE allows for any length of hair at anytime, forever, no matter how the meds are going, how your hair color and texture is changing. People who want to keep on bulking up on top are the ones who you are talking about here, and I say the numbers of these people will fall as a proportion of educated HT consumers. On the other hand, ignorance and willingness is always there too, granted, just as it is today and many a young guy will walk out of clinics around the world today with a brand new strip scar across their heads.

 

5) A lot of the protocols, whether well-meaning, or/and economically motivated, for FUE extraction ratios are de-bunked already.

[CaddyTad77]

Dr Konior does fantastic work. Whether your a fan of FUT or FUE you can't deny that Dr K has done some miracle repair cases on people that were really messed up. I respect that.

[CaddyTad77]

With the choi impanter pen, what size gages do the top FUE docs use now? Is there visible scarring ?

[scar5]

Dr Konior does fantastic work. Whether your a fan of FUT or FUE you can't deny that Dr K has done some miracle repair cases on people that were really messed up. I respect that.

 

Dr. Kornior bakes beautiful scones too, and is a handy fisherman.

[hsrp10]

Don't want to get into the FUT vs FUE battle as fue seems to be progressing in terms of yield.

 

So back to the original subject line, has anyone here had SMP into a strip scar with good results?

I was a victim of Bosleaze at an early age, and would like to make it less noticeable.

(my other "scars" are almost impossible to find)

[greatjob]

Don't want to get into the FUT vs FUE battle as fue seems to be progressing in terms of yield.

 

So back to the original subject line, has anyone here had SMP into a strip scar with good results?

I was a victim of Bosleaze at an early age, and would like to make it less noticeable.

(my other "scars" are almost impossible to find)

go to the smp section of the forum, there are some in there.

[scar5]

?...So back to the original subject line, has anyone here had SMP into a strip scar with good results?

)

 

Yes, I have. 3 times, in the same scars.

Plus one laser to remove it.

 

Key points to consider.

 

1) The ink drained from the scar line quicker than from the surrounding tissue.

2) Depending on the light I am in, the ink will look darker or lighter than the surrounding area, but probably, only you will notice.

3) I would like to tidy up the patches

4) For the most part it still worked

 

2003

Local makeup lady. Results.. Disaster

2005

Laser to remove local makeup lady

2011

Major SMP chain for scars only

Faded, inadequate, but looked promising leaving the clinic

2012

Major HT clinic with bolt-on SMP service.

All scalp, patchy,, blueish, look older but less-scarred, somewhat suspicious of it, but the scars are now taken care of, as well as empty reddish HT areas where old minis had been removed.

[hsrp10]

Scar5,

 

thanks for those points to keep in mind! Looks like you have been through a lot.

I had not heard of bolt-on SMP, so do you recommend it and how short do you keep you hair?

 

I have to keep mine long because of this damn Boz scar and even the top docs say it cannot be removed unless I stayed immobilized for 2-3 months. Would like to cut it shorter but have to be careful when its wet as my skin is fair and it stands out.

 

Also what was the rough cost of the bolt-on SMP?

[scar5]

'Bolt on" just refers to an SMPservice that an HT clinic has established, or is at least presenting in that way( it could be the financial and liability of the SMP part are independent of that clinic, but the HT clinic is allowing them to appear as one, or it could be that the HT staff actually do all the SMP stuff themselves)

 

Yeah, so forget the bolt BS. It is a BS term of mine!!

 

Price? Ask at the clinic, they will be more than happy to tell you, and quite frankly, it is a ripoff of the highest order if you go to an HT clinic in the states and ask for SMP. I've heard of a guy, a hair dresser, in Cali doing it for 1500 and he seems as good/bad as they come.

 

It's such a shonky industry. Be warned. They tell you nothing useful to help to compare prices in practical terms, well, almost nothing. Inks used, depth used, tools used, color.

 

If you are going for scarring only, it is safer, but I would check about their policy of spreading ink above and below the scar.

 

I think overseas is cheaper, but then you can't get the touch ups yo need, so I'd say shop around. There is massive mark-ups on the price so it should be negotiable. Consider an SMP specialist, but then how do you know??

 

If I base it strictly on impressions alone , impressions from the web, and the marketing spiels, I would stay away from the two big original SMP clinics in the states, but I cannot say that from experience and I'm not naming them

 

Anyway, I have wasted most of my adult life trying to repair HTs. Too bad, don't let it happen to you!!

[hsrp10]

Thanks for your honest and frank reply Scar5 ! I will consider what you mention about SMP.

 

I've had three HT now, one horrible one from Bozly around 18 years ago that left me scarred for life which I am trying to address now.

The second one was from one of the best and it changed my life in an amazingly way, just had my third one by another world top -class surgeon for density few months ago.

 

I believe HT's do work, but there are those of who have been scarred for life in some form so one really has to be careful.

Am thankful this site exists to help educate people and steer them away from the butchers out there!

[Spanker]

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.[/

 

Meh...

 

1) It's not a numbers game anymore, but speaking of numbers,

 

Over 10,000 fUEs will be become common. Is that enough? NO? Then then the gu y with 10000 FUE gets a strip scar at the eleventh hour for another 1000? That, I grant you, is possible given the diabolical mental affects of hairloss and investment we pour into it (at the expense of having a normal life)

 

2) FUE scalps , free of a strip scar (warning guys, don't get a strip scar) need less hair in the donor in the final analysis. In fact you want the horse shoe much thinner, to blend in with the weaker recipient. The scope for FUE extraction artistry to develop is wide open. Strip, of course, thins the donor by stretching the remaining surface area over the scalp, but you have no choice about how it looks. In fact, what you end up doing is having to grow, and grow, often well past the optimal length for a look to balance a tinning crown. This is where the strip guys who tell us, 'Unless you want to shave, you'll be OK with strip" are missing the point. It's not about shaving, it is about having to have bulk at the back when you are thin in the crown. Very underwhelming feeling.

 

3) Strip transplants need the big volume, combed-back things if loss progresses. It's nice for frontal photos and news readers, but it isn't the global thing.

 

4) FUE allows for any length of hair at anytime, forever, no matter how the meds are going, how your hair color and texture is changing. People who want to keep on bulking up on top are the ones who you are talking about here, and I say the numbers of these people will fall as a proportion of educated HT consumers. On the other hand, ignorance and willingness is always there too, granted, just as it is today and many a young guy will walk out of clinics around the world today with a brand new strip scar across their heads.

 

5) A lot of the protocols, whether well-meaning, or/and economically motivated, for FUE extraction ratios are de-bunked already.

 

1. Common? I do not understand where you get this. Did a doctor tell you that 10,000 will be a common number? Did you research it in a published study? Have you seen high amount of 10,000 graft FUE scalp cases?

 

2. I see you point, and it seems reasonable. However, you would have to take from the unsafe zone to do this. Say you did this on a 30 year old NW5, and blended the horse show area, his sides could drop another inch or 2 in his lifetime, leaving with progressive thinning from the transplanted hair. With all that said, you are right, you probably could give a better blend for a shorter cut, but when you started taking quite a bit you would have to leave the safe zone in the upper and lower ends to make it look good in many cases, especially for a high norwood person with dark hair and light scalp.

 

3. I have no idea what that means. Are you saying that FUE patients are happier with lower levels of density? I don't think that is true. I don't have any reason to believe that.

 

4. No it doesn't. It may allow for shorter length, but to say that it allows any length is inaccurate, I have seen a bunch of FUE cases where a person can not razor shave their hair, and I have seen a bunch where the transplant is obvious at a one or two as well. I think you are presenting "facts" that a doctor may not be able to deliver on, depending on the person's physiology and characteristics. FUE is not scarless.

 

5. Can you point to a study on this or has a doctor told you that the possibility of high transection rates is not true? I agree that a select few are getting great but I haven't heard anyone saying anything about transection being debunked, especially not from a doctor that does both procedures. I have seen that the blunt tol techniques can reduce it, but by how much I don't know. Saying that something is debunked doesn't mean it is actually debunked. What are doctors saying that are performing strip and FUE about transection rates? Is there a percentage that is acceptable? I am not saying it isn't true, I just wonder how and when they were debunked.

 

 

 

My point behind this is mostly that I see people just saying a lot of things that don't really mean a lot. I wish that everything that is being said IS true. I wish that FUE was scarless. I wish that blending in the horseshoe are spoke of did not significantly increase the chance and almost guarantee the transplantation of dht susceptible hairs. I wish you could get more bang per graft with FUE and that the highest quality grafts did not come from the strip zone, I wish that transection was myth. The problem is that wishing something and writing something on the forums with conviction does not make them true. Some of what is being said is true, some of it I am honestly not sure if it is true, and some of it I know is not true (like the hair at any length), and some of it may be true, but is flawed IMO (like thinning out the donor to match better with the thinner recipient, therefore having to leave to safe zone to do this blend).

 

On a positive not, the pharmaceutical industry and the transplantation industry is getting better/closer every year. In the past 2 years, a few FUE surgeons have really stepped up its game and set a new bar. My hope is that some of these things written above may be true someday. Someday you may be able to get a scarless transplant in which you can wear your hair at any length, including actually shaved, you may be able to guarantee someday that an FUE can be performed without transection, you may be able to figure out your final pattern someday and not run the risk of going out of the safe zone (this is getting more and more common from the pictures that I have been seeing). Unfortunately, that day is not here yet, but maybe it is coming, or maybe a pharma company will kill the HT industry and this website will be a dusty memory, only here to help people find scar repair solutions from the old days when you had to move hair from the back to the top of your head.

 

 

I am pro FUE for the right candidate and pro strip for the right candidate. I don't have a crusade going for either method, I just know that FUE is not as flawless and as fool proof as it is often pushed as being lately.

[Spanker]

Dr. Kornior bakes beautiful scones too, and is a handy fisherman.

 

I can vouch for the fishing but I am unsure about the scones...can you cite this?

[Mickey85]

1). That is bold claim. You can say whatever you want to, but that is blind opinion based on pure conjecture. I am pretty disappointed in that. I don't think that anyone that knows Dr. Konior would describe him as lazy. He does do FUE, but I do think that he feels that strip offers the most consistent results. I am not speaking directly for him on this, just from the conversations that I have had. He's not lazy.

 

2). Where are you getting this? Eligibility for strip is harder than FUE? How do you know that? Where did you get that? Man has been living on Mars for years. Saying things like they are factual for not make them factual.

 

3). That is your right to believe that, but I disagree. I was about a 2.5 and elected strip after 2 years of research because I felt the most comfortable that I would get a favorable outcome that way. Is a doctor unethical for giving a person that is educated on the subject what he wants I don't think so.

 

1) It is of my opinion it comes down to laziness and not wanting to learn a new method. Hence why I said "I believe". I have no doubt Konior is a hard working surgeon but I do believe that he has not taken the proper time to master a method that would be beneficial to some patients. Strip offering more consistent results has been rendered false by Lorenzo, Erdogan and such. I believe their results are on par with Konior's. In fact I would go so far to say that their results are more impressive than Lindsey's, Feller's, Farjo's, Bernstein's etc strip results. So if FUE is capable of being on par with strip and has been demonstrated as such, there is no other reason not to master it than laziness. I'm sorry if that disappoints you but I don't feel it is an attack on you.

 

2) Strip mainly needs density and laxity in the scalp, two factors. Strip is much more invasive. If someone has a tight scalp, the amount of grafts one can harvest is much more limited. If someone has low density, the amount of grafts one can harvest is much more limited. FUE mainly needs donor density. Even surgeons like Bisanga and Feriduni refuse strip on patients in their 20s due to issues with the skin. It is basic logic.

 

 

 

Around the 1.10 minute mark.

 

"Everybody under 30 is in general a good candidate for FUE"

 

3) I believe it is unethical for a surgeon to perform a more invasive method on a patient where a less invasive method could easily suffice. Yes.

 

Is a doctor unethical for giving a person that is educated on the subject what he wants

 

We both know that surgeons often need to put the foot down when it comes to high expectations and bringing the patient down to a logical and reasonable level. What the patient wants, is not always best and the surgeon is not obligated to give the patient what he wants if it is not in the patient's best interests. If the patient only has minor loss and the surgeon is not adept at FUE, I believe the surgeon is at fault for not expanding his skills and for not providing the best range of options for the patient.

Edited October 5, 2013 by Mickey85

[Mickey85]

 

5. Can you point to a study on this or has a doctor told you that the possibility of high transection rates is not true? I agree that a select few are getting great but I haven't heard anyone saying anything about transection being debunked, especially not from a doctor that does both procedures. I have seen that the blunt tol techniques can reduce it, but by how much I don't know. Saying that something is debunked doesn't mean it is actually debunked. What are doctors saying that are performing strip and FUE about transection rates? Is there a percentage that is acceptable? I am not saying it isn't true, I just wonder how and when they were debunked.

 

 

 

 

 

Circa 2.55 minute mark

 

A 5% discrepancy in yield between strip and FUE according to Feriduni. I believe Erdogan, Lorenzo and Hakan's yield rates are actually on par with strip.

Edited October 5, 2013 by Mickey85

[greatjob]

IMO yield and almost all other factors that were once used against fue are completely irrelevant in the right hands, and there really isn't any reason in debating them anymore.

 

The only issue that is relevant is that for most patients, except for those who have low laxity and high density, strip will yield more grafts over their lifetime than fue, and for patients that undergo both the amount of grafts that can be extracted is the absolute maximum that can be obtained.

 

Saying that in a few years time there will be tons of 10,000 graft fue cases is as ridiculous as saying in a few years time there will be tons of 10,000 graft strip cases, because only a very small portion of patients have that amount of grafts available from either procedure.

 

Sure, Lorenzo has extracted 11,000 grafts, but that is an extraordinary case. Just like the highest graft count from H & W is an extraordinary case. The problem I have with most hardline fue advocates is they tend to speak in absolutes, and the only true absolute is that until donor regeneration is a verified reality strip will still be a better option for some patients, and therefore cannot be an outright replacement for strip.

[Spanker]

1. I don't think it is an attack on me, but it is a direct insult to some hard working doctors that do have a high work ethic. I am not sure where you are from, but where I am from, calling someone "lazy' is about as harsh of an insult that you can make. You are free to your opinion, I just don't find that statement to as reasonable as I have seen you be. For whatever reason that Konior is still focusing on strip (he does do FUE btw and there will be photos available in the near future) I can assure you that laziness is not involved.

 

The doctors that you mentioned seem very skilled, and I agree produce better results that some strip surgeons. My only concern with the work I have seen from a few of the top FUE docs is harvesting outside of the zone. There was a patient just posted today in his 20's that had a harvest all the way down to the bottom of his hair line in the back not taking into account any retrograde thinning at all. I feel very confident that this gentleman will lose a noticeable portion of transplanted grafts if he lives long enough. Several months after the procedure his harvest area is still noticeably thinner as well. I am just pointing this out to say that initial yield and strip scars are not the only thing that a person should concern themselves with. Back to the doctors you mentioned though, they are highly skilled and I would let both of them work on me, but like I said, 3 or so doctors that share very good FUE results can not fill the entire needs of the industry. I have said it before, not all doctors are created equal. Not all strip surgeons are performing at a Rahal/Konior/SMG level, and not all FUE surgeons are performing at a Lorenzo/Koray level either. People expecting high yield and high artistry should have a very short list in my opinion, no matter what method they use.

 

2. You can add hair curl to FUE side of making a good candidate, offering at least 2 variables to FUE candidates. I did watch some of the video and saw what you were talking about but I don't know what he meant by "problems with the structure of the skin", I wish there was some more elaboration on tha in a more detailed manor. "Problems with the structure of the skin" is pretty a pretty broad and unscientific statement, and nothing that would be publishable in a medical journal. I respect the doctor, I just don't know what he means. Is he saying that there is less stretch in the skin before 30? More clarification would be nice on that, but it is interesting. At about the 3 minute mark he also stated that in general he gets about 5% less regrowth with FUE, which I do think is a fair trade-off for someone worrying about a lot about a scar. Dr. Lorenzo stated to Matt that not everyone is a good FUE candidate and would be contrary to what Dr. Feriduni is saying. I can't elaborate any more on that because I do not have any details on that. Not everyone is a good strip candidate either, so, again, I really do not know if that means anything as far as the debate goes.

 

3. That is fair for you to think that. I think it is unethical for doctors to decimate someone's donor supply who perform sub-par procedures on a regular basis, no matter what the method. However, I do not feel that it is unethical for an educated patient to prioritize what is important to him and chose a method that fits his needs. You spent a lot of time writing your pros and cons (I have not looked at it lately), I remember reading them at the time thinking that it was a pretty fair write-up. Do you not think that someone could walk away looking at your work and deciding that the strip pros were more important to them? And if that is the case, is it still unethical to perform that procedure because your own thoughts of which pros and cons are most important decide if a doctor is ethical or not? I can see with you preferring one procedure over another, but I think that patients have a right to prioritize what pros and cons mean the most to that individual patient, and there are pros and cons to both, and make their decision based on what is important to them.

Edited October 5, 2013 by Spanker
spelling

[Spanker]

 

 

 

Circa 2.55 minute mark

 

A 5% discrepancy in yield between strip and FUE according to Feriduni. I believe Erdogan, Lorenzo and Hakan's yield rates are actually on par with strip.

 

Transection rates and regrowth rates are not the same thing. I was stating that transection is still an issue. The doctor knows before he places it if a graft is transected and these may end up in the trash and not effect the regrowth rate of transplanted hair at all. The docs that you mentioned may be on par with top strip surgeons, I really don't know. It is pretty hard to differentiate 5 percent growth. Even at 5 percent, I agree that it is fair trade off for someone really sweating a strip scar. At the same time, don't expect to get 3 or 4 thousand FUE grafts and expect it to not be noticeable with a shaved head very low, because usually I think it will be from the photos I have seen, but to be fair, less noticeable than a strip.

[greatjob]

I did watch some of the video and saw what you were talking about but I don't know what he meant by "problems with the structure of the skin", I wish there was some more elaboration on tha in a more detailed manor. "Problems with the structure of the skin" is pretty a pretty broad and unscientific statement, and nothing that would be publishable in a medical journal.

 

I would imagine it is the same thing gillinator brought up with the Fox test that he was then mocked over by scar5.

[Spanker]

I would imagine it is the same thing gillinator brought up with the Fox test that he was then mocked over by scar5.

 

I missed that, but its 2:30am and Netflix time. I'll try to check that out tomorrow.

[Mickey85]

1. I don't think it is an attack on me, but it is a direct insult to some hard working doctors that do have a high work ethic. I am not sure where you are from, but where I am from, calling someone "lazy' is about as harsh of an insult that you can make. You are free to your opinion, I just don't find that statement to as reasonable as I have seen you be. For whatever reason that Konior is still focusing on strip (he does do FUE btw and there will be photos available in the near future) I can assure you that laziness is not involved.

 

The doctors that you mentioned seem very skilled, and I agree produce better results that some strip surgeons. My only concern with the work I have seen from a few of the top FUE docs is harvesting outside of the zone. There was a patient just posted today in his 20's that had a harvest all the way down to the bottom of his hair line in the back not taking into account any retrograde thinning at all. I feel very confident that this gentleman will lose a noticeable portion of transplanted grafts if he lives long enough. Several months after the procedure his harvest area is still noticeably thinner as well. I am just pointing this out to say that initial yield and strip scars are not the only thing that a person should concern themselves with. Back to the doctors you mentioned though, they are highly skilled and I would let both of them work on me, but like I said, 3 or so doctors that share very good FUE results can not fill the entire needs of the industry. I have said it before, not all doctors are created equal. Not all strip surgeons are performing at a Rahal/Konior/SMG level, and not all FUE surgeons are performing at a Lorenzo/Koray level either. People expecting high yield and high artistry should have a very short list in my opinion, no matter what method they use.

 

2. You can add hair curl to FUE side of making a good candidate, offering at least 2 variables to FUE candidates. I did watch some of the video and saw what you were talking about but I don't know what he meant by "problems with the structure of the skin", I wish there was some more elaboration on tha in a more detailed manor. "Problems with the structure of the skin" is pretty a pretty broad and unscientific statement, and nothing that would be publishable in a medical journal. I respect the doctor, I just don't know what he means. Is he saying that there is less stretch in the skin before 30? More clarification would be nice on that, but it is interesting. At about the 3 minute mark he also stated that in general he gets about 5% less regrowth with FUE, which I do think is a fair trade-off for someone worrying about a lot about a scar. Dr. Lorenzo stated to Matt that not everyone is a good FUE candidate and would be contrary to what Dr. Feriduni is saying. I can't elaborate any more on that because I do not have any details on that. Not everyone is a good strip candidate either, so, again, I really do not know if that means anything as far as the debate goes.

 

3. That is fair for you to think that. I think it is unethical for doctors to decimate someone's donor supply who perform sub-par procedures on a regular basis, no matter what the method. However, I do not feel that it is unethical for an educated patient to prioritize what is important to him and chose a method that fits his needs. You spent a lot of time writing your pros and cons (I have not looked at it lately), I remember reading them at the time thinking that it was a pretty fair write-up. Do you not think that someone could walk away looking at your work and deciding that the strip pros were more important to them? And if that is the case, is it still unethical to perform that procedure because your own thoughts of which pros and cons are most important decide if a doctor is ethical or not? I can see with you preferring one procedure over another, but I think that patients have a right to prioritize what pros and cons mean the most to that individual patient, and their are pros and cons to both, and make their decision based on what is important to them.

 

1) The term "lazy" where I am from is not necessarily an insult. I can be lazy at times, I admit that. Is it a positive trait? No. I'm sure Konior is a hard working surgeon, but I do feel he has not expanded his skills at FUE, I don't feel he has taken the time to perfect it so that he can offer his patients more options. Maybe it is laziness, maybe it is not. But he has not perfected or bettered it to the point where he can offer low Norwood patients a less invasive option.

 

In regards to the "3 or so doctors" that perform exquisite FUE, it is more than 3. More list of recommended FUE surgeons are(as of this moment); Feriduni, Bisanga, Mwamba, De Reys, Lorenzo, Reddy, Maras, Hakan and Erdogan. Nine. It is a short list.

 

In regards to top surgeons taking hair outside the safe zone, I would like some citation of that. Not that I don't believe you, but for my own records so I can reevaluate my sentiments on those particular surgeons and inform others. I have seen Diep take hair WELL out of the safe zone on a norwood 4/5, that is why I do not recommend him, AT ALL. I don't recommend Vories either because I don't think his work is refined or aesthetic.

 

2) Hair curl is a factor for some races. As is this "skin structure" Feriduni spoke of in strip. I will email him on what he means about that.

 

I do feel however that the majority of people are better candidate for FUE rather than strip due to its less invasive nature and laxity being a non-factor.

 

3)Do you not think that someone could walk away looking at your work and deciding that the strip pros were more important to them?

 

Everyone is free to make their own conclusion when looking at my pros/cons thread. If someone was a Norwood 6, was in his 40s, was on a tighter budget, didn't cut their hair too short and did not want multiple FUE sessions, then I would have no qualms about them seeking a good strip surgeon as long as they are aware of the potential pitfalls. I would recommend a surgeon like H&W or Konior.

 

And if that is the case, is it still unethical to perform that procedure because your own thoughts of which pros and cons are most important decide if a doctor is ethical or not?

 

My pros/cons thread is just a guide.Personal factors of each individual may prohibit them from seeking the route they desire. There are some patients that would look at the pros/cons thread and that might think strip is the way to go but if they are say a Norwood 2 and had poor laxity but good density, then I feel it is absolutely unethical for any surgeon to perform strip on them, regardless of how well informed and educated the patient is. If someone had signs of diffuse thinning in the donor region, I believe it is absolutely unethical for any surgeon to perform strip or FUE on them. There has to be a line in the sand where the surgeon says "stop". Things like age, poor laxity, minor recession, bad healing etc need to be taken into consideration regardless of how well educated the patient is or what he wants. The onus is on the Doctor to say "well, there are contraindications that make this method inadvisable". That does stand for FUE also, I have frequently told members not to go through with any procedure because they looked fine. I tell them to spend the money on a holiday instead but no one listens. I could say more about that but I don't want to ruffle any feathers(not yours mind you).

Edited October 5, 2013 by Mickey85

[greatjob]

There are some patients that would look at the pros/cons thread and that might think strip is the way to go but if they are say a Norwood 2 and had poor laxity but good density, then I feel it is absolutely unethical for any surgeon to perform strip on them, regardless of how well informed and educated the patient is.

So what if a patient went to Lorenzo ( or any other top fue surgeons) with great laxity, poor density and a high norwood level, would these doctors also be considered unethical for performing surgery on this patient?

 

The main problem with this debate on each side, is people try to compare the best case scenario of the method they support with the worst case scenario of the method they hate.