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Has the tide turned on FUT vs. FUE?


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It did?

You don't think much higher cost is a drawback?

You don't think higher tran-section rates are a drawback?

You don't think less over-all donor grafts is a drawback?

You don't think generally smaller sessions over multiple days is a drawback?

You don't think a much smaller pool of top doctors is a drawback?

 

One of the reasons for the "FUE is growing so fast" stat

is partly because so many doctors that basically are not

hair transplant surgeons decide to buy a NeoGraft machine

and start offering hair transplants. Many of these "FUE/NeoGraft"

doctors are not very experienced and their techs/staffs are not either.

 

I still think FUT for many reasons is by far the Gold Standard in

hair transplant surgery in North America and probably in the world.

Most guys in the general public are scared off because of cost

involved in a hair transplant surgery. With FUE the costs are even

higher and Mickey85 the resident "FUE Expert" basically states he

doesn't think there is an elite FUE doctor in North America...so besides

higher surgery costs the US or Canadian FUE patient would have to travel

overseas to get FUE surgery from an elite surgeon.

 

Bro all the things you say is just the same blast from the past. Everyone is tired of debating the same things over and over again. I mean the results are everywhere we look in the forums, FUE megasessions,, nw4,5,6 amazing transformations,good prices if thats your thing.

 

Why should i risk opening my scalp removing a piece of it and stretch it back together to close it anymore? Why should i risk the possibility of scar stretching even if its small at the first procedure it multiplies after! Why should i settle with having a strip scar that locks me forever into a longer haircut.

 

All i am saying is we all know transplants have risks and we take them when we go in, things sometimes go wrong. But from what i ve seen from FUE doctors in terms of growth and results strip just doesn't anymore justify the risks Vs benefits we all recognised in the past.

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I personally don't believe the tide has fully turned on strip. I do believe that FUE's "place" has exponentially grown within the last few years especially and continues to do so. At this point in time, I think in general that for guys who are Norwood 3 or less, the smarter choice would be FUE. Of course, specific factors such as donor density, stabilized loss, age etc can affect that and could make strip a more viable option. But I do feel that guys who have minor hairloss should explore the FUE avenue first. I don't think it is wise for guys who have minor hairloss to undergo strip to remedy their situation as I feel that FUE is less invasive and has fewer drawbacks and can accommodate their needs. However, some higher norwood guys just don't have the density required to give them a cosmetically acceptable look via FUE alone and may need a strip/FUE combo or may just decide to go with strip exclusively. I can understand that as long as they were well informed about the possible risks.

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If we are to believe your blanket statement then had I waited till today to begin my repair, instead of 2002, I would eventually have the same result but with all FUE?

Joe, if you took Fin and Dut diligently since 2002, you would still be a borderline case either way.

 

Having already been graced with a life-sentencing strip scar, u were screwed before 2002.

That's the beauty of stip, it loves you forever.

 

So you are forced to go for 'big hair'. Had you had Fin/Dut and a series of moderate FUEs through the period 1998 - 2008, I think you would rock a good buzz/ and have more hair or the crown.

 

But your hair quality is very nice, and being a realist, you grow to the sweet spot with grand effect. Still, your story, is no endorsement for strip, it just prolonged the agony, which is a credit to you, and the skills of Hasson and Wong.

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I. However, some higher norwood guys just don't have the density required to give them a cosmetically acceptable look via FUE alone and may need a strip/FUE combo or may just decide to go with strip exclusively. I can understand that as long as they were well informed about the possible risks.

 

Personally I think the guys you are referring to who don't have the density required are better off to wait for something better to come along than FUE OR STRIP. Who knows maybe pilofocus proves to be viable and in three years we will be having a FUE VS PILOFOCUS debate :P

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I personally don't believe the tide has fully turned on strip. I do believe that FUE's "place" has exponentially grown within the last few years especially and continues to do so. At this point in time, I think in general that for guys who are Norwood 3 or less, the smarter choice would be FUE. Of course, specific factors such as donor density, stabilized loss, age etc can affect that and could make strip a more viable option. But I do feel that guys who have minor hairloss should explore the FUE avenue first. I don't think it is wise for guys who have minor hairloss to undergo strip to remedy their situation as I feel that FUE is less invasive and has fewer drawbacks and can accommodate their needs. However, some higher norwood guys just don't have the density required to give them a cosmetically acceptable look via FUE alone and may need a strip/FUE combo or may just decide to go with strip exclusively. I can understand that as long as they were well informed about the possible risks.

A long time ago I didn't think you and me would ever agree on much of anything, however I think if I didn't know better I might think I wrote this :P

 

Still, your story, is no endorsement for strip, it just prolonged the agony, which is a credit to you, and the skills of Hasson and Wong.
I could say the same thing about the huge fue megasessions posted recently, they are not realistic for most patients because few people have the donor available to go over 6000+ grafts with fue. So they really aren't something to point to as an endorsement for fue.

 

On a side note I pray for the day that consistent regeneration is a reality and then you guys can really proclaim strip dead, and I'll join in with you. I'm not pro-strip or anti-fue, I'm olnly pro putting hair on my head and anti being bald :eek:

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I personally don't believe the tide has fully turned on strip.

I do believe that FUE's "place" has exponentially grown within

the last few years especially and continues to do so.

 

Very well stated and balanced post Mickey85!

Dr. Dow Stough - 1000 Grafts - 1996

Dr. Jerry Wong - 4352 Grafts - August 2012

Dr. Jerry Wong - 2708 Grafts - May 2016

 

Remember a hair transplant turns back the clock,

but it doesn't stop the clock.

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Anyway to each their own, maybe there is a difference to how we see FUE here in Europe cause most of the best doctors here are famous for their FUE results. Its somehow difficult to see the transformations from Lorenzo in Spain-England and the doctors in Belgium and Turkey and still think that strip is needed.

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A long time ago I didn't think you and me would ever agree on much of anything, however I think if I didn't know better I might think I wrote this :P

 

 

 

My account was hacked!!! Heheheheh ;) Hope you have been well buddy.

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I think Mickey is going soft on us, in an act of appeasement, but if one wants to change the world, without jackboots and bloodshed, one must win votes, and I credit him more than any other poster,for creating a fundamental change in the mood of this forum, dragging it out of its stodgy conservatism and into a new age..

My concern is about the tone of his remarks that FUE suits small, but the the standout is the point aboutothedensity issue.. Having poor density is no excuse for getting a strip scar, itsan excuse for avoiding an HT altogether. But even then, having a thinned out donor os,an advantage to a hairloss sufferer, not a disadvantage.

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Scar5, it has nothing to do with appeasement. When I wrote that post, it was done in sincerity and had no underlying motive or agenda other than expressing my sentiments on both methods. I am still VERY much pro-FUE and think it should be the first avenue observed for surgical intervention. If a Norwood 5 or 6 could restore their hair via strip or FUE and asked me which method to go for, I would say FUE unequivocally as I believe it comes with fewer drawbacks. However for the unlucky individuals that might not have the density required to achieve a cosmetically acceptable look via FUE alone, he could either not undergo strip or undergo strip. If that individual HAD to attempt to fulfill his desire for a good head of hair and was FULLY informed on the potential risks involved(I'm talking 150% disclosure about no guarantees the scar won't stretch, change of progressive gradation, possible permanent numbness, everything) then it would be permissible.

 

I know strip scars suck. Believe me. It has been the bane of my life for some time. I know they suck. In an ideal world, either none of us would bald, or none of us would be concerned about balding. Unfortunately it is not an ideal world. I only sanction the use of strip for those who are (1)of an advanced Norwood pattern, (2) do not have the density required to give a cosmetically acceptable result via FUE, (3) have been fully informed of the potential pitfalls of strip and (4) have attempted wholeheartedly to abandon the desire for hair restoration but cannot discard the notion. It is not that I am advocating FUE only for slight recession, quite the contrary, it is more that I reserve the use of strip for very advanced recession. Strip should be the last resort in my humble opinion.

 

But everyone is free to decide for themselves.

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Scar5, it has nothing to do with appeasement. When I wrote that post, it was done in sincerity and had no underlying motive or agenda other than expressing my sentiments on both methods. I am still VERY much pro-FUE and think it should be the first avenue observed for surgical intervention. If a Norwood 5 or 6 could restore their hair via strip or FUE and asked me which method to go for, I would say FUE unequivocally as I believe it comes with fewer drawbacks. However for the unlucky individuals that might not have the density required to achieve a cosmetically acceptable look via FUE alone, he could either not undergo strip or undergo strip. If that individual HAD to attempt to fulfill his desire for a good head of hair and was FULLY informed on the potential risks involved(I'm talking 150% disclosure about no guarantees the scar won't stretch, change of progressive gradation, possible permanent numbness, everything) then it would be permissible.

 

I know strip scars suck. Believe me. It has been the bane of my life for some time. I know they suck. In an ideal world, either none of us would bald, or none of us would be concerned about balding. Unfortunately it is not an ideal world. I only sanction the use of strip for those who are (1)of an advanced Norwood pattern, (2) do not have the density required to give a cosmetically acceptable result via FUE, (3) have been fully informed of the potential pitfalls of strip and (4) have attempted wholeheartedly to abandon the desire for hair restoration but cannot discard the notion. It is not that I am advocating FUE only for slight recession, quite the contrary, it is more that I reserve the use of strip for very advanced recession. Strip should be the last resort in my humble opinion.

 

But everyone is free to decide for themselves.

I can't disagree with this at all.

 

My account was hacked!!! Heheheheh ;) Hope you have been well buddy.
I have been well, just busy trying to finish up with school, hope you have been well also!
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On a side note its funny how this revolution on FUE that we all talk about looks like its based on the creative use of a plastic little tool!The implanter.

 

I think thats shows that the creative use of tools can change the perception and reality of a procedure that is basically the same since the day it was invented!

 

Basically what these doctors did is that they managed to make it more efficient time wise in order to raise the graft numbers and bring in megasession results!

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Wow, this thread went viral since I last posted to it.

 

But here again, plenty of testimonials from both sides.

 

Plenty of happy patients! ;)

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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Still, your story, is no endorsement for strip, it just prolonged the agony, which is a credit to you, and the skills of Hasson and Wong.

 

I don't really get this, what does this mean? That his hair is going to fall out and he is going to have to shave his head and sport a scar?

 

Not everyone advances to a nw6 or 7. Joe was pretty bald in the first place, so I don't really see him getting to the point of agony that you describe.

 

 

 

 

BTW, what is your ultimate goal personally? Are you having another procedure?

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

View Spanker's Website

I am not a medical professional and my opinions should not be taken as medical advice.

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I actually do think that the commercially the tide has turned. I am not going to go into why and when one is better than the other, because it has been done to death. But there is a why and when whether you want to believe it or not. My personal thought process was that I would eventually need more grafts than my safe zone would support through FUE (I am a little thin above and in front of the ears), cost was a factor at the time but now Turkey is an option but it was not back then that I knew about, and I was not going to give up the fight....so, I decided to strip out first and then get my final 1K to 2K FUE if I need it. I never plan on giving up and shaving my head, and if I do, I will have surgery on my CVG lumps and will have a lot more scaring then just a strip scar.

 

While commercially the tide has turned, I see a lot of FUE follicular units being taken out of some seriously suspect zones, so I think that this is not a time tested procedure and that we are going to see some unhappy people 10 years from now that have a lot less donor then they thought they had. This is something that is important to consider. Some doctors are doing a good job at keeping their extractions safe, but I think it is important to add that this is an important conversation to have with your doc. I have actually seen extractions out of the crown on this site and just seen people say how good it turned out. The doctors that are doing good extractions with minimal scarring are really taking FUE to a new level and I applaud them. Still, however, there are many reasons to chose one over the other and they should all be considered. There is a reason that after years and years and thousands of patients that have come here, this site is not riddled with hundreds of unhappy, disfigured, angry at the world HT customers. That is because FUT can do some great things and stand the test of time.

 

I think that the subject of the scar has become quite overly dramatic lately.

 

That said, I am thankful for anything new and exciting in hair transplantation and would definitely not rule out FUE at some point if needed.

I am an online representative for Dr. Raymond Konior who is an elite member of the Coalition of Independent Hair Restoration Physicians.

View Dr. Konior's Website

View Spanker's Website

I am not a medical professional and my opinions should not be taken as medical advice.

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Scar5,

 

Joe, if you took Fin and Dut diligently since 2002, you would still be a borderline case either way.

 

I'm not sure what your point is with this statement. I agree but I don't see how it has any relevance. S2thoudriver said that FUT equals 2003, FUE equals 2013. He then went on to say "Stick with the old, or go with the evolved." . If I had my repair work started in 2002 or 2013, I still would not have the result I have now had I gone with FUE. That's a fact.

 

Having already been graced with a life-sentencing strip scar, u were screwed before 2002.

 

Let me refresh your memory. I had TWO strip scars, both wide. I was definitely screwed before 2002 but it wasn't because of strip. It was because of BAD strip and an unscrupulous doctor that convinced me I would not lose much hair as I got older. Truth be told, had I had access to finasteride as a 22 year old kid I probably wouldn't be here today because most of my hair would not have fallen out to the point that I would be bordering a NW7 like I was in 2002 so I would not have been in need of so much repair work that, again, FUE would not have been able to deliver even today.

 

So you are forced to go for 'big hair'. Had you had Fin/Dut and a series of moderate FUEs through the period 1998 - 2008, I think you would rock a good buzz/ and have more hair or the crown.

 

Erm, no. I had two strip scars so this wouldn't have been in the cards. And I wasn't forced to go for "big hair". I've never had a procedure over 2500 grafts and I could have easily stopped with my first session from Dr. Wong that netted 2406 grafts My old work was camouflaged and I looked natural, finally. I could have stopped there and been done with it but fate had other plans, hence "Jotronic" was born. Oh, and in 1998 I couldn't have had started with small FUE sessions since no one was doing FUE except for one doctor and back in 1998 no one had really heard of him.

 

Still, your story, is no endorsement for strip, it just prolonged the agony, which is a credit to you, and the skills of Hasson and Wong.

 

 

I have to say, this is a very naive statement. I am far from being in agony and I don't appreciate the implication. My life is a complete 180 from what it was twelve years ago. My agony ended on March 18th, 2002 when Dr. Wong did the first pass on me. That was when my agony ended and my new life began, a life that I never would have imagined.

The Truth is in The Results

 

Dr. Victor Hasson and Dr. Jerry Wong are members of the Coalition of Independent Hair Restoration Physicians

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There are also strips taken outside of the so-called safe zone. The safe zone is more ambiguous between patients.

 

Too many surgeons simple eye ball the occipital zone and assume it is DHT resistant. They do not perform a microscopic evaluation for signs of miniaturization nor do they measure and classify hair shaft diameter.

Gillenator

Independent Patient Advocate

I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice, but are my own views which you read at your own risk.

Supporting Physicians: Dr. Robert Dorin: The Hairloss Doctors in New York, NY

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I really don't get why some keep mentioning this myth about FUE having a worse yield than FUT...

 

This depends on the surgeon.

 

And not only that recent studies have shown that with FUE we get a better yield since there's no blads trespassing our scalp and cutting many grafts.

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I really don't get why some keep mentioning this myth about FUE having a worse yield than FUT...

 

This depends on the surgeon.

 

And not only that recent studies have shown that with FUE we get a better yield since there's no blads trespassing our scalp and cutting many grafts.

 

Well, you are saying three different things here.

 

1) the myth bit, why?

2) depends on the surgeon, which deflates the power of 1) as well as your next point

3) which is the badness of strip, (to which I thoroughly agree btw)

 

So if the doc is good, all strip problems go away??

Of course, I know you didn't mean that.

 

Anyway, I've long pondered the yield issue. It was always my belief that FUE looked a bit thinner, so I assumed that the bulbs got damaged as so a three hair grafts became a two and so on..

However, now my idea is turning not to yield and to something different, perceived volume.

The fat around strip follicles, sliced by a straight blade gives the shape of the grafts a squarish cushion and when that is squeezed into a slit, there is no telling how the hair trajectory will be, apart from of course, the slit angle itself. And the result of this is that strip transplants produce more of a spread, a kind of mushroom effect as the hair splays more. This has a huge benefit for volume once a certain length is reached, and if grown out, the weight of the hair negates the effect but retains the spring, hence the huge volume.

 

FUE grafts in the sub-.85mm range are much leaner and hence stay less springy.

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Well, you are saying three different things here.

 

1) the myth bit, why?

2) depends on the surgeon, which deflates the power of 1) as well as your next point

3) which is the badness of strip, (to which I thoroughly agree btw)

 

So if the doc is good, all strip problems go away??

Of course, I know you didn't mean that.

 

Anyway, I've long pondered the yield issue. It was always my belief that FUE looked a bit thinner, so I assumed that the bulbs got damaged as so a three hair grafts became a two and so on..

However, now my idea is turning not to yield and to something different, perceived volume.

The fat around strip follicles, sliced by a straight blade gives the shape of the grafts a squarish cushion and when that is squeezed into a slit, there is no telling how the hair trajectory will be, apart from of course, the slit angle itself. And the result of this is that strip transplants produce more of a spread, a kind of mushroom effect as the hair splays more. This has a huge benefit for volume once a certain length is reached, and if grown out, the weight of the hair negates the effect but retains the spring, hence the huge volume.

 

FUE grafts in the sub-.85mm range are much leaner and hence stay less springy.

 

It's a myth because if you have the best surgeons doing FUE and FUT the most probable scenario is FUT having the lowest yield.

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It's a myth because if you have the best surgeons doing FUE and FUT the most probable scenario is FUT having the lowest yield.

 

So what is yield anyway?

 

1) Grafts lost in the process of extraction vs grafts that actually grew in recipient.

 

(IMO > FUE is a handsome winner)

 

Rationale - hundreds of grafts lost in strip linear extraction along periphery of the cut and lost as invisible 'vacant' follicles in the telegon stage unseen by the techs and yet contained within the extracted strip - into the waste bucket. More lost in the 'slithering' process. Typically the last in the row (slither) get lost.

 

1) Grafts extracted vs Grafts that actually grew in recipient

 

(IMO > Even , maybe slight advantage to FUE vs strip)

 

Rationale - Transection and partial damage to FUE grafts in extraction. Dehydrated FUE grafts lost in storage due to longer waiting period and less fat to protect them.

Matched by the figures of slithered or lost telegon follicles

 

2) Grafts planted vs Grafts that actually grew in recipient

 

(IMO > strip wins?)

 

Rationale - Once the grafts have been through the pipeline and are ready to go in, the FUE grafts chances of survival surely must be less than the strip ones on account of the fat?

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So what is yield anyway?

 

1) Grafts lost in the process of extraction vs grafts that actually grew in recipient.

 

(IMO > FUE is a handsome winner)

 

Rationale - hundreds of grafts lost in strip linear extraction along periphery of the cut and lost as invisible 'vacant' follicles in the telegon stage unseen by the techs and yet contained within the extracted strip - into the waste bucket. More lost in the 'slithering' process. Typically the last in the row (slither) get lost.

 

1) Grafts extracted vs Grafts that actually grew in recipient

 

(IMO > Even , maybe slight advantage to FUE vs strip)

 

Rationale - Transection and partial damage to FUE grafts in extraction. Dehydrated FUE grafts lost in storage due to longer waiting period and less fat to protect them.

Matched by the figures of slithered or lost telegon follicles

 

2) Grafts planted vs Grafts that actually grew in recipient

 

(IMO > strip wins?)

 

Rationale - Once the grafts have been through the pipeline and are ready to go in, the FUE grafts chances of survival surely must be less than the strip ones on account of the fat?

 

In my case, FUE, the time the hair follicules were resting in recipeints before being put into my scalp was not that much.

 

If a surgeon is good enough to cause no damaga at all to gratfs while extracting them (which is more commom right now) then the yield is gonna be basically perfect.

 

Yet with FUT you can be the best surgeon in the world but it's inevitable the lost of grafts while using the blade to make the strip.

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