Are some people choosing FUT for lack of intelligence?

[olmert]

I share KO's confusion. It sounds to me like more 1 + 1 = 3. Joe Tillman says that new skin fills the gaps in the stretched skin. But the new skin does not bring new hair with it, or change the surface area, which is determined by the skull.

 

Density = hair grafts / surface area of scalp. New skin filing in gaps will not increase the hair grafts. It will not reduce the skull surface area. Therefore, it will not increase hair density.

[JoeTillman]

Thanks for the post. Could you clarify the bolded? How could reduction in density not be one to one?

 

Hi KO,

 

I think I should clarify. With each FU removed via FUE there is a clear and specific gap created that is greater than the diameter of the FU removed. I have had no such reduction of my density. My density has been reduced due to stretching the remaining tissue to make up for the gap left from the strip removed. Let's remember what density is. It is the number of follicular units, or to some it is the number of hairs, in a specific area of measurement. Normally we refer to this in square centimeters (cm2).

 

In my case all of the hair AND the tissue that supported it were removed, dissected, the excess tissue disposed of and then the hair was reimplanted to the recipient zones. The edges of the donor wound were pulled together to fill the gap. The remaining density of the donor zone was not depleted on a 1 to 1 ratio of what was removed due to the mechanics of skin elasticity as previously explained. As the tissue is stretched to make up for the "gap" each hair is pulled slightly further away from each other. If the gap from strip removal is 2cm there is not an equal stretch between follicular groupings to make up for this. It is subtle between each FU, and the combination of these small changes is what makes up for the difference of the larger area removed. The tension, and therefore the reduction of density, will be greater in the vicinity of the donor strip immediately post-op and for the first few months but because of the new tissue growth triggered by the sustained tension the issue will become less noticeable, physically and visually, as the tissue relaxes due to eventual tension relief. Remember, the tension is not completely isolated to the first few millimeters of the strip perimeter as it is spread out beyond into the greater donor zone, the sum of which is far greater than the size of the strip removed to begin with. This is why strip patients can liken the overall post-op feeling to wearing a helmet. They feel the end result all over the back and sides of the scalp due to a combination of the obvious tension but also minor short term general swelling.

[KO]

I didn't see that....

maybe he was being sarcastic or "counter-punching"

but who started this insulting TRASH thread?

Not Dr. Karadeniz!

Nope, he said it first. A poor choice of words but maybe you get the context now.

[olmert]

Remember, the tension is not completely isolated to the first few millimeters of the strip perimeter as it is spread out beyond into the greater donor zone, the sum of which is far greater than the size of the strip removed to begin with.

 

Let me phrase it this way to try to understand. Assume a 2.5 inch wide donor FUT region. Assume 10,000 hair follicles evenly spread in it. Therefore hair density is 4,000 hairs/inch = 10,000 hairs / 2.5 inches.

 

Assume FUT cuts out the middle half inch and takes 2,000 hairs, leaving 8,000 hairs behind. Assume the remaining 2 inches stretches out to cover the missing half inch.

The donor region now has density of 8,000 hairs / 2.5 inches = 3200 hairs / inch

 

If you FUE, instead, and take 2,000 hairs out, you end up with the same 8,000 hairs / 2.5 inches = 3200 hairs / inch.

 

Now, Joe Tillman says that over time the stretched out post-FUT skin breeds new skin to fill in the holes caused by the stretching. He says that this new skin raises the hair density. But, it seems, the equation does not change. There remains 8,000 hairs / 2.5 inches = 3200 hairs / inch. Adding skin to fill in holes over time does not change this.

So how is this reasoning not more 1 + 1 = 3 ? I can't make sense of it. It appears KO can't either.

[JoeTillman]

I share KO's confusion. It sounds to me like more 1 + 1 = 3. Joe Tillman says that new skin fills the gaps in the stretched skin. But the new skin does not bring new hair with it, or change the surface area, which is determined by the skull.

 

Density = hair grafts / surface area of scalp. New skin filing in gaps will not increase the hair grafts. It will not reduce the skull surface area. Therefore, it will not increase hair density.

 

Olmert,

 

Density, in the context of surgical hair restoration, does not equal hair grafts /surface area of the scalp. It is more micro than macro, measured by each cm2, as this helps to determine where the surgeon will harvest the hair from. There are wide variations of density in various regions of the scalp.

 

You asked which method or combination of methods will allow for more hair to be transplanted. I gave you the answer without saying that more hair is generated or the surface area is reduced (although volume is). The point is to stay below the threshold that eliminates the illusion of nature by not reducing VISIBLE density too much to cause notice. As I stated at the beginning of my first post, with FUE alone you can pluck yourself clean like a turkey to get FAR more grafts if you wish but that eliminates the "undetectable" issue that we all strive for. If this is not an issue then FUE, all the way, will give the most grafts.

 

This isn't a debate on which procedure is better, just what will give the most grafts over the long term, assuming the goal is to remain relatively undetectable in the donor zone. If someone has a tight scalp then obviously FUE will win assuming average density in the donor zone. If laxity is fine but the density is low then FUE might still be the better choice but if the laxity is there and is considered average and in the hands of a competent surgeon then a combination approach will get the most hair. Just because you may not understand does not mean that 1 + 1 = 3 but because you most likely are too linear in your thinking the answer just might be 3 indeed.

[olmert]

OK, so you are saying that there is a difference between technical density (hairs per square inch) and visible hair density. You say after FUT (as opposed to FUE) there might be the same number of hairs per square inch in the donor area, but there will appear to be more. And you say new skin plugging in holes caused by the FUT stretch is what raises the visible hair density, without raising technical hair density. It is a difficult for me to visualize how skin plugging in holes raises visible density.

[JoeTillman]

OK, so you are saying that there is a difference between technical density (hairs per square inch) and visible hair density. You say after FUT (as opposed to FUE) there might be the same number of hairs per square inch in the donor area, but there will appear to be more. And you say new skin plugging in holes caused by the FUT stretch is what raises the visible hair density, without raising technical hair density. It is a difficult for me to visualize how skin plugging in holes raises visible density.

 

Indeed, it is a difficult concept to visualize and even more difficult to explain as I do not have a math background. I think Young's modulus can help explain it but I'm not sure it applies but this is where my experience comes in to play because I have seen this day in and day out for over a decade and it is obvious to me on my own scalp. Yes, you can refer to visible hair density as the "illusion" of density. I hate that word but you get the idea.

 

Now, to maybe better visualize what I'm talking about consider the space between follicular units. This distance can be 1mm to 1.4mm from one grouping to the next. When you use a punch to remove a grouping you increase the distance between the groupings surrounding the extraction point. If the punch is .8mm or just large enough for a two or three hair graft, then that "gap" is now considerable (contextually) and is absolute throughout the donor zone. Multiply that by 2000 and you've got 16 cm2 of newly exposed scalp on TOP of the already normal amount of scalp visible between follicular units, depending on hair length, type, blah blah blah.

 

If you "stretch" the distance of a half inch, per your original question to cover a strip removal you have to remember that both sides only need to move 1/4 inch to meet in the middle. Now, I don't have any specific numbers to measure how the distance between each grouping is increased from the donor closure but if we stick to the basics we can extrapolate a general idea of what's going on. Assume an average donor density of 80 per cm2 and factor in that in order for us to get 2000 grafts the half inch (1.27cm) wide strip will have to be 20 cm long (19.6851cm x 1.27cm x 80 per cm2 = 2000.00616 grafts). We are closing the donor wound by pulling the top edge of the wound and bottom edge of the wound no more than a quarter inch each in total (6.35mm). The part that may be difficult to understand is that the stress from stretching is not isolated to the areas above and below the donor wound inside of your 2.5 inch wide box. It expands beyond this due to elasticity so it is more stretched out in the beginning along the immediate perimeter of the donor wound but it relaxes as new tissue growth relieves the stress and the overall reduction in density is more uniform and even. With 6.35mm (1/4 inch) of stretching on either side will not be distributed through each space between grafts like it does with FUE. Each new space between existing bundles is an absolute with FUE whereas with the spaces caused by a donor wound closure is more gradual and the aggregate of so many more bundles being pulled away from each other through the larger donor area, but in much smaller distances, makes up for the equal number of grafts removed. This is where I get the comparison that the reduction in density with FUE is on a one to one ratio whereas with FUT it is not so stark as it is gradual and relative to the amount of stress in the immediate area of tension.

 

Keep in mind that the .8mm punch is not taking out a graft that is exactly .8mm in diameter. Each hair is considerably smaller and make a larger footprint when they are in a bundle but also length and angle make the diameter appear larger than it really is. This is nitpicking and dealing with issues that no one really sees but I hope that this is more clear. This isn't a matter of saying that 1 + 1 = 3. It's a matter of knowing that there are more variables to consider to get to understand why the answer is 3.

[KO]

I think I understand what you're saying, the gaps between the follicles increase, but the increase in gaps is not equal to the width of the follicle removed. That makes sense to me, however, the density, in terms of gr/cm2 should decrease by the same amount regardless of procedure, would you agree?

 

So basically, FUT is depleting density, but doing it in a smoother way?

[scar5]

the density, in terms of gr/cm2 should decrease by the same amount regardless of procedure, would you agree?

 

 

Of course there is no difference . ZERO! ziltch!

 

It is easy to get caught up in all this spin the strip guys try to throw a you.

Just remember the fact - you have twenty chairs in a room. Take out 5 - anyway you like.

 

Now there are fifteen chairs in the same room!

 

No amount of spin can disguise that.

 

The hole left by the FUE extraction is irrelevant.

[Shampoo]

Nope, he said it first.

 

He said what first?

Can you provide a link?

[1978matt]

This is such utter fallacy I do not even know where to begin. Why do you make zero mention of the dormant grafts that exist in a strip that cannot be used and are discarded? Surely you must compare apples with apples. Where on Earth did you get such figures as 40% of follicles being damaged on a 4th FUE procedure? Even more ridiculous is the assertion that 50% of the grafts in the 5th procedure are damaged. Do you have any evidence of this? Considering you state a specific figure I'm assuming you have evidence enforce this? This is complete hyperbole and erroneous.

 

Now I do not support the notion that anyone who chooses strip has a lack of intelligence, but I will not stand idly by while pure fictitious claims are being made.

 

As someone who has actually stood next to a tech while she has been dissecting part of a strip, I can tell you that it is something of a Myth that 'a high number dormant follicles go in the bin'. Let me put it this way: Why would someone performing FUE stand a better chance of seeing dormant follicles better than someone performing FUT?

 

Of course they can't. FUE is blind, FUT isn't. With FUT you still have the ability to see most of those dormant follicles under a microscope, remembering that they will likely be in different growth stages. Some will be more easy to spot than others while with FUE you can't see a thing.

 

The 2-5% FUT wastage rate was actually determined by examining the discarded strip tissue from a number of doctors. Dr .... in Atlanta actually concluded it was around the 5% mark and he's more pro FUE than you!

 

So this whole idea of hundreds of dormant strip follicles going in the bin is a complete myth. Anyone who doesn't believe me can do a bit of research and speak to some Doctors.

 

The 40% and 50% etc were for illustrative purposes to show that trying to extract 100% of the strip area with FUE would never render anywhere near the number you would get with FUT.

[1978matt]

Indeed it is.

Here you have a strip doctor patting the back a poster peddling the 'good 'ol gospel"..What a croc of $%&!

All of it is rubbish beginning to end.

 

The reason FUT is better first is because it suits the strip industry and the strip industry owned the HT landscape for so, so long, that so many have invested in it emotionally and financially,

 

All of that Matt stuff is a pile of crap..., and the docs stuff is utter nonsense too.

This density does not decrease nonsense! What a load of... I have no words..no patience.. absolute rubbish.

Five more years will bury this for good!

 

I'm still waiting for you that to post an example where someone had strip and his donor looks visibly less dense. Still waiting...

[1978matt]

1. As to 1978matt’s points, I must first thank him for not saying "1+1=3.” But at this day and age, 1) can’t you go to a mega FUE guy, like Dr. Bhatii and get 5000 FUE’s in one session? And moreover is the transection rate really reduced by a whopping 50% by the fifth FUE? ; 2) Furthermore, don’t a lot of doctors say their FUE transection rate are just 2% worse their FUT transection rate: a 10% transection rate sounds fine to me, while a 50% transection rate sounds so bad that I would not get the surgery.

 

 

Therein lies the problem. A doctor can never know what your transection rate is until he starts making some extractions. Some don't even record the numbers.

 

The 50% was to illustrate that trying extract 100% of a strip area would never yield as many grafts. It is universally accepted that the more you take from an area the harder it gets. So it is fair to say that the average 20% is likely to rise over multiple sessions. By how much from doctor to doctor is almost impossible to determine.

[Loags79]

I'm in agreement with Matt. Though fue has the desirable dot vs linear scar, it will never equal FUT which has superior yield and lower transection.

Edited November 16, 2014 by Loags79

[scar5]

As someone who has actually stood next to a tech while she has been dissecting part of a strip, I can tell you that it is something of a Myth that 'a high number dormant follicles go in the bin'. Let me put it this way: Why would someone performing FUE stand a better chance of seeing dormant follicles better than someone performing FUT?

 

FUE is blind, FUT isn't.

 

Right, so you are standing next to a strip tech, in a strip clinic, the staff are all making a living performing strip, and the strip tech is going to tell you all about it, right?

 

You are going to walk away from a strip clinic with unbiased objective facts, right?

 

What did they tell you? That they can see an empty follicle?

 

FUE is blind? FUE can see from the surface, that's all. Strip doesn't even care. It is like an open cut coal mine. You get what you get.

 

But I am sure that FUE transection is brutal, but for the same reasons that strip is - economics!

 

Do I think FUE is clean and pure and honest? No way! It is disease ridden, corrupt etc. for all the same reasons strip is. It is simply that you don't end up with a line drawn across the back of your head. And that is the reason you should do FUE and meds first, if you are male and under 45, IMO.

[Mickey85]

As someone who has actually stood next to a tech while she has been dissecting part of a strip, I can tell you that it is something of a Myth that 'a high number dormant follicles go in the bin'. Let me put it this way: Why would someone performing FUE stand a better chance of seeing dormant follicles better than someone performing FUT?

 

Of course they can't. FUE is blind, FUT isn't. With FUT you still have the ability to see most of those dormant follicles under a microscope, remembering that they will likely be in different growth stages. Some will be more easy to spot than others while with FUE you can't see a thing.

 

The 2-5% FUT wastage rate was actually determined by examining the discarded strip tissue from a number of doctors. Dr .... in Atlanta actually concluded it was around the 5% mark and he's more pro FUE than you!

 

So this whole idea of hundreds of dormant strip follicles going in the bin is a complete myth. Anyone who doesn't believe me can do a bit of research and speak to some Doctors.

 

The 40% and 50% etc were for illustrative purposes to show that trying to extract 100% of the strip area with FUE would never render anywhere near the number you would get with FUT.

 

Thanks for the reply.

 

In regards to the 40%, 50% etc being for illustrative purposes, I can understand that but from the way it was worded it sounded very dogmatic and firm. I think alot of people saw it that way even though you did not intend for it to be taken literally.

 

Now for the dormant grafts. I was not referring the the 2-hair, 3-hair, 4-hair grafts that may contain dormant follicles as chances are that some of the hairs in those grafts would be visible. I'm referring strictly to the single-hair grafts that are invisible to the eye entirely when in the dormant phase that are discarded in the strip. Between 10-14% of all hairs are dormant at any given time on someones head so 10-14% of the SINGLE-hair grafts in the strip are discarded. The larger the strip session, the more singles are discarded. Granted this might only equate to a few hundred single-hair grafts(very rough estimate, depends on the individual and the strip session) but it is something that I feel should be taken into account. With FUE the dormant singles are not discarded because they simply are not targetted because they cannot be seen. The notion that 10-14% of ALL the grafts in the strip are discarded is patently false.

 

I have no problem in saying most clinics have better strip yields than their FUE yields. I think Shapiro have far better strip yield than their FUE yield, same with Lindsey/Feller etc. With guys like Feriduni and Bisanga, I think in general their FUE yield is slightly under their strip yield, However I do believe top tier FUE surgeons FUE yields are better than alot of strip surgeons strip yields. I am far more impressed by Lorenzos/Erdogans/Bisanga's FUE yields than I am with Carman's/Charles/Lindsey's strip yields. If we compare the elite FUE surgeons to the elite strip surgeons(Konior, Hasson, Wong, etc), I think the discrepancy is very slight, if any. Just my opinion. But I do agree that most clinics are better at strip than they are with FUE, mostly due to having much more time spent with strip.

[scar5]

Agreed. Plenty of telogen follicles make it through. My bet is to avoid scalp stretching exercises that strip clinics advocate as you are easing out the last hairs.

 

In all my (paltry, it must be said) research, the term 'dormant follicle' has featured predominantly, suggesting that a follicle goes, well, 'dormant' and therefore either sheds all of its 1-2-3 or 4 hairs pretty much all together. But contrary to this, I have also seen pics that claim to show a follicle with a dormant hair within it. It is pretty confusing. One thing I will grant the strip clinics, is that dormant hairs do not necessarily fall out, and so if a hair is still identifiable, even if it is somewhat, for want of a better expression, 'on it's way out' of the follicle, at least the zone can be identified and then dissected.

 

But even so..it's no deal.

 

Don't forget about the linear transection factor too (the bit where they cut, and claim not to cut follicles) - big losses here too.

[hairweare]

How many follicles are transected from the scalpel along the incision line? I assume it is also possible that the sutures could also to a much lesser degree damage follicles as well. Nonetheless, I would agree with Mickey85's assessment that the yields of the best FUE and FUT surgeons are likely quite similar. I personally would never consider going to a clinic that doesn't specialize in FUE or relies on robots. For North Americans that certainly limits the choices.

[Number47]

I am sure that pretty soon we will be seeing FUE robots in strip clinics cause you can't teach an old dog new tricks. The tide has changed, most patients simply don't want to suffer a procedure like this for hair especially when they see the same or even better results from FUE doctors.

 

I really don't care about the same old arguments i only care about the results i see. And to tell you the truth i feel sorry for guys who fall for the multiple strip procedures trip, cutting them self open again and again as their hairloss progresses or if meds fail them cause they can't buzz them down. At least with FUE you can bail out more easily if s**t hits the fan.

 

Lets be honest all this maxed out talk carries risks! Every time you do a strip the chances of a stretched scar goes up. Changing the laxity of your scalp for hair is not risk free yet you don't hear about that! Most people are not Shar Pei dogs.

 

 

All this don't make FUE a blessing but certainly make it less risky!

[JoeTillman]

Between 10-14% of all hairs are dormant at any given time on someones head so 10-14% of the SINGLE-hair grafts in the strip are discarded.

 

Mickey my friend, this is not accurate. If we go by your statement that 10% to 14% of ALL hairs are dormant at any given time on someone's head the statement above is assuming that all of the hairs dormant are single hairs follicular units. This is not true. In reality, the former part of your statement is correct, 10% to 14% of all hair on one's head is in telogen (according to various studies) but when you factor in that up to 25% of all follicular units on the scalp are single hair units on their own, and apply this to the larger picture, then we are looking at 2.5% to 3.5% (25% of 10 = 2.5 or 25% of 14 = 3.5) of all SINGLE hairs follicular units are discarded through the strip process (assuming complete invisibility).

 

However, this is assuming that multi-hair follicular units go into telogen as a complete unit which is not true either therefore if we take the 10% to 14% number and apply that to ALL follicular units in the strip, both single hair and multi-hair, with the understanding that some hairs will go into telogen in the same follicular unit that other hairs are still in anagen, the kill rate is not so clear but appears to drop further for strip thus it is a safe assumption that the actual percentage of discarded hairs (due to lack of visibility via telogen) from a properly and efficiently removed strip will be somewhere below 3.5% assuming the high end of the averages and below 2.5% assuming the low end of the averages. Conversely, because individual hairs in a multi-hair grouping can go into telogen while the neighboring hairs that are part of the same bundle can remain in anagen we see the potential for peripheral transection from FUE going up.

 

Aside from this the kill rate is dependent on the surgeon skill and the tools he uses. For example, if you have a surgeon with a multi-blade scalpel he/she will have a massive kill rate on the grafts through transection regardless of skill whereas a surgeon that uses a single blade scalpel, tumescence and pushes the blade so he can see the path between bundles as opposed to pulling will have an extremely low kill rate due to transection.

 

In the end, this is all academic and if the patient has a choice, he'll usually go for FUE due to the lack of a linear scar as long as the result looks natural with regards to graft angulation, direction, etc. and enough obvious growth to have an aesthetically pleasing result. If this is accomplished no one really cares about the details. If the patient wants the most grafts at once and has an advanced pattern of balding, doesn't ever want to shave and understands the risk then he'll choose strip.

[Spanker]

I am sure that pretty soon we will be seeing FUE robots in strip clinics cause you can't teach an old dog new tricks. The tide has changed, most patients simply don't want to suffer a procedure like this for hair especially when they see the same or even better results from FUE doctors.

 

I really don't care about the same old arguments i only care about the results i see. And to tell you the truth i feel sorry for guys who fall for the multiple strip procedures trip, cutting them self open again and again as their hairloss progresses or if meds fail them cause they can't buzz them down. At least with FUE you can bail out more easily if s**t hits the fan.

 

Lets be honest all this maxed out talk carries risks! Every time you do a strip the chances of a stretched scar goes up. Changing the laxity of your scalp for hair is not risk free yet you don't hear about that! Most people are not Shar Pei dogs.

 

 

All this don't make FUE a blessing but certainly make it less risky!

 

I would say that that this is a reasonable post. Risk does go up with multiple procedures and fue is easier to bail out on. I disagree that you can't teach an old dog new tricks. Artistry, discipline for protocol, attention to detail, etc. All transcend from one procedure to another. The extraction method is a small portion of a transplant.

[JoeTillman]

I am sure that pretty soon we will be seeing FUE robots in strip clinics cause you can't teach an old dog new tricks.

 

"will be seeing"? Where do you think ARTAS got it's start? ARTAS started out in strip clinics with Dr. Harris and Dr. Wasserbauer being the leads in the FDA trials. Many strip clinics have had the ARTAS for a while now and it is only growing in popularity. It is the more legitimate option to quickly and easily get into FUE and it is currently being heavily marketed to clinics outside of the established hair restoration field. Soon (if not already), your local rhinoplasty clinic will offer robotic hair restoration to compliment your new nose.

[KO]

I am sure that pretty soon we will be seeing FUE robots in strip clinics cause you can't teach an old dog new tricks. The tide has changed, most patients simply don't want to suffer a procedure like this for hair especially when they see the same or even better results from FUE doctors.

 

I really don't care about the same old arguments i only care about the results i see. And to tell you the truth i feel sorry for guys who fall for the multiple strip procedures trip, cutting them self open again and again as their hairloss progresses or if meds fail them cause they can't buzz them down. At least with FUE you can bail out more easily if s**t hits the fan.

 

Lets be honest all this maxed out talk carries risks! Every time you do a strip the chances of a stretched scar goes up. Changing the laxity of your scalp for hair is not risk free yet you don't hear about that! Most people are not Shar Pei dogs.

 

 

All this don't make FUE a blessing but certainly make it less risky!

 

This. No doubt Strip gives the best yield, but you have no exit strategy.

 

While I agree that FUT does not deplete density visibly due to the reasons JoeTillman explained, the line coming from clinics and posters in the past was that density would be unchanged after a strip, and that is the reason that many on the forums get irritated.

[Mickey85]

Mickey my friend, this is not accurate. If we go by your statement that 10% to 14% of ALL hairs are dormant at any given time on someone's head the statement above is assuming that all of the hairs dormant are single hairs follicular units. This is not true. In reality, the former part of your statement is correct, 10% to 14% of all hair on one's head is in telogen (according to various studies) but when you factor in that up to 25% of all follicular units on the scalp are single hair units on their own, and apply this to the larger picture, then we are looking at 2.5% to 3.5% (25% of 10 = 2.5 or 25% of 14 = 3.5) of all SINGLE hairs follicular units are discarded through the strip process (assuming complete invisibility).

 

However, this is assuming that multi-hair follicular units go into telogen as a complete unit which is not true either therefore if we take the 10% to 14% number and apply that to ALL follicular units in the strip, both single hair and multi-hair, with the understanding that some hairs will go into telogen in the same follicular unit that other hairs are still in anagen, the kill rate is not so clear but appears to drop further for strip thus it is a safe assumption that the actual percentage of discarded hairs (due to lack of visibility via telogen) from a properly and efficiently removed strip will be somewhere below 3.5% assuming the high end of the averages and below 2.5% assuming the low end of the averages. Conversely, because individual hairs in a multi-hair grouping can go into telogen while the neighboring hairs that are part of the same bundle can remain in anagen we see the potential for peripheral transection from FUE going up.

 

Aside from this the kill rate is dependent on the surgeon skill and the tools he uses. For example, if you have a surgeon with a multi-blade scalpel he/she will have a massive kill rate on the grafts through transection regardless of skill whereas a surgeon that uses a single blade scalpel, tumescence and pushes the blade so he can see the path between bundles as opposed to pulling will have an extremely low kill rate due to transection.

 

In the end, this is all academic and if the patient has a choice, he'll usually go for FUE due to the lack of a linear scar as long as the result looks natural with regards to graft angulation, direction, etc. and enough obvious growth to have an aesthetically pleasing result. If this is accomplished no one really cares about the details. If the patient wants the most grafts at once and has an advanced pattern of balding, doesn't ever want to shave and understands the risk then he'll choose strip.

 

Hey there Joe. I'm quite sure we are talking about the same thing. I said 10-14% of all single-hair grafts are invisible and thus discarded(the singles in the strip). Whilst a lower figure for the 2 hair grafts(due to the lower chance of both HAIRS being dormant and thus invisible) being discarded and an even lower chance for 3 and 4 hair grafts. I did not state 10-14% of all grafts were discarded though. That is what is often believed. If someone had 100 single hair grafts in his strip zone(dormant or live) then 10-14 would be dormant and invisible. Hence discarded. I think we mean the same thing.

[Number47]

Many strip clinics have had the ARTAS for a while now and it is only growing in popularity. It is the more legitimate option to quickly and easily get into FUE and it is currently being heavily marketed to clinics outside of the established hair restoration field. Soon (if not already), your local rhinoplasty clinic will offer robotic hair restoration to compliment your new nose.

 

I understand what you mean Joe, I hope it grows in popularity due to its results and not its marketing or cause its an easy solution for doctors who can't perform FUE manually.

 

In the end its all about the results, if we see it perform we will al be cheering. I heard the radio show you sounded pretty confident about it, i hope its as good as it sounds!