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How must FUT be priced (honestly?)


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  • Senior Member

FUT operations must be charged honestly (for the good of the patients not for the own (economicall) good of doctors,

 

price X per cm2. of the strip (not for price X number of grafts)

 

The proofs:

 

The strip (after removed) contains constant number of hairs. Depending the hair density of the donor strip, this strip may give more or less hairs varying from person to person.

 

The FU means "hairs that making groups". FU can contain single,or 2 , 3 ,4 sometimes but rarely even 5- or 6 hairs.

 

Lets say 60 cm2 strip (30x2 cm) contained 10000 hairs. Graft harvesting team (technicians team of course:) may remove 3000 or 5000 grafts, but both graft numbers would still hold the same number of hairs (10000)

 

(in parctice, many hairs wasted during cutting process, the number of hairs at the end of cutting process is less than the beginning)

Attempting to remove more number of grafts do add nothing but carry all disadvantagous things; during cuıtiing process (a good number of) hair follicles) may be wasted or be damaged. More number of grafts with less average number of hairs provide less density and inferior result than the less number of grafts with good average number of hairs.

 

Docs. knows that facts, but still try to remove much more number of grafts from the strips just to increase the number of grafts, to give more price and / or to compete with the FUE.

 

Pricing for the dimension of the grafts is honest and also good for the surgeons. Surgeons wiould fell themselves free to cut the strip more accurately and honestly.

 

But hair loss sufferers should know that, (bigger) longer the strip means longer scar extending to the temples, and wider the strip means bearing more risk for larger scar or even no closure of the wound (will be left open to be healed by itself, as we know an example here)

 

60 cm2 strip is average (even large) and can provide around 3500-4000 grafts, and can close all the hair loss area for NW 1-4 (sometimes 5) hair losses.

 

Using a milimetric grid paper and measuring the size of the strip provide accurate, honest and reliable pricing for the patients.

 

Doctors must stop to rob the hair loss sufferers by using pricing per graft system for FUT,

 

Honest pricing system must be price x cm2 of strip, for example ...$$ for cm2 of strip, then patient and surgeon can decide (negotiate) together about the size of the strip to be necessary. :)

 

After this negotiation, hair loss sufferer will feel comfortable himself about pricing also doctor will do about the number of grafts. Honest and win and win system for both part.

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  • Senior Member

I don't agree with this and I can't really understand the logic behind it. If I had 67 grafts per cm square I'd get 8040 hairs. Next guy comes in and has 80 grafts per cm square and 2.2 hairs per cm square and he gets a little over 10500 hairs, well over twenty percent more hair. Why should they pay the same?

 

If you don't completely trust your doctor to give you what you paid for, you should find another doctor.

 

This suggesting will never ever happen. Patients wouldn't want it, docs wouldn't want it.

 

First time someone gets a stretched scar he would be blamed for trying to get too big a strip.

 

There are some docs that charge x about for under a thousand grafts, x about for anything under 2 thousand, and so on. This may reduce the worry that you seem to have that docs are splitting good follicular units for money.

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

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  • Senior Member
FUT operations must be charged honestly (for the good of the patients not for the own (economicall) good of doctors,

 

 

You are in a fantasy there my friend.

I don't want to patronize you and you bring some good points - many, many grafts are wasted in strip.

 

1) Vacant follicles (telogen)

2) Loss along the line of linear incision- superior and interior sides of BOTH edges of the strip (beware the doc showing you the best side of the cut to show lack of transection)

3) On the bench in the slithering process

4) On the bench in the trimming process

 

You get what you pay for - at least in theory. The best thing that can be said about strip, is that they might be inclined to use more good follicles, with fat around them that helps them survive.

 

The price is just supply and demand with a bit of marketing strategy thrown in for good measure. You think the doc over charges? Maybe he/she "makes up for it" in another way.

 

There is no holding these guys to account - it is part of the bargain we enter into.

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This is not an assembly line set up . Hair transplants have become a commodity but surgeon skill is not.

 

I would rather the best surgeons charge more and get paid for their skill than the mediocre ones.

 

Surgery is a skill first and foremost -- it is not just about cutting up / punching someone's skin -- the important part which people sometimes forget is skill in graft placement , survival and design. thats where the surgeon earns his fees in my opinion -- that is the outcome you are paying for. The outcome which hopefully leads to improved confidence and future earning power as a result.

 

I agree with scar5 that ultimately you get what you pay for . where you don't, those people get exposed very quickly in this day and age. It is difficult for anyone in the cosmetic surgery business to overcharge patients over any considerable length of time.

---------------------------------------------------------------------------------------

FUT #1, ~ 1600 grafts hairline (Ron Shapiro 2004)

FUT #2 ~ 2000 grafts frontal third (Ziering 2011)

FUT #3 ~ 1900 grafts midscalp (Ron Shapiro early 2015)

FUE ~ 1500 grafts frontal third, side scalp, FUT scar repair --300 beard, 1200 scalp (Ron Shapiro, late 2016)

 

http://www.hairrestorationnetwork.com/eve/185663-recent-fue-dr-ron-shapiro-prior-fut-patient.html

---------------------------------------------------------------------------------------

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as usual ur posts make ppl LOL....:rolleyes:

 

FUT operations must be charged honestly (for the good of the patients not for the own (economicall) good of doctors,

 

price X per cm2. of the strip (not for price X number of grafts)

 

The proofs:

 

The strip (after removed) contains constant number of hairs. Depending the hair density of the donor strip, this strip may give more or less hairs varying from person to person.

 

The FU means "hairs that making groups". FU can contain single,or 2 , 3 ,4 sometimes but rarely even 5- or 6 hairs.

 

Lets say 60 cm2 strip (30x2 cm) contained 10000 hairs. Graft harvesting team (technicians team of course:) may remove 3000 or 5000 grafts, but both graft numbers would still hold the same number of hairs (10000)

 

(in parctice, many hairs wasted during cutting process, the number of hairs at the end of cutting process is less than the beginning)

Attempting to remove more number of grafts do add nothing but carry all disadvantagous things; during cuıtiing process (a good number of) hair follicles) may be wasted or be damaged. More number of grafts with less average number of hairs provide less density and inferior result than the less number of grafts with good average number of hairs.

 

Docs. knows that facts, but still try to remove much more number of grafts from the strips just to increase the number of grafts, to give more price and / or to compete with the FUE.

 

Pricing for the dimension of the grafts is honest and also good for the surgeons. Surgeons wiould fell themselves free to cut the strip more accurately and honestly.

 

But hair loss sufferers should know that, (bigger) longer the strip means longer scar extending to the temples, and wider the strip means bearing more risk for larger scar or even no closure of the wound (will be left open to be healed by itself, as we know an example here)

 

60 cm2 strip is average (even large) and can provide around 3500-4000 grafts, and can close all the hair loss area for NW 1-4 (sometimes 5) hair losses.

 

Using a milimetric grid paper and measuring the size of the strip provide accurate, honest and reliable pricing for the patients.

 

Doctors must stop to rob the hair loss sufferers by using pricing per graft system for FUT,

 

Honest pricing system must be price x cm2 of strip, for example ...$$ for cm2 of strip, then patient and surgeon can decide (negotiate) together about the size of the strip to be necessary. :)

 

After this negotiation, hair loss sufferer will feel comfortable himself about pricing also doctor will do about the number of grafts. Honest and win and win system for both part.

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  • Senior Member

Uhm, maybe you guys didn't get yesterday's news about "GraveD11gger?" Bill did some ISP sleuthimg. Apparently, GraveD11gger was Maral's rep, MikroFUE, who used the GraveD11gger alias and a number of other aliases (Fisher4man, Truthfu11, lifeisbeautiful, Longetiva) to promote The Maral Klinik and its technician-only FUE model, and to bash the competition. None of these aliases have made an appearance since. I think it safe to say that MikroFUE/GraveD11gger/Fisher4man/Truthfu11 (particularly ironic)/Longetiva/lifeisbeautiful has left the building.

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  • Senior Member
Uhm, maybe you guys didn't get yesterday's news about "GraveD11gger?" Bill did some ISP sleuthimg. Apparently, GraveD11gger was Maral's rep, MikroFUE, who used the GraveD11gger alias and a number of other aliases (Fisher4man, Truthfu11, lifeisbeautiful, Longetiva) to promote The Maral Klinik and its technician-only FUE model, and to bash the competition. None of these aliases have made an appearance since. I think it safe to say that MikroFUE/GraveD11gger/Fisher4man/Truthfu11 (particularly ironic)/Longetiva/lifeisbeautiful has left the building.

 

Wow just saw that -- what a scam His posts all makes sense now ... its actually hilarious at so many levels

---------------------------------------------------------------------------------------

FUT #1, ~ 1600 grafts hairline (Ron Shapiro 2004)

FUT #2 ~ 2000 grafts frontal third (Ziering 2011)

FUT #3 ~ 1900 grafts midscalp (Ron Shapiro early 2015)

FUE ~ 1500 grafts frontal third, side scalp, FUT scar repair --300 beard, 1200 scalp (Ron Shapiro, late 2016)

 

http://www.hairrestorationnetwork.com/eve/185663-recent-fue-dr-ron-shapiro-prior-fut-patient.html

---------------------------------------------------------------------------------------

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  • Senior Member
I don't agree with this and I can't really understand the logic behind it. If I had 67 grafts per cm square I'd get 8040 hairs. Next guy comes in and has 80 grafts per cm square and 2.2 hairs per cm square and he gets a little over 10500 hairs, well over twenty percent more hair. Why should they pay the same?

 

 

 

 

OK, lets say 60cm2. strip contains 8040 hairs in the first, 10500 hairs in the second guy.

 

Yes, 4020 grafts in the first, and 4800 grafts in the second guy can be obtained by cutting.

 

Yes, they can pay the same (predetermined) price, because both graft numbers would be obtained from the same size of strips. The number of the grafts depends their donor density, second has more and got it. This is accurate cutting.

 

But, if the team wants, 5000 grafts can be cut from the first strip(guy) but 4000 grafts can be cut from the second strip (guy) That said, team always can adjust graft numbers regardless of strip hair density.

Edited by GraveD11gger
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  • Senior Member
many, many grafts are wasted in strip.

 

1) Vacant follicles (telogen)

2) Loss along the line of linear incision- superior and interior sides of BOTH edges of the strip (beware the doc showing you the best side of the cut to show lack of transection)

3) On the bench in the slithering process

4) On the bench in the trimming process

 

 

 

1) Vacant follicles (telogen)

 

It is an exaggeration that 'many' follicles are lost. Dr Bernstein estimates ~1%:

 

In FUT Hair Transplant, What Percentage of Telogen Phase Follicles on Donor Strip Wasted? | Bernstein Medical

 

2) Loss along the line of linear incision- superior and interior sides of BOTH edges of the strip (beware the doc showing you the best side of the cut to show lack of transection)

 

Some docs take more care than others during the strip removal. You can estimate what the worst case might be. 80 fu/cm2 donor equates to about squareroot(80)= 9 follicles per linear cm.

 

So if every single follicle was transsected along the cut lines the absolute worst case would be:

 

30cm strip x 2 sides x 9 follicles = 540 follicles transsected.

 

If it is hit and miss we are still talking no more than about 300 follicles/hairs.

 

I would suggest that the fewer strips taken the better. Unfortunately you can't escape loss of hairs with FUE either.

 

3) On the bench in the slithering process

4) On the bench in the trimming process

 

One only has to watch some youtube videos to see that this is not the case.

4,312 FUT grafts (7,676 hairs) with Ray Konior, MD - August 2013

1,145 FUE grafts (3,152 hairs) with Ray Konior, MD - August 2018

763 FUE grafts (2,094 hairs) with Ray Konior, MD - January 2020

Proscar 1.25mg every 3rd day

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) Vacant follicles (telogen)

2) Loss along the line of linear incision- superior and interior sides of BOTH edges of the strip (beware the doc showing you the best side of the cut to show lack of transection)

3) On the bench in the slithering process

4) On the bench in the trimming process

 

1) On the high end there are 15% of the donor hairs in telogen. What most people do not understand is that telogen does not occur only to single hair follicles. If it did then you are looking at, on the high end, 15% of the 25% that singles take up out of the whole picture. So say you have a 4000 graft strip, where 25% are singles. That is 1000 grafts. 15% of 1000 is 150 so IF all telogen hairs were singles then you'd have 150 hairs gone with a bare spot in place of the hair, free to be destroyed by the passing blade. However, telogen occurs to singles and to multi-hair units alike and you don't always have all hairs in a follicular unit disappearing into telogen at the same time. Sometimes you will have one out of three, or even two out of three so there is still a hair in the spot thus allowing the practitioner the option of avoiding it. Furthermore, hair shafts do not always shed when they are in full telogen. Sometimes it takes the new hair from anagen to push out the old hair shaft that preceded it so this means that just because a hair may be in telogen the hair shaft isn't necessarily going to be missing with a bare spot in it's place

 

The above reasoning means that the overall kill rate due to telogen is lower than what some will have you believe. When you're dealing with 4000 grafts in a properly removed donor strip you are looking at an extremely minor kill rate that has zero impact on the final outcome. On the surface, it makes sense to say that all of the these hairs in telogen have the potential to be forever destroyed but when you dig deeper with the facts then the final impact is seen to be much lower.

 

2) When a donor strip is properly removed, the doctor will use tumescense to inflate the donor zone. This does two things.

A) When the scalp is tumesced the skin is spread apart thereby making the spaces in between the FU bundles much greater and easier to navigate safely.

 

B) When the scalp is tumesced the internal pressures are greatly increased as is the lateral pulling pressure of the skin. Think of pulling a piece of latex apart with both hands. A good doctor will not just dive in and start cutting. He will use the edge of the scalpel to score the top of the skin. This makes the wound open up so that the visibility into the tissue is obvious. The more light scoring is done the more the tissue widens and separates. This is one reason why Dr. Haber's blunt donor excision works without a sharp blade. As the wound opens the doctor can see which direction the hair shaft takes and avoid it. He can already push the scalp in between the bundles as seen from the top so as the wound opens it confirms his assumptions or contradicts and he can make adjustments as is necessary.

 

f the doctor shows the patient one side to demonstrate the lack of transection, what makes you think that the other side is the complete opposite? What is the logic to say that one side is done perfectly while the other is bad enough to hide from the patient?

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