FUT is less costly compared to FUE. Can i choose FUT?

[Blake Bloxham]

Yeah, so I was confused about the vortex punch. I tried to ask Dr Vories in another thread, but I think he didn't go back and read it. I was confused as to whether or not it was just a sharpened punch you put into a handle -- like the versi handle, a motorized tool, etc -- or if it was an actual tool/device in and of itself?

 

The only thing I find when I search "vortex FUE punch" is a motorized device. Maybe John Casper can clarify? Respek if he's doing all manual! That's the way I personally like it.

 

Also, the quote I was talking about for Dr Vories was one where he was discussing his testing before actually doing the procedure. Some call this a "FOX" test. It's essentially just where you extract a few grafts to get a better idea of depth, angle, etc. Unless I've merged conversations in my head, he says unless he's getting 80% during this, he stops. This would mean if he got 81, 82% etc, he'd go forward. I don't think this convo was about the AA patients.

 

Also, the yield, graft survival, and transection are all different things. Saying "85%" graft survival isn't the same as 85% growth technically. However, I feel like I'm putting words in Dr Vories mouth here, so I won't speculate.

 

Weare,

 

The "which gives more grafts" strip v FUE debate is about as eternal as this one! Haha. Frankly, I think you'll probably get the "most" grafts by "stripping out" and then going back and salvaging as much via FUE as possible. You can get a ton of grafts via straight FUE as well. But then this gets into defining the safe zone, taking more than 50% density, etc, and is another discussion for another day.

 

Also, it's difficult to price strip procedures and FUE procedures the same, in my opinion, because people don't really do strip "price per graft" any longer. Most seem to charge by "session size" for strip and by graft for FUE. Don't really know why, but that just seems to be the trend.

[KO]

Indeed, can we ask Dr Vories/Casper to confirm what he uses to punch grafts? May be good to set it straight because I have heard as well that he uses the Neograft to score follicles.

[ontop]

I'm one of these guys who's undecided of FUE v FUT & both has there pros & cons for obvious reasons but over a long time reading & research i hear a lot of guys having a small FUE surgery to cover up the scar which kinda bothers me to be honest as it seems to be a waste of grafts.

 

How much better yeild from FUT, I've no clue because over the yrs read so many different stats.

 

I'm with blake....its down to many factors not just the scar but Drs & Pts must try & look into a crystal ball of what the future could be such as age, what MPB & what sort of folicals they have blah blah blah.

 

I'm kinda happy there is better & more options today than 10 / 15 yrs ago but IMO I think FUT will play itself out in the next 5/ 10 yrs as a lot of guys just don't want the smiley face on the back of there head even though it may end up a pencil thin scar & can't see it but you know its there & be mindful at it.

 

The way I look at this is FUT is good for the older guys who has stable hair loss & will never buzz down as with the younger guys FUE there is a get of jail card not saying for one second there is no white dots but its something they can live with a lot better than a smiley face.

 

Just my 2 cents & I'm still undecided if I go with FUT or FUE or maybe nothing at all...but I won't be rushed into anything though.

[scar5]

Scar,

 

1) Patients will always be better for one procedure or the other.

 

2) The key is seeing a doctor who will objectively describe the pros and cons of both procedure

 

3) A...guy... just wants the temple recession filled in for now, et cetera, is an FUE patient.

 

4) A guy like Cali who wants the biggest "bang for his buck"

 

 

1) & 2)

 

Isn't it strange how 'objective advice" varies according to geography (i.e. legal concerns, economic realities) in different regions of the world as well as in time. (last 10 years) and yet it is presented as objective fact carved in the rock of truth.

 

3) & 4)

 

What a guy wants varies through each decade of his life. Be careful with what you wish for.

 

Blake telling us you how much you 'love FUE' - aren't you being a little subjective?

 

Let's think about this.

 

Now being objective, how much for an hour of your precious time, crouched in an awkward position doing manual extraction on a head?

 

Now make that the first hour.

 

How about the second hour? ...and now the third? going straight through for the tenth?

 

Imagine planning your entire week around that kinda thing? Your month? Your year? Your career?

 

You have no choice in New York - that is if you wanna do what you love -FUE, because techs cannot extract legally.

 

Now, wouldn't it be wise to keep strip a relevant procedure in 2015, and fight the fight with all you've got?

Edited May 20, 2015 by scar5
? Let's think line to separate the stuff above

[KO]

^I disagree with your point there that it's only because of economic concerns/fatigue that Blake will not prefer FUE. I think there's something to be said for the fact that many of these doctors simply believe FUT to be the superior procedure, even you have pointed out before....strip will give you bouncier hair. Which I agree with, I think the cases with the best artistry, density, and overall appearance have been FUT results...

[hairweare]

Lower the price of FUE to be comparable to Europe and the demand for it in the US will skyrocket. It is really as simple as that.

[ontop]

^I disagree with your point there that it's only because of economic concerns/fatigue that Blake will not prefer FUE. I think there's something to be said for the fact that many of these doctors simply believe FUT to be the superior procedure, even you have pointed out before....strip will give you bouncier hair. Which I agree with, I think the cases with the best artistry, density, and overall appearance have been FUT results...

 

 

Strip will give you bouncier hair? Care to share?

[hairweare]

If my FUE hair was any bouncier I could be a human pogo stick while doing headstands.

[ontop]

I see a patern here with FUT v FUE its like VHS v Betamax...

VHS was the cheaper to buy but you could get more movies to rent but betamax less chioce but better picture.

 

VHS won in the end but only a few yrs later DVD took them out & kinda makes you think is FUE the DVD today & FUT is the VHS holding on to dear life.

 

On the flip side...

 

Will we be even Talking FUE in 10yrs?

Edited May 20, 2015 by ontop
edit

[Blake Bloxham]

So many replies just in the time I went to bed! This thread is active, boys!

 

Ontop,

 

Yeah, that's all I've really been trying to say. Maybe I'm just too loud or verbose about it, er something! I think there are patients who are well suited for both procedures. Doctors should be aware of all the facts and properly consent the patients.

 

KO,

 

I agree. I think there are some legitimate areas where strip has the edge over FUE. Just like there are areas where FUE has the edge of strip -- IE cosmetic scarring in the donor region (in most cases). There are MANY doctors who could buy a machine, fire 90% of their staff tomorrow, charge twice as much, and essentially stay in business based on their prior street cred no matter what the results look like. Yet they don't. This is why I don't understand the "economics" argument as much. Though some say this argument is more about laws prohibiting techs extracting. But, you guys have gotten to know me over the years. I've put too much effort into this field to do the above.

 

Also -- and, Jesus, this is probably going to add another 5 pages to the thread -- I agree with both your points: I still see more "wow" results from strip -- though there are a lot of EXCELLENT FUE results shared on the forums all the time; AND I do think there are textural differences to the hair that grows from FUE grafts versus strip grafts. The texture of our hair is determined by the width and orientation of the internal root sheath (IRS) of the follicle. If this becomes disoriented -- either via compression or traction injury, general damage to the lower third of the follicle, crush injury, etc -- the hair will grow differently. This is why I personally think the hair grows a little different during the first 8-9 months of any hair transplant -- follicles are settling and maturing. However, I've noticed it tends to stay a bit "kinkier" with FUE grafts. I think this is because of permanent changes to the follicles during the FUE process. Then again, maybe this is just me??

 

Scar,

 

Glad you joined us again!

 

1/2) I would really hope doctors would be objectively objective -- for lack of a better term. Physicians shouldn't be salesmen. Period. It's their job to lay the facts out on the table without distortion. If patients generally want to know where they can get FUE for $2 a graft, and the doctor knows, they should tell them about it. I've done this many times in consultations. However, remember that doctors still must make recommendations to their patients too. If a doctor has explained the data -- not "feelings" -- behind FUE and strip, laid the options out at the table, and still says "I think you're better suited for strip and I recommend doing it with X number of grafts," then they've still been objective and fair. If they distort facts and offer something they know is sub-par based upon customs -- like you said above, then this is wrong. I guess this is why it's so important to work with trustworthy docs.

 

3/4) I do love FUE!! I promise! Haha. Look, being a hair transplant surgeon is an amazing job. I've been blessed to have the opportunity to work at the best hair transplant resource on the web and cut my teeth with some of the best in the business. Truly. I'm grateful, and I thank you all for the opportunity. Compared to some of the other types of surgery you can do today -- and Weare will back me up on this one -- the "fatigue" factor with FUE really isn't an issue. Try standing over an OR table working on a plastics case for 12 hours, or harvesting vessels with a vascular guy for hours on end. These cases, for me at least, are fatiguing. Yet guys make 40 year careers out of it. Frankly, I don't find myself feeling overly fatigued or taxed during FUE procedures any more than strip. I get to sit in a comfy chair, I don't have to wear layers of surgical garb or lead aprons (seriously), I get to actually talk to awesome patients while I work. Trust me, this is 10 billion times less fatiguing than any other surgical sub-specialty out there, not to mention 90% of other fields of medicine.

 

Also, there are ways of making the tech model work in the US. Guys have done it for years.

 

To be continued ...

[Blake Bloxham]

Weare,

 

Don't a lot of the top guys in Europe charge similar prices to US guys? I thought Lorenzo was 6 pounds (9.32 US dollars) for the first couple thousand while he was in Europe? I think where we really see the price difference is Turkey. This is because of the technician-driven model. And, again, that discussion is a whole other beast!

 

Have a good one, gents!

[keyser-soze]

The last time i checked blake both Madrid,Spain and Manchester ,England were both still in Europe,

Fut is going to be something we have to look up in the hisory books in the not to distant future as more and more people want fue, and why would we go to the US for fue when theres beter exponents of fue in europe or turkey at a fraction of the cost.

I thought lorenzos prices went up while he was at farjos in the uk but dropped once he returned to spain.

So what is this new fue technique you keep banging on about blake?

I cannot really see how the fue technique can be improved greatly unless you have developed a punch that cuts the graft out at its base then extracts it and then implants it in the recipient area.

Are you ever going to divulge all the imformation about it?

::eek:

Edited May 20, 2015 by keyser-soze
bad spelling

[KO]

For sure, I think the best results have come from strip. While Lorenzo is great, I don't think his best cases stand up to the best ones coming out of strip clinics, and while he is good at grafting between native hairs, he doesn't bring a lot of density to his results.

[Blake Bloxham]

Keyser,

 

My bad! I meant to say "when he was in the UK," not "while he was in Europe."

 

I'm going to make the annoucement this week as long as I get a few photographs I need.

 

I have not invented a robot on the level you describe above. I fear SkyNet too much to ever do something like this : )

 

All jokes aside, I do think the new technique addresses a few of the FUE "problem areas" I talk about. I'm trying not to overhype it too much though. It's definitely been very reliable and impressive for us, and I think it's a great approach for a lot of patients, so I don't want it to seem like some marketing gimmic.

[scar5]

 

Scar,

 

1) Physicians shouldn't be salesmen.

 

2) If a doctor has explained the data.. laid the options.....says "I think you're better suited for strip..." then they've still been objective and fair.

 

3) ... the "fatigue" factor with FUE really isn't an issue.

 

 

 

1) I am in no position to question the ethics or expertise of physicians- but there would be no forum if physicians were not salesman - you guys pay the fees! And BTW, I'd appreciate if you send me some cash for my typing class. (I make typos as you can see) I once was so naive, (and if you think I am stupid now, well, then, try to imagine me then!) Doc was a big new FUE kid on the block. I asked him to count and tally my transections. He gave me a neat table at the end of the procedure showing columns of groupings and their transection rates. Never exceeded 5%) Later, I was visiting another leading FUE doc and he said my yield was about 50%! IMO, both were wrong, but there 'aint no such thing as objectivity, lack of commercial pressure - it is not a vacuum. It is a market and now with the internet, the stakes are higher than ever.

 

2) I have spoken to so many doctors and their staff over the years. Explaining the facts? As I've tried to explain the facts are elastic and they stretch over continents.

If techs could extract legally, competition would ensure FUE drops. It makes no difference that you are sincere or conscientious or that you have put a great amount of effort into this forum. (Of course we value it) But the 'fact' remains, anyone knows now - it takes a doc 40 minutes to pull a strip with the number of grafts that would require 2 long days with FUE...which brings me to your next point.

 

 

3) Fatigue? No problem?

Please give us a break Blake! Nobody believes this. Or ask Dr. Feller about that. He was always forthright about it. But I don't even need his confirmation, I have consulted doctors who have;

1) Stopped FUE altogether

2) Had RSI injuries

3) Have significantly changed their FUE motion from twisting to a plunging action.

 

FUE is incredibly taxing, and you should be given a stern warning by us for trying to tell us it isn't.

 

If FUE isn't taxing it is because you are not doing it often enough or haven't done it for long.

 

FUE is a pain in the ass for doctors and all doctors know it - hence, the high price and the strip recommendations. Again, nothing to do with your sincerity or conscientiousness.

[hairweare]

Lorenzo's fees are 6 Euros for the first 1K then 4 Euros for the next 1K and 2.5 Euros for all grafts thereafter. Other than for Dr. Vories I don't believe that anyone doing FUE in the US has competitive rates and arguably he is one of the best. I received a quote from a dedicated FUE doc on the West Coast for $8/graft but he later extended to me a $1/graft discount as a professional courtesy.

 

KO, we must be viewing different videos because I find few posted FUSS cases graft for graft that look denser than his.

 

I agree that Blake's comment about performing FUE to be a breeze is not credible. Lorenzo is somewhat of a freak, robotic in his rapid movements and is totally spent by the end of the procedure. Definitely not a walk in the park.

Edited May 22, 2015 by hairweare

[ontop]

We all go back & forth with what is best & the truth is that HT has moved in a much better place than where it was in the crazy pluggy 80s/90s.

Social media is such a powerful thing today & them crappy Drs back in the day won't survive with the top guns of today.

 

So yep comp is good for all of us & prices will drop down in the US in the future if the US docs want to stay in business.

[KO]

Then I do not know which Lorenzo cases you are referring to, because I have seen tons on the Ganarpelo/recuperarpelo, and the best ones out of Hasson, Konior, Rahal, Shapiro IMO show better density and naturalness that Lorenzo just doesn't seem to get. There are others on recuperarpelo who also note this. This is after Lorenzo operating in Southern Europe and getting a lot of patients with coarse, wavy hair and multiple follicular units.

 

Not to mention, his best work is often cases that involve 3-4 passes. That's a long time, something that is not immediately apparent on a video.

[hairweare]

Well, I have coarse wavy mediterranean hair which is turning salt and pepper and I purposely chose a" low and slow" approach v. a 3 day 5K graft scalp and beard Hail Mary toss into the end zone procedure which was the alternative option presented to me in the US. Besides I like to travel and took two fun mini vacations while I was at it. My entire head was not shaved either time, I needed no pain meds and within two weeks I was looking and feeling normal again. I can't say that about my experience with FUSS. I know all about surgery and and hate the term "minor, which I believe is misleading. In my forties vanity left me with no other choice but if I had to do it over again the decision would be an easy one. I think you too have made it easy for yourself, go for the strip and don't look back. If you wouldn't be happy with Lorenzo like results I doubt any of the alternative FUE clinics would be satisfactory either. Now you only have to choose among your 4 doc short list so what is holding you back?

Edited May 21, 2015 by hairweare

[Blake Bloxham]

KO,

 

Completely agree on all points. Especially with the multiple pass comment. Many guys don't want to wait 3-5 years -- assuming you wait 12 months, which is pretty standard for maturation, between procedures -- for a full restoration. This isn't clear in many video results.

 

Scar,

 

Don't know what to say; all I can claim is my first hand experience, and, in the grand scheme of medical/surgical subspecilties, FUE is not all that taxing. I don't think I ever called it "a breeze," but I find myself MUCH less fatigued than I do after a 14 hour shift in an ED or on medicine wards or on other surgery services. Some of the comments about it leaving you an arthritic cripple are a bit of an exaggeration, in my opinion. This also doesn't take using motorized tools into consideration. All I can say is guys, especially in medicine, make life long careers out of things that are much more taxing.

[scar5]

 

Scar,

 

...all I can claim is my first hand experience, and, in the grand scheme of medical/surgical subspecilties, FUE is not all that taxing.

 

 

 

Nothing to do with medicine or the spectrum of possibilities within. Everything to do with the relative comparative advantage of strip vs doctor extracted FUE for a clinic set up in a jurisdiction like New York.

 

So we have 40 minutes to pull out a strip vs two long days to pull out the equivalent number of grafts with FUE done manually, which you are compelled, by law, to do in the state of New York. (Again check with Dr. Feller)

 

It isn't much of a contest is it?

 

Guys,

 

I don't bitch on strip for nothing and I don't think FUE is all that great either. Just giving yourself the option to retreat is not only the concern of a guys who want to do an undercut at 24. It is the concern of every balding man .

[KO]

Blake I recall you noting that you believed sharp manual punches were the best. Are you going to use manual or use D Felllers motorized techniques?

[voxman]

You gotta love the fact that the OP started this thread and never came back...

[ontop]

Yep...

LMAO...

We proberly went over & above what he wanted to hear.

If he was confused prior he sure is now LOL...147 in his inbox, the poor guy.

Edited May 21, 2015 by ontop
edit

[voxman]

Maybe he was distracted by a cow on the side of the road or something...