Senior Member Ali Emre Karadeniz Posted April 30, 2015 Senior Member Share Posted April 30, 2015 36 year-old patient presented with a Norwood 5-6 hair loss pattern. He had fine hair and requested an FUE hair transplant. The FUE test performed at the beginning of surgery showed an unfavourable result and patient was advised to have FUSS, however the patient refused this option. 1450 grafts were extracted via FUE and placed at the frontal area. The photos were taken at 10 months post-surgery. The patient used 5% minoxidil. Ali Emre Karadeniz, MD (Dr. K) AEK Hair Institute Istanbul, Turkey Link to comment Share on other sites More sharing options...
Senior Member Hairsearch21 Posted April 30, 2015 Senior Member Share Posted April 30, 2015 FUE test? Whats that? Link to comment Share on other sites More sharing options...
Senior Member Ali Emre Karadeniz Posted April 30, 2015 Author Senior Member Share Posted April 30, 2015 FUE test?Whats that? An Fue Test or 'Fox Test' is a very important step before proceeding with a large FUE session. Unlike FUSS, FUE is a procedure that requires favourable tissue characteristics that allows for easy extraction of grafts without significant topping, shearing and transection of the grafts. Unfortunately, the public widely thinks that FUE is a straightforward procedure that can be used on every patient. However, some patients are not good candidates for FUE. The challenge is that, this can only be found out after doing an FUE Test, a test that has to be performed either at a separate visit or at the beginning of the procedure itself. Due to practical factors, we almost always get the chance to do the test at the beginning of the surgical procedure. The test actually is a subjective evaluation of how easy the graft extraction is for the surgeon. The ease of extraction is directly related to the yield of good quality grafts. If the FUE test is rated 'unfavourable' by the surgeon, he should sit down with the patient an reevaluate surgical options. If the extraction is very unfavourable then the options should be doing FUSS or cancelling the procedure. If it is unfavourable, but still possible, yielding a lower graft number, then the patient should decide between proceeding with FUE, doing FUSS or totally cancelling the procedure. In our case, the extraction was unfavourable but not impossible and the patient chose to proceed with FUE. It should be noted that, FUE-only clinics don't widely use the FUE test, as an unfavourable extraction would lead to being faced with cancelling the operation frequently. Not being able to offer FUSS decreases the motivations of a surgeon to find out if the extraction is going to be favourable or not. It is hard to imagine an FUE-only surgeon doing an FUE test, occasionally cancelling the procedure after rating the test unfavourable and advising the patient to go to another clinic. Some of the patients that we hear about getting poor yield after having an FUE procedure are probably related to this problem. Ali Emre Karadeniz, MD (Dr. K) AEK Hair Institute Istanbul, Turkey Link to comment Share on other sites More sharing options...
Senior Member PupDaddy Posted April 30, 2015 Senior Member Share Posted April 30, 2015 Despite this patient having had an unfavorable FUE/Fox test, his cosmetic result turned out great -- especially considering the relatively small number of grafts transplanted and his fine hair caliber. He looks miles better than before. He should be thrilled. Good job, Dr. K! Link to comment Share on other sites More sharing options...
JoeTillman Posted May 5, 2015 Share Posted May 5, 2015 This is a nice result for so few grafts. Obviously there was a boost from medication but it is a prime example of how medical and surgical treatments working in tandem can have a significant cosmetic improvement. Link to comment Share on other sites More sharing options...
Senior Member hairweare Posted May 5, 2015 Senior Member Share Posted May 5, 2015 For some reason I am not seeing any pictures Link to comment Share on other sites More sharing options...
BUSA Posted May 6, 2015 Share Posted May 6, 2015 how many available donor grafts did he have to use? looks good for the few amount of grafts utilized. why wudnt he opt for more? 1450 grafts can't cost very much in Turkey. Link to comment Share on other sites More sharing options...
JoeTillman Posted May 6, 2015 Share Posted May 6, 2015 Hi Busa, It isn't so much related to why the patient would not opt for more. It has to do with how many grafts can be safely extracted in a day. If you read Dr. K's post above you'll see that it was a difficult case. Because Dr. K said the extraction was difficult he had to take a lot more time to get the number of grafts that he did. The goal is to do what is necessary to extract the best grafts and in this case the care necessary to do so required a full day of work. If the extractions were easier then double this number could have been achieved. Thankfully, the time and care that Dr. K took to perform the extractions worked out in the patient's best interest. Sometimes taking the slow road is more beneficial in the long run than taking the fast road. I hope that makes sense. Link to comment Share on other sites More sharing options...
Senior Member 1978matt Posted May 6, 2015 Senior Member Share Posted May 6, 2015 Nice result and good explanations. Different photo lighting but it is clear that the grafts grew. 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 Link to comment Share on other sites More sharing options...
JoeTillman Posted May 6, 2015 Share Posted May 6, 2015 Nice result and good explanations. Different photo lighting but it is clear that the grafts grew. Hi Matt, Yeah, I asked doc about the lighting but these are photos taken by the patient so that explains it. Thanks for your comment. Link to comment Share on other sites More sharing options...
BUSA Posted May 8, 2015 Share Posted May 8, 2015 makes sense. thanx Hi Busa, It isn't so much related to why the patient would not opt for more. It has to do with how many grafts can be safely extracted in a day. If you read Dr. K's post above you'll see that it was a difficult case. Because Dr. K said the extraction was difficult he had to take a lot more time to get the number of grafts that he did. The goal is to do what is necessary to extract the best grafts and in this case the care necessary to do so required a full day of work. If the extractions were easier then double this number could have been achieved. Thankfully, the time and care that Dr. K took to perform the extractions worked out in the patient's best interest. Sometimes taking the slow road is more beneficial in the long run than taking the fast road. I hope that makes sense. Link to comment Share on other sites More sharing options...
JoeTillman Posted May 11, 2015 Share Posted May 11, 2015 Glad it helped, BUSA. Link to comment Share on other sites More sharing options...
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