INTRODUCING: Modified FUE (mFUE)

[Dr. William Lindsey]

Pupdaddy hit on the high points.

 

I think scarring will be quite good IF the person is not a bad scar former in general, and IF each site is closed individually rather than with a long running suture like plugs used to be closed. Having closed MFUE both ways....individually is more time consuming but is alot better.

 

So far my biggest cases are 1500 grafts, done in about 3 hours, like a strip. Maybe 4 hours on one guy who was chatty with my techs.

 

One of those is in Florida and I don't expect to see him for a while. He's older and all plugged out with great wirey hair, but no computer skills to email pics. He comes in 2 x a year to DC for medical checkups so I hope to get 1 year pics this fall.

 

The other guy is local, and has gone silent....One of the techs saw him at a big box retail store and he "looked good" and said he'd come in... I think he was pretty early on and like all new things we do he got a cheap price in exchange for a new technique...however my understanding of him therefore showing up for pics periodically wasn't followed by him.

 

They'll be more growing and coming in this year.

 

Dr. Lindsey

[ontop]

Dr L....

If you done smaller stripts..

 

Do you cherry pick locations on the scalp for this & if so

Would this method have lesser of a tight scalp being you space out slits unlike previous Pts?

would by doing more cuts is there a more of a chance for more shock loss in such locations

& never recover?

What is your thoughts on this or what have you seen while you been doing such methods?

[keyser-soze]

Well to be honest blake I am disapointed after looking forward to some new ground breaking technique you'vecome up with something that's already been tried and dissmissed.

 

For the life of me I cannot see any advantage that is not far out weighed by the disadvantages.

Surely you can tell us the lenght and width of the punch sizes?

With fue individual fu are targeted but with mfue surely follicles cannot be avoided being damaged on the perimeter of the punch.

Whilst your obviously trying to keep scaring to a minimum I still think it will stick out like a soar thumb with close cropped hair once a larger session is carried out especially on those who scar badly.

I think the chances of shock loss will probalby be greater than with standard fue.

All in all your demonising of fue that you have been doing for some time now becomes clear.

The majority of the time when carried out by the worlds best fue drs fue is a match for the best fut drs but without the linear scar.

Patients don't want visible scaring allowing them to shave as close as possible with it being undetected and with this technique I just do not see this being the case.

Damage to donor area- unaceptable scaring- cost? - to do what has been achieved with regurlar fue for many many years now.

If you had come up with some way of lifting a fue graft out rather than force having to be exserted now that would of been a step forward.

I applaud all new trys at advancment in ht and I appreciate all your efforts but as dr vories said this has been tried with results he did not even felt warranted documenting.

Dr feller is one of the most expensive drs going so is this technique going to be cheaper or more expensive than his proper fue rates?

I was intrigued but now I just feel a little deflated.

[Blake Bloxham]

BUSA,

 

We don't have costs fully established yet. However, it will NOT be more expensive than traditional FUE. Plus, it is much more time efficient. Like Dr Lindsey said above, the time of the procedure is closer to strip than traditional FUE. If "time is money," this should be good news.

 

I'm also contemplating whether it would be more reasonable to price the procedure based on session size rather than cost-per-graft. This is how it's done in strip versus FUE, and it may come out more fair and balanced in the end.

[hairweare]

The true challenge will to be able to present a multitude of mFUE cases at an international conference demonstrating at minimum non inferiority to what is now state of the art FUE which I believe is manual extraction and an implanter. It will also have to be priced competitively at between 3-5 USD per graft or why should anyone consider it seriously when there already is a proven alternative?

[Blake Bloxham]

Pup,

 

Wow! Dr Lindsey is right, you touched on all the high points.

 

Scarring, thus far, has really impressed us. I suspect very acceptable scarring in large cases.

 

As far as the number of mFUE grafts needed for these bigger mFUE cases, it breaks down roughly like this: we experimented with punches of a VARIETY of sizes. The goal was to maximize the number and quality of grafts while minimizing the scarring. It's hard to say the punches are "this size" because they aren't round. It's not like they are 1mm, 2mm, 3mm, etc. Describing it would requiring calculating the surface area extracted by each mFUE punch and then comparing it to the surface area extracted by round punches.

 

However, I can tell you this: the punch we like extracts about 18 FUGs per mFUE punch. Based on what you asked above, a 1,500 graft case would take 83 grafts, a 2,500 would be 138 grafts, and 3,000 FUGs would be 166 grafts. When you look at the significantly smaller number of grafts AND the fact that this method significantly decreases subcutaneous scarring, it puts scarring into perspective a bit. And, by the way, the scarring we've seen thus far is comparable to FUE.

 

Your experience with the old grafts being removed is something I studied extensively! Seeing the very, very good scars people had when old, pluggy grafts were removed is something that encouraged me to pursue this method even further. You describe it perfectly. Based on this, and the information above, think about 80 of these millimeter-length scars compared to 1,500 punctuate scars from traditional FUE. Again, I find this very comparable. Especially when we are getting much better hair from those follicles and avoiding the subcutaneous scarring that decreases yield in repeat FUE procedures.

 

Thanks for the kind words!

[hairweare]

Blake, it must be emphasized that your criticism and stated shortcomings of the current state of the art FUE are your personal opinions and not proven clinical science. Until your hypothesis is adequately exercised on a significant number of subjects and presented for peer review, it is prudent to remind readers that mFUE is merely an unproven hypothesis at this point and may turn out to be better or worse than what you are proposing.

[ontop]

Oh let me get my pop corn out.

[Blake Bloxham]

Keyser,

 

I think terms like "futuristic" or "ground breaking" are used far too frequently in hair restoration. Many times, there are cool treatments like this on the horizon. However, they have one thing in common: they are light years away. Tangible techniques are just that; real procedures we can perform today. That's what mFUE is. We don't make any unobtainable claims or use any "buzz words" to create hype and not deliver. This obviously won't be as "sexy" as some claims, but it's honest and real.

 

I disagree about transection near the perimeter of the punch. It's very easy to move and position the punch to decrease transection along the edges. And, like I said, transection of all follicles not near the perimeter is 0. Even if transection was bad along the edges, which it is not, it would still be less than traditional FUE.

 

Also, lifting the grafts out without pulling is one of the main benefits of the technique. We gently dissect the mFUE graft out of the scalp with needles and/or a blade. This takes the pulling -- and all the graft damage that comes along with it -- out of the equation.

 

Also, Dr. Vories saying something similar didn't work doesn't nullify the technique. It sounds like his technique was significantly different -- IE bending a circular punch -- and we have, and will present more, objective, photographic evidence backing our claims. This will always happen when a new or different approach is suggested -- sources saying it's been tried and abandoned for whatever reason.

[hairweare]

Blake, the burden is still to convince your professional peers that mFUE is not a "solution" in search of a problem. Presenting this on what is primarily a lay forum should be viewed as marketing and not a serious scientific hypothesis subject to professional review. Until you do so, it should be taken for what it is, an advertisement for your clinic.

[keyser-soze]

Blake with all due respect you are a moderator you should not be allowed to be plugging this (new) technique there is definately a conflict of interest here and imo there has been with you for some time.

When you say that (your) (new) technique has less ttransection than standard fue on what are you basing this statement? How do you know the transection rates of any drs? You don't. You can't.

I thought you said you were not going to make any wild claims you could not back up.

With (your technique)I would suggest that the chance of transection is greater because it must be that much harder working with the bigger punch and the greater the donor density the more chance there must be of transection surely?

The biggest benefit I see in this approach is to the us clinics were they can utilise techs to a certain degree in the procedure as its basically mini strip.

Show us the recipient areas.Show us the donor shaved down close.Fingers holding back hair on a strip scar does not reveal much then when we see it shaved down for a fue op its a tottally different kettle of fish.

Shows us please erdogans's bisangi's lorenzo's transection rates.You know you cannot so stick to what is fact without putting down proven technique to big up one you are promoting and selling.

Quit as a mod or stop promoting what your selling and stop attacking the proven effectiveness of fue its what more and more people are opting for.

[BUSA]

BUSA,

 

We don't have costs fully established yet. However, it will NOT be more expensive than traditional FUE. Plus, it is much more time efficient. Like Dr Lindsey said above, the time of the procedure is closer to strip than traditional FUE. If "time is money," this should be good news.

 

I'm also contemplating whether it would be more reasonable to price the procedure based on session size rather than cost-per-graft. This is how it's done in strip versus FUE, and it may come out more fair and balanced in the end.

sounds like good news. thanx Blake.

[hairweare]

Keyser you are spot on but perhaps more blunt than I was. To get a new medical technique acknowledged by ones peers as an advancement it is necessary to show an enhancement and at very minimum non-inferiority to what the mainstream view as state of the art. mFUE it would appear is quite aways from achieving that basic standard.

[keyser-soze]

I will say one thing I would much rather have this than strip that's for sure

[BUSA]

lmao.... u sound really dumb no offense and so do u hairweare. so because he is a moderator that works with a highly skilled doctor that means he can't post a new technique the doctor has been working on that might help people and reduce scaring?

 

this is a debate like all new techniques are which is why we have forums to discuss different opinions and techniques and hear what others think.

 

got any other bright ideas?:rolleyes:

 

Blake with all due respect you are a moderator you should not be allowed to be plugging this (new) technique there is definately a conflict of interest here and imo there has been with you for some time.

When you say that (your) (new) technique has less ttransection than standard fue on what are you basing this statement? How do you know the transection rates of any drs? You don't. You can't.

I thought you said you were not going to make any wild claims you could not back up.

With (your technique)I would suggest that the chance of transection is greater because it must be that much harder working with the bigger punch and the greater the donor density the more chance there must be of transection surely?

The biggest benefit I see in this approach is to the us clinics were they can utilise techs to a certain degree in the procedure as its basically mini strip.

Show us the recipient areas.Show us the donor shaved down close.Fingers holding back hair on a strip scar does not reveal much then when we see it shaved down for a fue op its a tottally different kettle of fish.

Shows us please erdogans's bisangi's lorenzo's transection rates.You know you cannot so stick to what is fact without putting down proven technique to big up one you are promoting and selling.

Quit as a mod or stop promoting what your selling and stop attacking the proven effectiveness of fue its what more and more people are opting for.

Edited May 31, 2015 by David - Moderator

[TakingThePlunge]

keyser,

 

You're welcome to your opinion of course but I have to say that it's rare to see anyone burst on the scene here with such negative and disagreeable posts out of the gate. Also, the familiar way in which you address Blake and Joe Tillman leaves one wondering if you've been more than just lurking for the past then years.

 

Your user name's reference to "The Usual Suspects" is not lost on me.

 

For the record, we do not feel that Blake sharing this procedure is a conflict of interest or in any way undermines the credibility of our community. The procedure, as presented, was devised by two Coalition physicians in addition to Blake's involvement.

 

Anyone is free to comment and discuss the potential merits and shortcomings of the procedure to their heart's content, but it can be done politely.

 

Frankly, I've never enjoyed debating such things because time will either prove or disprove its value to patients of surgical hair restoration. Until then, it's all speculation.

[ontop]

Hold on David...

First of all I like you guys....but it must be said I don't think its a good idea for any Mod of this forum to get involved with post unless there its getting out of hand or some body coming through the back door trying to get free advertisement....is that what blake is doing now? Even tho his heart is in the right place & I do feel he's trying something new for the sake of hairloss science but still rules are rules right?

 

Blake works for Dr Feller right? He's also a Mod for this site right? ...so there is no conflict of interest then? Please come on...

If you want a forum to be honest , fair blah blah....don't jump I'm so fast david as your showing your colors also.

 

Again I like you guys but let's have some fair play here.

Edited May 31, 2015 by David - Moderator

[KO]

I don't see any conflict of interest in posting this. He has been completely open about his affiliations, and given that Feller is a recommended surgeon here, his clinic has the right to advertise.

 

That and I don't think this is an advertisement, merely describing a technique they are working on. Is Dr Wesley posting about piloscopy an advertisement?

[BaldingBogger]

Keyser you are spot on but perhaps more blunt than I was. To get a new medical technique acknowledged by ones peers as an advancement it is necessary to show an enhancement and at very minimum non-inferiority to what the mainstream view as state of the art. mFUE it would appear is quite aways from achieving that basic standard.

 

I would agree with this. Firstly i commend anyone challenging the status quo and trying to devise new and improved techniques. I definitely agree its all speculation at this point and very much 'the proof will be in the pudding' . So we look forward to seeing more results and more in depth picture documentation of scarring and results.

 

However if a new person came online and read this post first they would be led to believe that all regular FUE has around 60-70% yield. Its not very clear here that is a personal opinion based on some non industry accepted research. When we know this is in fact not true and leading FUE clinics can get yields in the 90% range.

 

I also think Blake should be posting this from a new independent account and not as a moderator.

 

Just my 2 cents.

[KO]

leading FUE clinics can get yields in the 90% range.

 

 

Please back up this statement. There is no getting around the fact that FUE is weaker in terms of yield, graft quality, and graft trauma.

[ontop]

I don't see any conflict of interest in posting this. He has been completely open about his affiliations, and given that Feller is a recommended surgeon here, his clinic has the right to advertise.

 

That and I don't think this is an advertisement, merely describing a technique they are working on. Is Dr Wesley posting about piloscopy an advertisement?

 

YES....

 

There is a confllic of interest Blake is a MOD on this Forum & works for Dr Feller clinic.

If that's not a conflict of interest I don't know what is?

 

I must say that. In Blakes defense I don't think that he has. Not try to come through the back door but only the interest of members & the practice of hair science rather than iplugging this Dr Clinic.

 

But working for this Forum & posting. Under a certain clinic "is a conflic of interest"

 

Mods & seems to be the same old members are quick to jump on certain Pts & clinics why because Mods feel that they don't pay so they can not play....simple as that.

 

David....

I try to send such a same sorta post but got kicked back.....why is that?

Why do you jump straight in if somebody says Boo to Blake? Why is that if anyone else you would leave it ride out unless it A gets out of hand or B the certain Clinic don't pay to be on here....strange that huh?

 

Listen I've no beef with any of you, we all have the same common goals but for the record Mods should not get involved with posting there personal opions & only step in when things get out of hand...

 

& again just for the record....I think Blake means well in the name of hair loss science but he must detatch himself from a Mod in the fairness to other paying clinics.

 

You just can't work for both....its unfair & not right.

[KO]

What is the conflict of interest? He is a mod, true, and he's describing a technique he is working on. I see no issue. And who are you to dictate that mods should not express their opinions? They can do as they well please.

 

Keyser soze got what he deserved, I doubt he'll last long here.

[Blake Bloxham]

Guys,

 

Just for clarification sake: I'm not currently working for both Feller & Bloxham and HTN. I'm currently employed by HTN and will be leaving this position when I officially partner with Dr Feller in July.

[ontop]

What is the conflict of interest? He is a mod, true, and he's describing a technique he is working on. I see no issue. And who are you to dictate that mods should not express their opinions? They can do as they well please.

 

Keyser soze got what he deserved, I doubt he'll last long here.

 

I'm a member on here who looks for fair play post that who I am.

Just like the 100s of others...

[ontop]

Guys,

 

Just for clarification sake: I'm not currently working for both Feller & Bloxham and HTN. I'm currently employed by HTN and will be leaving this position when I officially partner with Dr Feller in July.

 

Thank you for that blake & I wish you well.

 

Now can we get back on track please.

 

I wanted to ask you in doing this mFUE is it a fair statement that more shockloss & less tightness on the scalp than FUT strip pts mention several yrs past there surgery.

Edited May 30, 2015 by ontop
typo