INTRODUCING: Modified FUE (mFUE)

[Uk86]

Let's just hope in a few years the best surgeons will master this and make it an improved method to strip and fue.. Until then we should remain hopeful and skeptical. Maybe they will change the name to make people feel more at ease with what they are selling too??

[Mickey85]

Blake(Doctor ) how big is the punch exactly. There seems to be alot of confusion going on which could possibly dilute the impact of you newly developed procedure. Are individual grafts punched(ie 1/2/3/4 hair grafts) or groups of grafts(ie 6 bundles of grafts)via the elliptical punch? I'm lead to believe that multiple grafts are punched within a single insertion, with the targeted site excavated and closed via staples/suture/tissue seal. In essence, these would be akin to mini-strips. One photo shows 18 grafts removed from a site and approximately 1cm wide(stapled so the height is indeterminable) which gives off the impression that a 1cm wide(height undetermined) punch is being used unless I am severely mistaken(if so I apologize in advance).

[keyser-soze]

Blake has been asked the punch size many times but does not seem to know but why he cannot just simply make a phone call to the punch manufactuer to clear this up i dont know.

you are right mickey several groups are extracted so in esence a mini strip.

The use of fue in the title is just piggy backing on the popularity of fue which is blatantly obvious..

Blake has been rubbishing fue for about a year now while all the time working on this OLD i mean new method of extracting cash i mean hair.

What size is the punch?

What ammount of damage is done to the follicles on the perimeter of the punch both on the STRIP that is removed and the edge of the wound because it is certainly not the 1.6% blake has quoted?

Were are pictures of a shaved down donor area post op?

Why use a punch? Why not cut them out with a blade to avoid donor damage?

If as you state Blake we should be trying to preserve every available hair why are you plunging a large punch into the scalp when it is obviously going to damage the donor supply?

I think the results will look ok but at what cost to the donor region?

To me it just seems like a rush job to extract fugs so techs can be used because the drs cannot be bothered to just get stuck in and give people what they really want and that is PROPER FUE at a resonable cost.

I would suggest looking at dr vories work ethic and prices then follow suit

 

Imgonna modify sarcasm now its called SCAR CASM very funny post scar i think you must have some english blood running through your veins .

 

Blake(Doctor ) how big is the punch exactly. There seems to be alot of confusion going on which could possibly dilute the impact of you newly developed procedure. Are individual grafts punched(ie 1/2/3/4 hair grafts) or groups of grafts(ie 6 bundles of grafts)via the elliptical punch? I'm lead to believe that multiple grafts are punched within a single insertion, with the targeted site excavated and closed via staples/suture/tissue seal. In essence, these would be akin to mini-strips. One photo shows 18 grafts removed from a site and approximately 1cm wide(stapled so the height is indeterminable) which gives off the impression that a 1cm wide(height undetermined) punch is being used unless I am severely mistaken(if so I apologize in advance).

[BaldingBogger]

Just to let you all know I sent my pictures to spex who forwarded them onto dr feller who came back to tell me my hair loss was way too advanced for fue and I would need two strips!

Only through my research on this site I found dr lorenzo who informed me I could achieve coverage from fue procedures! All I can advise anyone is research research research don't rush into anything. For me fue was the only way to go I've got the option in the future of getting out of the battle by shaving down. Just had a hair cut today on the Sides and back down to a 1 grade one month after second procedure total 6152 grafts and absolutely no visual scarring in donor. This is key for me when this battle is over I will shave down!

 

Good for you. Doing your research paid off big time. I think this precise point is what people are getting most worked up about for this whole issue. There is an element of hoodwinking patients or pushing the less informed in to FUT when they could really be FUE candidates.

 

Obviously a strip scar is a very big deal for a lot of people and cause real depression and issues post op. And if their hair loss progress's and they cannot keep up with it they are up sh1t creek with Strip as they cannot shave down close and move on with a framed face unlike FUE.

[Blake Bloxham]

Hey Mick!

 

Good to hear from you. It seems like you essentially have the right idea:

 

1. A larger mFUE punch is used to remove a graft with multiple FUGs

2. The punch site is closed

3. The mFUE graft is dissected into individual FUGs under magnification

4. The FUGs are implanted in the recipient

 

I'm really not trying to be clandestine about the size of the punch. It's just that an elliptical shape doesn't correlate to the circular sizes we are used to, so I can't say it's "X" mm. However, I can say we are dealing with millimeters, not centimeters.

 

In fact, and this will address Keyser's question, the reason why we couldn't just cut out little "mini strips" with a scalpel is because they would be too large. Dr Feller tried this in the past and wasn't happy with the scarring. Now this method would truly be "modified strip." But that's not what we're doing.

 

Also, Joe, thanks for the excellent reply! The great scarring I saw when I was studying these plug repair cases is what motivated me to keep moving forward with the mFUE technique.

[ontop]

i think we need to see cases of shaven #1 donor with low to average density. Blake have you got any to show us at this time?

Also i will ask again will this new Method run the risk of shockloss in several different locations and may run the risk of never to return which could very well happen.

 

Thanks.

[keyser-soze]

...C

A<>B What is the big problem? eg A TO B = 8MM C TO D=5MM

...D

Crude picture but please understand what you are being asked its not the area of the punch but its simply the size.

You should be in politics blake with the way you answer what you want and avoid other questions.

You praise joe for his post yet seem to contradict wht he said.

You say dr feller tried to cut out strips but they were leading to unacceptable scarring.

Joe said dr wong carved out the old plugs which left nearly undetectable scarring.

Not only have you been knocking fue for some time and quoting ridiculus figures of 50% to 70% something that your co hootes differ on but i read somewhere today dr lindsay is saying its 40% yeild with fue.

This is making the three of you look really desperate.

You have shown us nothing of this new techniques advantages but the three of you seem to have concentrated your efforts on attacking a proven most attractive most popular technique whyis this?

Are we to believe dr feller is unable to carve out micro strips to the same skill as dr wong?

You have said that the punch can be manouved to avoid damange to folicles on the perimeter of the punch but this i find insulting to our inteligence its impossible esecially in a dense donor region.

Stop berating proven technique and prove your own or should i say dr vories seen as how he had done this technique but abbandoned it because of it short comings in regard to donor damage. Another step in the right direction would be to think of another name that does not reffer to this being anything like fue.

The only similarity between this and fue is a punch is used but gods knows what size it is because up till now nobodie else does not even it seems the drs who have been using it.

I think scar5 was both funny and not off in his post.

Over the last 6 months or so i have seen several really shoddy attempts to belittle fue and tech involvement and you blake even saying US drs are more ethical than docs from over seas because they dont do fuss and the US docs do.

Rather than try and push some old revamped technique whilst belitting fue i would suggest that a big group of US ht docs lobby to have the shackles of non tech involvementammended before the monoply that the US once had on all cosmetic surgery ends u dead and buried.

Dr feller once known for good fue but no longer theres much better cheaper options a plane flight away.

Dr Lindsay who has never been recognised as being excelent at fue.

And a complete rookie who is in a priviledged position that imo exploited his position to try and mislead hair loss sufferers into thinking fue is crap and fuss and now miracle mfue is a patients best option.

But still theres no conflict of interest here - carry on as you were

Hey Mick!

 

Good to hear from you. It seems like you essentially have the right idea:

 

1. A larger mFUE punch is used to remove a graft with multiple FUGs

2. The punch site is closed

3. The mFUE graft is dissected into individual FUGs under magnification

4. The FUGs are implanted in the recipient

 

I'm really not trying to be clandestine about the size of the punch. It's just that an elliptical shape doesn't correlate to the circular sizes we are used to, so I can't say it's "X" mm. However, I can say we are dealing with millimeters, not centimeters.

 

In fact, and this will address Keyser's question, the reason why we couldn't just cut out little "mini strips" with a scalpel is because they would be too large. Dr Feller tried this in the past and wasn't happy with the scarring. Now this method would truly be "modified strip." But that's not what we're doing.

 

Also, Joe, thanks for the excellent reply! The great scarring I saw when I was studying these plug repair cases is what motivated me to keep moving forward with the mFUE technique.

Edited June 5, 2015 by keyser-soze

[hairweare]

Agreed, it is not difficult to measure the width and length of the punch. It is not credible that a doc wouldn't know what the size of the wound that he just created is yet can argue as to the best way to close it. Blake has also been asked how many 1500-2000 graft FUE cases he has performed by himself to know that it is not labor intensive. I have been the recipient of such work twice and both times the doc looked fairly spent for the effort. Personally, I am not sure that I would be able to perform such a tedious repetitive procedure on a daily basis and this comes from a guy who stood over a table wearing a lead apron and sweating in a surgical gown for 10 hours a day.

Edited June 5, 2015 by hairweare

[ontop]

It must be hard work 5 days a wk.

 

Look at Dr Vories profile pics under clinic tour when he just finished 3k FUE.

He looks beat.

 

Hair Restoration Social Network - Hair Loss and Transplant Photos

[keyser-soze]

Were is the evidence to disprove the 90% claim? Has blake,Dr feller,Dr lindsay,Dr beecher ect ect actually done a analysis of the yeild of the top docs doing fue? NO So use your head and ask yourself why we are being quoted these ridiclus figures of yield with no evidence of what is acheivable at the hands of top fue surgeons?

Ialways ask myself when someone is selling something whether what they are telling me is acurate. All ht docs are sellers dont just take their word as gospel same goes for clinic reps use common sence and do your own research.

Is joe going to say to a patient asking about dr karadeniz i think you would be better going to my old boss dr rahal or dr wong? of course hes not they dont pay him anymore dr karadeniz does or has. This make sense?

I think blake Dr lindsay and dr feller is saying is beliele what we say tarring all fue docs with the same brush of poor fue yield as they are achieving. They are asking us or rather telling us to disbelieve our own eyes but believe these ridiculus figures all the while pushing this ( NEW) technique.

Kinky hair with fue were exactly is all this kinky hair? The only place i see kinky hair is in porn films. Blake you are constantly avoidind questions regarding this (NEW) technique why is this? Politicians employ the same tactic were they dont want to lie just in case it can be proved they are lieing or they do not want to tell you the truth because it does not serve them to do so.

Dr feller has to increase his workload to accomadate his new partner does he not? His partner is also a mod on a site full of potential customers berating their biggest competions technique. and surprise surprise some people are smelling what their shoveling.

Dont piss on my shoes and tell me its raining.

This would be laughable if it did not have such serious consequences for patients. As with just about anything in life nowadays its all down to money. The drs make mega money, the reps it pays their wages anyone with a vested interest is unlikkely to be 100% honest with you. What US rep is gonna say our fue produces a poor yield and we are gonna charge you a lot more so your beter to go to our competitors and get a beter job at much less cost?

Edited June 5, 2015 by keyser-soze

[JoeTillman]

Is joe going to say to a patient asking about dr karadeniz i think you would be better going to my old boss dr rahal or dr wong? of course hes not they dont pay him anymore dr karadeniz does or has. This make sense?

 

This is an unfortunate assumption because it means you think I'm for sale, which I am not. For some reason you can't grasp the idea that I don't work for Dr. Karadeniz in a patient consulting position. I'm a consultant for his business. I've spoken to many patients that have asked about him but I've also sent patients to my favorite doctor, Dr. Wong and I have a profile page for him on my website, along with a consultation submission form, of which I receive ZERO compensation. I've discussed the prospect of seeing Dr. Rahal with other patients, a few of which are on this forum. I've also sent patients to a doctor in LA I like, as well as Dr. Feriduni, Dr. Doganay, Dr. Bhatti, and Dr. Lorenzo; none of which have given me a single cent. I don't play the "one doctor is best for all" game anymore because it simply is not true. It is self-serving to the doctor, and the consultant that works for him, and is not in the best interest of the patient.

 

Leave me out of your debates as a point of reference, please, because it is a mistaken assumption that my position reinforces your point.

[mav23100gunther]

This is an unfortunate assumption because it means you think I'm for sale, which I am not. For some reason you can't grasp the idea that I don't work for Dr. Karadeniz in a patient consulting position. I'm a consultant for his business. I've spoken to many patients that have asked about him but I've also sent patients to my favorite doctor, Dr. Wong and I have a profile page for him on my website, along with a consultation submission form, of which I receive ZERO compensation. I've discussed the prospect of seeing Dr. Rahal with other patients, a few of which are on this forum. I've also sent patients to a doctor in LA I like, as well as Dr. Feriduni, Dr. Doganay, Dr. Bhatti, and Dr. Lorenzo; none of which have given me a single cent. I don't play the "one doctor is best for all" game anymore because it simply is not true. It is self-serving to the doctor, and the consultant that works for him, and is not in the best interest of the patient.

 

Leave me out of your debates as a point of reference, please, because it is a mistaken assumption that my position reinforces your point.

 

I recently consulted with Joe regarding choosing between one of his former bosses and a surgeon that to my knowledge Joe has never had or does not currently have any affiliation to at all. Although I was sort of expecting Bias towards his former boss, the opinion I got was completely objective and based on the facts and circumstances specific to my own situation, Joe recommended the other surgeon, his rationale made perfect sense, and was clearly in my own best interests. I really appreciated his objective viewpoint and honesty. Joe had nothing to gain in this instance and is clearly trying to share his own wealth and knowledge. Thank you Joe!!!

[ontop]

I recently consulted with Joe regarding choosing between one of his former bosses and a surgeon that to my knowledge Joe has never had or does not currently have any affiliation to at all. Although I was sort of expecting Bias towards his former boss, the opinion I got was completely objective and based on the facts and circumstances specific to my own situation, Joe recommended the other surgeon, his rationale made perfect sense, and was clearly in my own best interests. I really appreciated his objective viewpoint and honesty. Joe had nothing to gain in this instance and is clearly trying to share his own wealth and knowledge. Thank you Joe!!!

 

I 100% agree with this post.

 

Keyser..

Joe is now independent meaning he don't work for anybody & has nothing for sale or gain but to only help / mentor hair loss suffers with his un bias advice & that's it!

 

Adding his name in this mix is not relevant & should be kept out & only comment directly on the topic itself.

[fueguy]

I’m really disappointed to read this thread. It's borderline false advertising and has the potential to do more harm than good. It's not FUE. Has nothing to do with FUE. And to be honest, sounds like a desperate attempt to ride the popularity of FUE. In anything, we should be calling this mSTRIP, which is what it is.

 

There are serious limitations to the technique, however, and growth and quality of FUE hair is still not on par with strip. But why is this? The best evidence we have available may offer an explanation.

 

There is only one limitation with FUE: you have to be good at it. Unfortunately, most doctors just don’t have the skills or desire to master FUE. Look at Artas. It’s not popular because it’s a great technique. I’m my opinion, it’s a terrible technique.

 

It’s popular “with second tier doctors” who don’t have the skills to offer motorized/manual FUE with sharp punches, see HTs as a means to make a quick buck and are basically lazy and looking for a quick fix to a labor intensive procedure. Great FUE doctors have a transection rate equal to strip. Only strip doctors will tell you different.

 

STEP 1: A custom elliptical ("football shaped") punch slightly larger than a traditional FUE punch is used to superficially score (cut) the donor region

 

Slightly larger than a traditional FUE punch? Really? I promise you it’s MUCH larger.

 

It's difficult to quantify how "big" the tools are for two reasons: 1. we have played around with many slightly different sizes to optimize the number and quantity of the grafts we get with each punch and will still probably use slightly different ones depending on the patient -- like traditional FUE; 2. the punch is elliptical, not round and trying to figure out the surface area is messy -- and I've tried. Haha.

 

Please Google, “Ellipse Circumference Calculator.” It’s not so messy

 

To quote Dr Lindsey, the scarring can be "impeccable!" After viewing the results, I feel this technique exceeded our initial goal of creating strip results without a strip scar, and actually allowed us to achieve “strip results with FUE-level scarring.”

 

Sorry, but you basically created dozens of small strips scars and possibly even limited future procedures for the patient. Please show a patient’s donor area shaved after dozens of these strip scars.

 

This approach has been tried, and with similar tools. We simply bent 4 mm and 2 mm Miltex punches into an elliptical shape, and also closed the wound with suture. We abandoned this approach because of unacceptable scarring, even with the 2 mm punch

 

BINGO!

 

Interesting idea. So this is basically a ton of mini-strips?

 

BINGO! It’s modified strip

 

I'm a novice in this stuff to other members but to me it sounds like more slits & bigger punch sizes.

 

BINGO!

 

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.

 

Agree.

 

This is not FUE. Please do NOT call it FUE. It has nothing to do with FUE.

 

100% agree! Think about the damage this “advancement” can do to patients. It’s a desperate attempt to ride the popularity of FUE. Call it what it is—mSTRIP. Then you have my support. At least patients patients are informed then. By definition, it’s not FUE. Don’t pretend its FUE. You’re miss-leading patients. It’s strip and false advertising.

 

This is an unfortunate assumption because it means you think I'm for sale, which I am not. For some reason you can't grasp the idea that I don't work for Dr. Karadeniz in a patient consulting position. I'm a consultant for his business.

 

Joe. Do you get ANY compensation from Dr. Karadeniz?

 

You’re a great resource for guys no doubt. But let’s be clear. You’re compensated by Dr. Karadeniz. He has hired you to get him patients and represent him. Nothing wrong with that. But lets not pretend otherwise.

[JoeTillman]

FUEGuy,

 

The point of my post was to address an inaccurate statement by Keyser.

 

Is joe going to say to a patient asking about dr karadeniz i think you would be better going to my old boss dr rahal or dr wong? of course hes not they dont pay him anymore dr karadeniz does or has. This make sense?

 

I appreciate your comments about me being a useful resource but I'm trying to do things differently. This post directly implies that I will only recommend a doctor that is paying me to recommend him/her when in reality nothing could be further from the truth. I'm not being paid to be a consultant, I'm being paid to help his business which, by proxy, means he'll get, and is getting, more patient inquiries. If this means, and it does, that patients will be asking about doctors I work with then great, I'll give my opinion and how it applies to them but I'll give (as evidenced by Mav23100gunther) the advice I think is best for the patient, not what the doctor tells me I should be saying is best for the patient. To do this would be selling out and wasting my knowledge and experience.

 

What I'm doing is very unconventional in the hair restoration world. I'm not running a "recommended" list and I'm not a consultant. Rather, I'm somewhere in between but I don't expect everyone to understand. If I were simply offering myself as a consultant for hire I could not stomach being in this industry any longer. Been there, done that and I want nothing more to do with it.

 

For myself, I'm in a position where I can educate about the reality of surgical hair restoration without having a doctor looking over my shoulder. I'm free to innovate and offer educational tools and resources like no one has. For doctors that meet my requirements on a number of levels and feel I can help their clinics, they get my insight and know how and a listing as someone that I feel has more than just solid surgical skills but solid ethics and solid patient care (or wants to have). Great results are being performed by a lot of doctors but few give a damn enough to take care of patients after surgery has failed unless the patient screams online. That's wrong and I'm determined to find those few and help them get the attention they deserve, among other things.

 

I'm sure this will come up again but let's save it for another thread. This thread is already weird enough.:eek:

[fueguy]

Joe. Do you get any compensation from Dr. Karadeniz? Curious as to what your arrangement is.

[JoeTillman]

FUEguy,

 

You first asked...

 

Joe. Do you get ANY compensation from Dr. Karadeniz?

 

I replied...

 

...I'm being paid to help his business...

 

You then asked...

 

Do you get any compensation from Dr. Karadeniz?

 

Did I misunderstand the question? Why are you asking me twice?

[KO]

Joe has been very clear about his affiliation...but that's not what it is about is it? He asks as a rhetorical point of view to attack somebody's credibility. Getting paid to do something? How sleazy!

[Swooping]

Thanks Blake. Sounds good from what I see. Perhaps this method will indeed cope with the slight less mean yield and more variable in normal FUE at least this is my opinion. Nobody knows how much it really does differ. We simply lack proper studies. There are way to many variables to take into place anyway.

 

Anyway are you going to present more high detailed examples of cases? I think we all would want to see that as that actually counts not opinions.

 

What do you think of the scarring thus far? How many patients did you perform this method on approx? Were they happy about the scarring?

 

Also how long does a procedure like this compare to a FUE procedure in terms of time is what I am curious of?

 

A portfolio of more cases with proper high detailed pictures would be nice.

[Blake Bloxham]

Hey Swoop,

 

Thanks for the reply!

 

Yeah, we are going to present more highly detailed examples of cases. Bigger cases, more details, et cetera. This was only supposed to be our "teaser announcement," but it took on a life of its own! Haha.

 

I've been very surprised by the scarring. Initially, I didn't think we could honestly say that it was cosmetically equivalent to traditional FUE. I thought mFUE would be "strip results without the strip scar." However, the scarring has exceeded our expectations. It's more accurate to call it "strip results with FUE-level scarring."

 

It's been performed on approximately 30-40 patients. I'd really have to confirm with Dr Lindsey and go through our own records to be sure. Many of these were smaller cases, and this is why we're looking for some larger ones now. And yes, they've been very pleased with the scarring thus far -- the ones I've spoken to at least.

 

The procedure is much quicker than traditional FUE. It's closer to a strip case -- time wise. Probably a little longer, but much shorter than FUE.

[Blake Bloxham]

Ontop,

 

Dr Lindsey told his patients that some temporary shock loss -- it's almost always temporary in the donor region -- is possible. However, he tells his regular FUE patients the exact same thing.

 

He posted a video about a week ago where he asked an mFUE patient about his shock loss. He said he had temporary shock loss in one extraction site.

 

Frankly, I don't think it will be any more of a concern than it would be with strip or FUE.

[Swooping]

Hey Swoop,

 

Thanks for the reply!

 

Yeah, we are going to present more highly detailed examples of cases. Bigger cases, more details, et cetera. This was only supposed to be our "teaser announcement," but it took on a life of its own! Haha.

 

I've been very surprised by the scarring. Initially, I didn't think we could honestly say that it was cosmetically equivalent to traditional FUE. I thought mFUE would be "strip results without the strip scar." However, the scarring has exceeded our expectations. It's more accurate to call it "strip results with FUE-level scarring."

 

It's been performed on approximately 30-40 patients. I'd really have to confirm with Dr Lindsey and go through our own records to be sure. Many of these were smaller cases, and this is why we're looking for some larger ones now. And yes, they've been very pleased with the scarring thus far -- the ones I've spoken to at least.

 

The procedure is much quicker than traditional FUE. It's closer to a strip case -- time wise. Probably a little longer, but much shorter than FUE.

 

It sure did lol! It sounds good to be honest. From my point of view at least in theory then this method could have more advantages than FUE. Meaning that mFUE would be basically a better alternative for everyone than FUE. I'm still not fully convinced though and my opinion doesn't matter obviously that's why we need more evidence and case results. That is ultimately what counts.

 

As the procedure being quicker is only a plus as from patient perspective and practitioner perspective which is great. Plus it would have the advantage of less TOB time which is nice to take along all with it.

 

I wish you good luck and look forward to detailed cases in the future.

[1978matt]

Dr B,

 

Just a suggestion but why not offer a free 'mFUE' procedure (undertaken by your good self) to a participant willing to be filmed before/during/after?

 

I nominate voxman!

[Sean]

Introducing: mFUE

 

What is modified FUE (mFUE)?

 

mFUE is a new approach to the follicular unit extraction (FUE) technique. The goal of the procedure is to create FUT-level results with FUE-level scarring. This means the growth and quality of strip surgery (FUT or FUSS), but without the linear "strip" scar.

 

Why create a new approach to FUE?

 

The FUE technique continues growing in popularity. Patients clearly want FUE. Whether it's the less invasive nature or the lack of the linear scar, hair loss sufferers have spoken!

 

There are serious limitations to the technique, however, and growth and quality of FUE hair is still not on par with strip. But why is this? The best evidence we have available may offer an explanation:

 

*The "blind" approach to FUE graft harvesting creates transection rates as high as 32%.

*The small punches and pulling of grafts during delivery severly "skeletonizes,” or removes the protective tissue layer surrounding follicular unit grafts. According to studies, the growth rate of skeletonized FUE grafts is between 48-68.7%. This means only 1/2 to 2/3rd of all these "skeletonized" FUE grafts grow.

*This same analysis shows that grafts extracted with an appropriate amount of supportive tissue grow 45% better than skeletonized FUE grafts (Reference).

 

So what does this tell us? FUE is becoming very popular, but it may be less efficient and produce more variable results. Hair loss patients only have a finite number of available follicular unit grafts, and each one of these grafts must be optimized and used wisely. We do not believe the FUE techniques available today utilize these precious grafts properly, and wanted to find a way to overcome these issues and deliver the results patients deserve with the minimal scarring they want.

 

From this, we created mFUE.

 

How is mFUE performed?

 

Here is a step-by-step breakdown of the mFUE approach. It highlights the differences between traditional and modified FUE, and explains why we like this method.

 

Please note: all procedural images are taken from experiments with a porcine model. They are not from real patients. Ink is used to make the skin scoring more visible. These may not completely reflect the way these aspects of the procedure look on a real patient.

 

STEP 1: A custom elliptical ("football shaped") punch slightly larger than a traditional FUE punch is used to superficially score (cut) the donor region

 

 

The superficial depth decreases transection and the gentle rocking motion of the punch decreases the torsion and rotation injury associated with the twisting of a traditional FUE punch. The larger size of the tool also ensures that the follicular unit grafts in the center of the punch have a 0% risk of transection. The ability to move and position the mFUE tool creates very minimal transection rates along the border of the punch as well (equivalent to strip transection rates – roughly 1.59%).

 

STEP 2: The physician then grasps the corner of the mFUE graft with forceps, lifts it gently, and uses a needle or blade to dissect it from the donor region.

 

 

This allows for gentle removal of the donor follicles without skeletonization of the grafts, injury to the crucial base (bulb) of the follicles from pulling the grafts,"splaying" of the follicles (which significantly complicates graft placement), or ripping/tearing of the follicular units. This also ensures that 100% of the grafts scored are successfully removed - 100% "attempts made to grafts successfully extracted ratio."

 

STEP 3: The mFUE graft is then handed to a technician who dissects it microscopically into perfect follicular unit grafts.

 

 

This ensures all grafts are ideally shaped for placement and contain the correct amount of supportive surrounding tissue. This significantly decreases the greastest threat to FUE grafts: dehydration.

 

it also creates grafts that look like this:

 

 

and not this

 

 

 

STEP 4: The small (millimeters) defect left behind by the elliptical punch is then closed by primary intention. In other words, it is closed with surgical material. This can be done three different ways: either by staples, which are removed after approximately 10 days (this is the method Dr Feller and I have mainly experimented with); by sutures, which are removed after 10 days as well (this is the method Dr Lindsey prefers); or by a third option: closure with TissueSeal (histoacryl) -- a clear tissue adhesive that requires no suture or staples, no removal, and naturally holds tension equivalent to sutures for the first 7-10 days. The adhesive also serves as an anti-biotic agent, a water-proofing agent, and naturally falls away after the 10 day mark. This option is designed for those who want the traditional FUE post-operative experience or want to return to "normal life" sooner.

 

Here are examples of each closure technique and a comparison to a traditional FUE post-extraction donor region.

 

 

 

Please note: Because the mFUE technique requires a fewer number of extractions, the number of staples or sutures used to close wounds in the donor area is approximately equivalent to the number of staples or sutures required to close a strip wound.

 

STEP 5: The microscopically dissected grafts are then placed in the physician-made recipient sites (the same way they are placed during traditional FUE or FUT/strip surgery)

 

 

What does the donor region scarring look like?

 

Our original goal was to create a procedure with strip-level results without a linear strip scar. Initially, we weren't sure the mFUE scarring would be comparable to the minimal scarring created by traditional FUE. Throughout our clinical testing, however, we were pleasantly surprised with the healed scars.

 

According to most dermatology texts, the size of the wound we create with the mFUE punch is small enough to not require closure by primary intention (sutures, staples, or tissue adhesive). We wanted the best scars possible, however, so we decided to spend the time to close the wounds. Clearly, this made a huge difference.

 

To quote Dr Lindsey, the scarring can be "impeccable!" After viewing the results, I feel this technique exceeded our initial goal of creating strip results without a strip scar, and actually allowed us to achieve “strip results with FUE-level scarring.”

 

Here is an example from Dr Lindsey:

 

"This patient prefers to buzz his sides short, and has had no problem shaving down to the 2 guard he used before surgery."

 

Here is a shot of his donor region.

 

 

Note how the patient has a thinner donor region in general. If you look in the area near his crown, where no mFUE grafts were taken, you'll see it is less dense than we would like. Even with this lower density, the mFUE scars are still, essentially, undetectable.

 

Here are a few more angles (sides of the scalp):

 

 

 

Here is Dr Lindsey showing an mFUE scar up-close.

 

 

Frankly, I still have a difficult time seeing it. I zoomed in 100% and think I found it here:

 

 

What are the benefits/advantages of mFUE?

 

*Strip-quality grafts and strip-level growth yields. This means 98% growth, no skeletonization, no harsh extraction injuries, and no grafts scored with failed delivery.

*Strip quality hair. None of the "wiry" or "kinky" hair we sometimes see from traditional FUE – which is caused by damage to internal root sheath or distortion of the internal follicle.

*FUE-level scarring. No linear scar! Diffuse, very cosmetically acceptable scarring in the donor region like we see in traditional FUE. This allows patients to "buzz" their sides short.

*Hundreds of follicular unit grafts (FUGs) from only a few cuts ("insults") to the scalp. We can extract approximately 100 FUGs with only 5-6 mFUE punches.

*Less "insults" to the scalp means MUCH less of the subcutaneous FUE scarring – which theoretically can make extraction more difficult and decrease yield during future hair transplant procedures.

*Less punches means a significantly smaller number of scars too.

*Ability to undergo larger sessions in a single pass without compromising extraction techniques.

*All manual tools and techniques. Nothing is motorized or automated.

*All extraction is done by the hair transplant surgeon.

*Easier to use for a "hidden" FUE approach -- because only a limited number of small spots need to be shaved for extraction.

*Significantly decreased graft "out of body time" compared to traditional FUE procedures of similar size (meaning even less dehydration).

 

Clearly, we are very excited about this new approach! It took nearly two years to conceive and test, and we -- Dr Feller, Dr Lindsey, and I -- are very excited to finally make the announcement.

 

We are currently offering mFUE sessions up to 1,500 grafts at Feller and Bloxham. I'll let Dr Lindsey expound on his current practices. We are limiting the session sizes temporarily to make sure everything meets our expectations as we move from clinical testing to offering the procedure on a large scale. Eventually, we will start offering larger sessions.

 

This is just our “teaser announcement.” Please stay tuned for more examples of donor scarring and mFUE “before and after” results.

 

Thank you for taking the time to view the post. I look forward to comments and questions!

 

Great thread with medical claims by professionals .

 

Surgical tools need to be defined for patient safety. Medical claims need to be supported by grounded evidence. Photos need to be shown of claims with supporting evidence as this is a procedure with defined claims as indicated, with reported benefits, advantages, and reasons it is being publically marketed for.

 

Pending further review. Would like to see results and research.

 

Interesting to see how much of a difference it makes over other procedures.

[tommygun]

Blake, will you please post your math on why FUE makes clinics more money? I have been looking but can not seem to find it. Did you assume the same price/graft in that calculation? Thank you.