Strip vs FUE vs mFUE - Dr. Alan Feller Great Neck, NY

[Dr Blake Bloxham]

Bill,

 

To add to what Dr Feller said:

 

I personally think mFUE is really the only term that describes what we are doing. It isn't mini-strips. FUT via the FUSS method, by definition, involves removal of a strip of FUGs with a scalpel blade. The strip is generally at least 1cm wide and many cm long. The blade removal involves a number of cuts from multiple angles. Like Dr Feller said, taking a number of these types of small strips has been tried before. It worked better on paper than it did in practice.

 

What we do is remove FUGs from the donor area with an elliptical or circular (depending on the patient) punch. It's larger than a traditional FUE punch, so the mFUE graft is divided into FUGs under a microscope. Because the punch is larger, the incision left behind is closed as well -- differing from traditional FUE where the incision is left open.

 

Because the overall procedure is closest to FUE, this was the most accurate way to describe it. Many grafts removed via a punch leaving diffuse, minimally visible scarring in the donor region. Definitely a much closer relative to FUE than strip. However, it isn't traditional FUE so we further clarified by calling it a "modified" FUE approach.

[ontop]

wonder what the numbers would be of Pts having FUT or FUE in the coming yrs.

I would think FUE would be catching up really fast on the FUT & FUT in 10yrs time will be very rare.

That's my 2 cents anyways.

[Dr. Alan Feller]

It's been 14 years since FUE came on the scene, and in that time it hasn't made much of a dent. At the same time FUT has skyrocketed and continues to do so.

 

Very similar to solar panels. They have been around since the seventies and experience periods of hype, but the king of energy production is still the much vilified fossil fuel power plants.

 

Truth of the matter is if there were no FUT there would be no substantial HT industry for FUE to hang on to. Same thing with solar panels. If we didn't have the solid foundation of generator produced electricity we wouldn't be playing around with solar panels.

[KO]

Funny, I also thought solar power is a good analogy for FUE. They cannot provide baseload power the way coal can, but can provide power for the appropriate situation.

[Dr. Alan Feller]

It's also more interesting, seemingly high tech, and very expensive just like FUE compared to strip. It has it's place, but very very limited. An augmentation to our standard power sources, but certainly not an alternative.

[ontop]

It's been 14 years since FUE came on the scene, and in that time it hasn't made much of a dent. At the same time FUT has skyrocketed and continues to do so.

 

Very similar to solar panels. They have been around since the seventies and experience periods of hype, but the king of energy production is still the much vilified fossil fuel power plants.

 

Truth of the matter is if there were no FUT there would be no substantial HT industry for FUE to hang on to. Same thing with solar panels. If we didn't have the solid foundation of generator produced electricity we wouldn't be playing around with solar panels.

 

 

Dr Feller,

 

With Respect Sir

 

I'm very confused in 2013 how the ISHRS showed that 30% of all HT surgeries were FUE.

 

This is a documented statistic by the ISHRS. There is no way what you can claim that FUT has "skyrocketed". It is FUE that has skyrocketed and it will eventually overtake FUT in the next Decade IMO & is what the reports states.

 

Please show me where your getting your numbers from, if you have any to show that is. if not i guess the Members would have to take face value of what the ISHRS presents and not from shear emotional vocal coming from your good-self.

 

as you would say...is that fair?

 

Thanks

Edited July 19, 2015 by ontop
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[ontop]

It's also more interesting, seemingly high tech, and very expensive just like FUE compared to strip. It has it's place, but very very limited. An augmentation to our standard power sources, but certainly not an alternative.

 

Dr Feller,

 

I strongly disagree solar panels can & do create some good dam electric and in fact you could end up selling electric to you local Electrical company.

USA is behind the modern technology always have always will compared to Europe & rest of the world.

 

Next time you go to England, Scotland Wales , Ireland, or even Europe take a look at the roofs or go in the local council house and ask them how much do they use solar energy and how much more they will use in the Future and will they save money...they will sure give you the numbers.

 

Everything is pricey when first come out, just like dvd, blue Rays , plasma, LCD Tvs but now look at the prices dropped down to the floor why because everybody got one, demand is/was there same goes for solar panel or FUE pricey at the start but now in hands reach of the average blue collar worker and that's always good for the customer.

Fair Point?

 

Please Dr Feller with respect again take off your blinkers.

Edited July 19, 2015 by ontop
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[Dr. Alan Feller]

Dr Feller,

 

With Respect Sir

 

I'm very confused in 2013 how the ISHRS showed that 30% of all HT surgeries were FUE.

 

This is a documented statistic by the ISHRS. There is no way what you can claim that FUT has "skyrocketed". It is FUE that has skyrocketed and it will eventually overtake FUT in the next Decade IMO & is what the reports states.

 

Please show me where your getting your numbers from, if you have any to show that is. if not i guess the Members would have to take face value of what the ISHRS presents and not from shear emotional vocal coming from your good-self.

 

as you would say...is that fair?

 

 

 

Thanks

 

 

First, you need to look at how those statistics are gathered to understand why I don't believe them. They are NOT verified in any way, shape, or form. Most doctors will not admit in writing that they are not proficient in FUE and that they are not doing them for fear of loss of reputation and/or business. No doctor wants to think or have others believe they have fallen behind and can't do something a competing doctor in the next town can do. The joke, however, is that most likely that that doctor in the next town is no more proficient or experienced in FUE than himself.

 

Second, most HT doctors do not perform FUE surgery. So who is doing all this skyrocketing FUE surgery?

 

Third, most of the FUE reported by doctors are SMALL procedures of a few dozen to a few hundred in a session, not the megasessions being hyped on this and other chat forums. Only megasessions are considered legitimate for the FUE proponents I've been reading on this site. A doctor who only does a few dozen or hundred FUE in a session isn't considered "qualified".

 

Forth, the number of patients with prior FUE cases that come into my office are minuscule compared to prior FUT. After 14 years there should be a lot more than that.

 

Fifth, there was an increase in FUE procedures but this is as a direct result of the popularity and acceptance of FUT procedure. Over the past 14 years the popularity of FUT has SOARED. Look at how many clinics have popped up in that time. How many of them are FUE only? Want to know how many FUE only clinics have popped up in my town- and remember, I'm located one block from New York City? NONE ! How many have popped up in your town?

 

So how and where are all these FUE procedures being performed? Simple, they are NOT being performed. Not in the numbers you seem to want to believe, and definitely not 30% of the HTs being performed in the United States.

[ontop]

Dr Feller,

Thank you for your personal detailed reply.

 

so ill ask you again

Have you got any numbers of your claims or is this just your personal option or hunch from what comes through your doors from the NY streets....(sorry don't mean to be sarcastic)

 

I myself is going on what the numbers say from the ISHRS but you dont trust those stats so would like to know if you can show something different

 

Thanks

[mav23100gunther]

 

Forth, the number of patients with prior FUE cases that come into my office are minuscule compared to prior FUT. After 14 years there should be a lot more than that.

 

.

 

Probably because you charge a ridiculously high $ per graft for FUE at or in excess of $9 a graft or something like that compared to around and less than 3 euros a graft by top surgeons in Europe & Turkey.

[Dr. Alan Feller]

Dr Feller,

 

I strongly disagree solar panels can & do create some good dam electric and in fact you could end up selling electric to you local Electrical company.

USA is behind the modern technology always have always will compared to Europe & rest of the world.

 

Next time you go to England, Scotland Wales , Ireland, or even Europe take a look at the roofs or go in the local council house and ask them how much do they use solar energy and how much more they will use in the Future and will they save money...they will sure give you the numbers.

 

Everything is pricey when first come out, just like dvd, blue Rays , plasma, LCD Tvs but now look at the prices dropped down to the floor why because everybody got one, demand is/was there same goes for solar panel or FUE pricey at the start but now in hands reach of the average blue collar worker and that's always good for the customer.

Fair Point?

 

Please Dr Feller with respect again take off your blinkers.

 

I think you mean "blinders" and you are projecting.

 

The price of producing solar panels has not significantly dropped. Rather two things have happened to artificially make it seem like it has. The first is that the governments in these countries have bowed to the enviro crazies and SUBSIDIZE the purchasing and installation of these inefficient glass monsters. It had to be subsidized because nobody would want them otherwise. The second is that fuel prices have been driven up artificially due to over regulation and taxes which are in turn the direct result of socialist policies. The UK and Europe are infected with socialism and it shows in the price of energy. Your council buildings have solar panels as a showcase to demonstrate how "green" they are...and of course the council members don't have to pay for them themselves. YOU DO!

 

There are hidden costs associated with solar panels as well. Ever try to get on the roof and clean them? Know how many visits to the ER there are from people falling off roofs because they went up there to clean their panels? That price is never factored in or advertised because it would ruin the illusion that it is "clean" "free" power. Over time the suns UV rays and the weather fog the glass cutting down the light that reaches the crystal. Oh, and the crystal breaks down as well.

 

Always trust the market. If something really works people WANT it, and no government subsides or regulations are needed for people to want to buy it. Look at iPhones, everyone wanted one. No government intervention required. Now take solar panels. The Obama administration dumped BILLIONS into Solyndra, a solar panel start up, and it fell flat on it's face. The market didn't want it, the people didn't want it, so it was rejected. That's what a free society can do. Now in the UK they shove their socialist nightmare down everyones throats, so even if it is inferior and nobody wants it you will forced not only to have it, but PAY for it as well. One way or the other. Your government knows what's best for you. Sure, the UK and Europe are way ahead of the United States, that's why there are so many Americans running the borders to get in, right?

[Spanker]

Our experience is that our FUE transplants have a higher percentage yield compared to the years we were doing FUT transplants. I believe this is due to our use of the Lion Implanter pens for placement, as we were performing forceps placement with our FUT procedures.

 

I would say that this was due to poor technique in placement or protocols in graft storage waiting to be placed maybe? Too long it off body compared to you fue technique? I can't find one reason that strip extraction and cutting would cause more damage to the follicle than fue and reduce yield.

[BadBeat]

With all due respect Dr. Feller, you come across as a know-it-all, arrogant individual. Now I know that sometimes in forums the "tone" can be misinterpreted but this is a 32 page thread and it's gotten to the point that you are debating about solar panels??? We get it, you're not a FUE fan. So focus your business on strips and be the best you can be at it. It really seems like you have a lot of fear that FUE is going to take off and hurt your business. That's how I interpret it at least.

[Dr. Alan Feller]

Dr Feller,

Thank you for your personal detailed reply.

 

so ill ask you again

Have you got any numbers of your claims or is this just your personal option or hunch from what comes through your doors from the NY streets....(sorry don't mean to be sarcastic)

 

I myself is going on what the numbers say from the ISHRS but you dont trust those stats so would like to know if you can show something different

 

Thanks

 

Ontop,

Yes, I have something different: the real world observation that 30% of HTs are NOT FUE . This is not a "hunch", this is a reality that is not available to you because you are not in this business. My patients come from around the world, most foreigners are from the UK by the way. Very few have had FUE, and all was poor work. I am also contacted online daily by patients from around the world and almost NONE of them have had FUE. That is a lot more valid than non verified questionnaires that are sent out to HT doctors from the club known as the ISHRS. I also speak regularly to other HT doctors and they perform either no FUE or very very little. Why? Because strip works better.

 

It is not my job to disprove somebody else's wild claim. It is there job to prove it.

 

If you believe the ISHRS statistic so much, why don't you invest in an FUE clinic. To you it's a sure bet, so put your money where your mouth is and go for it.

[ontop]

Dr Feller,

 

Do you really believe what your saying? LOL

 

& no i meant "Blinkers" something what you put on a race horse so he/she can keep a eye on the finish line & not drift towards the rails....But if you want to split hairs no pun intended its the same thing.

 

Ill pop in NY City one day and take you out to Greenwich Village we can have a political debate on worldwide issues, you never know by the end of the night after several pitches and some good Italian food we may come away with a answer/s to all our problems in this world even with our beer Goggles on LOL.

[ontop]

Ontop,

Yes, I have something different: the real world observation that 30% of HTs are NOT FUE . This is not a "hunch", this is a reality that is not available to you because you are not in this business. My patients come from around the world, most foreigners are from the UK by the way. Very few have had FUE, and all was poor work. I am also contacted online daily by patients from around the world and almost NONE of them have had FUE. That is a lot more valid than non verified questionnaires that are sent out to HT doctors from the club known as the ISHRS. I also speak regularly to other HT doctors and they perform either no FUE or very very little. Why? Because strip works better.

 

It is not my job to disprove somebody else's wild claim. It is there job to prove it.

 

If you believe the ISHRS statistic so much, why don't you invest in an FUE clinic. To you it's a sure bet, so put your money where your mouth is and go for it.

 

That is a Bit Harsh anit it Dr Feller?

I was only showing you what me the general public gets to see & i ask you have you got anything else to show us? being we the Members or general public are not in the HT business which brings me to my other point, Ive no intention of investing in my own FUE Clinic no more than you interested in investing in buying rocks from the moon so why make un called comments like that seem to be a little childish but okay different folks different strokes i guess.

 

FYI..I'm living in the USA not UK.

[Dr. Alan Feller]

That is a Bit Harsh anit it Dr Feller?

I was only showing you what me the general public gets to see & i ask you have you got anything else to show us? being we the Members or general public are not in the HT business which brings me to my other point, Ive no intention of investing in my own FUE Clinic no more than you interested in investing in buying rocks from the moon so why make un called comments like that seem to be a little childish but okay different folks different strokes i guess.

 

FYI..I'm living in the USA not UK.

 

The difference is I'm not advocating the rocks on the moon have any value whereas you are vociferously advocating for FUE based on one study whose very first words include the following:

 

Prepared by Relevant Research, Inc. Chicago, IL, USA

Notice: This Practice Census is published by the International Society of Hair Restoration Surgery (ISHRS) and is a compilation of information provided solely by participating physicians. The information published in this survey was developed from actual historical information and does not include any projected information. Neither Relevant Research, Inc. nor ISHRS has verified the accuracy, completeness or suitability of any information provided here, and ISHRS does not recommend, encourage, or endorse any particular use of the information reported in this survey. ISHRS makes no warranty, guarantee or representation whatsoever and assumes no liability or responsibility in connection with the use or misuse of this survey.

 

The Village would be the absolute last place I would go to discuss politics. They are way to intolerant down there. The Italian food is a different story, however.

[Dr Blake Bloxham]

Ontop,

 

I'm not the guy to ignore data. However, objective data is only relevant if it's collected correctly. I've recently been made privy to the way the ISHRS data is collected. And, like Dr Feller said, it's not research style data. Nor, as the above statement shows, does it pretend to be. It's a survey that is sent out to members and reported without verification. You could say that your practice is dedicated solely to FUE cases bigger than 10,000 grafts/daily and that's what would be published.

[ontop]

I think people have to keep in mind is that most of the guys who are doing great work in FUE are the ones who are showcasing patients with ideal donor characteristics - thick coarse, wavy hair, multi-follicular units etc. It in and of itself doesn't prove anything about FUE as surgery. People look at these showcase patients and assume that FUE has "90% yield". Not so! What you are seeing is the power of good characteristics, which are probably more important than the surgeon's talent. Good quality fish = good quality sushi.

 

If you're a Southern European, Middle Eastern, or Indian guy who has these characteristics, it could well be a very good fit. For East Asians, it's a bit different as they have thick hair and low FU count. For the typical Caucasian patient with north/central european extraction with fine/average straight hair, they simply won't benefit from this.

 

So if this was true & if you look at some of Dr Vories Pts esp the last several of them don't look like they have a ideal density for FUE but the results look dam good.

Any reason for that?

Is that down to the skill of this Dr & the tools used?

 

I do agree however that I do feel that esp in Europe / Turkey they cherry pick to a certain degree but also most of there Pts come from same country or close & if so they do have good density blah, blah.

So yep I feel there is a bit of a smoke screen & sexy marketing going on more than the average john doe will think.

 

Just my 2 cents.

Edited July 19, 2015 by ontop
edit

[ontop]

Ontop,

 

I'm not the guy to ignore data. However, objective data is only relevant if it's collected correctly. I've recently been made privy to the way the ISHRS data is collected. And, like Dr Feller said, it's not research style data. Nor, as the above statement shows, does it pretend to be. It's a survey that is sent out to memberoks and reported without verification. You could say that your practice is dedicated solely to FUE cases bigger than 10,000 grafts/daily and that's what would be published.

 

Hay blake how you doing?

 

Okay so its a grey area I will agree but being that's the only report as baseline we obvious need a worldwide servey & not what Dr F. Pts or piers tell him on the phone & that we should take a one mans view as gospel?

 

So when or how will we get a better solid answer not as if it makes a whole lot of difference anyways to the man on the streets.

[hairshopeing]

Dr feller

With respect you are 1 Dr, there are 100s of Dr's world wide performing hair restoration and yet you think that only your views and opinions matter! You seem to believe that if you shout long enough and hard enough over and over people will start to believe you, and granted some will which is a shame!! Because quite frankly your opinion on fue is wrong! Sub standard procedure? In your hands yes! And I say this again because you DO NOT HAVE a portfolio of proven successful fue procedure that rival in numbers or results even close to the likes of lorenzo, feriduni, erdogan, maras, reddy,diep,etc etc! So it seems that because you cannot produce high standard consistent results then the procedure it's self is flawed, maybe just maybe it might be your not as good at it as other Dr's, because the Dr's iv listed and many more ARE producing consistent high standard well documented results on much more regular basis then you are with fue or fut and that is factual based on how many results are shown on here, on other forums,on u tube, on their own websites! So do your self a favour and talk about how good your results are with fut back them up with life changing results REGULARLY and leave other people who have a different opinion to yours to make heir own minds up by carefully researching the pros and cons of both procedures and to chose a Dr who they trust and believe is PROFICIENT IN THE PROCEDURE THEY WANT! So if it's fue it clearly isn't you, if it's strip them maybe it is but let people have their own opinions because they come as news to you but YOUR OPINION ISN'T THE ONLY ONE THAT MATTERS!! And can I just add that if fue isn't growing, which it's is by the way and strip cases are ALWAYS more successful, which it isn't by the way! Why an earth would you produce a totally new procedure (which is basically old style plugs but just dieting the follicular units before replanting) would you include it's name relating to a sub par, non growing procedure? ? If fue is so poor and unpopular then it would be madness to link it by name to your new ground breaking technique! !

Maybe it's because if it had fut or strip or plug in its name then nobody would consider having it, which seems very strange considering in your world that's what everyone is still going for!! So it just seems mad to market your procedure linking it's name to a sub par procedure that doesn't grow well and isn't growing in terms of popularity or actual surgery's performed!!! Why not call it something completely different? I'll tell you why because you want to relate it to fue as despite your constant knocking of this procedure you know it is growing hugely and you know there are Dr's out there doing it profeciently ,regularly and with high end yield producing natural results!!! Again I'M NOT BASHING FUT! It is needed for certain patients without doubt and choice is always a good, but I cannot sit hear reading one man who thinks his opinion is gospel trying to be little anyone's opinion that duffers to his because he is a hair transplant Dr! So for heavens sake LET YOUR RESULTS DO THE TALKING! And just to clarify taliconwest was not happy with his results was not growing well and as you not heard from him in a while as you stated I'd imagine nothing changed bur if it's has it would he great to get an update, perhaps as he was an unhappy patient of yours you could take 5 min of this thread and contact him for an update?? And I hope he is really happy with it now as every single person who sits in a Dr's chair deserves and great result!!!

And again before you ask you can't have my email address and I'm not interested in a 3 way call with you and another Dr! !

[hairshopeing]

Ps excuse my grammar I'm using a phone and can't read it before I post!!!!

[thatoldchestnut]

I don't intend to get involved in this (at this point, often rather petty) debate one way or the other but I will say one thing. I realise that members of this forum probably value their anonymity, but if Dr.Feller's offer of a three way phone call with a doctor is genuine then I'm shocked that someone hasn't been minded to take him up on it. I think it would be immensely interesting to get a FUE specialist's (that is not meant as disrespectful, i simply mean a doctor for whom FUE work constitutes the majority of their practice) direct opinion on matters.

 

There have been some pretty bold claims made on both sides of this debate but as of yet Dr. Feller has been given carte blanche to make largely irrefutable claims (though with a little too much anectdotal conjecture for my liking ) simply because he is a qualified hair transplant surgeon. If people are really so certain he is wrong about what he is saying, what have they to lose by taking him up on the offer of such a phone call? I'm certain that by putting many of the key points in this thread to a "FUE favourite", it would be immensely educational for the party involved and could be reported back to the community.

[BaldingBogger]

1. Absolutely incorrect. There are NOT as many "dud results"in FUT as FUE. Not even close. Love to know where you get your "data" from before you irresponsibly posted on this thread something that is blatantly untrue.

 

2. I didn't write that FUT results COULD look better, I wrote that they indisputably WILL look better. And for the reasons I've listed enough times in this thread already.

 

3. Your quote of Dr. Vories is interesting. So, you are saying that he's saying that IF an FUE graft survives it will grow as well as an FUT graft? That's if it survives, right?! This was a weak and disingenuous statement.

 

4. The "retreat" option is not an option at all. It is a self fulfilling prophecy of failure.If patients wish to fade buzz their donor area after a strip surgery, they can. So what's the problem?

 

5. "I even recall a recent FUT case from Dr Feller Taclinowest which was not a success." Another completely false statement. Putting aside the clear attempt at libel on your part, did you point out the indisputable failure of FUE results on the part of any FUE practitioners? Of course not, you singled me out.

 

The last I saw Taclinowest was years ago, not recently, and he was growing and healing fine and his transplant was successful. I have had no contact from him to the contrary nor have I read anything of the sort online, so what are you talking about? Regardless, is it your position that he would have grown BETTER had he had an FUE instead of FUT?

 

The problem is that the real and true reason that people want FUE is NOT the haircut options they may have afterward, nor the linear scar it leaves. Rather it is FEAR of the strip procedure itself. Fear is what's driving FUE and it's proponents, and there are no shortage of people who are willing to take advantage of that fear.

 

No you are wrong. This is all just your swayed opinion to allign with what your clinics offers - FUT. Yes the patient can of course shave their donor after FUT. The difference is they will have a massive linear scar on show. Not a big deal is it.? Go ask the prospective patient and ask him if it not a big deal.

 

My quote of Dr Vories is no disingeneous at all. It is pivotal coming from another recommended surgeon who performs FUE to a high standard. As it totally contradicts what you Blake and Dr Lindsay are saying regarding the graft quality and supposed superiority of FUT grafts over FUE grafts.

 

So Dr Feller now resorts to sending out private messages threatening legal action over my comments!! This is an open forum Dr Feller where we are free to comment on results and there is nothing libelous in my posts. The last post i read regarding Taclinowest he did not seem to be growing that well and stopped updating. If you are saying otherwise thats great for him why don't we see an update to clear this up ? I make the reference to this case as you are giving the impression to everyone FUT is almost a cast iron guarantee of great results. It isn't and prospective patients should be aware of that. There are without doubt lots of sub par results out there from both procedures. Which is one of the crux of my points, there are no guarantees with either technique.

 

You really are making yourself look more and more ridiculous with these posts and threats.

You think your bully boy tactics will make everyone go away and agree with your opinion. Pathetic.

 

Again everyone would be better off getting back to letting their results do the talking instead of propaganda campaigns.

Edited July 19, 2015 by BaldingBogger

[hairshopeing]

I'll tell you why, do you need a phone call to view hundreds of documented results showing wet,dry, styled in styled hair, shaven donor areas to a .5 mm grade? Does a phone call provide documented viewable results? Does a phone call change my own result via fue? Bear in mind iv got light coloured thin hair? Would a proven reputable fue practinoer be bothered do debate with another Dr who clearly is a rail road type person who only thinks that their opinion is gospel?? Why are Dr's not bothering to comment on this thread or starting up a new thread saying how great their fue results are and how bad fut is and how bad a scar can result from this type of surgery! ! Because they don't need to! It's quite simple they are just doing what they do producing what they produce and letting potential patients make up their own minds! They don't need to try and discredit or persuade they just show consistent regular results and let people make their own informed decisions on who to choose and what procedure to have! Yes there are bad fue results out there without doubt, yes there are Dr's performing this and fut procedures poorly with sub par results but you cannot deny on the other end of the spectrum using both types of surgery Dr's are producing some amazing transformations! So to be blunt I'm not interested in speaking with Dr feller as any respect I had towards him, which before this thread I did have has unfortunately dwindled! ! I don't think this type of thread has achieved what he set out to achieve, yes there will be people who agree with him, that's a given and they are as just as in titled to their opinions as I am to mine and he is to his but maybe we can agree to disagree and continue to let results do the talking!