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

[delancey]

Regardless of who is performing the surgery, growth and quality are compromised. The fact that people prefer FUE does not mean it will give you better results. And yes, I've seen tons of results from both techniques.

 

The rest of your case is just talk about economic incentives, which is really irrelevant to the merits of the technique and the results provided.

 

Btw, Dr Feller here is an early adopter of the FUE method, in fact one of the very first, and adopted FUE before all the doctors people call "Top FUE". FUE was first popularized in the US after its "rediscovery" by Bernstein and Rassman. So your comment about the best FUE clinics being early adopters is wrong.

 

Each person should consult with a variety of clinics in order to make a well-informed decision that best suits his needs. Clinics operate differently and are set up to achieve results via different techniques depending on their business model. It is therefore of absolute importance to understand why a clinic may be recommending a certain technique or strategy over another.

 

Secondly, the most impressive FUE results are unequivocally coming from the clinics that have been performing FUE consistently for many years. Some of these clinics were early adopters/early majority of the technique and have helped revolutionize the hair transplant industry by being more risk oriented and community leaders in the hair transplant industry.

[Yaz89]

Buzzing your hair preop makes it look thinner. Why is it so hard to grasp? This result is nowhere near as impressive as what Bobman had done. The doctors you mentioned have never posted anything near this, or Hasson and Wong's earlier results. FUE just doesn't give that density or naturalness on men with significantly bald areas (unless the patient has very thick hair, in which case FUT would do well too). People are looking at results from guys with ideal donor hair and saying "Aha, FUE has proved it can do as well as FUT". Not so...

 

Bobmans donor was beyond average. In fact he had super donor which not every fut patient has! Buzzing makes hair look thinner? Not really. A balding or thinning person would not be able to pull this Beckham look. I leave it for now. We had a good discussion! Good luck if you chose fue. I seen your pics in another thread and feel fue would suit you.

[Dr. Alan Feller]

KO,

 

If the thousands of cases posted by the best FUE surgeons in the world don't convince you of its ability and quality, I'm sorry to say that nothing ever will. It is a method that has been developed, improved upon, and grown in popularity as a result of the desire of the millennials to wear short(er) hair styles. When performed by and under the supervision of a qualified FUE Doctor and Technician(s), growth and quality shouldn't be compromised.

 

--

 

Few clinics can provide strip mega sessions as a result of not having the required and qualified staff on hand. For those that do, there is a clear economic incentive to continue providing a service that it is equipped to provide. Therefore, many strip clinics will have few economic incentives to make any changes to their business model provided that there continues to be a sufficient demand in the market for strip. Even the most ethical clinics believe in maximizing profit as long as results are not compromised. From a cost perspective, the barrier of entry seems to be quite low in order to provide FUE as long as the clinic isn't set up as a large strip clinic. There is, however, a reason why the same FUE clinics continue to provide us with the best FUE results in the industry: the level of skill and practice required is at a very high level. Many of the best FUE clinics were early adopters of the FUE method. It's difficult to compete against 10+ years of daily practice and experience.

 

Finally, I've never been one to question a clinic's pricing structure. A clinic can charge what the market is willing to pay. However, there is also such a thing as setting the price of FUE so high that it is out of reach for most consumers. Undoubtedly high FUE prices in the U.S. incentivize consumers to choose strip.

 

Just my perspective.

 

 

"It is a method that has been developed, improved upon, and grown in popularity as a result of the desire of the millennials to wear short(er) hair styles. When performed by and under the supervision of a qualified FUE Doctor and Technician(s), growth and quality shouldn't be compromised."

 

Delancy,

I understand this is just your perspective. But you need to understand that what you are writing publicly is simply not correct in the real world:

 

1. FUE has NOT been improved upon in any significant way since its inception in the 1930s and it's reintroduction in the 2000s. The same issues that plagued it then, plague it now. Absolutely nothing has changed. NOTHING ! For any clinic to claim otherwise is FRAUD and an engagement in the illegal act of failing to give INFORMED CONSENT to their patients.

 

2. FUE has not grown in popularity as a result of the desire of millennials to wear shorter hair styles. That has never really been the motivation of the overwhelming majority of patients who want FUE. The real reason is FEAR of having strip surgery. The thought of having a surgical procedure that includes the removal of a lengthy piece of skin is frightening to many people.

 

It invokes such a deep phobia that they become almost hostile to the idea and openly vilify not just the procedure, but the surgeons who perform them as well. It is this fear that is at the base of the motivation of nearly every hardline FUE proponent on chat forums like this one.

 

Claiming that it allows for shorter haircuts is merely a distraction. Make no mistake, millennials are not the first, nor the last, to want to be able to fade cut the back and sides of their heads.

 

3. "When performed by and under the supervision of a qualified FUE Doctor and Technician(s), growth and quality shouldn't be compromised. "

 

This quote is colossally incorrect. How in the world do you support and justify this completely fallacious statement? I haven't met an FUE doctor to date who has made this claim. Delancy, if a doctor or clinic told you this PLEASE give me the name of that person or clinic. Then give me your name and address and I will call them on a three way call WITH YOU on the line. We will record the answer and discussion that follows and post it ONLINE for the world to hear.

 

Fair enough?

 

Dr. Alan Feller

[home1212]

Dr. Feller, I agree that a big motivation for those that choose FUE over strip is the fear factor and not having a large piece of skin removed from the back of their head. But isn't the flip side of that being able to heal much quicker from an FUE procedure than from strip? I've had both procedures, and from my experience, FUE was a breeze compared to when I had strip. Isn't that another significant benefit of FUE?

[Dr. Alan Feller]

Thank you for joining in Home.

FUE doesn't heal any quicker than strip.

 

As for the recipient area the healing time and process is 100% identical.

 

As for the donor area the healing time is also identical. The only difference being that in the strip procedure all the damage has been done along one thin line such that all the skin and follicles above and below the strip line are virgin. Whereas in the FUE procedure the damage is multiplied 13 times and distributed over large swathes of the donor area forever scarring and damaging them.

 

I think you were really referring to post op PAIN in your question. Yes, strip is more uncomfortable due to the presence of the sutures. This concentrated area of healing is more uncomfortable, but usually only for the first night or two and easily dealt with by use of pain tablets. If you're strip experience was worse than that then that is the exception and not the norm.

 

FUE may well be more pain free in the donor area because the damage has been distributed throughout a much larger area. HOWEVER, this benefit is a one time only freebie. Thereafter your next FUE surgery will be more painful. Just to numb the skin will take more time and be more painful because of all the fibrosis the first FUE will have caused throughout your donor area. Furthermore, your post op pain will not be similar to your first FUE, but rather quite painful and deep. A burning like feeling. This is common to most second time FUE patients. Not all, but MOST. And any FUE doctor will tell you second time FUE patients are harder to numb and keep numb in the donor area. The reason for this is that the skin is no longer like a sponge but rather fibrosed and hard and can't hold and distribute pain medication as it used to. Also, all that fibrosis causes an extra growth of nerve endings to compensate for the loss of normal sensitivity throughout the skin. Temporary or permanent donor neuralgia may follow. This is not nearly as much a problem in FUT.

 

Dr. Feller

[Bill - Seemiller]

Dr. Feller,

 

I'm sure my post got lost several pages back, but when you get a chance I'd like your input on my comments/questions.

 

All the Best,

 

Bill

[Bill - Seemiller]

Dr. Feller,

 

I agree with most of what you say, but I'd like you to further explain the below comment.

 

1. FUE has NOT been improved upon in any significant way since its inception in the 1930s and it's reintroduction in the 2000s. The same issues that plagued it then, plague it now. Absolutely nothing has changed. NOTHING ! For any clinic to claim otherwise is FRAUD and an engagement in the illegal act of failing to give INFORMED CONSENT to their patients.

 

It's my observation that 5 and 10 years ago you rarely saw many excellent FUE cases being presented online. Now, many excellent physicians (including yourself) are presenting advanced FUE cases with outstanding results. Innovations to tools (such as the Feller Punch, the SAFE Scribe, automated devices such as ARTAS) have also helped to change the procedure and make it better. I mentioned the ARTAS here but I have my own opinions of its success that I won't get into here. Nonetheless, it's still an innovation. These, plus a physician's dedication and experience in performing the technique have helped to improve FUE which is in part why its popularity has increased. This of course, is just my opinion. If you have one that differs, I'm certainly all ears as the sharing of information is what educates people and builds upon knowledge.

 

I look forward to your input.

 

Bill

[Dr. Alan Feller]

Dr. Feller,

 

I agree with most of what you say, but I'd like you to further explain the below comment.

 

 

 

It's my observation that 5 and 10 years ago you rarely saw many excellent FUE cases being presented online. Now, many excellent physicians (including yourself) are presenting advanced FUE cases with outstanding results. Innovations to tools (such as the Feller Punch, the SAFE Scribe, automated devices such as ARTAS) have also helped to change the procedure and make it better. I mentioned the ARTAS here but I have my own opinions of its success that I won't get into here. Nonetheless, it's still an innovation. These, plus a physician's dedication and experience in performing the technique have helped to improve FUE which is in part why its popularity has increased. This of course, is just my opinion. If you have one that differs, I'm certainly all ears as the sharing of information is what educates people and builds upon knowledge.

 

 

I look forward to your input.

 

Bill

 

 

 

Hi Bill,

First, I truly appreciate you putting me in the "excellent physician" category. I work very hard to be worthy of a good reputation and maintain it. So it means a lot to have someone actually write it in a public forum. In the end, reputation is the currency of the internet and a part of it is being honest. Brutally honest at times. Even when it flies in the face of people who are convinced they are right. Even when it might affect my bottomline.

 

I did not see your questions because this thread is so impossibly long at this point. I had no idea it would gain this much popularity and participation. I will check back and get to those questions later, but for now I will answer your immediate ones.

 

Yes, there have been what SEEM like technical advances in FUE. I have contributed to these "advances" with my own cutting and motorized instruments and patents which I sold to a large company who now produces my instruments commercially. I no longer have any stake in them and can speak freely and without bias.

 

While such inventions look technical and are sophisticated looking they do not actually change the dynamics of FUE. To do this they would have to overcome the three detrimental forces of FUE which are

1. Torsion

2. Traction

3. Compression

 

NONE OF THEM DO!

Instead, several of the inventions you mentioned were designed to allow the novice HT doctor to "get into the game" without the hardship of building up technique, experience, or a practice dedicated to state of the art HT. And to that end these technologies have failed. None of them have improved the procedure overall. Mine included. If they had, we wouldn't be having this discussion and this thread would not exist, much less after 28 pages!

 

In the end a punch like tool must still be applied to the skin, pushed in and twisted, and then the graft has to be grasped, compressed, and literally ripped free of the dermis. No device you've mentioned or known gets around these basics. And until they do, there will have been no advancement in the field. Better to perform the procedure by hand as it is still a far better "machine" than anything yet devised or built by mankind.

 

There are more FUE results out there because there are more doctors doing them and more patients requesting them. But the consistency of success and failure has NOT changed. Even a broken clock is right twice per day. But what about the rest of the day where it is completely wrong? Little is said about that. The same goes for FUE. The best results are reported and poor ones are under reported and buried. Think a clinic is going to post a poor result online? Think someone who feels foolish that they paid a fortune for a chewed up head with poor growth is going to post online? Not likely. A few do, but most don't want to face it any more than they have to.

 

No matter how good an FUE case result looks, it would have looked better with strip AND have the added benefit of a less impacted donor area. Meaning more grafts available for future use after the strip case as compared to the FUE.

 

Of course with anything the dedication of the practitioner is key. And there are a few out there that I know of. But even with all their hard work, good intentions, and experience their best work still can't compare to the benefits of strip. Mine included.

 

I'll writ it again:

NO MATTER HOW GOOD OR BAD AN FUE RESULT LOOKS, IT WOULD HAVE LOOKED BETTER HAD IT BEEN DONE AS A STRIP.

 

I'm in the business and am balding. I've had only strip work done on myself and would not have FUE done on me even for FREE as long as I had a strip alternative. Which I do.

 

FUE should be limited to those who are "stripped out" or are precluded from strip surgery for other reasons. FUE is not an alternative to strip, it is complimentary to strip and should be seen as such.

 

You can put a patch on a pair of pants, even two patches. But you don't make an entire pair of pants with patches. You could, but it would be ridiculous. That's how I view FUE, as a patch. Of course you can do an entire HT with FUE, just like you can make a pair of pants from patches, but I can assure you a pair of pants made with patches comes with a higher price tag for something that isn't quite as good as a pair of pants and will not hold up as well.

 

Dr. Feller

[Angelino]

I agree with Dr. Feller here.

 

I had 3 strip procedures with Dr. Mohebi. He told me FUT would yield better results. I didn't care about the scar. I wanted as much hair yield as humanly possible! I don't wear my hair super short wear you would see a scar, so I never cared.

[Dr. Alan Feller]

I agree with Dr. Feller here.

 

I had 3 strip procedures with Dr. Mohebi. He told me FUT would yield better results. I didn't care about the scar. I wanted as much hair yield as humanly possible! I don't wear my hair super short wear you would see a scar, so I never cared.

 

 

Angelino,

99% of the hair loss community thinks and feels just as you do. The idea is to get as much hair with the BEST chance of growth with the LEAST amount of damage...and no HT procedure does that better than FUT (strip). You are in very good company. Since MOST people grow their donor area out a few inches the scar should and does mean absolutely nothing. I couldn't care less about my scar either as long as I get the most hair out with the least amount of damage possible.

 

Thank you for joining in.

 

Dr. Feller

[tommygun]

Dr Feller, do you happen to have any literature in which you are able to share that proves your statements correct? You have been so steadfast in your postings, that surely you must have something that you can share with the community. As someone that has undergone a strip surgery and will have another surgery at some point, I am extremely interested in this topic/debate. Based upon what we all see on this board, there are amazing FUE results being posted almost daily.

[Britanium]

I also agree with Dr Feller. I got all stripped out with FUT before going to FUE to further boost my results.

I believe that for those of us with extensive balding its the way to go. I could not care less about my strip scar - now its been revised anyway.

I think that BHT also has its place. Again if your stripped out and still need some extra hair (who dosnt) or if you get hair greed (guilty)

[irishsailor]

I went fue in my third procedure, but only as I needed to cherry pick my finer hairs for temple points.

For me it's like an artist, being given a pot of paint, to do his canvas and his fue alternative 3/4 pot of paint and asked to do the same painting, with the same detail. It can't be done.

[BaldingBogger]

Dr Feller, do you happen to have any literature in which you are able to share that proves your statements correct? You have been so steadfast in your postings, that surely you must have something that you can share with the community. As someone that has undergone a strip surgery and will have another surgery at some point, I am extremely interested in this topic/debate. Based upon what we all see on this board, there are amazing FUE results being posted almost daily.

 

There are amazing FUE results being posted because they are being carried out daily. I totally disagree with Dr Fellers statements in the results could look better with FUT. I would agree that a higher norwood's final result could look better via FUT purely with the amount of grafts able to be harvested. However I think as Dr Vories also agreed there should not be a difference graft for graft quality once they have matured and cycled.

 

What is not being mentioned here is there are just as many dud results in FUT out there as there is in FUE. The impression been given is FUT is a guaranteed gold standard result which is not the case. There are no guarantees with either technique, I even recall a recent FUT case from Dr Feller Taclinowest which was not a success.

 

The difference in this case is this guy cannot go and shave down his head without obvious scarring on display and move on with his life. THIS IS THE HUGE DEAL FOR PEOPLE. More so than the thought of having the Strip extracted. It is the thought that the surgery wont be successful and they have removed the retreat option as they now have a huge tell tale linear scar on their head and are branded for life as a failed HT patient. If he had FUE and it was was sub par he still has the option shave down without visible scarring. And possibly with a framed hairline.

[Dr. Alan Feller]

Dr Feller, do you happen to have any literature in which you are able to share that proves your statements correct? You have been so steadfast in your postings, that surely you must have something that you can share with the community. As someone that has undergone a strip surgery and will have another surgery at some point, I am extremely interested in this topic/debate. Based upon what we all see on this board, there are amazing FUE results being posted almost daily.

 

 

Tommy,

 

"...there are amazing FUE results being posted almost daily".

 

This is blatantly untrue. If it were true there would have been about 300 new "amazing" FUE cases on this board in the past year alone. There has been nothing even close to that number. Even cumulatively there haven't been that many in the past 14 years !

 

 

My statements about FUE are correct and true based on real world experience in both performing FUE and from seeing the results of multiple other FUE practitioners. I am the guy who writes the literature, and I've posted plenty of it on this very chat site since 2001. Every word has been correct and irrefutable since then.

 

****Notice no FUE practitioner has come on here to refute a single word I've written? ****

 

Think about that when you decide which procedure to choose for your next procedure. Remember, it's your scalp and you only get one.

 

Dr. Feller

Edited July 18, 2015 by Dr. Alan Feller

[HairJo]

It makes perfect sense to me Dr. Feller thousands of scars vs one scar I'll take the one linear scar

[Dr. Alan Feller]

There are amazing FUE results being posted because they are being carried out daily. I totally disagree with Dr Fellers statements in the results could look better with FUT. I would agree that a higher norwood's final result could look better via FUT purely with the amount of grafts able to be harvested. However I think as Dr Vories also agreed there should not be a difference graft for graft quality once they have matured and cycled.

 

What is not being mentioned here is there are just as many dud results in FUT out there as there is in FUE. The impression been given is FUT is a guaranteed gold standard result which is not the case. There are no guarantees with either technique, I even recall a recent FUT case from Dr Feller Taclinowest which was not a success.

 

The difference in this case is this guy cannot go and shave down his head without obvious scarring on display and move on with his life. THIS IS THE HUGE DEAL FOR PEOPLE. More so than the thought of having the Strip extracted. It is the thought that the surgery wont be successful and they have removed the retreat option as they now have a huge tell tale linear scar on their head and are branded for life as a failed HT patient. If he had FUE and it was was sub par he still has the option shave down without visible scarring. And possibly with a framed hairline.

 

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.

Edited July 18, 2015 by Dr. Alan Feller

[Michael Vories, MD]

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.

[ModernHair]

Dr. Feller - I'm not saying this to be argumentative because I think you raise some great points, but aren't you vastly overstating the success of the FUT strip when compared to how many follicles are harvested vs. how many actually grow?

 

I'm not anti-FUT strip by any measure and can see, especially for large sessions, why it is a fantastic tool, but isn't the patient also losing 10-20% of their hair follicles up-front with an FUT strip procedure because there are that percentage of dormant hairs that get discarded (because they can't be seen) when you are harvesting the scalp for transplantation? In the FUE, you can cherry-pick only the actively growing follicles and thus have no "wastage" of dormant hairs when harvesting.

 

So, while FUE may have the 3 issues you refer to which can cause slightly lower yields, isn't it also true that FUT strip starts off with a deficit of up to 20% verses FUE because of the dormant hairs which are completely lost in the procedure and are literally thrown away? I think the dormant hairs lost to FUT strip are being left out of this great conversation and including those in the mix probably makes FUT strip and FUE pretty even in the end regarding how many follicles are taken out of your head vs. how many end up back in a different spot and actually grow. That's the only comparison between the procedures that seems fair to me, at least as far as yields are concerned (but of course, there are many other reasons to choose one over the other).

 

Interested in your thoughts.

[KO]

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.

 

 

But that is a placement issue, not a harvesting. Implanter pens were originally used with FUT as well.

[KO]

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.

[Dr. Alan Feller]

ModernHair,

Thank you for joining in.

 

May I ask where in the world you got your information about how FUT dissection is performed? Because whoever told you was pulling your leg.

 

I think I remember back about 17 years ago people talking about loss of dormant hairs during dissection but that was before ultra refined techniques were invented and microscopes were used routinely. But even then I don't believe the loss factor was more than perhaps 5%.

 

Dormant follicle destruction would be much higher for FUE than it would be for FUT. While during FUT dissection a trained technician can easily see the well illuminated and magnified follicular grouping and delicately cut them apart. Even a dormant follicle can be easily visiualized with no problem. FUE, in sharp contrast, is completely blind and includes the necessary ripping of the follicle from the skin. Honestly, which procedure do you think would cause more damage to dormant follicles?

 

By the way, you bring up "cherry picking grafts" during FUE. This is supposed to allow the practitioner to select one, two, or three hair groupings selectively. Many FUE practitioners make this claim as some sort of advantage over FUT. However, it is the presence of dormant follicles that lays waste to the claim. At the time of extraction all the doctor can see is the number of hairs at the surface. He has no idea how many dormant follicles lay below. So, going after a supposed one hair graft via FUE may actually result in a two or three hair graft when extracted !

 

So your understanding of FUE and FUT and which is safer for dormant follicles is reversed.

[Dr. Alan Feller]

KO,

I think the best FUE doctors are the ones who are VERY selective and prescreen their patients along the lines you mentioned in your post. Excellent post by the way.

 

Dr. Feller

[KO]

KO,

I think the best FUE doctors are the ones who are VERY selective and prescreen their patients along the lines you mentioned in your post. Excellent post by the way.

 

Dr. Feller

I disagree that they prescreen patients, as I have seen guys with fine hair and relatively poor characteristics get work done by people like Lorenzo, Erdogan, or Demirsoy, even on this forum. I know that Bisanga only believes patients with good characteristics are FUE candidates, but others like the ones mentioned as well as Dr. C### believe that if you are an FUT candidate, then you are an FUE candidate as well. Here are a few examples:

 

http://www.hairrestorationnetwork.com/eve/171358-fue-dr-erkan-demirsoy-3033-grafts-turkey-instanbul.html (Diffuse donor thinning, he had good caliber hair though)

 

Mi operacion con Dr Lorenzo 2012 (relatively weak donor hair)

 

Dr. Lorenzo 2.451 ufs (mayo 2013) (very advanced loss)

 

JOSE LORENZO OPERACI?N 3000 UFS APROX. (depleted donor area)

 

http://www.hairrestorationnetwork.com/eve/176904-my-4000-grafts-repair-dr-erdogan-%96-september-29th-30th.html (short donor area/stripped out)

 

http://www.hairrestorationnetwork.com/eve/175962-difficult-case-1-a.html (Pretty bad one)

 

They just aren't the showcase patients.

[Dr. Alan Feller]

Dr. Feller,

 

I have yet to read all the comments on this topic although I imagine there's a lot of debate given that there's over 26 pages :-). However, I have to say that I was very impressed with this video and I agree with the vast majority of what you said. Frankly, I still firmly believe that those who are candiates for strip surgery should undergo strip first and then later, after being "stripped out" should undergo FUE in order to maximize the number of hairs that can be moved.

 

FUE may allow men to wear hair at shorter lengths without visual signs of scarring, but underneath the scalp, I agree that there is far more damage. Thus, those who've undergone FUE will most likely never be able to undergo strip and if they do, many of the surrounding follicles will already be damaged from the resultant trauma from FUE.

 

I also agree that strip surgery (FUT) has the capacity to produce superior results. That's not to say that FUE can't be as effective or yield as much growth as strip in some patients. However, overall, strip provides physicians and their staff with the ability to see what they are doing and as a result, there is less damage to the follicles during extraction and growth yield is higher.

 

Simply put, guys who are concerned about maximizing both coverage and density should undergo strip first (if they are candidates) and then top it off with FUE. The group of people that are terrified of a linear scar for some reason (which frankly really never bothered me) should probably avoid strip and simply undergo FUE and just make the best of it. There are excellent physicians (including Dr. Feller) doing top notch FUE with excellent results. But I agree with Dr. Feller that strip (overall) produces more consistent results.

 

mFUE is an interesting concept. I am curious though...why call it modified FUE and not modified strip? I suppose it's as much strip surgery as it is FUE since you're basically harvesting mini-strips. When you have an opportunity, I'd like to speak with you more on the phone and learn more about this procedure. I know that you've been working with Blake on this as well so I'd like to get his input also. It sounds interesting however, I'm having a difficult time grasping why it would be beneficial to go this route. But perhaps as I learn more and see examples of it, it will become more obvious.

 

The one thing I want to say in general is that it bothers me that strip is referred to FUT. I know I've done it myself several times, but the reality is - strip, FUE and mFUE are ALL FUT procedures. FUT as you said, stands for follicular unit hair transplantation. It is termed this because follicular units (hair groupings as they occur naturally in the scalp) are harvested from the donor area and transplanted to the recipient area (balding areas of the scalp) in order to produce the most natural looking appearance. Strip, FUE and now mFUE are all referring to donor harvesting techniques and nothing more. Follicular Unit Transplantation is the overlying procedure that incorporates all of these donor harvesting methods.

 

Thanks again for sharing this and I look forward to learning more about mFUE.

 

Best wishes,

 

Bill

 

 

Bill,

It looks like we agree on the broad strokes, so that's good.

 

Your issue is the nomenclature. The reason I wouldn't call it modified strip procedure is because it is not a strip. A strip conjures up a line running across the back of the scalp. mFUE is not that. But I also agree it is NOT FUE. But since it is not strip, and it is not FUE, and it is closer to FUE than strip I decided to call it mFUE instead of mStrip (or mFUT).

 

But even FUE is not FUE because many times you get more than one follicular unit in a single extraction.

 

I suppose we could have called it mPLUG since that is probably closer than FUE or Strip. However, we close the skin after extraction and the plug is divided up under microscopes, so you see that doesn't fit either.

 

Probably the best name for it is non-linear scar. But nobody will remember that and we really don't need to add NLS to the alphabet soup of hair transplant names. So mFUE is the closest and that's what we call it.