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

[Mickey85]

I wish Docs and clinics would just post good work instead of coming off like informercial salesman. Sorry if that offends anyone, but that is my opinion and that is how I feel. Luckily the majority like Dr Hasson, Lorenzo, Wong, Konior are focused on doing great work.

 

Totally agree. Bottom line, irrespective about method, just comes down to great work.

 

Hey mickey,

 

The temple points I had with Dr Lorenzo turned out great. I'm glad I made the best of the time he spent in UK

 

Very happy that your temples turned out excellent. I have followed your progress since the early days. You got Lorenzo at the best time I believe.

[Blake Bloxham]

Whoa. Haha.

 

A few things:

 

1) Remember that Dr Lindsey never said FUE yield was 40%. He was referring to the final post-operative appearance of an FUE and strip result of the same size. In my mind, his comment was referring to decreased growth yield with FUE and the characteristics of FUE-derived hair. Both of these contribute to the decreased "fullness" he discussed.

 

2) Dr Lorenzo and Feller have actually known each other for quite some time. Dr Lorenzo has always been very complimentary of this work. One of the members in this thread actually underwent surgery with both and can confirm this.

 

3) The data I've shared about FUE transection rates and FUE growth rates comes from research Dr Wesley did while working on his Pilofocus technique. It was done using sharp, manual extraction with handheld tools. What I like about the data is that it supersedes the "well you say FUE only grows at X because you're bad at FUE" talk, because it: a) wasn't conducted by a doctor trying to prove the efficacy of his FUE, and b) Dr Wesley's methodology is solid -- I've discussed the research with him personally and he's researched at Yale, Princeton, etc. I won't repost the link because I have many times before, but the outcome showed significantly decreased growth (50-70%) of skeletonized FUE grafts (and the technique inherently skeletonizes) and roughly 45% overall better growth from grafts extracted via non-FUE methods. This data is as objective and un-emotional as it gets, and that's why I like referring to it.

 

4) No one is trying to belittle a specific practitioner here. I don't think "FUSS docs" are trying to specifically belittle any "FUE doc." There is a mutual respect between those who are really dedicated to this field. The doctors who post here are very much dedicated to hair transplantation.

 

5) Mick, the quote you received about a 5% difference in transection may be true. However, this is only one very small aspect of the entire "journey" of an FUE graft. Transection means the graft was sliced through and will not -- or should not -- be implanted. However, you can not transect a graft, but still put it through avulsion injury, torsion, or compression injury during extraction; it can also easily dehydrate while waiting to implant -- as FUE grafts, like stated above, are naturally skeletonized; it can also be damaged during implantation -- as there is less supportive tissue to grasp during insertion; AND, once it's placed in the scalp, it lacks the supportive tissue needed for cellular cross talk to cycle normally. All of these still lead to the same fate: the graft doesn't grow. However, it could be non-transected and still fall prey to any of these issues.

 

6) Keep in mind that no one here is out to start a war or destroy a procedure. We are all on the same team. However, there are things being said about FUE that haven't been mentioned online before -- or in quite some time -- and I understand why this could rile some feathers. There are certain procedures that are better for certain patients. As long as patients are properly consented on each, there is no problem. However, remember that there is "no such thing as a free lunch." Anyone who tells you that "FUE is 100% yield with strip-quality hair and 'scarless'" is being blatantly misleading. This is just as true as anyone trying to downplay the strip scar or tells you that "you'll be able to buzz as short as you like without the scar being visible."

 

But here's the truth: Strip has better yield. I know people will say: "Well, nuh uh! X surgeon uses Y technique and told me in an email it's equivalent to strip." The OBJECTIVE evidence we have shows us this is not true, and anyone who physiologically examines the two different extraction methods should logically come to the same conclusion. HOWEVER, the visible scarring is "better" in the sense that there is no strip scar. I also see noticeable differences in the characteristics of the hair and have personally seen subcutaneous scarring complicate future FUE procedures. Now, if patients are aware of this and still want to undergo FUE. That's great! They've been properly consented, they don't want the linear scar, and they have accepted the results.

 

Now, I really believe mFUE overcomes the problems I discussed above and delivers strip-quality results with FUE-quality scarring. Frankly, I would recommend this procedure above traditional FUE to any patient who absolutely couldn't deal with the linear scar ... but I won't light that fire here ; )

 

Mick, as usual, good to see you posting!

[Blake Bloxham]

PS:

 

Mick,

 

Have you talked to Lorenzo lately? Is it true he started using technicians for extraction when he went back to Spain? I heard conflicting things.

[Dr. Alan Feller]

That is exactly what I'm saying in no uncertain terms Mickey: Dr. Lorenzo has NOT overcome the 3 detrimental forces inherent to FUE. Nor has Dr. Feriduni, nor Dr. Bisanga.

 

What's more is that none of these doctors has claimed to.

 

It is only vociferous posters like yourself who make these claims anonymously and on their behalf. I am friends with these three doctors and have met them at meetings and we each have had this very discussion about FUE years ago when the last wave of FUE hype swept the internet- and they ALL agree that these three forces are the main limitations of FUE.

 

Notice THEY themselves have never come on here to make the claims that you and several others make. Never. Why? Because these claims would not be true. Furthermore, to make such claims would be to engage in the legally negligent practice of failing to give informed consent to patients.

 

That's why it's great to debate and squabble and hyperanalyze on an internet forum where there is no reality going on and no accountability, but when you cross into the operating room, all the supposition and BS goes out the window right fast and in a hurry.

 

FUE is a GREAT procedure. I am an FUE doctor and have been a part of it's growth and maturation, but it still isn't as good as strip. It still is not a SUBSTITUTE for strip. It remains an ALTERNATIVE to strip for those who can't have strip procedure or other rarely encountered physiological characteristics.

 

Feel free to point out and focus on the success of particular FUE doctors all you want. Fine, they are honest and well earned, but compared to strip success it is a drop in the bucket. A drop in the ocean in fact. Truth is, most of the FUE experiences I read online are negative or disappointing. That says a lot. Compare that to the literal THOUSANDS of fantastic online strip results. No contest at all. That is reality.

 

If the world outlawed strip tomorrow it would make no difference to me, I can do 3000 FUE grafts in a day and still be in business. No worries and no rush to learn how to do it. Unfortunately it's because I know how to do it and KNOW what the limitations of it are that I promote strip over it.

 

If any FUE only doctor cares to correct me on anything, the floor is yours:

[HairJo]

I still believe there is less transection in the strip method there is no yanking or pulling out the grafts . The strips are cut into grafts by technicians who have more tissue to work with while preparing the correct graft size and microscopes to ensure less damage to the follicles and tissue protecting the integrity of each and every graft. Making the grafts with an FUE punch isn't that like going in kind of blind you can't see whats going on under the skin and I guess you have to pull them out individually trimming a graft to perfection by the techs seems to be a better the best choice for less trauma and healthier grafts in the strip method. For small touch up though I think FUE is a good choice but for a large area I would go with strip . I also think its better to preserve your donor area for further HT's down the road if you can get another full solid strip rather than one who has had a lot of grafts removed during a mega FUE session. But if you have faith in your FUE doctor and he can produce the same or better results then by all means go with what you know and how confident you are with your doctor and your decision,

[KO]

PS:

 

Mick,

 

Have you talked to Lorenzo lately? Is it true he started using technicians for extraction when he went back to Spain? I heard conflicting things.

 

I'll answer for Mickey. Lorenzo was using techs for extraction before his Manchester stint, and I believe has always used them to assist in the harvesting. Reports from patient accounts confirm this, along with his Spanish language site. (Not his English site though. )

[hairweare]

Lorenzo works with his team and assigns extractions based on what he feels to be appropriate. The day begins at around 9AM and he works constantly with minimal breaks throughout the day and early evening generally finishing up around 10-11PM. Regardless of the case load he does all of the implantations.

 

Dr. Feller only speaks for himself and none of us should speculate as to how another physician might respond if given the opportunity. I have had this discussion with him myself but I will defer to him if he chooses to debate these points directly. I think it is common knowledge that Dr. Lorenzo chose to under go 5000 FUE grafts which by itself say something about his faith in the procedure does it not?

 

Blake you know better than to cite a single operator study with only a handful size cohort and call that settled science. I am sure Dr. Wesley would be embarrassed by your argument. Why not repeat the study yourself and use an implanter pen to see if that is an important variable left out of the study design?

 

Pt. postings on the internet is not a fair representation of the degree of success or failure of either technique. Let's be honest, most people after undergoing elective cosmetic surgery do not spend hours and days of their lives posting anonymously about their experiences. Admittedly, we are all members of a select subgroup who for whatever reason including obsession or addiction log in here well after it is time to be moving on with life. Heck there are even people who have been here for years with thousands of posts who have not even undergone a single procedure. Again, not the typical patient who undergoes elective cosmetic surgery.

[Dr. Alan Feller]

Hairweare,

 

You are incorrect that I only speak for myself. I speak for every single doctor with whom I've ever had an FUE discussion. Have you? Not one would disagree with the video. Not one has ! Notice that yet?

 

And that includes Dr. Lorenzo. He and I met at a meeting and we discussed in detail his FUE method. He even gave me a video on CD of it. He made up some very good methods he calls "tricks" to extract grafts, but to be sure they still subject the grafts to the three detrimental forces just like every FUE practitioner. He would not deny this.

 

Tell you what, why don't you PM me your real name and phone number. Then I can make a three way call between you, me, and Dr. Lorenzo and you can hear first hand what he has to say about the subject. He may not care for you speaking in his name and I'd be curious to see if he supports the positions you have been advocating on this site in his name. After that, we can call ANY other doctor you wish at my expense and have the same discussion. Then you can post it here.

 

As far as other doctors being given the "opportunity" to respond, they have computers and internet connections, don't they? They clearly have the opportunity. And with over 1,500 views of my video you can be sure they or their representatives have watched it.

 

What you don't know is that FUE hype is not new. It precedes your time here by almost 15 years. At that time some clinics made the outright claim that FUE was as good or better than Strip surgery. You sure as hell don't see that claim being made anymore. In the United States that is a golden ticket to a medical malpractice lawsuit and all sorts of other charges- not to mention a load of very unhappy patients.

 

But it is no longer the clinics making the claim. It is now vociferous posters who anonymously make claims IN DOCTOR'S NAMES without their permission to support an uninformed and wishful thinking view of Strip and FUE.

 

Most of what you wrote is factually incorrect. You should read what HairJo wrote above your post. He is absolutely correct in the details he is reporting here about the trauma FUE grafts sustain.

Edited June 8, 2015 by Dr. Alan Feller

[hairweare]

If you are not just speaking for yourself Dr. Feller I suggest you try to do so since you are indirectly accusing any FUE specialist of malpractice if they do not fully disclose that their method is inferior to yours.

 

I don't speak for Dr Lorenzo or anyone else but myself, I am not promoting anything or a specific agenda. Nor I am affiliated with any particular doctor. Can you honestly say the same? My first FUSS was with Bill Rassman in 1993 and we later discussed FUE as he and Robert Bernstein were arguably the early FUE pioneers in the US and certainly on the West Coast. I thought it was a novel idea but not ready for prime time and passed on the opportunity to be one of their early cases.

 

You have every right to self promote yourself on this site since after all you are paying for it. I think though that just as when you attacked Dr. Umar a few years back you do yourself no favors by directly maligning a technique which has developed to the point of clinical non-inferiority among the leading practitioners and gaining universal acceptance by the ROW patients. Perhaps you should hone your old methods and reconsider adding it back to your armamentarium like your fellow strip docs such as Rahal and H&W. Are they seeing something perhaps that you are missing?

[FUE2014]

Tell you what, why don't you PM me your real name and phone number. Then I can make a three way call between you, me, and Dr. Lorenzo and you can hear first hand what he has to say about the subject. He may not care for you speaking in his name and I'd be curious to see if he supports the positions you have been advocating on this site in his name. After that, we can call ANY other doctor you wish at my expense and have the same discussion. Then you can post it here.

 

Dr F, I suspect if you were based in Europe (where there are less constraints on tech involvement) and could achieve the results Dr Lorenzo does with large FUE sessions, you would not care for the position you are currently advocating because to do so would be cutting off your nose to spite your face. The demand for FUE is clearly huge and with the quality of work coming out of Europe and cheaper costs than the US, it is going to continue growing in popularity. FUE is where the money is which is why you are not going to get FUE docs coming on here to highlight its limitations to the same extent you are (assuming those limitations are valid)

Edited June 8, 2015 by FUE2014

[hairweare]

I should add that after 2900 recent scalp FUEs I do not feel or look like someone took a shotgun to the back of my head but on the other hand following my third strip I did feel like I was hacked in the back of my head with a machete and had to wear my hair longer to hide the unsightly linear scar until 301 beard grafts were successfully implanted into it.

Edited June 8, 2015 by hairweare

[Mickey85]

That is exactly what I'm saying in no uncertain terms Mickey: Dr. Lorenzo has NOT overcome the 3 detrimental forces inherent to FUE. Nor has Dr. Feriduni, nor Dr. Bisanga.

 

What's more is that none of these doctors has claimed to.

 

It is only vociferous posters like yourself who make these claims anonymously and on their behalf. I am friends with these three doctors and have met them at meetings and we each have had this very discussion about FUE years ago when the last wave of FUE hype swept the internet- and they ALL agree that these three forces are the main limitations of FUE.

 

Notice THEY themselves have never come on here to make the claims that you and several others make. Never. Why? Because these claims would not be true. Furthermore, to make such claims would be to engage in the legally negligent practice of failing to give informed consent to patients.

 

That's why it's great to debate and squabble and hyperanalyze on an internet forum where there is no reality going on and no accountability, but when you cross into the operating room, all the supposition and BS goes out the window right fast and in a hurry.

 

FUE is a GREAT procedure. I am an FUE doctor and have been a part of it's growth and maturation, but it still isn't as good as strip. It still is not a SUBSTITUTE for strip. It remains an ALTERNATIVE to strip for those who can't have strip procedure or other rarely encountered physiological characteristics.

 

Feel free to point out and focus on the success of particular FUE doctors all you want. Fine, they are honest and well earned, but compared to strip success it is a drop in the bucket. A drop in the ocean in fact. Truth is, most of the FUE experiences I read online are negative or disappointing. That says a lot. Compare that to the literal THOUSANDS of fantastic online strip results. No contest at all. That is reality.

 

If the world outlawed strip tomorrow it would make no difference to me, I can do 3000 FUE grafts in a day and still be in business. No worries and no rush to learn how to do it. Unfortunately it's because I know how to do it and KNOW what the limitations of it are that I promote strip over it.

 

If any FUE only doctor cares to correct me on anything, the floor is yours:

 

That is a fair response actually and clears up some of your perspective. I will also take the label of being vociferous(maybe we have something in common then hey ).

 

In response, I never said those 3 factors never existed(or cease to exist), just that those aforementioned surgeons(I think I referenced Lorenzo, Bisanga, Erdogan, Feriduni etc) have found ways to mitigate or bypass those factors. I don't think they need to come on here to claim otherwise, they are simply content to focus other things, Many would simply not be interested in getting into an online discussion with anyone. Feriduni is booked out til at least early 2015 and Lorenzo's 2015 dates are gone. I don't think they need to convince anyone. Again I'm not saying those 3 forces do not exist but from the results posted(Lorenzo has 200 alone) I'm saying they have found a way around them. I find Dr. Lorenzo's results better than alot of recommended and coalition clinics strip result. How is that?

 

I have no doubt you were heavily involved in FUE in its infancy but forgive me for saying this Doctor but it does seem like you have abandoned the method almost entirely whilst others after you have embraced it. I have not see an FUE case from you in several years(even a small one). I know you developed manual and motorized tools for it and have written books about it but in terms of results, they have declined in quantity. I would love to see more of your FUE results as I would with any surgeon.

 

You say FUE remains an alternative procedure for those that cannot have strip. Many other surgeons suggest FUE first to patients who are applicable for both mainly because it is less invasive and allows for a shorter haircut. Does that make these surgeon's wrong in your opinion? That is their protocol, whist yours is relegated to those who can't have strip procedure or other rarely encountered physiological characteristics. You are making a blanket statement here I feel. Many other surgeons give their patients a choice of FUE or strip given they are suitable for both.

 

FUE results in general are a drop in the bucket because of it's relative infancy compared to strip and because of the general apprehension to it by many North American surgeons. I am continuously seeing more and more good-great FUE results. Yes I see failed ones but nothing extremely out of correlation compared to the amount of good and failed strip results. Comparing the two methods in terms of quantity is nonsensical in that one is a good ten years older than the other in my opinion.

 

Just my opinion. I don't want to offend you or Blake with my statements. I do wish you both luck with mFUE, but as usual, the results will speak for themselves.

[Mickey85]

Whoa. Haha.

 

A few things:

 

1) Remember that Dr Lindsey never said FUE yield was 40%. He was referring to the final post-operative appearance of an FUE and strip result of the same size. In my mind, his comment was referring to decreased growth yield with FUE and the characteristics of FUE-derived hair. Both of these contribute to the decreased "fullness" he discussed.

 

2) Dr Lorenzo and Feller have actually known each other for quite some time. Dr Lorenzo has always been very complimentary of this work. One of the members in this thread actually underwent surgery with both and can confirm this.

 

3) The data I've shared about FUE transection rates and FUE growth rates comes from research Dr Wesley did while working on his Pilofocus technique. It was done using sharp, manual extraction with handheld tools. What I like about the data is that it supersedes the "well you say FUE only grows at X because you're bad at FUE" talk, because it: a) wasn't conducted by a doctor trying to prove the efficacy of his FUE, and b) Dr Wesley's methodology is solid -- I've discussed the research with him personally and he's researched at Yale, Princeton, etc. I won't repost the link because I have many times before, but the outcome showed significantly decreased growth (50-70%) of skeletonized FUE grafts (and the technique inherently skeletonizes) and roughly 45% overall better growth from grafts extracted via non-FUE methods. This data is as objective and un-emotional as it gets, and that's why I like referring to it.

 

4) No one is trying to belittle a specific practitioner here. I don't think "FUSS docs" are trying to specifically belittle any "FUE doc." There is a mutual respect between those who are really dedicated to this field. The doctors who post here are very much dedicated to hair transplantation.

 

5) Mick, the quote you received about a 5% difference in transection may be true. However, this is only one very small aspect of the entire "journey" of an FUE graft. Transection means the graft was sliced through and will not -- or should not -- be implanted. However, you can not transect a graft, but still put it through avulsion injury, torsion, or compression injury during extraction; it can also easily dehydrate while waiting to implant -- as FUE grafts, like stated above, are naturally skeletonized; it can also be damaged during implantation -- as there is less supportive tissue to grasp during insertion; AND, once it's placed in the scalp, it lacks the supportive tissue needed for cellular cross talk to cycle normally. All of these still lead to the same fate: the graft doesn't grow. However, it could be non-transected and still fall prey to any of these issues.

 

6) Keep in mind that no one here is out to start a war or destroy a procedure. We are all on the same team. However, there are things being said about FUE that haven't been mentioned online before -- or in quite some time -- and I understand why this could rile some feathers. There are certain procedures that are better for certain patients. As long as patients are properly consented on each, there is no problem. However, remember that there is "no such thing as a free lunch." Anyone who tells you that "FUE is 100% yield with strip-quality hair and 'scarless'" is being blatantly misleading. This is just as true as anyone trying to downplay the strip scar or tells you that "you'll be able to buzz as short as you like without the scar being visible."

 

But here's the truth: Strip has better yield. I know people will say: "Well, nuh uh! X surgeon uses Y technique and told me in an email it's equivalent to strip." The OBJECTIVE evidence we have shows us this is not true, and anyone who physiologically examines the two different extraction methods should logically come to the same conclusion. HOWEVER, the visible scarring is "better" in the sense that there is no strip scar. I also see noticeable differences in the characteristics of the hair and have personally seen subcutaneous scarring complicate future FUE procedures. Now, if patients are aware of this and still want to undergo FUE. That's great! They've been properly consented, they don't want the linear scar, and they have accepted the results.

 

Now, I really believe mFUE overcomes the problems I discussed above and delivers strip-quality results with FUE-quality scarring. Frankly, I would recommend this procedure above traditional FUE to any patient who absolutely couldn't deal with the linear scar ... but I won't light that fire here ; )

 

Mick, as usual, good to see you posting!

 

Hey there Blake

 

1) Lindsey said something to the extent of strip results looking 40% 'fuller' compared to the equivelent FUE result. I simply do not buy this. I think it is untrue. I see Bisanga 3,000 FUE results and they do not look like they could have been done with 1,800 strip grafts. The same with Feriduni. The same with Maras and Mwamba. Maybe he was talking about his own results(to which I wouldn't have a problem with) but it did sound like he was making it out to be the general consensus.

 

2) Dr Feller does good strip work, whilst I don't rate his FUE highly in terms of scale or yield much(my opinion). I don't doubt that they have spoken but I don't see their relationship to be a factor in this discussion.

 

3) Whilst that study was not conducted by a surgeon trying to prove the efficacy of his FUE, that make it more flawed simply because he was not trying to prove th efficacy of his FUE. I don't consider Dr Wesley to be an elite FUE surgeon. I really really like his as a person and a doctor but I don't consider him to be great at FUE. His transection rates very well might be lower than Dr. XYZ. The data may be objective but still based on one human being's talents and skills. I believe that every clinic has different yield rates. Clinic X may get 85% yield whilst clinic Y might get 40%. Dr Feller and Lindsey imply or outright state that high FUE rates are an anomoly across the board. There must be alot of unhappy Lorenzo patients out there(sarcasm )

 

4) I feel that it is a select amount of strip-dominant surgeons trying to downplay FUE and indirectly, the clinics that perform FUE either exclusively or predominantly. Pulling out arbitrary numbers like 40% fuller and making it seem like the general consensus is silly to me. Doctors like Erdogan/Lorenzo/etc all seem to have no problem getting great results from a quantity of grafts that strip would also warrant(Erdogan likes to use more for more aesthetic hairlines and density I'll admit). They certainly do not look 40% thinner.

 

5) Dr Bloxham, I believe Dr Feriduni's clinic said it was the actual 'yield' of the graft being 5% higher for strip. Not transection. Dr Bisanga also has a similar protocol where anything less than 90% for strip warrants a free repair and 85% for FUE. These are yield statistics(grafts that grow in the scalp), not transection.

 

6) I have no problem with the general consensus being that FUE has a slightly less yield than strip. But for one clinic to make a blanket statement across the whole world does seem like fear mongering to me especially when the European surgeons(mainly) have show that FUE can be used exclusively and growth rates can be consistently good to great. I won't lie,I find Dr Lorenzo's FUE better than Dr Lindsey's strip. Many others do too as I'm sure you remember the reception Dr Lorenzo received when he first posted results on here. I find Lorenzo's FUE also better than Dr Feller's strip but I do admit Dr Feller does put out some great strip results(Chrisdav and Irishsailor being notable).

 

If Dr Feller/Lindsey/any doctor came out and said "FUE yields are just under that of strip" I would not have a problem. But instead it is almost like he demonizes it("someone taking a shotgun to the back of the head?!?!" and is not content until he convinces the whole world that FUE yields from any clinic are much much lower and that it is almost an experimental method of HT. I do find it funny that those that are talking down FUE are also the ones who cannot perform it to the extent of Feriduni/Bisanga/Lorenzo etc. I don't mean to offend anyone here and I'm sorry if I do, but that is how I feel. If Feller/Lindsey were able to perform FUE's to the caliber of Dr Lorenzo and turned around and said "it just exhausts too many wasted grafts, we can use much less strip grafts for the same result" than I would be much more inclined to believe them.

 

Again I'm sorry to say that because I like Dr Lindsey from what I have seen from his persona and Dr. Feller seems likeable from his videos and his penchant for personally helping patients on here. And you know I respect you alot Blake and will continue to do so. As I told Dr Feller in my response to him, I wish you all the best with mFUE. I will let the results do the talking but until then I will just wait

 

PS. to my knowledge, Dr Lorenzo is using techs to assist in extractions. I believe he has another doctor at the clinic with whom he shares implantation duties with. He does do some of the extractions but no straight out percentage.

[JoeTillman]

As far as other doctors being given the "opportunity" to respond, they have computers and internet connections, don't they? They clearly have the opportunity. And with over 1,500 views of my video you can be sure they or their representatives have watched it.

 

Pardon me, Dr. Feller. Which video is this that has 1500 views? I see your mFUE vs. FUE vs. Strip video with 162 views at the time of this post. Is there another on the subject I'm mssing?

[Mickey85]

Pardon me, Dr. Feller. Which video is this that has 1500 views? I see your mFUE vs. FUE vs. Strip video with 162 views at the time of this post. Is there another on the subject I'm mssing?

 

Hey Joe, I think he may be referring the the thread itself(now upto circa 1,800 views). I could be wrong though.

[hairweare]

Mickey, we have said essentially the same thing so nothing bears repeating at this point. I do want to publicly thank you for if not for your contemporaneous and cogent posts on the merits of FUE and particularly Dr. Lorenzo's mastery of it, I might have chosen a different path and would not have had the fortunate success that I have subsequently achieved as a hopeless NW7. I have stayed on to essentially pay it forward and privately helped and guided several members here in their own decision processes. Before I find it time to move on I did want to extend my gratitude to you as one of the most valuable posters on this site. The information that you have provided I am sure has also helped many others. Best of luck with your own quest and warmest regards from the great NW.

[irishsailor]

2) Dr Lorenzo and Feller have actually known each other for quite some time. Dr Lorenzo has always been very complimentary of this work. One of the members in this thread actually underwent surgery with both and can confirm this.

 

hi Dr B,

 

Yes that was me. I can confirm that to be true. I had a great procedure withe Dr feller and , Dr Lorenzo said looking at my before pics and what sat in front of him for my FUE consultation ,he could tell I had as close to a 100% yield.

He was very complimentary of Dr fellers work. Actually the first time I heard of Dr Lorenzo was when in Dr fellers office having surgery in 2011, Dr feller had mentioned him in conversation, I think it's safe to say they both respect and hold each other in high regard.

 

I have always said that FUSS was best surgery for myself, due to hairless pattern and what I may need down the road. However having coarse hair, I believe FUE was best option for temple points.

 

I think they both bring great things to the table, I've never seen it as good vs evil.

Congrats for qualifying, hope to see you as a coalition doc on here sometime soon.

[Mickey85]

Mickey, we have said essentially the same thing so nothing bears repeating at this point. I do want to publicly thank you for if not for your contemporaneous and cogent posts on the merits of FUE and particularly Dr. Lorenzo's mastery of it, I might have chosen a different path and would not have had the fortunate success that I have subsequently achieved as a hopeless NW7. I have stayed on to essentially pay it forward and privately helped and guided several members here in their own decision processes. Before I find it time to move on I did want to extend my gratitude to you as one of the most valuable posters on this site. The information that you have provided I am sure has also helped many others. Best of luck with your own quest and warmest regards from the great NW.

 

Thank you so much for the very kind words my friend. Really appreciate it. Really glad that you got great results from a method that some mistakenly deem as vastly inferior. Very cool of you to stay on to pay it forward and sad that you may be leaving. I to was close to leaving the forum and probably will in the near future but feel compelled to stay. Some may laugh at that and that's fine.You are right in that we have said all that can be said. Thanks again for the awesome post, all the very best to you in everything

[KO]

Blake you know better than to cite a single operator study with only a handful size cohort and call that settled science. I am sure Dr. Wesley would be embarrassed by your argument.

 

 

These are awfully big words from a guy whose only argument on this forum has been "But Lorenzo does this", "But Lorenzo says this", "But Lorenzos work proves this". "But Lorenzo believes this". "But Lorenzo would never do this"

 

 

 

Single operator? Nope..."But Lorenzo!".

[KO]

Dr F, I suspect if you were based in Europe (where there are less constraints on tech involvement) and could achieve the results Dr Lorenzo does with large FUE sessions, you would not care for the position you are currently advocating because to do so would be cutting off your nose to spite your face. The demand for FUE is clearly huge and with the quality of work coming out of Europe and cheaper costs than the US, it is going to continue growing in popularity. FUE is where the money is which is why you are not going to get FUE docs coming on here to highlight its limitations to the same extent you are (assuming those limitations are valid)

 

FUE is where the money is.

 

 

There is no doubt that FUE is more popular, and it's not hard to understand why. But that doesn't really refute Feller's argument about the merits of FUT.

Edited June 8, 2015 by KO

[Dr. Alan Feller]

KO,

You wrote exactly what I was about to write.

 

And Irishsailor, I remember you, you were a great patient and excellent company the day of your surgery. I'm glad you remember me speaking fondly of Dr. Lorenzo as this not a Good vs Evil contest as you put it. Unfortunately, many here make it into that for reasons I'll never understand.

 

 

FUE is not more popular-here or in Europe. It is the popular WISH of the uninformed masses. That is simply a fact.

 

I will not perform FUE on a person who clearly needs a strip procedure. I do not bow to outside pressure when I know it's the wrong thing to do. By the way, during consultation I discuss the realities of FUE with every patient who requests it and 99% of them willingly drop it because, unlike in the fantasy world of a chat forum, they know the next stop is the operating room where wishful thinking has no place.

 

Why are other strip clinics getting into FUE now? Perhaps they are only figuring out what I did 14 years ago that it is a great procedure for a limited number of patients and in limited amounts. But have they abandoned strip? Not a chance. Why not ask them publicly to answer on the forum instead of YET AGAIN invoking the name of doctors who don't know you are speaking for them?

 

I think I'll make a video about this thread.

[thatoldchestnut]

There is a troubling number of competing agendas in this thread and on this website as a whole. Makes the whole place a veritable minefield.

[Swooping]

FUE is not more popular-here or in Europe. It is the popular WISH of the uninformed masses. That is simply a fact.

 

Dr. Feller I love how you keep speaking of "facts" or the "truth". You are no authority really.. So do you have data to backup this statement?

 

You keep doing this repeatedly in almost every post of you but frankly said much of you say is just your opinion. And from my point of view you are looking at several points from a (heavy) bias.

 

Yes the extraction process of FUE is more harsh to the grafts and this will probably results overall in a slightly lower yield. How much? Nobody knows really. Because we lack scientific data about this point. I think this only portrays that the hair transplant industry needs properly well set up scientific studie. They are terribly lacking. Studies like this are extremely hard to set up though for obvious reasons.

 

FUE does require more skill and time invested to become really good at it. That's why it's so incredibly important to chose a good FUE practitioner. And if we put up a good FUE practitioner vs a good FUT practitioner I believe the mean yield going to be only slightly lower with a bit higher variable overall.

 

Feriduni states kinda the same on his site;

 

Generally speaking, grafts extracted via FUE are much more sensitive, as the extraction technique leaves much less protective tissue around the hair follicles. This ultimately leads to a slightly lower survival rate.

 

Anyway I'm pretty sure that a slightly lower yield trade off is what many people would happily chose for to avoid linear scar on the back of their head. FUT is getting very old fashioned and I believe FUE is getting more popular too. It probably already is. In fact when I at my national hairloss forum (Dutch) I see that hair transplants are pretty popular and the section in the forum is too. I can tell you that 95% of the topics in the section are people who go/went for a FUE. Most of people travel to Turkey for that. Is this a representation for Europe? No, it isn't but in my opinion it is indicative. By the way this isn't only on the Dutch national forum but also on other forums. Jup, I can make screenshots and count the topics for you if you want on these forums.

 

A few days ago someone made a topic about his donor problems with FUE. You didn't even see a picture yet you were that fast to make a video about the problem of "mega fue sessions" in relation to the donor. Specifically talking about how the tiny little holes in a mega session in the donor area can disrupt blood flow and cause problems. Your whole story is quite incorrect and thus provides as a source for misinformation. I can go into this later. Anyway the whole thing seemed to me like a opportunity to try to bash FUE.

 

Now you can keep loving your FUT puppy and define it as the "golden standard' for yourself. However consumers eventually dictate the market not you.

 

About mFUE..... If you will prove that it can prove itself up to FUE then that is great. So if you get the same scarring and the same results as the top FUE practicioners with mFUE then I applaud you. I'm not that excited of another method which doesn't substantially act as a real innovation. However if you manage to get great results with it just as the top FUE guys then I'm sure people will appreciate that. Thus, I'm looking forward to more professional documentation with high quality pictures.

 

To other people who are reading/watching this topic I can only say that no idea/thing is just true because someone says so. Keep that in your mind!

[KO]

Regarding Lorenzo showing great hair volume on his HTs - it is true, his results look great, but let's look at the typical characteristics of his showcase patients. They seem to be fairly high NWs, with a good amount of MFUs, and typically with a hair shaft diameter of 60 microns. I think forum members underestimate the power of great characteristics, which are the main variable in an HT result, not the surgeon. A patient with 60 mic hair is going to have >40% volume for every hair transplanted, compared to a patient with a more average 50 mic hair. If you have fine hair, say 45 mic, the difference is going to be more than 70% in terms of hair volume! Doubling hair diameter quadruples hair volume, it is staggering really.

 

So if Lorenzo had a portfolio of patients of high NWs and fine/average hair, his results would be significantly less impressive.

[FUE2014]

At the end of the day, the majority of us, as lay people, can't argue as forceably on the technical aspects of hair restoration procedures as the docs, such as Dr Feller, who perform the work day in day out. For the most part we are relying on second hand information from the internet and discussion forums to support our views. However, where our views do carry as much weight as the docs, or anyone for that matter, is from the results published online. Everything else being equal, this is what we are left with. Results. And my opinion on results, from what I observe online, is as valid as anyone else's. And if we accept all of FUE's limitations, for sake of argument, we are still left with something which gives really good results in the hands of the right docs without the linear scar. Isn't that all that matters?