FUT is more popular than FUE

[Dr. Alan Feller]

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Feller himself has had 3 FUT transplants, 2 unsatisfactory yet he goes around slamming FUE and wants to drag others into his stripped out logic.

 

 

Incorrect.

I had one unsatisfactory FUT procedure over 23 years ago by a low end doctor who doesn't even perform HT anymore. Despite this I did not have a large or regrettable scar.

 

I also do not "slam" FUE. You are projecting. I perform both FUT and FUE. It is you and other FUE-only advocates who "slam" FUT every chance you get. Don't you ever tire of tearing things down instead of building them up? You are pure negativity on these threads. It's your view or no view, right?

 

In truth, most of the opposition to FUT is blind fear of the procedure itself, not the normal and easily concealable scar it leaves behind. In reality it is FUE scarring that causes more damage to the skin and the remaining donor follicles limiting overall available follicles in the future.

 

The formula for hair transplantation is simple: Do as much FUT as possible, then finish with FUE.

[Sethticles]

The formula for hair transplantation is simple: Do as much FUT as possible, then finish with FUE.

 

how does this make any sense, scar yourself for life and then when all else fails FUE which thins the area you want are so desperate to hide... screams madness to me

 

 

and sorry Dr Feller 1 unsatisfactory transplant, my mistake,

[Eurofue]

Incorrect.

I had one unsatisfactory FUT procedure over 23 years ago by a low end doctor who doesn't even perform HT anymore. Despite this I did not have a large or regrettable scar.

 

I also do not "slam" FUE. You are projecting. I perform both FUT and FUE. It is you and other FUE-only advocates who "slam" FUT every chance you get. Don't you ever tire of tearing things down instead of building them up? You are pure negativity on these threads. It's your view or no view, right?

 

In truth, most of the opposition to FUT is blind fear of the procedure itself, not the normal and easily concealable scar it leaves behind. In reality it is FUE scarring that causes more damage to the skin and the remaining donor follicles limiting overall available follicles in the future.

 

The formula for hair transplantation is simple: Do as much FUT as possible, then finish with FUE.

Wow you really don't listen to prospective patients!

Yes we all understand that more grafts are available with FUT! We Get It. The 3 forces!!!!!!!!

We just don't care. People who would rather opt for FUE chose it for one factor alone. They don't want to risk the Linear scar turning out awful. Whatever chance of that actually happening be it 0.1% or even less. They want to be able to have shorter hair in the region of that scar so this has the best viable option to do that. Yes we understand that there is also chance of possible scarring with FUE but generally that option is easier to cover up than the linear scar if goes bad. From all that has been written and posted that's what I get from everything. Is this not the case at all?

[Dr. Alan Feller]

how does this make any sense, scar yourself for life and then when all else fails FUE which thins the area you want are so desperate to hide... screams madness to me

 

 

and sorry Dr Feller 1 unsatisfactory transplant, my mistake,

 

Apology accepted, Seth.

Just goes to show that everyone needs to be careful who they pick for their doctor no matter which procedure you favor. I didn't know at the time how inexperienced my first HT doctor and his staff were and thus I had 50% growth. Even FUT in the wrong hands can produce dismally low yields. I honestly think this site helped to clean up the FUT field by exhaustively parsing out and publicizing the details of the FUT procedure itself and naming which doctors performed which techniques. That made the procedure improve REAL fast. Back then people were truly interested in the technical details. But not anymore. Not with FUE. The analysis and intellectual curiosity and discussion has been replaced with a caveman grunt and a wagging finger pointing at a few good to mediocre results. When asked about poor results the response is usually nothing or in a captain caveman voice: "nothing see over there, move along!"

 

By the way Seth. ALL surgery scars you for life. FUE is definitely included in this category. But FUT gives you a greater chance to cover up the scar after a megasession.

[Dr. Alan Feller]

Wow you really don't listen to prospective patients!

Yes we all understand that more grafts are available with FUT! We Get It. The 3 forces!!!!!!!!

We just don't care. People who would rather opt for FUE chose it for one factor alone. They don't want to risk the Linear scar turning out awful. Whatever chance of that actually happening be it 0.1% or even less. They want to be able to have shorter hair in the region of that scar so this has the best viable option to do that. Yes we understand that there is also chance of possible scarring with FUE but generally that option is easier to cover up than the linear scar if goes bad. From all that has been written and posted that's what I get from everything. Is this not the case at all?

 

No, you've got it backward. Should a linear scar stretch or become "hyper scarred" the FUT patient can just leave his hair at a normal length and it will easily be concealed. It is the megasession FUE patient who runs into trouble because to remove that much hair from the donor site requires a wide area approach that necessarily thins out the area to a cosmetically noticeable level. And that doesn't even include the shock loss that accompanies megasession FUE. If you are not sure where the shock loss is on such patients, if you have chance to view the donor area of an FUE megasesion recipient just look at the fibrotic and disrupted nature of the donor area. It won't take long even for an untrained eye to spot it.

 

Also, you analysis neglects the most important reason for having an HT : hair growth. FUE handicaps the grafts through trauma inflicted by the extraction process itself. FUT has no such detrimental forces of dissection and no equivalent. So growth is better for FUT.

 

Finally, most FUE practitioners today are HT novices. They buy what seem like high tech machines and think FUE surgery is a "turn key" business. Take the suction FUE machine users, they are the prime example. I believe these practitioners don't even know what they don't know.

[Crockett]

Would Acell or PRP reduce scarring for FUE or FUT?

[Dr. Alan Feller]

Yes we understand that there is also chance of possible scarring with FUE but generally that option is easier to cover up than the linear scar if goes bad.

 

Euro,

Take a look at this man. Did FUE give him the ability to "back out" of looking like he had a hair transplant ?

 

How would he cover that FUE donor extraction fibrosis ? The answer would be to grow his hair a bit longer. But that is the same exact remedy for concealing an FUT linear scar. The difference here is that the FUE recipient now has far more damage around the FUE scars because there are far more of them compared to FUT.

 

Choosing FUE as the "back out" procedure is simply not true because clearly this man cannot shave his head and pretend like nothing happened.

 

By the way, this is the NORM for FUE megasessions, not the exception.

[Dr. Alan Feller]

Would Acell or PRP reduce scarring for FUE or FUT?

 

No, unfortunately they would not.

 

Acell is powdered pigs bladder and has no clinical efficacy that I have seen to date. Yes, I heard the story about the guy whose fingertip regrew with Acell, but never anything before or since. To me, it's just an unnecessary foreign substance being introduced into a fresh wound that would more likely inflame the tissue.

 

PRP would absolutely make the situation worse. PRP stands for Platelet Rich Plasma. That means that one of the prime elements of clotting and fibrosis are injected in concentrated amounts right into fresh donor wounds. This would produce hyper scarring. Besides, do you know how PRP is "activated" ? It's done by injecting an area with PRP and stabbing it hundreds of times with a needle. This multiple stabbing alone would add massive fibrosis to the tissue.

Not a good idea.

 

If there were something that could reduce inflammation I and everyone would be using it. Steroids and antihistamines have been tried by me and MANY others, but they don't appear to do anything.

 

Skin is living tissue, and it's very sensitive. It has to be, the slightest break has to met with a vicious response lest an organism get a foothold in the body. During an HT the skin doesn't know it's in controlled and antiseptic conditions, it just thinks it's being attacked and breached so it responds with massive inflammation and fibrosis each and every time. There are no exceptions. The more stab or cut the skin, the more it reacts.

 

That's why FUT is superior to FUE. The "attack" is limited to a small area, and most of that area is actually removed. So there is about a ten fold less surface area for the skin fibrose over during healing compared to FUE.

 

Come up with a way or chemical that will allow the skin to heal normally but not become inflamed or fibrosed and you will be an overnight BILLIONAIRE, and a 6 month TRILLIONAIRE.

 

Look at the photo in the thumbnail below. See that wide area of scarring? Well obviously the FUE doctor didn't actually puncture every square inch with his punch. He only had to punch a small percentage of the area and fibrosis and confluence of fibrosis did the rest. This would not have happened in your average strip closure. All the grafts would have been taken from one area and then sealed leaving just a line instead of that mess.

[Michael Vories, MD]

I agree with Dr. Feller in that I have seen little effect of Acell or PRP on improving donor healing. However, the FUE photo shown is not consistent with what we see with the use of smaller punch sizes. (0.85 mm or smaller). Showing photos like this without indicating the punch size can be misleading.

[Dr Tejinder Bhatti]

Euro,

By the way, this is the NORM for FUE megasessions, not the exception.

This is not a MEGASESSION!

I agree it is a very bad scar, Dr Feller. And unacceptable.

Is this is a case that came to you today?

Even if it is picked from your library of scars, an FUE scar should never be like that.

The problems here are not in the healing but in the technique-

1. Punch size is clearly over 1 mm. In Caucasians the ideal punch diameter is 0.75 mm and no greater.

2. Each punch scoring has been made adjacent to the previous without leaving adequate intervening bridge of skin. Ideally we must leave one follicular grouping between 2 adjacent punches or else the thin bridge will necrose and the punches become confluent leading to confluence of scars which make then appear “moth eaten” or “rat chewed”. This is highly preventable and is not due to healing but because of bad technique.

3. Lastly he may have poor growth since nape of the neck hair is mostly not DHT resistant.

[hairshopeing]

That is not typical fue scaring! !!

 

We can all bring up the worse strip scars out there and put them on this thread and call them typical but that would be very misleading!! Sure fue scars, but typically not like this! We have seen hundreds of fue shaven donor areas and very very few look like this!! Can this happen? Yes! Is it typical, no!

[Dr. Alan Feller]

This is not a MEGASESSION!

I agree it is a very bad scar, Dr Feller. And unacceptable.

Is this is a case that came to you today?

Even if it is picked from your library of scars, an FUE scar should never be like that.

The problems here are not in the healing but in the technique-

1. Punch size is clearly over 1 mm. In Caucasians the ideal punch diameter is 0.75 mm and no greater.

2. Each punch scoring has been made adjacent to the previous without leaving adequate intervening bridge of skin. Ideally we must leave one follicular grouping between 2 adjacent punches or else the thin bridge will necrose and the punches become confluent leading to confluence of scars which make then appear “moth eaten” or “rat chewed”. This is highly preventable and is not due to healing but because of bad technique.

3. Lastly he may have poor growth since nape of the neck hair is mostly not DHT resistant.

 

This is an unhappy FUE patient who posted his own photo unsolicited on this very site.

 

At least we agree on a few things about this case:

1. It was performed via FUE

2. It is an unacceptable result

3. The extractions never should have been taken from below the donor safe zone

4. Nape hair grows poorly and should be avoided

 

I do not believe the punch used for this procedure was larger than 1mm. In fact I think it was a .8 mm because if you look at the extractions this doctor actually took from the proper donor area above the nape the punch holes look much smaller. The punches just looked bigger at the nape of the neck because the skin was more flexible and stretched/fibrosed more during healing.

 

Even with a small punch this case produced a lot of fibrosis. Grafts were taken from the inferior donor zone and nape which should not have happened. But this practice is all too common among FUE megasessioon practitioners and is in evidence in just about every megasession case.

 

But let's say this doctor DIDN"T extract from the nape or inferior donor zone. Then this would have meant he would have had to take even MORE grafts from the proper donor area. More punches means less space between extractions and more inflammation and fibrosis during healing. So in this case the bulk of the scarring would have been shifted from the nape of the neck into the proper donor area causing the same moth eaten effect, scarring, and thinning of the hair.

 

There is no way around this problem unless you do fewer extractions. And fewer extractions means moving away from megasessions.

[Dr Tejinder Bhatti]

 

There is no way around this problem unless you do fewer extractions. And fewer extractions means moving away from megasessions.

 

haha!

Fewer extractions do not mean moving away from megasessions...

... Fewer extractions mean moving to Dr Feller!

Just joking!!

[Dr. Alan Feller]

That is not typical fue scaring! !!

 

We can all bring up the worse strip scars out there and put them on this thread and call them typical but that would be very misleading!! Sure fue scars, but typically not like this! We have seen hundreds of fue shaven donor areas and very very few look like this!! Can this happen? Yes! Is it typical, no!

 

Actually, this is typical FUE scarring. You are just focusing on the inferior donor area and the nape of the neck where the scars expanded and fibrosed. Now look into the proper donor area above. It is massively thinned out. Now imagine that the grafts that were wrongly taken from the nape were actually taken from the proper donor area instead. That area would look even worse.

 

The more FUE grafts you extract, the greater the extent of the donor damage.

[Dr. Alan Feller]

haha!

 

... Fewer extractions mean moving to Dr Feller!

Just joking!!

 

Quite true !

[Dr Tejinder Bhatti]

The following post shows an everyday FUE megasession scar-

http://www.hairrestorationnetwork.com/eve/179786-fut-more-popular-than-fue-84.html

My Case of the Day of August 17, 2015.

Picture is again attached.

[Melvin- Admin]

Euro,

Take a look at this man. Did FUE give him the ability to "back out" of looking like he had a hair transplant ?

 

How would he cover that FUE donor extraction fibrosis ? The answer would be to grow his hair a bit longer. But that is the same exact remedy for concealing an FUT linear scar. The difference here is that the FUE recipient now has far more damage around the FUE scars because there are far more of them compared to FUT.

 

Choosing FUE as the "back out" procedure is simply not true because clearly this man cannot shave his head and pretend like nothing happened.

 

By the way, this is the NORM for FUE megasessions, not the exception.

 

This man with a "bad" FUE scar still looks 100x better than your average FUT scar, try again Dr. Feller

 

[Crockett]

Besides, do you know how PRP is "activated" ? It's done by injecting an area with PRP and stabbing it hundreds of times with a needle. This multiple stabbing alone would add massive fibrosis to the tissue.

Not a good idea.

 

Would the recipient site be effected with fibrosis when you place grafts?

 

I talked to Greco about his stand alone PRP/CRP I have to admit results look impressive not just from him but form others. Granted they only show the best. Actually it's like a HT and the patient starts using Fin and you see an amazing result from the HT. I can only wonder if fin did 70% of that amazing results.

 

What could drive down the cost of FUT or FUE?

[hairshopeing]

Hey Dr feller

 

Thanks for commenting on my post I thought that for some reason everything I post on this thread was invisible for you to view!!

 

I disagree this isn't your average scaring for fue, iv researched this site and several others for at least 4 years and see hundreds of posted fue donors my own included! Iv had fue over 2600 grafts I have until recently regularly shave down to a 1 grade and you could not tell is had anything extracted! Not one single person has ever commented or commented on my hair at all apart from people saying how thicker and healthier it looked! !

 

But hey, since you can read what I post maybe you could answer all of the questions I have asked on this thread if you can't find them I will be happy to post again if your happy to answer them and not ignore them as you have previously done??

 

Thanks

[hairshopeing]

Hey Dr feller

 

Thanks for commenting on my post I thought that for some reason everything I post on this thread was invisible for you to view!!

 

I disagree this isn't your average scaring for fue, iv researched this site and several others for at least 4 years and see hundreds of posted fue donors my own included! Iv had fue over 2600 grafts I have until recently regularly shave down to a 1 grade and you could not tell is had anything extracted! Not one single person has ever commented or commented on my hair at all apart from people saying how thicker and healthier it looked! !

 

But hey, since you can read what I post maybe you could answer all of the questions I have asked on this thread if you can't find them I will be happy to post again if your happy to answer them and not ignore them as you have previously done??

 

Thanks

[Dr. Alan Feller]

This man with a "bad" FUE scar still looks 100x better than your average FUT scar, try again Dr. Feller

 

 

 

But don't you see HTsoon that you had to show a completely shaved photo to make your point? FUT does not make the claim that you can shave your head. It's FUE that makes that claim, and it's simply not true.

 

I don't know about that huge scar at the top of the donor, I've never seen anything like that before. But the linear scar in the donor below probably is from an FUT and is EASILY concealed when the hair is not shaved. He could even do a fade cut right up to the bottom border of the scar.

 

You are so concerned with "winning points" or "gotchas" that you lose sight of objective reality.

[Dr. Alan Feller]

The following post shows an everyday FUE megasession scar-

http://www.hairrestorationnetwork.com/eve/179786-fut-more-popular-than-fue-84.html

My Case of the Day of August 17, 2015.

Picture is again attached.

 

I'm sorry, Dr. Bhatti, but that is an extremely scarred and fibrosed scalp. Where as the scar and damage would have been confined to a few millimeters in an FUT procedure, in your FUE example it is everywhere. I can see even from that very complimentary picture the confluence of scar throughout the donor. When one looks close there is so much confluence of scar it looks like punches of 5 mm or more were used in areas. I'm sure they weren't, but as the smaller scar coalesce they form groupings of scar tissue that gives that appearance.

 

I hope he grows well, but he would have been far better off with FUT not only because it would have greater growth yields in the recipient site, but it would have left the rest of the donor area virgin for surgery in the future.

[Eurofue]

This man with a "bad" FUE scar still looks 100x better than your average FUT scar, try again Dr. Feller

 

 

Hehe exactly what I was thinking if it's bad yes you would have to grow your hair longer. We take that risk but not the same risk "HOWEVER LOW THAT MAY BE" of it turning out extremely awful and you being absolutely gutted to the point I think my mental wellbeing maybe scarred for the rest of my life knowing I had that mess at the back of my head. That would definately leave me depressed about my life I'm pretty sure of it. Is it worth the risk in my mind NO WAY!

[Swooping]

Is that the best you can add to the discussion?

 

Punching out hair from the back of the head has been around since the late 1950s. It's just in the last 50 years it has evolved from 4mm plugs to punching out single follicular units, thanks to the use of magnification loupes and smaller punches. There is virtually nothing high tech about it.

 

I saw your thread of your own FUE results. Very nice. Glad it worked out so well for you but what about the 3 or 4 guys on here who went to the same Doctor and ended up with miserable results? One guy seems very distraught.

 

Maybe you can tell us where it all went wrong for them? Just bad luck or could it be that FUE is less reliable?

 

As you can tell I do not like comments like yours. All they serve is to frighten people off FUT and walk aimlessly into an FUE procedure. I've noticed that happen a lot the last few years.

 

No problem if they eventually opt for FUE, as long as they are presented with all the facts and able to make a rational decision that is not based on 'fear' of having a strip of skin removed from the back of their head.

 

 

What is there to add to this discussion? I have spoken my words earlier in this topic. The absolute truth is impossible to find in this one. This topic is filled with opinions based on observations. It’s that simple. You do understand this right?

 

My remark about FUT being brutal and old fashioned, yes it is harsh. However it is my opinion. I can tell you however that the general public concurs with this statement even more than me and increases to do so. The procedure itself is already seen as that, not to mention the scar it leaves.

 

I have seen your results too. Beautiful result, world class work, no doubt. I don’t neglect the fact either that FUT has produced stunning results over the years and has brought on many happy patients. However it’s 2015 and I can tell you something that does somewhat reflect the truth. Most people don’t want FUT anymore primarily because of the reasons I just said. When we look at this topic the name is “FUT is more popular than FUE”. Well it couldn’t be more wrong then that. Not to mention the 99% favour to FUT what is slammed around here lol.

 

Look at the following results taken from ISHRS census results;

 

http://s17.postimg.org/4fvx1eurz/FUEpopularity.jpg.

 

Numbers from 2014 show almost a 50/50 scenario between FUT and FUE. Look at the growth too over the years in favour of FUE. Also go look around on forums like HLH, BTH, HLT. I dare you to make a topic about FUT to attract opinions on these forums. Have a look furthermore on results posted on international and national forums other than this forum. FUE is so heavily favoured over FUT, it’s not even a competition. All these observations are highly indicative of what people want and that is FUE. This will continue to do so. People just primarily don’t want to be left with a linear scar.

 

FUE does offer a escape route when one needs to shave down. What if your donor area will thin in the future? What if your native hair will miniaturize further? What if one has to drop finasteride because of possible induced side effects in the future? What if someone wants to accept his baldness and move on in the future? Jup, if you had FUT and you want to shave it down then a linear scar will always be properly visible, even if the scar is perfectly “pencil thin”.

 

Thanks for the comments on my FUE. I’m not going to respond too specific failures. However to return the ball I can tell you that in the last 3 months I have seen 2 or 3 failed results from H&W, the elite if not the best at FUT worldwide. At least they are considered as that online by many people. Bad luck? You tell me.

 

Could it be that FUE is less reliable is what you ask me. Everyone has different opinions about that. Remember it’s all opinions because the truth is as I said impossible to find in such questions. Only proper studies could possibly somewhat reveal the truth, but these would be just probably too hard to set up. Furthermore the FUE of X doctor isn’t the same as FUE of Y doctor.

 

What are we left with anyway? The opinions of doctors, members and our own observations. Hell, look at Dr. Lorenzo his site for example;

 

“One of the most vital aspects of this technique is the quality of the units which are removed. We have found from our studies in previous years that the quality and strength of the grafts removed are better than those extracted by the strip method. The follicular units are much cleaner when removed one by one then by separating them under the microscope. This also helps to reduce wounding to the recipient area. Our surgeons have presented these studies in various seminars on hair transplants“

 

I assume they stand for what they have written on their site and as such they argue that their graft quality of FUE is better than FUT and this is even supported by their studies (Knock knock.. bias?!). However perhaps they do get the same yield as the best FUT practitioners. You don’t know period. Or do you?

 

We have no proper conducted studies to go by. Therefore I would advise everyone to never listen to a single particular doctor. Research thoroughly and form your own opinion.

 

As such I formed my opinion that I think FUE is just about on par with FUT in yield and reliability. That is assuming you go with a skilled top notch surgeon. These minor possible differences however are far less important to me and worth the small very small risk instead of having a linear scar on the back of my head. And I bet many people think like this.

 

And that is why FUE marches on.. Both supply & demand are heavily changing in favour for FUE. This will only continue to do so until FUT will go the way of the “dodo”, like Spencer founder of the IAHRS said it in one of his last shows.

[Yaz89]

And that is why FUE marches on.. Both supply & demand are heavily changing in favour for FUE. This will only continue to do so until FUT will go the way of the “dodo”, like Spencer founder of the IAHRS said it in one of his last shows.

 

FUE is only gaining popularly thanks to the all the hair mills offering FUE especially from novice surgeons, tech run clinics (Dr M anyone!) and inexperienced clinics using micro-motors. FUT will never go away. FUE might surpass on the above points I have stated. How many surgeons are there offering FUE to the highest standard possible? Not many? All the proven FUE surgeons charge a premium which the common working man simply at times cannot afford. The diamonds such as Erdogan, Bhatti, Vories, lorenzo, Keser and the others are simply too expensive to the common man. (Bhatti in Indian standards is quite expensive). Thus the rise of FUE thanks to budget, amatuer run clinics whose patients hardly research and only think about the cost but not the quality!

 

For example, I paid nearly 7k in British pounds. England is well known for high living costs, low wages. When friends, family and people who I knew found out I paid this amount; they were like "fcuk why did you pay so much when you could have done it for 1200 pounds!". They did not understand I had researched for nearly 3 years (still am) and I chose an reliable surgeon. My result speaks for it self. Meanwhile, 6 of my friends used whatclinic.com and chose the cheapest clinics in Turkey. And guess what! Horrible donor extractions, donor destroyed by micro-motors, I was told all the nurses did the work; the end result? Little growth, lack of yield and density. And permanent shock loss to non-transplanted areas. How do I know this? Thanks to my 5 years of research!

 

FUE will only increase in popularity thanks to these rogue clinics scattered around the globe. But the diamonds are rare. There are not many Feller's, Lindey's, Bhatti's, Erdogan's, lorenzo's or Vories's out there.

Edited August 22, 2015 by Yaz89