FUT is more popular than FUE

[Dr. Alan Feller]

It is simply a fact that FUT is still more popular than FUE...by far.

 

In the Tom Hanks movie Apollo 13 Jim Lovell's wife asks why her husband's flight to the moon was not being televised live. The answer that was offered was that NASA "made going to the moon seem like a trip to Pittsburgh ". The same goes for FUT.

 

The success and popularity of FUT has been so well established and proven over the past 20 years that it is taken for granted. There is no excitement in viewing the results of an FUT patient because we have already seen, literally, thousands of them online. Sure, there are variations from doctor to doctor, but by and large the results are predictably good.

 

FUE SEEMS like the "next step", but it has been around for 14 years and it's safe to say that it has failed to launch. What has happened is that the pool of wishful thinkers and uninformed patients has grown and there has been no shortage of clinics willing to service these patients. So the number of patients has grown and thus the number of results online. But if you compare the ratio of successful to unsuccessful procedures FUT wins hands down. And this is for predictable reasons.

 

FUE suffers from three detrimental forces that no doctor, clinic, or innovator has yet to overcome: Compression, Torsion, and Traction. You can add Skeletonization to that list as well. FUT does not suffer from these forces.

 

This illusion of popularity is sparked by the interest of a FEW posters on websites like this one. But it is the very nature of this interest that betrays the weakness of FUE. We are all captivated by the man who walks along a tightrope a hundred stories off the ground. "Will he fall?" Same thing with FUE, but in this case it's "will it grow?" And if it grows "will it be as good as strip"?

 

For all the distortion surrounding FUE one line has not been crossed, and that's the claim that FUE actually grows better than Strip surgery. Thankfully, that hasn't happened...yet. The best FUE can claim is that it grows AS WELL AS STRIP. So why not just get strip?! I'm in the business 20 years and that's what I did. You think I would pick an inferior procedure?

 

Vehement FUE supporters, all of them lay non-doctors, say that FUE has improved over the past 14 years. This is simply NOT TRUE. It is wishful thinking. Nothing about the procedure has changed except for the hype and the number of clinics offering it because patients engage in either wishful thinking or are simply uninformed.

 

NOT A SINGLE FUE DOCTOR HAS COME ONLINE ANYWHERE THAT HAS MADE A CLAIM THAT THEY USE NEW TECHNOLOGY. Only lay, non doctor, unaccountable FUE chest beaters who post anonymously have made this claim.

 

Recently a poster on here made such a claim and I offered to host a three way call between him, me, and the doctor he said made the claim- and then post the call online. He did not take me up on the offer. Instead he made a limp-wristed attack on me and then disappeared.

 

Nothing has changed in the world of FUE. A punch is used to score around a graft causing torsional damage. The graft is then grasped with a forceps causing compression damage, and then finally it is literally RIPPED out of the scalp causing traction damage.

 

Sure, there are new machines to assist in taking out the grafts, but they either cause more damage doing it, or they only mimic (poorly) what an experienced FUE practitioner can do. I won't even go into the ridiculous extra costs these "technologies" involve.

 

FUE has it's place, and in some cases it even has a place in megasessions. But I state without reserve that ANY time you see an FUE result, no matter how good or bad it looks, that same patient would have looked BETTER if he had a strip procedure. Furthermore his prospects for future surgery would be better and his donor area could be used more efficiently.

 

FUE is the "have your cake and eat it to" procedure. And in some cases this may be the case. Such as in the hands of very dedicated and very experienced physician practitioners who carefully screen their patients. However, just scanning this website's chat forums alone I have seen more negative postings from patients who actually underwent FUE than I do positive ones, and precious few posts that involve actual FUE results from patients themselves. What you really see are posts by enthusiastic hopeful patients right after FUE surgery but no actual results posted- even years later. What happened to these FUE patients? While the same thing does happen with FUT from time to time, FUT already enjoys thousands of online megasession before/after photos, whereas FUE hasn't even made it to more than a hundred to two hundred yet...and that's after 14 years!

 

If every doctor who performed a hair transplant surgery tomorrow were to check in on this forum and tell us what HT surgery they performed on that particular day you would find 99.9% would be FUT, not FUE. But you would not know that by reading forums because FUT is old news and unexciting. How many before/after pictures of a 2500 graft case can you look at before you become bored? And it is this very reality that demonstrates the reliability and strength of this procedure.

 

FUE has it's place, but NOT first place, and it never will.

 

Dr. Alan Feller

Edited June 12, 2015 by Dr. Alan Feller

[Sethticles]

wow business must be booming to be able to spend that much time having an internet rant like that one. impressive

[mav23100gunther]

Thank you Dr. - once again a lot of good info. I'm a supporter of FUT myself, but to be quite honest, this is starting to get old quickly. You have been very vocal on this forum on the topic, and kudos to you for taking the time to express your point of view. I definitely respect your passion on the topic.

 

Quick question if you don't mind - who performed your strip procedure? Was it Dr Hasson? In a much older post, I thought someone had mentioned you were spotted at h&w to get your own HT.

[Mickey85]

wow business must be booming to be able to spend that much time having an internet rant like that one. impressive

 

Post of the decade. Who exactly is he trying to convince? If strip were truly much more 'popular' 'by far' than FUE, why would he need to come on here to declare that? To a bunch of "laymen". Add in some words with in full CAPITALS and it must be the truth right.

[mav23100gunther]

"What you really see are posts by enthusiastic patients right after FUE surgery but no actual results posted- even years later. What happened to these FUE patients? While the same thing does happen with FUT from time to time, FUT already enjoys thousands of online before/after photos, whereas FUE hasn't even made it to a hundred yet...and that's after 14 years! "

 

Fair point, but I gotta say that some awesome FUE results from Erdogan have been posted recently

[BUSA]

that post made LOL...... geez sounds like someone has a superiority complex. ill bet more people go to Bosley then any of the top doctors on this site. people are mis informed and they just don't know FUE exists in the first place.

 

my buddy of 30 years said to me a few months ago that he was thinkn bout goin to Bosley for a HT. I was like WAT!!!

 

I had to set him straight but nonetheless not everyone who gets a HT comes to this or any other forum to learn so ignorance is why, not informed decision making.

 

my buddy had no idea wat FUE was and he was shocked after we talked and he said he was glad he didn't go thru with it cause now he can have a scarless HT or shud I say VISIBLE scarless....HT but he was pissed they didn't tell him that procedure exists.

 

cause FUT doctors think its the better procedure which is why u have to be ur own advocate and educate urself when having surgery done to ur scalp.

[Dr. Alan Feller]

Personal attacks- the main weapon of the anonymous lay FUE chest thumper. Some things never change.

 

Not a word to contradict the substance of the post. What a surprise.

 

Remember hair loss sufferers new to HT- these guys hide behind aliases and are NOT accountable for what they tell you.

 

Mav, I don't discuss who did my procedures online, but thank you for your civil comments.

Edited June 12, 2015 by Dr. Alan Feller

[FUE2014]

Dr Feller your own online rep, Spex, has told me via email that in his opinion there is no difference in yield between Dr Feriduni's FUT and FUE. I can forward you the email if you like. What do you think of that?

[Dr. Alan Feller]

I don't think much of it.

[Yonex]

Fantastic post Dr Feller, I admire you for taking the time to come on a forum such as this to give your thoughts, after all you are at the coalface of this industry everyday, I agree with what you say and this is coming from someone who has had a recent FUE procedure with a recommended doc from this forum.

 

Before this thread descends into chaos like many that have gone before, I think it would be great to hear the thoughts of other recommended doctors on here. Would it be possible for the mods or clinic reps to invite guys like Konior, Feriduni, Bisanga, Rahal , Erdogan etc to add their thoughts to the whole FUT/FUE debate, maybe make it a sticky and moderate it such that only the recommended docs can contribute to the thread, I think that would be a great educational source of information for all of us interested in the debate.

[BaldingBogger]

Dr Feller your own online rep, Spex, has told me via email that in his opinion there is no difference in yield between Dr Feriduni's FUT and FUE. I can forward you the email if you like. What do you think of that?

 

Must make things rather confusing for a propective patient with such unaligned clinics working to a different MO.

[Sethticles]

FUT doctors know full well that their time is running out, with more and more FUE clinics popping up all over the world and with that the prices are coming down FUT clinics they know it and they are hanging on by a thread, a rant by a FUT Doctor of this magnitude only solidifies the panic in the FUT to world, so if any newbie HT candidate out there, his post speaks loud and clear how ancient history FUT is.

 

Furthermore I challenge any FUT doctor to google - Hair Transplant Scar - then see the 1000s of butcher jobs examples from the last 20 years

Edited June 12, 2015 by Sethticles

[BaldingBogger]

wow business must be booming to be able to spend that much time having an internet rant like that one. impressive

 

The internet connectivity must be very poor in his neck if the woods..

 

As i have certainly seen far more successful FUE results than that. Lorenzo alone nearly hits that amount. If FUT is so successful and so busy for Dr feller why even bother come on here with his ridiculously arrogant posts and his modified strip technique.. It's no surprise though having read earlier threads in how he has handled his unhappy patients.

 

successful Clinics are working with a 6-12 month waiting list.

 

Are you telling me with this volume of FUE procedures with 60% yield we would not be hearing about it on here DAILY. This whole latest campaign has been a PR disaster. If you have a new technique lets see the results and judge from there. To come online and orchestrate this campaign that flies in the face of actual results people are getting daily is just embarrassing.

[MAGNUMpi]

The best FUE can claim is that it grows AS WELL AS STRIP. So why not just get strip?

With all due respect, because it might help to avoid a potentially stretched and problematic scar on the back of the head. There are too many scar repair cases to count on forums like these that are still coming in daily. The fact that even the best doctor cant predict whether a scar will stretch, and considering a HT is cosmetic surgery, if the front looks good at the cost of the back looking bad, it would make sense to elect a surgery that does not inherently come with that risk. ((depending on the personal goal/characteristics/NW pattern/future loss/ etc. of the patient)) Just my opinion. That being said I respect Dr. Fellers work very much, but this one point kind of struck me.

[keyser-soze]

Fut more popular that fue? In the states yes the rest of the world I would say fue.

In the states drs said themselves they managed to talk two thirds of people wanting fue into having fut. Why is that? Pure and simple is the laws regarding tech involvement.

How many strip clinics are there outside of the states that just do strip?

Dr Feller are you telling us all these other clinics that offer fue only or indeed both techniques are lying to us when they quote 90% yields from fue?

That sounds like what your saying and have been since you reappeared on this forum after a long absence?

Your reappearance at the same time as taking on a new partner and unveiling a (new) technique would have nothing to do with all this fue attacking would it?

Why did the isrhs threaten to expel members if the doctor did not sign up to agree to do ALL extractions?

Who tabled that motion let me guess was it by chance a US doctor?

Outside of the states people get what they want and for the vast majority imo its fue and in the states the same patients get talked into fuss

You have shown us next to nothing and told us little of ( mfue) but are trying to widen the gap in yield between fue and fuss and trying to slip (mfue) in there.

Even the name (mfue) is parasitic in that parsitez latch on to their host to benefit from them.

Whilst I prefer other drs to you in both techniques I have up until all this nonsense held you in high esteem and this is probably the case with your peers also.

Let your work do the talking like most other drs do.

Yourself and the north American ht industry seem to be trying to fight tooth and nail to stay relevant but I think if your not already you will be playing second fiddle shortly.

Where are all these dissatisfied fue patients? Were are all these fue patients with different hair in the recipient compared to the donor?

One case study by two inferrior fue practioners is no basis for stating fue yield %.

You yourself Dr feller must of had poor yielding fuss it happens with either technique.

How many over harvested fue cases have we seen posted? Now how many people wanting their fut scars sorting.

The guy last week had SMP into a bad fut scar created by a reccomended dr He had fue then 3 days post op the SMP into the fut scar.

You lept at the opportunity to bash fue without knowing all the facts.

In my eyes Dr feller you've harmed your previous outstanding reputation.

[Blake Bloxham]

... straps on helmet ...

 

Obviously I don't want to dive too deeply into this battle, but I did want to mention a few things:

 

1) I suppose you could doubt my claims, but I've seen Dr Feller's schedule first hand and I can say with certainty that he has one of those impressive waiting lists like the ones mentioned above. Many of these are FUE patients as well. Take that as you will.

 

2) Many probably don't remember, but these type of threads and this type of straightforward attitude is how Dr Feller earned his reputation in the first place. He's a no-nonsense kind of guy. He also doesn't stray from his beliefs and isn't afraid to rile any feathers by telling the truth online. If you look at his posting track record, you'll see that this isn't the first issue he's tackled and received heat for (see: low level laser therapy). I understand why people would want to assume it's because of a "lack of business" or fear of "FUE take over," but this just isn't the case. Like Dr Feller's said before, he could stop doing strip tomorrow and still have a waiting list for strict FUE. And that's without technicians extracting and higher prices than places that do uses techs for extraction.

 

3) The mFUE controversy is actually pretty interesting, in my opinion. Frankly, I don't think we expected it to receive this type of buzz -- as it really isn't a controversial approach. My thread was only supposed to serve as a "teaser" announcement. This is akin to how movie studios will release 20 second trailers for upcoming attractions as a "teaser" months before the full trailer is released. The teasers really don't contain much information, and serve really as a "heads up" to what's coming. In this sense, there will be MUCH more mFUE content coming up in the future. In fact, Dr Feller and I are in the process of recruiting for larger, more detailed cases right now. Like I said before, we weren't expecting to do this, but clearly the interest is there.

 

A few more thoughts on mFUE:

 

a) The name is accurate. It's truly a modified approach to the FUE technique. Taking mini-strips was tried by Dr Feller in the past. The scarring wasn't good enough and it was abandoned. This technique was invented as a way to perform FUE on a patient who had undergone multiple strip and FUE procedures in the past, but his scalp was way too wrecked and tight to remove another strip or extract fragile FUE grafts. Hence, mFUE. It's removing FUGs with a handheld punch and in a non-strip fashion. Don't know what else to call it. Haha.

 

b) This technique is a very valid approach. And it's not a complicated premise. Traditional FUE puts a lot of strain on the grafts and yield/quality suffers. Strip doesn't do this, but some patients are concerned about the linear scar. Solution? Find a way to extract quality grafts in a non-strip harvesting method. FUE-level scarring with strip-level results. mFUE. : )

 

4) The cases of low yield and changes in hair quality are on the boards. I've seen a few good examples of characteristic changes in fully matured patients recently. I'll post them when I'm home this evening.

 

5) The objective research I've posted has nothing to do with the perceived results of the surgeons. They were acting as researchers, not cosmetic surgeons. Grafts were removed gently and via the best protocol. The results were clear: skeletonized grafts don't grow well. This is how science works. Techniques are advanced, they are studied objectively, and cold, hard, irrefutable data is published. If we relied on "feelings" or subjectivity in all of medicine, surgery, and biology, it would be anarchy! If anyone has research refuting the claims made in those initial studies, I'd legitimately love to see it. However, I don't think I can stand hearing "well Lorenzo ..." as a rebuttal one more time. Haha.

 

6) As far as strip disappearing or strip-prominent docs playing "second fiddle," I'm willing to bet anything that we will be having this same discussion in 2025 and 2035, the same way we had it in 2005. There will continue to be a role for both models. There will always be patients who are better served by one over the other. FUE mega-sessions can't overcome strip megasessions until they've discovered a way to reduce the stress/strain on the grafts. Frankly, mFUE could do this, but I already touched on that above.

[Swooping]

2011 ISHRS census results - FUE 22%

 

2013 ISHRS census results - FUE 40%

 

By this trend alone we can predict that FUE is highly likely already more popular. We are almost in 2016. Again look around at all forums guys you will see that the overwhelming majority is about FUE not FUT. FUT is slowly fading away and FUE has taken over and is the golden standard for people. FUT is becoming more a niche as we speak.

 

Dr. Feller tries to play the authoritative clown here. Who cares anyway Dr. Feller you ain't dictating the market. It seems you have already to much time on your hands, business not going so well huh ? .

Edited June 12, 2015 by Swooping

[HairJo]

In my opinion I would much rather have my grafts in tact and as healthy and strong as they can be when they go back in my head to grow . I don't want to worry that I am receiving a torn skeleton of a graft I want my procedure to be done under a microscope by qualified technicians and of course a qualified doctor. In my opinion that's the way I would go . I do believe FUE has it's place for a small procedure just to fill in . Maybe if the patient is dead set on FUE I still would do a small area first just to see if it works for that person before they commit to a mega FUE every one grows different, their hair is different their skin is different so many factors to consider when doing FUE or any procedure . I still prefer keeping the integrity of my grafts with the strip method . Anyway what's so new about FUE it's been around since HT began only then it was called plugs now 14 years later they are much smaller but still the same procedure . Just think is it better to rip a plant out of the ground to plant it or dig around it and transplant it with most of it's surrounding soil in tact . Which plant do you think would have a better survival rate? Thanks for your input Dr. Feller it is what I have believed to be true with the research I have obtained

[Mickey85]

 

Not a word to contradict the substance of the post. What a surprise.

 

What substance exactly did you bring Doctor? What data? What independant study? What consensus? Where is your proof for this statement:

 

"If every doctor who performed a hair transplant surgery tomorrow were to check in on this forum and tell us what HT surgery they performed on that particular day you would find 99.9% would be FUT, not FUE."

 

Either it was severe hyperbole or simply based on your own arbitrary whim. You like to talk about facts, well please enlighten us with where you got this 99.9% figure from.

 

I have to be honest. When I saw the title of this thread I thought "surely this couldn't be a Dr. Feller thread". Sadly I was mistaken. I'm not taking a shot at you Doctor, I respect your strip work, but I did find this unprofessional. I don't mean to offend you and I apologize if I do, but I certainly cannot imagine many other surgeons coming on here and berating an opposing HT method with such unprovoked aggression.

[HairJo]

I can see why most doctors don't want to get involved and post and respond . It's probably because they don't like all the attacks and insinuations . I can see this, not much response from too many other top notch doctors just opinions from God know's who including myself . It would be great to hear more from the seasoned doctors as to what they think which procedure is best in their HONEST opinion.

[BaldingBogger]

Deleting content

Edited June 12, 2015 by BaldingBogger

[Mickey85]

Really? Were there any prohibited surgeon's names included in the post?

[delancey]

It would be interesting to see the MFUE scarring on someone who had 10,000 grafts extracted. Something tells me that a strip scar would look better than 100s of uneven, spaced apart MFUE scars.

[Blake Bloxham]

Bogger,

 

Your post was flagged because it contained an unintentional trigger word. You said "neck of the w**ds," and the last word is what tagged it. No other moderation otherwise.

[Blake Bloxham]

Delancy,

 

10,000 FUG grafts would equate to somewhere around 550 mFUE grafts. Obviously we haven't done a case of this size, nor have many FUE cases been done of this size either -- even after multiple procedures. From what we've seen thus far, the scarring would be comparible to an FUE case of similar size. Keep in mind though that extracting anything over 50% of the available donor with FUE results in severe thinning. So a strip scar might look better in general here -- as patients don't have 20,000 grafts in reserve, so this would be a severe depletion of the donor via either traditional or mFUE. We will know more for sure as the cases continue increasing in size. What we've seen thus far, however, has encouraged us to keep pushing further with the technique.