FUT is more popular than FUE

[Eurofue]

Lol so you drop a third for good luck hehe. Hit the edit button����

Emoji's don't work I tried to put in the thumbs up!

[Michael Vories, MD]

Don't know about others, but I started doing FUE in 2002. Instrumentation was poor, and I stunk at it, so switched to FUT. When the instrumentation improved, i.e. implanted pens, I was concerned about dealing with strip scars so reverted back to FUE in 2009. It takes much more work for the physician, but the patients are much more grateful.

[1978matt]

Hi hairshopeing,

 

Thanks for the kind words on my result. Glad you got the outcome you were looking for from Dr Feriduni.

 

In order to contradict something he would have had to say pretty much the opposite so maybe you can search through the 700 posts and find his contradictions?

 

 

 

Hi matt

Saying the above condradicts NOTHING Dr feller has said isn't right if you can show me where on this thread he said that good fue results are close to strip and that 80% of the time in very close to strip yield in the right hands that Koran and lorenzo are producing consistent 5000 _6000 graft procedures and that several steps are needed for 80-90% yield is in this thread I'd be interested because I dint remember reading that anywhere on this thread had Dr feller said the above I dint think this would of been a problem as most of that I'd probably correct but from what iv read none of them statements were made!!

 

Congrats on your outcome by the way great transformation one of the best I've seen by strip or fue!! You chose well koniour is indeed one of the best!!☺

[lileli]

Don't know about others, but I started doing FUE in 2002. Instrumentation was poor, and I stunk at it, so switched to FUT. When the instrumentation improved, i.e. implanted pens, I was concerned about dealing with strip scars so reverted back to FUE in 2009. It takes much more work for the physician, but the patients are much more grateful.

 

Very blunt Dr. Vories and now you perform FUE on a high quality consistent basis. So there must be something to better tools and experience.

[chrisis]

A friend of mine had FUT. His scar is ~2mm at most, meaning fantastic by FUT standards. However he cuts his hair very short and when I first saw it (I did not know he had a HT, nor much about HTs at the time), it looked scary. I thought he had a brain surgery.

 

 

This is exactly why I had FUE. Today I had a guard #1 hair cut on the back and side and there's no scar to see. I did not see the sense in swapping my paranoia about hair at the front for paranoia about the back of my head. Even if transection rates were inferior to strip (which has been theorised but not proven), then I'd still accept a10-20% transection rate to not have a strip scar. I don't think I'd go as far as 50%, but I don't think a reputable FUE surgeon would be transecting every other graft and still producing good results.

[1978matt]

There's actually a 3rd video interview I missed where Dr Ron says he has not seen fibrosis causing an issue over 2 FUE megasessions, so I will grant you that one. But one disagreement out of a dozen is not exactly significant.

 

I'm just thankful he didn't mention 'expanding crowns'!

 

I watched those videos and heard NOTHING that contradicted Dr Feller. To summarise into bullet points what Dr Ron said in the interview:

 

 

• 
  
• Some doctors are doing good FUE.
  
• FUE had similar early problems to when FUT first introduced.
  
• FUE grafts are weaker.
  
• Doctors [at the FUE Mediterranean Conference] where there showing techniques they use to 'try' to get similar growth to FUT.
  
• Disagreed with Dr Lindsey suggestion that on average, FUE results '40% less full' than FUT. Felt it was nearer 20%.
  
• FUE grafts are more fragile than FUT grafts.
  
• A lot of steps needed to get 80-90% FUE graft survival.
  
• FUE grafts weak.
  
• Good FUE can have a very close growth rate (compared to strip) at least 80% of the time.
  
• Increased risk of lesser growth with FUE.
  
• FUT still 'has the edge' over FUE.
  
• Isn't sure yet exactly how many grafts you can get using FUE exclusively.
  
• Believes doing FUT first then FUE gets more overall grafts.
  
• Lorenzo/Koray showing consistent results in 5-6,000 range.
  
• Doesn't yet know how consistent the 8,9,10,000 graft cases can be.
  
• Said that there are not enough cases in this range yet to know how consistent they are.
  

 

[fortune11]

My basic training is as a plastic & reconstructive surgeon and I wandered all over the United States from 1997-2001 trying to learn the pearls of cosmetic plastic surgery for which I visited Drs Sherrel J Aston and Daniel Baker in their Manhattan hospital, Dr Ian Jackson of Detroit to learn how to manipulate the skull, Dr Bhangoo in Buffalo to learn all the tucks I needed to learn and last but not the least I spent time with DrsTessler and Aronovitz in Southfiled, Michigan to learn the tricks of FUT hair transplant surgery.

I never knew all the principles of nips and tucks that I would learn would come to naught and have no meaning and set me thinking after your sweeping statement that skin does not stretch, Dr Feller.

Well, how does facelift, necklift, tummy tuck, body lift, and even scalp reduction work then?

Well if crowns won't stretch , can you please throw some wisdom on why they do not in light of above accepted principles of plastic surgery!

 

I was among those urging Dr Feller to address the "expanding crown " issue raised by Dr Bhatti and I found Dr Feller's explanation satisfactory.

 

When I posted on this forum in 2004 after my first HT (FUT), one of the highlights of my story that I was excited about was the apparent "facelift " that my forehead got and all the lines just disappeared . But alas , over the next few months my scalp adjusted and the wrinkles etc came back. So it was more the "rubber band " effect , only in slow motion. Same problem also exists with a lot of these nip and tuck surgeries , where immediate results look good but then over time skin sags / expands again.

 

That being said, I do think that scalp laxity is somewhat of a meaningful factor in terms of FUT effectiveness -- especially given Dr Fellers assertion (and one I agree with) that FUT is more suited for megasessions. Megasessions also require taking bigger strips.

 

 

On a side note, I wasn't aware of any "accepted principles " of plastic surgery . I live in an area in Southern California where every fourth person has had some cosmetic surgery type work done on themselves (non HT) and the results vary a hell of a lot , especially on aging bodies . Actually all considering , we HT patients (especially FUT ones) have a more remarkable consistency of results , relatively speaking, than some of these other procedures. Atleast from seeing the results posted on this forum.

[mav23100gunther]

Mav, I already answered this question, but I'll do so again.

 

The issue of so-called "crown stretching" is a non-existent phenomenon. It was a distraction invented by Dr. Bhatti to find something, anything, to throw at FUT to discredit it on this thread. Have you ever seen any posts online of patients discussing this or even complaining about it? None.

 

I've never had a patient of mine nor anybody else's come to my office and complain of "crown stretch". And the reasons are obvious.

 

Let's say Dr. Bhatti's numbers are correct (although I have no idea where he got them from). Then you are looking at about a 5mm "stretch" in the skin from the donor scar all the way up to the crown. This 5mm will be distributed throughout the scalp and not result in 5 mm of displacement several inches away.

 

Dr. Bhatti's diagram was incorrect and disingenuous because he treated the donor in his diagram like a bed sheet. A one inch pull on one end results in a one inch pull on the other end. The difference is, the skin is attached to the skull all along its length and it stretches so pulling on one end does not easily translate to the other end. Think of a rubber band bonded to the surface of a table at several points. Then pull on one end. See how well it translates to the other. Not well, thankfully.

 

Another disingenuous thing about his diagram is that in the "after" diagram there is no hair on the patient. The whole idea of the surgery was to put hair on the top of the head and it is in absence in his after diagram.

 

So let's say the guy is a stage 7 as depicted in the diagram. Do you think it matters if he has an extra 5mm of crown from stretch (if that's really happening) if the front half of his head went from cue ball to puffy hair? Of course not.

 

Again, Dr. Bhatti just put this out there to present some sort of equivalence in detriment between FUT and FUE and avoid answering my questions. Did he really stop performing FUT due to this heretofore unheard of complaint or phenomenon? Was the dreaded "crown stretch" something he discussed with his patients during his past life as an eeeevil FUT surgeon and included in his informed consent? I highly doubt it. Or did he just invent it for the purposes of this thread? He was trying to find an equivalent negative in FUT to compare with the very real detriments of FUE that I have been discussing in great detail and without any substantive opposition on his part.

 

And he failed because the three detrimental forces of FUE are real and I have been describing and discussing them for 14 years. They also explain the very real complaints by very real patients online as to why most FUE results are inferior to their equivalent FUT counterparts. The only stretching going on here is with the truth.

 

Thanks Dr Feller, very informative!

[Swooping]

Getting back to the original title of this thread 'FUT is more popular than FUE' if anyone cares to checkout the threads posted by patients on this website say for the last 5 years I think the FUE cases come out on top although most of them are in Europe and Asia it must be said ,

maybe the title of this thread should read 'FUT is more popular than FUE in the USA'

 

Census results of ISHRS 2015 results say it's 50/50 now. However the trending growth of FUE is extremely high and will continue his march. This will only continue to do so until FUT becomes a small niche pick. It's inevitable. One could pretty much say that worldwide FUE is already more popular, no doubt.

 

Perhaps FUT does have a slight edge when we look at the outcome. However the reality is that people don't care about this slight edge. What consumers want is FUE. And the market will drive towards that. In fact it's already doing that in full speed.

 

I think this is a excellent development. FUT will go slowly to the graveyard while the focus is set on FUE worldwide. This can only stimulate new innovation/progress. That's what we all want.

[Mick50]

As much as I respect Dr feller and his opinions great to have someone with his experience posting on this website and he's right, FUE clinics have a duty to give the whole story regarding FUE scarring,potential damage to grafts etc but I still have to agree with you I actually think FUE is in it's infancy, I know it's been around for 15 years or so but it's only in the last 5 years that it's permeating the general public's awareness be it through celebrities like Wayne Rooney having an FUE as well as plenty of online results from the likes of Dr Lorenzo Erdogan etc.

 

Although I believe FUE is on the rise i think everyone who has contributed to this thread should thank Dr Feller whether they agree with him or not as he is the only Dr I have read who points out the drawbacks with FUE and we as patients deserve to know the whole picture. I'm actually basing my views on this subject more to do with my views of human nature I just think guys will opt for FUE to avoid the scar even though the yield will be lower irrational I know given that most scars are pretty much undetectable most of the time done by the Likes of Dr Feller and Dr Lindsey but just the chance of it going wrong will put a lot of guys off

Edited August 14, 2015 by Mick50

[Dr Tejinder Bhatti]

Dr. Feller,

 

I realize that this post is several pages back but I just wanted to chime in here. While your statement may be true, I do not believe that Dr. Bhatti is quitting in the middle of any debate. This "debate" is ongoing and in actuality has no end. I truly appreciate and respect Dr. Bhatti for coming on here and sharing his point of view, which in essence is contributing to an ongoing debate, not quitting before the end - since it never ends.

 

To Everyone,

 

I commend both Dr. Feller and Dr. Bhatti for sharing two different points of view. Ultimately, both of them are sharing your input based on their own experience. Personally, I believe the three forces constantly discussed here do exist but I also believe that some surgeons have been able to either get around or overcome them. In other words, I don't think these forces are always as detrimental as Dr. Feller makes them out to be.

 

At the end of the day, it's one physician's experience against another's. Assuming both are being honest, one could suggest that Dr. Bhatti has found a way to overcome these negative forces while Dr. Feller has not. On the other hand, if Dr. Bhatti has found a way to overcome these forces (assuming they are being understood correctly), he should do his best to demonstrate this to his physician colleagues, perhaps at the annual ISHRS meetings. He should also do his best to make his case in the court of public opinion (namely patients) to demonstrate this online. I would suggest educational videos that showcase an actual procedure with a detailed description of the extraction process that also shows each graft after harvesting and how it's placed into recipient sites (which also ultimately impacts growth yield).

 

At the end of the day, I think this perpetual online debate is healthy and provides patients with a lot of information. Does it end the debate? No. Will Dr. Feller or Dr. Bhatti folding and agreeing with the other (which I don't believe will ever happen) end the debate? No, because other physicians continue to see things differently.

 

Frankly, unless there is a scientific approach to FUE and a universal understanding of the procedure and how to overcome its hurdles, I believe the debate will continue for years to come. In the meantime, I thank you for everyone's contribution and look forward to reading additional input, hopefully that includes other physicians' opinions as well.

 

Best wishes,

 

Bill

 

 

 

 

Bill,

 

In continuation of Dr Feller's informative thread on the benefits of FUE vis-a-vis FUT in modern day practice of surgical hair restoration, I post herewith a video taken yesterday after you asked me to do so.

 

The video was shot impromptu in a case with extensive balding and we could harvest 2406 scalp grafts, 1312 beard grafts and 1177 chest grafts.

 

Such megasessions were unheard of till the advent of modern day FUE.

 

If you see the video closely, the forces of compression and torsion have clearly been overcome. The force of traction does exist but it does not adversely affect my yield and therefore it does not worry me.

 

The fourth force of transection has been reduced to almost 1-5 %. Partial transections can go higher.

 

Due to better honed skills,a few tricks in the FUE bag and a larger number of clients available to do FUE on, today the results of FUE compare very favorably to those of FUT. This was missing in yester years when FUE was done for small indications alone; and this continues to be the case with centers which do under 700 per occasional patient.

 

Lack of experience will never hone surgical skills.

 

I would like to add that I do all extractions myself. I have never employed another other doctor/ technician to do my harvesting for me and I never will. This is the most essential part of the whole procedure and only if the doctor harvests the grafts himself can he ensure quality and consistency of results in his practice.

 

In my opinion, any doctor who has the requisite eagerness to learn and the right amount of patience for the arduous procedure can acquire reasonable skills in FUE harvesting after having done one case each day for 6 months following adequate mentorship.

 

I would humbly submit that I have done over 7.65 million graft extractions (viable grafts only) MYSELF during my practice. However, Dr Feller calls me a newbie!

(@ Dr Feller: But, Sir, since you have been in the hair transplant industry for longer, I have no reservation in granting to you this liberty.)

 

Best wishes to forum members and I hope to hear your comments about my technique.

 

N.B.- The person being counseled in the video is not on whom the procedure was done. The procedure was on a healthy type 5 pattern Indian male. He did not give permission to be revealed.

Edited August 22, 2015 by Dr. Tejinder Bhatti
Titles added to each section of harvesting procedure for better explanation of technique. Content remains unchanged.

[NickBaron]

My name is Nick and I work for Dr De Reys who is an FUE-only specialist.

 

Firstly, my thanks and respect to Dr Feller whose medical opinion is of great value to many of the readers here.

 

Dr De Reys has specialised in FUE since its inception and chooses not to perform FUT.

 

We expect a very high growth rate mainly because the doctor has developed an extremely precise manual technique after transplanting millions of hair grafts over the years.

 

Using a manual punch, the doctor is able to 'feel' the root of each hair during extraction and avoids transecting the grafts.

 

Transection (accidentally splitting the root of the hair graft) can be a major issue for FUE with inexperienced staff or with automatic drills as Dr Feller says.

 

We preserve the grafts after extraction with the industry-leading nutrient solution Hyperthermosol so graft survival is not an issue with modern FUE as practiced by Dr De Reys.

 

The main reason why Dr De Reys does not perform FUT is that he is often called on to repair FUT scars.

 

This can be done in a number of ways:

 

1. A trichophytic closure can used to attempt to 'seal' the scar although such seals often reopen, especially after physical activity.

 

2. The other way is to fill up an FUT scar with FUE grafts in order to conceal the scar.

 

Dr De Reys always prefers to maximise the number of grafts in any operation and he sees scar repair as a waste of valuable grafts.

 

These grafts could be used to build density or create a stronger hairline so, in his view, this is a waste of grafts.

 

The number of grafts available is limited so wasting even a single graft is a loss.

 

Dr Feller rightly mentions the risks of badly-performed FUE however he also points out that,

 

"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."

 

This describes Dr De Reys' work and this is what we do.

 

We are careful with patient expectations however after transplanting using only the FUE method for many years on a range of patients, right up to Norwood 5/6, our experience is that patients are extremely happy with the strong growth they get from Dr De Reys' technique.

 

They are doubly pleased that they do not have a large horizontal scar across the back of their head.

 

Wearing your hair short is something that you can do comfortably with FUE.

 

It gives patients the freedom to choose how they wear their hair.

 

From our view, these are some of the main reasons why patients choose our clinic.

 

There are a few of our FUE-only patient cases on this forum which can be found by searching for Dr De Reys which I would encourage you to do.

 

Edited August 14, 2015 by David - Moderator

[FUE2014]

Hi Bill,

 

Hope you don't mind me posting this link.

 

(Sorry, but we do not allow links back to this website because they do not allow links back to ours)

 

I think it's important because it somewhat contradicts what Dr Feller is saying now about FUE.

Edited August 14, 2015 by David - Moderator

[Dr. Alan Feller]

My name is Nick and I work for Dr De Reys who is an FUE-only specialist.

 

Firstly, my thanks and respect to Dr Feller whose medical opinion is of great value to many of the readers here.

 

Dr De Reys has specialised in FUE since its inception and chooses not to perform FUT.

 

We expect a very high growth rate mainly because the doctor has developed an extremely precise manual technique after transplanting millions of hair grafts over the years.

 

Using a manual punch, the doctor is able to 'feel' the root of each hair during extraction and avoids transecting the grafts.

 

Transection (accidentally splitting the root of the hair graft) can be a major issue for FUE with inexperienced staff or with automatic drills as Dr Feller says.

 

We preserve the grafts after extraction with the industry-leading nutrient solution Hyperthermosol so graft survival is not an issue with modern FUE as practiced by Dr De Reys.

 

The main reason why Dr De Reys does not perform FUT is that he is often called on to repair FUT scars.

 

This can be done in a number of ways:

 

1. A trichophytic closure can used to attempt to 'seal' the scar although such seals often reopen, especially after physical activity.

 

2. The other way is to fill up an FUT scar with FUE grafts in order to conceal the scar.

 

Dr De Reys always prefers to maximise the number of grafts in any operation and he sees scar repair as a waste of valuable grafts.

 

These grafts could be used to build density or create a stronger hairline so, in his view, this is a waste of grafts.

 

The number of grafts available is limited so wasting even a single graft is a loss.

 

Dr Feller rightly mentions the risks of badly-performed FUE however he also points out that,

 

"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."

 

This describes Dr De Reys' work and this is what we do.

 

We are careful with patient expectations however after transplanting using only the FUE method for many years on a range of patients, right up to Norwood 5/6, our experience is that patients are extremely happy with the strong growth they get from Dr De Reys' technique.

 

They are doubly pleased that they do not have a large horizontal scar across the back of their head.

 

Wearing your hair short is something that you can do comfortably with FUE.

 

It gives patients the freedom to choose how they wear their hair.

 

From our view, these are some of the main reasons why patients choose our clinic.

 

There are a few of our FUE-only patient cases on this forum which can be found by searching for Dr De Reys which I would encourage you to do.

 

 

 

Thank you for the kind words, Nick.

I agree with Dr. De Reys' use of manual punches. I actually developed a motorized tool but abandoned it due to the loss of "feedback", or as you put it: "feel".

My best to you and your doctor.

 

Dr. Alan Feller

Great Neck, NY

[Dr. Alan Feller]

Hi Bill,

 

Hope you don't mind me posting this link.

 

(Link removed)

 

I think it's important because it somewhat contradicts what Dr Feller is saying now about FUE.

 

It's ok FUE2014. Even though your link is not allowed, I still have an old brochure from before I sold the company and the patents. I'll attach it to this thread. Just click the thumbnail below.

 

 

Ah, memories. That's from back in 2009!

 

No contradiction at all. I see your post as supporting what I'm saying, not contradicting.

 

That tool represents the very height of customized FUE tool design and manufacture to reduce or eliminate the three detrimental forces. But even it failed to bring FUE on par with FUT. I'm the inventor and I admit it.

 

No other instrument, device, or system to date has addressed the three detrimental forces more specifically and obviously than my oscillating motorized system/Feller Punch combination you linked to. Not ARTAS, not Neograft, not anything.

 

And that is my main point. Because there have been no advances that reduce the detrimental forces of FUE there can be no claim of parity with FUT. If a clinic or doctor is going to claim there has been an advance, then it is up to this person to demonstrate it.

 

I just viewed Dr. Bhatti's surgery and he's doing absolutely nothing differently than other FUE only clinics who performed megasessions 10 years ago. NOTHING. But yet he insists he is. His own video reveals he is not.

Rotating drill, standard punch, manhandling of grafts, and rushing through the procedure. Rush rush rush.

 

This may be before Bills time here, but there were at least two FUE-only megasession clinics who are now banned from this site who did this same exact thing 12 years ago. Nothing new.

Edited August 14, 2015 by Dr. Alan Feller

[matt1164]

so after reading all this I am inferring if you can get a FUT like result depending on what dr you go to.

 

I like Dr. Feller a lot and would have done a surgery with him in a heart beat but he really wanted me to fut but I really didn't want a scar. I wear a 1 or 2 guard in the summer. I understood his reasoning but it really was just my preference. I found him to be ethical when he said that he wouldn't do an FUE on me because he thinks its for smaller jobs and I needed about 1200 which he thought that would be too much trauma.

 

Dr. F is literally 15m from my house. I also think highly of blake from the forums so it would have been ideal. but as of right now I have a deposit to have my surgery done.

 

I also just developed alopecia areata so my surgery has been postponed indefinitely to see how the AA responds to therapy. Part of me thinks I am just not meant to have a HT. maybe the good lord thinks I am handsome enough and I would have an unfair advantage over mortal men if I were to have my beautiful head of hair back.

[Dr. Alan Feller]

so after reading all this I am inferring if you can get a FUT like result depending on what dr you go to.

 

I like Dr. Feller a lot and would have done a surgery with him in a heart beat but he really wanted me to fut but I really didn't want a scar. I wear a 1 or 2 guard in the summer. I understood his reasoning but it really was just my preference. I found him to be ethical when he said that he wouldn't do an FUE on me because he thinks its for smaller jobs and I needed about 1200 which he thought that would be too much trauma.

 

Dr. F is literally 15m from my house. I also think highly of blake from the forums so it would have been ideal. but as of right now I have a deposit to have my surgery done.

 

I also just developed alopecia areata so my surgery has been postponed indefinitely to see how the AA responds to therapy. Part of me thinks I am just not meant to have a HT. maybe the good lord thinks I am handsome enough and I would have an unfair advantage over mortal men if I were to have my beautiful head of hair back.

 

Thank you for the kind words, Matt.

Best of luck with your AA and your procedure when you finally have it done.

Come visit us afterward.

Best,

Dr. Feller

[Dr. Alan Feller]

 

Dr. Bhatti,

 

I'm sorry Dr. Bhatti, but your procedure does not support any of the claims of advancement you've made on this thread.

 

In fact, I find the contents of your video to be the most brutal FUE procedure I've ever seen. A layman can see how indelicate your method. There is a "wrongness" to it on its face, and you don't have to be an FUE practitioner to see it. To say you were racing is an understatement.

 

The use of a rotating drill and indiscriminate grabbing and yanking the grafts free at high speed are hardly innovative or new. Indeed, this method has been around since the inception of FUE 14 years ago. In fact, there were no less than two megasession FUE clinics who are now banned from this site that performed their procedures the same exact way 12 years ago. One company of which produced a video identical to yours. So what is new here sir? Nothing.

 

This is brute force and nothing more. No use of technology or advances-real or imagined. There is no feedback to the hand during scoring due to the weight and vibration of the tool, and there is absolutely no technique used to remove the grafts. No care either. They are just ripped free in any direction and smashed together with other grafts that were yanked free and crushed within the jaws of the forceps. While there are FUE practitioners who actually incorporate delicate and purposeful movements, feedback, and technique, this video of yours clearly demonstrates that you do not.

 

You just score holes as quickly as you can and then tear them out as quickly as you can. This is not working smart. This is just working fast. The one bit of technology that you are using is the drill, but you use that simply to speed up the procedure, not reduce detrimental forces. That is not an "advance".

 

You stated that there were indeed three detrimental forces associated with FUE but that "advances" in FUE had overcome them. The detrimental forces are in clear evidence in your video, but I see no "advances" in your instrumentation nor technique to neutralize them. Just the opposite in fact.

 

The three detrimental forces of FUE clearly in evidence in the video (Torsion, Compression, Traction):

 

Torsion:

 

Every time you bury that high speed drill driven punch into the skin you create torsion. A twisting force that twists the follicle ever more as you proceed deeper into the skin. As you drive the punch down past the 1.5 mm depth the torsion has already started to do it's damage. Not to mention the heat that is created. You claimed in another post that you scored very shallow, but what I witnessed was a scoring depth down to 3mm. About the average for all FUE doctors. Since most grafts are about 4-5 mm in total length I think we can safely conclude from your video that you are scoring at least 50% down the length of the entire graft. That is the red zone for torsional damage.

 

Compression:

 

Every time your assistant blindly grabs the grafts after they are scored she applies the detrimental force of compression. However, in your method the graft gets multiple exposures to compression because she doesn't pull the graft free and clear it from the field. Rather, unbelievably, she just keeps squeezing the same grafts over and over again blindly as she attempts to grab a clump of grafts in one scoop just to save time.

 

Traction:

 

And the traction force is incredible. It's bad enough that there is a minimum amount of force necessary to break the grafts free in the first place, but your assistant makes it even greater by increasing the speed of delivery AND doing so at the worst angles. In the video the traction force can be easily seen by the tenting in the skin. To lift an area of skin in the form of tenting takes incredibly focused force on the graft itself.

 

Greater traction force requires greater compression force as well.

 

The removal of grafts via FUE should be an intricate waltz, not an unruly mosh pit. Look at what some of your better fellow FUE megasessionist do. They do not race, they give each graft its own attention and time to be delivered as safely as possible, they respect each graft individually and clear it from the field before clamping onto the next one in preparation for the next delivery. Your staff just blindly clamp and pull. Do you honestly believe you are not injuring grafts compared to a more delicate and refined FUE approach? Do you honestly believe this does not injure grafts to a far greater extent than an FUT graft that experiences no such punishment at all ???

 

Also, your video excludes the ability of the viewer to see the grafts AS they are removed. At the speed and distance from the camera that the grafts are being removed scrutiny is impossible. Also, when you showed the petri dish filled with tissue it is almost impossible to evaluate the grafts. Despite this, I could still see skeletonized grafts.

 

At what point are you placing each and every graft under a microscope for inspection as you claimed? I do this. You claimed to do this. But I don't see where or how. You do not have it in your video.

 

Dr. Bhatti, your one video did more to make my point about the damage FUE visits on each and every graft far better than I ever could have written or even demonstrated in my own clinic. I think MANY people watching this thread who may not have understood what I was talking about experienced an instant understanding and awakening.

 

I look forward to the comments from viewers and other FUE practitioners as well.

 

One final question Dr. Bhatti: Do you believe most FUE practitioners perform surgery this way?

Edited August 14, 2015 by Dr. Alan Feller

[Mick50]

As someone who has always tried to be open minded regarding the FUE versus FUT debate I must say even before Dr Feller's comments I didn't think Dr Bhatti did himself any favours showing this video it does to a layman's eyes look a bit rushed and unrefined also how the grafts were stored in the petri dishes looked very haphazard

[Dr. Alan Feller]

 

 

 

 

 

 

 

 

 

 

Here is a video of me from at least 5 years ago performing the "scoring" phase of the FUE procedure using my oscillating motorized FUE device and custom punch tips. Look how I allow the tool to work it's way through the tissue rather than pushing it through. Also note how carefully I examine the target grouping before going for the next graft.

 

Now compare this to the technique used in the Dr. Bhatti video.

 

Which do you think injures the graft more?

Edited August 15, 2015 by Dr. Alan Feller

[Dr. Alan Feller]

 

 

 

 

 

And here is the worlds very first public FUE extraction in 2002 performed by yours truly in my Great Neck office and published online-making it the worlds first online FUE as well.

 

Note how gentile and purposefully the punch is oscillated into the skin. Then notice how carefully the target follicle is removed or "delivered" as I call it. I'm not being slow, I am waiting patiently for the lower dermis and fat to tear free so that I exert as little detrimental force of TRACTION that I can.

 

Now compare this to Dr. Bhatti's delivery technique. Which do you think preserves the integrity of the graft better?

 

And remember, I filmed that video 13 years ago!

Edited August 15, 2015 by Dr. Alan Feller

[Eurofue]

I agree with what is being said about the removal of the grafts and storing them. It doesn't look great big clumps of grafts having multiple grabs by the forceps.

I hope that isn't the norm for FUE. Maybe the pulling part may not be the problem. Not that I have any clue but just throwing it out there. Anyone tried to take a plaster off slowly it absolutely kills but when you pull quickly it doesn't seem to put the same stress as it comes out as the pain is much less. I will repeat, so I accept being shot down I have no clue about it I'm just wondering how Dr Bhatti can still get good results with what looks like a rather rough job of what's being done!

[lileli]

Dr. Feller,

 

Dr. Bhatti still gets consistent results, why? Could it be that you just got overly cautious about a few sub par FUE results? I am just wondering.

[Dr. Alan Feller]

Dr. Feller,

 

Dr. Bhatti still gets consistent results, why? Could it be that you just got overly cautious about a few sub par FUE results? I am just wondering.

 

Overly cautious, no.

 

I've seen enough FUE results to KNOW what's going on. Transmitting it to the public seems to be very difficult because it's hard to tell people what they simply don't want to hear.

 

You said Dr. Bhatti gets consistent results. What do you base that on?

 

What would you base the statement that FUE doctors in general get "consistent" results on? Look on this very chat site. Don't you see all the disappointed FUE patients? How about the ones who are worried or concerned? How about the ones who just disappear after a few posts?

 

The "ends justifies the means" argument is never valid because for the most part only the best "ends" are publicized. I see the unpublicized "ends" and it is mostly disappointing. And the reason for it is in that video Dr. Bhatti posted himself.

 

And how many grafts were sacrificed to create the "consistent" result you are referring to? You certainly can't tell from the result itself, or multiple results.

 

You've seen at least one or two other FUE doctors perform FUE in their own videos. Have they done it this way? Most of the clinics who went to the trouble to post their actual surgeries online posted careful and delicate technique. Individual attention to each and every follicle. But I don't think MOST FUE megasession clinics utilize such care. I think most are doing it as Dr. Bhatti showed in his video with attention primarily to SPEED SPEED SPEED! NUMBERS NUMBERS NUMBERS!!

 

Also, lileli, Dr. Bhatti spent every post claiming that his procedure incorporated advanced techniques and instrumentation to protect the grafts from what you think I am being overly cautious about. Did you see anything in his video to prove that claim? Don't you see a red flag here?

Edited August 14, 2015 by Dr. Alan Feller

[Pma]

Hi dr feller,

 

As a patient who has had over 6500 grafts fue with dr lorenzo with great results so far, and all his other amazing fue results is this what you mean by an exception to fue. A surgeon who has specialised in fue for many years and I suppose mastering his method of fue to a very high standard!!?