FUT is more popular than FUE

[voxman]

I think you meant 1 out of every 99

 

Does anybody even read the first post of this thread ? This clearly explains why.

 

I read the first post. You said

 

you would find 99.9% would be FUT, not FUE

which is 1 FUE out of 1000 FUT.

 

I am available for math tutoring.

 

 

C'mon, Doctor - smile and admit your math equation may be a little off.

Edited August 17, 2015 by voxman

[Dr. Alan Feller]

Dr. Feller himself just posted an FUE case he did back in 2003 that showed an absolute fantastic result, so obviously he was able to overcome the "threes detrimental factors" my question to him is how? .

 

I'll tell you how:

 

I utilized a very meticulous FUE technique to reduce the three detrimental forces.

 

1. I scored with a manual punch and did small angle oscillations allowing the punch to work it's way down into the dermis at it's own rate. No forcing in the name of speed. And certainly no rotary drill. This reduced torsion and heat.

 

2. Then I grasped each partially freed target graft individually and carefully and applied gentle but constant traction. This allowed the graft to work itself free at its own pace rather than being ripped out violently in the name of speed.

 

3. To decrease the traction force I slid a small needle into the scored opening and poked at the base of the still attached graft. This perforated it and allowed the graft to pop free with less traction and therefore trauma. See the video below.

 

 

 

 

4. Since I could apply less traction I could also apply less compression to hold the graft while delivering the graft.

 

5. As I delivered the graft I made sure to stay in the same line of traction the entire way. I didn't just yank and rip them out in any old direction in the name of speed. Nor did I attempt to score a bunch of target grafts and then try to grab them together as a clump and tear them free together in the name of speed.

 

6. Each graft was taken from the field one by one as they were delivered. I say "delivered" because I liken this procedure to delivering a baby. In child birth the doctor doesn't just grab the head with forceps and rip the baby out with great force because he has another birth to attend.

 

This is the technique that I use to deliver FUE grafts. In many cases it works well and the growth is impressive, even in a "hostile" recipient environment like a scar as seen in the repair case above. But even with all this caution and care patients may still fail to grow as satisfactorily as the equivalent FUT procedure.

 

This is why I say no matter how good or bad a result from FUE appears to be, the result on the same patient using FUT must be better because there isn't as much trauma to the grafts.

 

In the case of the FUE repair case above he happened to grow well. But if he hadn't, the chances are more likely that the decrease in growth would have been due to the three detrimental forces of FUE. If you can't overcome these forces then you have to get around them. The only way to do that is take more grafts than you otherwise would need to for FUT. And to do that you'd have to speed up your FUE procedure. And the faster you speed up your FUE procedure, the greater the detrimental forces are amplified. THAT, in a not so nutshell, is why I oppose large FUE sessions.

[voxman]

..actually it's 999 of of 1000 (but you get the idea)!

[LondonHTseeker]

You've got me confuzzled, I hate math!

[Britanium]

Voxman a new t shirt is perhaps looming ?

[voxman]

You've got me confuzzled, I hate math!

 

Consider this then ~

 

THE HALF IS GREATER THAN THE WHOLE

Hesoid - 700 B.C

[newbie33]

Reminds me of one of my favourite childish pun jokes - which really works best aloud.

 

Men are hairy. But women are more hairy on the whole.

[1978matt]

Doc,

 

In a previous life I gained a degree in Engineering at a reputable institution.... I wondered, is there not an adhesive force at the base of the graft that needs to be overcome? This puts the graft under Tension as well so is it not more than just 3 forces?

 

Compression

Torsion

Traction

Tension?

[Melvin- Admin]

I'll tell you how:

 

I utilized a very meticulous FUE technique to reduce the three detrimental forces.

 

1. I scored with a manual punch and did small angle oscillations allowing the punch to work it's way down into the dermis at it's own rate. No forcing in the name of speed. And certainly no rotary drill. This reduced torsion and heat.

 

2. Then I grasped each partially freed target graft individually and carefully and applied gentle but constant traction. This allowed the graft to work itself free at its own pace rather than being ripped out violently in the name of speed.

 

3. To decrease the traction force I slid a small needle into the scored opening and poked at the base of the still attached graft. This perforated it and allowed the graft to pop free with less traction and therefore trauma. See the video below.

 

 

 

 

4. Since I could apply less traction I could also apply less compression to hold the graft while delivering the graft.

 

5. As I delivered the graft I made sure to stay in the same line of traction the entire way. I didn't just yank and rip them out in any old direction in the name of speed. Nor did I attempt to score a bunch of target grafts and then try to grab them together as a clump and tear them free together in the name of speed.

 

6. Each graft was taken from the field one by one as they were delivered. I say "delivered" because I liken this procedure to delivering a baby. In child birth the doctor doesn't just grab the head with forceps and rip the baby out with great force because he has another birth to attend.

 

This is the technique that I use to deliver FUE grafts. In many cases it works well and the growth is impressive, even in a "hostile" recipient environment like a scar as seen in the repair case above. But even with all this caution and care patients may still fail to grow as satisfactorily as the equivalent FUT procedure.

 

This is why I say no matter how good or bad a result from FUE appears to be, the result on the same patient using FUT must be better because there isn't as much trauma to the grafts.

 

In the case of the FUE repair case above he happened to grow well. But if he hadn't, the chances are more likely that the decrease in growth would have been due to the three detrimental forces of FUE. If you can't overcome these forces then you have to get around them. The only way to do that is take more grafts than you otherwise would need to for FUT. And to do that you'd have to speed up your FUE procedure. And the faster you speed up your FUE procedure, the greater the detrimental forces are amplified. THAT, in a not so nutshell, is why I oppose large FUE sessions.

 

I do not condone large FUE sessions I myself got my first FUE only 1,800 grafts split in 2 days. However, it appears from what you're stating that you were able to overcome the "three detrimental factors" based on skill, instrumentation, but at the end it looks like you said you took out more grafts than necessary to make up for lower yields. Not sure if you're generalizing here or speaking about your case specifically, it's interesting to read your response I don't doubt that's why you got a good yield, but it makes me think if you were able to overcome these factors than its not impossible for other physicians. Although it seems much more time consuming and tedious for a low amount of grafts, if this is true than I would say I'm in agreemeIMG_4425nt, I think for FUE to get the same amount of grafts as FUT you will need to do more surgeries, that is something you should know prior to electing the surgery, it's something that Dr. Diep told me in the beginning. But the single most important aspect of this post is that these factors, although not proven to exist, can be overcome.

[Dr. Alan Feller]

Doc,

 

In a previous life I gained a degree in Engineering at a reputable institution.... I wondered, is there not an adhesive force at the base of the graft that needs to be overcome? This puts the graft under Tension as well so is it not more than just 3 forces?

 

Compression

Torsion

Traction

Tension?

 

Props to you Matt. Well done. A person needs to be a bit more of an engineer to understand the facts and forces I am trying to reveal. You clearly get it.

 

The tension force that you are referring to that is caused by the adhesion at the base of the partially released base IS the TRACTION force I'm referring to. So only three forces.

 

By using follicular perforation this adhesive force can be reduced and thus the required traction force can be reduced as well.

[Dr. Alan Feller]

I read the first post. You said

 

which is 1 FUE out of 1000 FUT.

 

I am available for math tutoring.

 

 

C'mon, Doctor - smile and admit your math equation may be a little off.

 

Sorry Vox, check your math books.

Here's my original post:

 

"Originally Posted by Dr. Alan Feller

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."

 

100% means 100 out of a 100

99% means 99 out of a 100.

-so-

99.9% means 99.9 out of a 100.

 

Not 1 out of a 1,000.

 

You are off by an order of magnitude.

[LondonHTseeker]

That's what I thought... then stopped thinking about it because it made my brain ache.

 

I like that ancient bearded dude's quote. Here's another by him; "Home is where the heart is."

[Melvin- Admin]

I'll tell you how:

 

I utilized a very meticulous FUE technique to reduce the three detrimental forces.

 

1. I scored with a manual punch and did small angle oscillations allowing the punch to work it's way down into the dermis at it's own rate. No forcing in the name of speed. And certainly no rotary drill. This reduced torsion and heat.

 

2. Then I grasped each partially freed target graft individually and carefully and applied gentle but constant traction. This allowed the graft to work itself free at its own pace rather than being ripped out violently in the name of speed.

 

3. To decrease the traction force I slid a small needle into the scored opening and poked at the base of the still attached graft. This perforated it and allowed the graft to pop free with less traction and therefore trauma. See the video below.

 

 

 

 

4. Since I could apply less traction I could also apply less compression to hold the graft while delivering the graft.

 

5. As I delivered the graft I made sure to stay in the same line of traction the entire way. I didn't just yank and rip them out in any old direction in the name of speed. Nor did I attempt to score a bunch of target grafts and then try to grab them together as a clump and tear them free together in the name of speed.

 

6. Each graft was taken from the field one by one as they were delivered. I say "delivered" because I liken this procedure to delivering a baby. In child birth the doctor doesn't just grab the head with forceps and rip the baby out with great force because he has another birth to attend.

 

This is the technique that I use to deliver FUE grafts. In many cases it works well and the growth is impressive, even in a "hostile" recipient environment like a scar as seen in the repair case above. But even with all this caution and care patients may still fail to grow as satisfactorily as the equivalent FUT procedure.

 

This is why I say no matter how good or bad a result from FUE appears to be, the result on the same patient using FUT must be better because there isn't as much trauma to the grafts.

 

In the case of the FUE repair case above he happened to grow well. But if he hadn't, the chances are more likely that the decrease in growth would have been due to the three detrimental forces of FUE. If you can't overcome these forces then you have to get around them. The only way to do that is take more grafts than you otherwise would need to for FUT. And to do that you'd have to speed up your FUE procedure. And the faster you speed up your FUE procedure, the greater the detrimental forces are amplified. THAT, in a not so nutshell, is why I oppose large FUE sessions.

 

Doc,

 

In a previous life I gained a degree in Engineering at a reputable institution.... I wondered, is there not an adhesive force at the base of the graft that needs to be overcome? This puts the graft under Tension as well so is it not more than just 3 forces?

 

Compression

Torsion

Traction

Tension?

Good thing for us and the hair restoration community, Dr. Feller had been kind enough to give us a blue print on how to overcome these now "4" issues, The doctor himself has overcome these issues, the issues concerning the strip procedure though have yet to be addressed. If Dr. Feller is not willing to address them on this thread. I'm willing to create a new thread if he'll participate.

[BadBeat]

I think you meant 1 out of every 99

 

Does anybody even read the first post of this thread ? This clearly explains why.

 

No, I didn't mean 1 out of every 99.

 

You said "99.9% of all HT's would be FUE." That is 1 out of every 1,000 procedures. If you would have said "99% of all HT's would be FUE" then that would mean 1 out of every 100 procedures.

 

Either way, it's laughable because I'd wager a large sum that it's not even close to 1 out of 100.

[voxman]

Sorry Vox, check your math books.

Here's my original post:

 

"Originally Posted by Dr. Alan Feller

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."

 

100% means 100 out of a 100

99% means 99 out of a 100.

-so-

99.9% means 99.9 out of a 100.

 

Not 1 out of a 1,000.

 

You are off by an order of magnitude.

 

Ouch. Math books checked. You can't offer a .1% Hair Transplant. You have to work integers of whole numbers. 1 Hair Transplant is the base.

 

So, what is 100% of 1000? Easy...it is 1000.

 

100% means 1000 out of 1000. Agree?

 

99.9 % means 999 out of 1000. Agree?

 

-so-

 

99.9% = 999 out of 1000.

 

999 FUT vs. 1 FUE.

 

Still available for tutoring.

[BadBeat]

Sorry Vox, check your math books.

Here's my original post:

 

"Originally Posted by Dr. Alan Feller

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."

 

100% means 100 out of a 100

99% means 99 out of a 100.

-so-

99.9% means 99.9 out of a 100.

 

Not 1 out of a 1,000.

 

You are off by an order of magnitude.

 

You're hilarious. You just proved yourself wrong.

 

You're right....99.9% does mean 99.9 out of 100.

 

So 99.9 x 10 = 999....or 1 in a 1000

 

Can you at least admit that you were wrong on the math here?

[newbie33]

Vox is right. If FUE was one in every 99, then FUT would be a total of 98.9% of all procedures. (Or 99% if we're rounding up correctly).

 

Twenty years after the event, some of my qualifications have found an application.

[Dr. Alan Feller]

No, I didn't mean 1 out of every 99.

 

You said "99.9% of all HT's would be FUE." That is 1 out of every 1,000 procedures. If you would have said "99% of all HT's would be FUE" then that would mean 1 out of every 100 procedures.

 

Either way, it's laughable because I'd wager a large sum that it's not even close to 1 out of 100.

 

My mistake. You are correct.

[Dr. Alan Feller]

You're right. I misread it as 99% not 99.9%.

I meant to write 99%.

Got it.

Guilty as charged.

Thank you.

[voxman]

Dr. Feller, out of respect and consideration of the practices that you and the Dr.s participating in this thread engage in that I do not, and at your bidding, I vacated my participation and deferred comments on the procedural issues surrounding the topic. (insert 'angel' smilie)

 

But for the love of God, give me props on my math!

Why, 4 out of every 3 people reading this would !! :cool:

[Dr. Alan Feller]

Dr. Feller, out of respect and consideration of the practices that you and the Dr.s participating in this thread engage in that I do not, and at your bidding, I vacated my participation and deferred comments on the procedural issues surrounding the topic. (insert 'angel' smilie)

 

 

Why, 4 out of every 3 people reading this would !! :cool:

 

Ha! Yes. Props on your math!

[Dr. Alan Feller]

40,000 HITS!

Who would have thought this thread would run this long?!

There must be some interest in the subject.

[HairLostYears]

Yea I hope this thread keeps chugging along, as I still find it both informative -and- entertaining.

 

Who needs Netflix??

[Melvin- Admin]

We should install a poll what procedure would you rather have. Dr. Feller aside from the differences and even though I'm sure you don't like seeing my username come up, I think we've all benefited from this thread, especially your response on how to overcome the " 3 detrimental factors" I don't know why you wouldn't hone your FUE skill? It's hereto stay why not make it an integral part of your practice? With your vast knowledge I'm sure you'd become one of the greats.

[Dr. Alan Feller]

I do not condone large FUE sessions I myself got my first FUE only 1,800 grafts split in 2 days. However, it appears from what you're stating that you were able to overcome the "three detrimental factors" based on skill, instrumentation, but at the end it looks like you said you took out more grafts than necessary to make up for lower yields. Not sure if you're generalizing here or speaking about your case specifically, it's interesting to read your response I don't doubt that's why you got a good yield, but it makes me think if you were able to overcome these factors than its not impossible for other physicians. Although it seems much more time consuming and tedious for a low amount of grafts, if this is true than I would say I'm in agreemeIMG_4425nt, I think for FUE to get the same amount of grafts as FUT you will need to do more surgeries, that is something you should know prior to electing the surgery, it's something that Dr. Diep told me in the beginning. But the single most important aspect of this post is that these factors, although not proven to exist, can be overcome.

 

Unfortunately I did not overcome the three detrimental forces of FUE. I diminished them a little through true and actual advances in instrumentation and technique, but not to the level of delivering an FUE graft that is as intact and uninjured as an FUT graft. If I had, I would only be doing FUE. But this is not the case.

 

The gold in your last post is that you are recognizing what I have been trying to say, and that is that if you are going to have an FUE procedure then you have to know, acknowledge, and consent to the reality that your grafts are going to be injured to a greater extent than that for FUT and will thus need more grafts transplanted to achieve the same cosmetic look.

 

The three detrimental forces of FUE have been identified and proven to exist, even if many FUE doctors refuse to admit it.

Torsion is evidenced by the immediate decapitation that occurs during the scoring process.

Traction is evidenced by the missing lower half of grafts that are removed, or lost parts of the lower half, or outright transection

Compression is evidenced by the crush injury that can be seen when the graft is removed from the scalp

 

All are in evidence and to try to minimize their significance is to go against 25 years of Hair Transplant gospel. Graft handling and preparation has always been at the heart of high yield hair transplantation. That doesn't go out the window because a few dozen practitioners decide it does.

 

In order for an FUE procedure with all it's involved injury to grafts to consistently produce results on par with FUT it must utilize more grafts during the procedure. The more the better. But this is only because so many are injured or killed in the process of extraction. Yes, you can point to a megasession recipient and say he looks great and thick. But he most likely needed more grafts to achieve that look because so many were injured in the extraction process. Specifically due to one or a combination of the three detrimental forces.