FUT is more popular than FUE

[Dr. Alan Feller]

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.

 

My definition of honing my skill is getting grafts out with more tissue and less trauma. This is working smart and represents a true advance.

 

The definition of most other FUE doctors of honing their skill is getting the grafts out FASTER and FASTER in greater numbers with no regard at all for graft injury or donor area sacrifice. This is a "brute force" approach and does not represent any advance.

 

Your doctor took the right path. By doing 900 per day he took his time to do it right. THAT is working smart, and more inline with my philosophy of surgery. In taking that route he spared you hundreds of grafts and considerable donor fibrosis.

 

I love doing FUE, it's quite a challenge. And I must admit that I am always on the look out for a better way to do it. In fact, one idea came to mind that I thought of a few years ago but never tried. Very different and counter intuitive. If I actually build it I will, as always, post it here. Maybe it will be "the answer".

[Rawkerboi]

I wish more doctor participate in this thread, but I guess they are just happy by paying their membership fees..

[Melvin- Admin]

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.

 

Well I put it in quotations for a reason it hasn't been proven. If it was proven I wouldn't use quotations. But nevertheless you bring up a point I'd like to have addressed, when you do scar repair and you do FUE do you take out more grafts than necessary? It would seem unnecessary with the amount of grafts needed. What you say makes some sense although again not proven in mega sessions, but how about small sessions of 1,000 or less grafts? For example the result you posted was impressive did you utilize more grafts than necessary?

[Raj Jayukdht]

The mega session hair transplant procedure is the most modern and advanced way to achieving the growth of a full head of hair, in the shortest period of time in people who are extensively bald and need body hair to be grafted besides scalp hair.

 

I have always believed that less surgery is better than more surgery in people with more extensive balding patterns. If you can get 5,000 grafts in two sessions, why go for 5 sessions of 1000 grafts each? If the density and laxity allow for it, than why not have one or two session and hopefully just be done with the surgical process quicker. This means in a practical sense that 6-12 months after the first session of 5000 grafts, you can see results which will impact your ability to style your hair. A skilled physician is necessary for any surgery you have and I believe Dr Bhatti has nailed it with doing mega sessions, Dr Bhatti knows the time the graft is out of the body is important, keeping it hydrated and handling well from punching to placement is vital…maybe that’s his secret to his success!!!

 

We all know that Dr Bhatti gets results with mega sessions and his happy patients are all over this forum and they can back me on this.

 

I think Dr Bhatti does no more than 4500 grafts a day including BHT (please correct me Dr Bhatti if the figure is wrong) and he achieves the most impressive results for far. When I was at Dr Bhatti clinic back in October 2014 I spoke to a lot of patients and most of them wanted a high density procedure as they want the benefits quickly and say goodbye to hair loss for good or for few years.

[Raj Jayukdht]

The mega session hair transplant procedure is the most modern and advanced way to achieving the growth of a full head of hair, in the shortest period of time in people who are extensively bald and need body hair to be grafted besides scalp hair.

 

I have always believed that less surgery is better than more surgery in people with more extensive balding patterns. If you can get 5,000 grafts in two sessions, why go for 5 sessions of 1000 grafts each? If the density and laxity allow for it, than why not have one or two session and hopefully just be done with the surgical process quicker. This means in a practical sense that 6-12 months after the first session of 5000 grafts, you can see results which will impact your ability to style your hair. A skilled physician is necessary for any surgery you have and I believe Dr Bhatti has nailed it with doing mega sessions, Dr Bhatti knows the time the graft is out of the body is important, keeping it hydrated and handling well from punching to placement is vital…maybe that’s his secret to his success!!!

 

We all know that Dr Bhatti gets results with mega sessions and his happy patients are all over this forum and they can back me on this.

 

I think Dr Bhatti does no more than 4500 grafts a day including BHT (please correct me Dr Bhatti if the figure is wrong) and he achieves the most impressive results for far. When I was at Dr Bhatti clinic back in October 2014 I spoke to a lot of patients and most of them wanted a high density procedure as they want the benefits quickly and say goodbye to hair loss for good or for few years.

[Dr Tejinder Bhatti]

Today's patient- received an FUT megasession some years back for his balding outside Asia. He has come for filling of his large crown area and possible scar correction.

[FUE2014]

That actually doesn't seem to be a bad strip scar, ive definitely seen a lot worse...

[FUE2014]

Dr Bhatti in your opinion why have some doctors, like Dr Lorenzo, abandoned strip all together ?

[California]

Dr Bhatti in your opinion why have some doctors, like Dr Lorenzo, abandoned strip all together ?

 

Hi FUE2014,

 

I can't speak for Dr. Lorenzo but for the record, our Clinic (Darling Buds India/Dr. Bhatti) has also abandoned the strip surgery all together for a few years now. We perform FUE procedures exclusively because that is what we believe in and that is what has worked for thousands of our Patients, who have documented their satisfaction on this Forum and other HT Forums on the web.

 

 

Best regards,

California

[Britanium]

Is that the result of 2 strip scars? The middle looks the worse. It seems to go up really high either side too.

Its more usual to see ear to ear level.

[Dr. Alan Feller]

Today's patient- received an FUT megasession some years back for his balding outside Asia. He has come for filling of his large crown area and possible scar correction.

 

So Dr. Bhatti posted a photo presentation that includes the eeeevil linear scar- and is allowing it to speak for itself.

 

 

 

But let's ask a question, would this patient have been better off with following megasession FUE scarring instead?

 

 

So let's listen to what Dr. Bhatti's photo presentation is actually telling us:

1. The scar was completely concealed before the donor area was shaved down. Can the same be said for FUE guy?

 

 

2. The donor area above and below the scar are completely virgin. See any virgin area in the FUE guy's donor area?

 

3. Dr. Bhatti can now perform a hair transplant BECAUSE the donor areas above and below the scar were spared by the FUT procedure. Can he get NEARLY as many grafts out of the FUE guy?

 

I have focused most of my efforts on this thread in pointing out the three detrimental forces of FUE. But I only just touched on the increased donor scarring and damage that FUE inflicts on the donor area over FUT. The more the donor area is damaged, the less hair one has to cover that damage and the less hair available for future procedures. Add to this the fact that the 3 detrimental forces cause a decreased yield in FUE cases and the choice between FUT and FUE becomes pretty easy.

Edited August 18, 2015 by Dr. Alan Feller

[California]

Hi All,

 

I just uploaded a Patient case for Dr. Bhatti on this Forum. Here is the link:

 

Dr. Bhatti- 1587 FUE scalp grafts for hairline and temples - Forum By and for Hair Loss Patients

 

One the pictures uploaded (attaching here too) is from the donor area 6 months post-op. Patient wears his hair short in the donor area. In spite of his darker skin, the donor area (marks/scars) are barely visible. You can note that an incidental thin scar above the nape of the neck looks prominent instead.

 

 

Best regards,

California

[Bill - Seemiller]

California,

 

Thanks, but why are you posting a link to Dr. Bhatti's case here? If the case demonstrates a point that you or others are trying to make here regarding FUT vs FUE, then please go ahead and make it. Otherwise, this topic (or any other) is not a place just to promote Dr. Bhatti's results.

 

I look forward to your response.

 

Bill

[California]

California,

 

Thanks, but why are you posting a link to Dr. Bhatti's case here? If the case demonstrates a point that you or others are trying to make here regarding FUT vs FUE, then please go ahead and make it. Otherwise, this topic (or any other) is not a place just to promote Dr. Bhatti's results.

 

I look forward to your response.

 

Bill

 

Hi Bill,

 

I posted a the link here, absolutely to make a point in the FUT vs FUE debate. The prior post on this thread was from Dr. Feller showing the donor area for a FUE Patient. I posted the link and attached the picture here to "also" show the donor area of a Dr. Bhatti (FUE) Patient 6 months post-op, who chose to wear his hair short in the donor area.

 

There is/was absolutely no intention to promote Dr. Bhatti's results. Been around on this Forum for a few years now and I am sure that you will agree that we do not resort to such tactics.

 

Please let me know if you have any questions and/or concerns. I will be happy to address.

 

Best regards,

California

[destorius]

I have logged back in after 4 long years to give my opinion! I don't think you can get GREAT results with either FUE or STRIP but with going with strip it gives you better odds. I generally do see better, denser results on this forum with strip. That said, you take on the linear scar which will probably be fine but *could* stretch. You pay your money and take your choice.

 

I would imagine that impact of FUE on the donor is worse than strip but if you don't need much work done in your lifetime that might not matter. I have had FUE myself with Dr Feller (1010 grafts), the left side grew in ok but the left didn't. I would estimate (and I am in no way an expert) that it was in the 50-60% range. Was this Dr Fellers fault? No I shouldn't think so it could well be my physiology, who knows and to be honest it doesn't really matter now, it's done. From a personal perspective, Dr Feller came across as an exceptionally knowledgable surgeon and obviously can hold some strong views and comes across as defensive in the thread. This thread has been made into Feller vs. FUE which isn't really fair as if you look back over the last decade he has done more than most to try and progress things.

 

Isn't it nice that we have a number of experts who will give their view on this forum. Kudos to Feller, Vories & Bhatti.

[newbie33]

Destorious

 

You know, that's a fear in the back of my mind that has so far stopped me from getting a HT - that neither strip or FUE give GREAT results. In pictures I know there are some great results, but in the handful of real-life results I've seen, I've always been a bit underwhelmed. Constant, nagging fear, that is.

[destorius]

Newbie... Sorry I corrected the post, I think you CAN get great results. Nothing in life is 100% though. I think a lot depends on your expectations. One thing I would say is that there is NEVER a rush to take the plunge. It can never be too late if you are on meds. Good luck!

[Dr. Alan Feller]

I have logged back in after 4 long years to give my opinion! I think you can get GREAT results with either FUE or STRIP but with going with strip it gives you better odds. I generally do see better, denser results on this forum with strip. That said, you take on the linear scar which will probably be fine but *could* stretch. You pay your money and take your choice.

 

I would imagine that impact of FUE on the donor is worse than strip but if you don't need much work done in your lifetime that might not matter. I have had FUE myself with Dr Feller (1010 grafts), the left side grew in ok but the left didn't. I would estimate (and I am in no way an expert) that it was in the 50-60% range. Was this Dr Fellers fault? No I shouldn't think so it could well be my physiology, who knows and to be honest it doesn't really matter now, it's done. From a personal perspective, Dr Feller came across as an exceptionally knowledgable surgeon and obviously can hold some strong views and comes across as defensive in the thread. This thread has been made into Feller vs. FUE which isn't really fair as if you look back over the last decade he has done more than most to try and progress things.

 

Isn't it nice that we have a number of experts who will give their view on this forum. Kudos to Feller, Vories & Bhatti.

 

Thank you for the kind words and the follow up. I think your post is dead on.

 

It's interesting to note that you basically wrote that one side grew well and the other only about 50%. So when I ran the numbers you had 75% overall growth. And that's the exact number I claim that grows on average with FUE.

 

Thanks for participating.

[newbie33]

Destorious - ah, right. Thanks for the reply. I shall keep the nagging doubt a little longer until I see more real-life results!

 

Dr Feller - silly question, but I don't want to assume anything: so, literally, how do you measure the yield to know it was 75% in Destorious's case? And is it something you routinely do in follow-up consultations with each patient?

[Dr. Alan Feller]

Hi Bill,

 

I posted a the link here, absolutely to make a point in the FUT vs FUE debate. The prior post on this thread was from Dr. Feller showing the donor area for a FUE Patient. I posted the link and attached the picture here to "also" show the donor area of a Dr. Bhatti (FUE) Patient 6 months post-op, who chose to wear his hair short in the donor area.

 

There is/was absolutely no intention to promote Dr. Bhatti's results. Been around on this Forum for a few years now and I am sure that you will agree that we do not resort to such tactics.

 

Please let me know if you have any questions and/or concerns. I will be happy to address.

 

Best regards,

California

 

California,

You neglected to tell Bill that photo I posted was in RESPONSE to Dr. Bhatti's original photo. I didn't initiate this disingenuous distraction. If you and your doctor want to continue this pointless cycle I have plenty of hideous FUE donor results in my databases.

 

Or you can simply stop the not so thinly veiled scare tactics.

Edited August 18, 2015 by Dr. Alan Feller

[Dr. Alan Feller]

Destorious - ah, right. Thanks for the reply. I shall keep the nagging doubt a little longer until I see more real-life results!

 

Dr Feller - silly question, but I don't want to assume anything: so, literally, how do you measure the yield to know it was 75% in Destorious's case? And is it something you routinely do in follow-up consultations with each patient?

 

The way I became sure about the yields of FUE in general was when I operated on patients who had already had FUE in the past. Either with me or elsewhere. I would note how many grafts they received, or told they received, and compare it to the number I counted when I shaved the hair down in preparation for the recipient sites. In the end, adjusting for telogen hairs, I concluded that the average was about 75%, and the best I'd seen on any kind of semi-regular basis was 85%.

 

In Destorious's case I just took the information he offered in his post and did some math. So I put FUEs into both sides. One side he said grew fine. So let's say that represents 100%. The other side he calculated only grew 50%. So if you crunch those two numbers you wind up with a 75% overall average yield.

 

The reason I pointed this out is because I have claimed for years and years that 75% is about the average growth yield for FUE, and here is one of my very own patients whom I haven't talked to in years stating quite unknowingly that he felt his own yield was in fact 75%.

 

What's even more interesting about his post is that he is not surprised that his results were not 100% or even near it. This is because I made absolutely sure he understood the variability of FUE as compared to FUT. And, I made him read an informed consent document that states the disadvantages of FUE very clearly that he had to acknowledge and sign before I would perform surgery on him.

So he knew I was being a straight shooter with him before operating on him. And like he said, he knew the risks and rolled the dice. Sounds like he did ok, but if he wants to fill in the weaker side he will need to do more FUE. And so it goes with FUE, the need for filling in and "touching up" is insatiable compared to the equivalent FUT.

[destorius]

I prob wasn't especially coherent in my post. The right side (400 grafts) give in well and the left (600 grafts) not well. Whether it is my feeling of 50-60% or 75% can't really be concluded without examination. Dr Feller did indeed give me consent form ahead of surgery and did go over the possible difference in yield between FUE/FUT. I am confident the donor looks good from Dr Fellers work and the right side blends in well with my native hair.

 

The issue is that despite being on propecia, I have lost ground which means I am prob approaching a NW3 now. This is something people need to be aware of with either surgery... Unrealistic that drugs will stop the loss forever and HT planning is essential. I am undecided on another HT, I will prob shave to a 1 or 2 grade if I stop being able to conceal it.

 

I feel like sometimes people jump into HT now without really thinking about the commitment you are making, this is especially true for FUE as there is little downtime and the ability to do smaller procedures. Anyway, sorry for diverting the thread- I have made my point. Good luck to all.

[California]

California,

You neglected to tell Bill that photo I posted was in RESPONSE to Dr. Bhatti's original photo. I didn't initiate this disingenuous distraction. If you and your doctor want to continue this pointless cycle I have plenty of hideous FUE donor results in my databases.

 

Or you can simply stop the not so thinly veiled scare tactics.

 

Dr. Feller,

 

I believe that Bill is also monitoring this thread and hence I do not need to share the entire "history" with him. He asked me a question and I responded to that. As simple as that.

 

What "scare tactics" are you referring to?

 

As far as what you call the "disingenuous distraction" goes, please note that Dr. Bhatti is NOT digging into his databases or archives to bring up bad FUT scar cases. He is just sharing his Patient cases in "REAL TIME". Please note that he had challenged you to post your Patient cases in "REAL TIME". Please refer to post # 821 on this thread. Copy/pasting below from Dr. Bhatti's post:

 

Please note that a conversation of cross recriminations is not the right way to proceed scientifically. I challenge you to share your FUE case of the day every single day till this thread is alive and kicking and I will reciprocate. Lets see what bad cases you get daily from FUE, Please post and show and so will I.

Let the members on the forum decide for themselves. Plain rhetoric has no place on this thread. Members want to see real stuff now. They are bored of your semantics.

See the TRP rating of this thread has begun to dip.

Lets breathe some life into it, Sir.

We all want to see the FUE cases you get so commonly with bad scars.

You show yours in real time and I will mine.

 

................................

Please note that Dr. Bhatti has just been doing what he challenged you to do. No database searching, no digging in the archives.....just real time Patients. We are still waiting for you to take up the challenge. We believe that it would benefit everyone if we could let the actual Patient cases (and not rhetoric) do the talking!

 

Best regards,

California

[newbie33]

Thank you Dr Feller.

 

Asked about the method as I just wondered if it was standard practice for doctors to note placement/number of grafts in a procedure and then later count said grafts (fairly laborious and difficult) or to do so in one square centimetre and take that as an average (which would assume even results throughout) or just examine and take an educated guess.

 

And thank you Des. That's another of my worries - a lifetime of chasing my tail.

[Dr. Alan Feller]

Dr. Feller,

 

I believe that Bill is also monitoring this thread and hence I do not need to share the entire "history" with him. He asked me a question and I responded to that. As simple as that.

 

What "scare tactics" are you referring to?

 

As far as what you call the "disingenuous distraction" goes, please note that Dr. Bhatti is NOT digging into his databases or archives to bring up bad FUT scar cases. He is just sharing his Patient cases in "REAL TIME". Please note that he had challenged you to post your Patient cases in "REAL TIME". Please refer to post # 821 on this thread. Copy/pasting below from Dr. Bhatti's post:

 

Please note that a conversation of cross recriminations is not the right way to proceed scientifically. I challenge you to share your FUE case of the day every single day till this thread is alive and kicking and I will reciprocate. Lets see what bad cases you get daily from FUE, Please post and show and so will I.

Let the members on the forum decide for themselves. Plain rhetoric has no place on this thread. Members want to see real stuff now. They are bored of your semantics.

See the TRP rating of this thread has begun to dip.

Lets breathe some life into it, Sir.

We all want to see the FUE cases you get so commonly with bad scars.

You show yours in real time and I will mine.

 

................................

Please note that Dr. Bhatti has just been doing what he challenged you to do. No database searching, no digging in the archives.....just real time Patients. We are still waiting for you to take up the challenge. We believe that it would benefit everyone if we could let the actual Patient cases (and not rhetoric) do the talking!

 

Best regards,

California

 

What scare tactics?! Your doctor posts an unsolicited shaved donor area with an FUT scar in it out of the blue with no explanation for it and have the nerve to innocently ask "what scare tactics" ? Do you really think I and the viewers are so na?ve?

 

And as for your disingenuous "challenge" I clearly DON'T perform daily FUE cases because I find them to be too damaging to the grafts and unethical in most patients. Now you know this, that is the very basis for this thread and most other FUE threads I've made.

 

The real challenge is in comparing techniques not how many patients you can inflict FUE on per day. Your doctor posted a hideous video of grafts being removed haphazardly and in haste. My video, on the other hand demonstrated a paced and delicate procedure. I win. Hands down.

 

By the way, gotten many kudos on the performance in that video? Here's another link to that piece of work:

 

 

You never did give your comments on it. Would YOU want that done to your grafts? How about to a loved one?

 

Also, this thread has over 41,000 hits so I don't think interest is dropping at all as you're doctor is claiming. There are more hits each 24 hour period compared to the previous 24 hour period.