FUT is more popular than FUE

[Dr Tejinder Bhatti]

Mr. KO,

 

Thank your for your question.

 

"If not, then why do you refer to FUT as the "Gold Standard"?"

 

I must clarify, FUSS is the gold standard in the industry. FUE is the standard in my clinic.

[mav23100gunther]

And then we have the luxury of a whole lot of body hair that the FUT only surgeon cannot get to.

 

.

 

Dr Bhatti,

 

What relevence is the BHT statement to your argument? Now that H&W also offer FUE , there are not many recommended FUSS only surgeons that I am aware of. Most surgeons can now offer FUT until stripped out, and then FUE no?

[mav23100gunther]

See the link below where Dr Feller extended an offer to Blake.

 

http://www.hairrestorationnetwork.com/eve/170915-new-videos-dr-feller-2.html'>http://www.hairrestorationnetwork.com/eve/170915-new-videos-dr-feller-2.html

http://www.hairrestorationnetwork.com/eve/170915-new-videos-dr-feller-2.html

 

 

Dr Bhatti, no comment on the link re Dr Blake?

[lileli]

Dr Bhatti, no comment on the link re Dr Blake?

 

Those more demonstrate that there was an offer put out there and Blake showed interest but it still doesnt clear up the overlap between both positions.

 

Mind you, I don't care about that issue at all. That is up to the moderators etc.

[adonix]

"I too have seen unsuccessful FUE work, but I have seen FAR MORE unsuccessful STRIP work"

 

This, dr. Feller, is pretty much a nail in the coffin of any further argument you may have. I know you will try to wiggle your way out, acting smart and condescending, but it will not work.

[Dr. Alan Feller]

Feller while searching for your independent FUE patient results something surprised me of your opinion in the past;

 

 

Factually you seem to state in more postings back then that you believe FUE has the same yield as FUT. That is assuming a viable graft can get extracted. However every graft will endure the forces you speak about right?

 

Why did your opinion change 180 degrees?

 

 

No change in opinion. I may have been a bit generous with my statement of FUE yields at the time, but that was because smaller cases were being done and doctors were being more careful with their extractions and whom they selected to do FUE on.

You do know you are quoting me from 9 and 11 years ago. Right? That was a very different time for FUE.

FUE Yields back then were almost identical to strip because back then your average case was only 500 grafts or less and were used primarily for fill in and repair work, not as a primary HT means and not much stand alone hairline work. The practitioner could take his time to perform the procedure as delicately as possible to minimize stress on the graft. Speed was willingly and necessarily traded for delicacy.

It wasn't until some clinics started speeding up the FUE process to perform larger cases in one day, or to even perform two cases in one day, that problems started being reported. In these clinics, delicacy was traded for speed. Healthy for the bottom line, but not so much for the grafts. To me, this is an unacceptable trade off. In fact, the very first four major FUE megasession clinics were banned from this very forum.

If you read point 2 in my post you will see that I wrote that session size should be limited to no more than 600 grafts on the average patient and 1000 grafts on the great patient. 1000 FUE grafts was considered a lot in those days. I even wrote why: because of fatigue and graft "yanking". Until clinics started speeding up, every doctor gently grasped their grafts and applied traction until the tissue released at its own pace as I demonstrated in my video 2002. To speed this up, the doctor would have to "yank" the grafts out quickly and with greater force as Dr. Bhatti demonstrated in his video of 2015.

I have not changed my mind since that time

The smaller the session the better the yield. The larger the session the worse the yields.

When I wrote that yield is the same between strip and FUE in 2006 it was under VERY different circumstances than that for which FUE exists in today. Far fewer patients qualified as candidates and much more time was used to remove the grafts. But since then, I have learned that in many patients no matter how careful the practitioner is, the final growth yields tend to be lower than it's strip counterpart, particularly with respect to FUE hairline success.

 

I also started to notice since 2006 how badly fibrosed the donor areas were getting for patients with multiple FUE procedures. My patients included. I came to realize that each FUE case was making it more difficult to extract for the next FUE case. But when I realized the ability to potentially grab a strip with any useful grafts in it was being compromised because of fibrosis and disfigurement I really backed off. And here we are today. That's why I don't even care for multiple small sessions of FUE to get to megasession numbers.

[newbie33]

Two points.

 

1) Dr Feller is not saying anything especially different now than he was then. He'd do 600 fue grafts on the right candidate then and now.

 

2) If the facts change - and with more experience and knowledge that's entirely possible in any new medical procedure (or even an old one) - what would be wrong with changing your opinion?

[Dr. Alan Feller]

This, dr. Feller, is pretty much a nail in the coffin of any further argument you may have. I know you will try to wiggle your way out, acting smart and condescending, but it will not work.

 

That's all it takes for you to declare a "nail in the coffin" gotcha? Really?

 

Could I have seen more FUT failures as opposed to FUE failures back in 2002 because FUE had literally only been introduced into North America less than a year before?

 

You couldn't figure that one out for yourself ?

[newbie33]

Bugger it - why not a third point.

 

3) All this searching for motives and conspiracies and hunting for contradictory statements are all basically the result of there being hardly any proper empirical scientific evidence.

[lileli]

Dr. Feller,

 

Do you attribute successful megasessions done by FUE specialists to patient selection then?

[Dr. Alan Feller]

Dr. Feller,

 

Do you attribute successful megasessions done by FUE specialists to patient selection then?

 

No. I don't think there is much selection going on at all out there. Certainly not like it used to be before FUE megasessions.

 

Now it's just grab as many FUE grafts as you can and throw them at the recipient area and hope they grow.

[Dr Tejinder Bhatti]

Mr. MavGunther23100,

 

Thank you for your additional questions.

 

"Dr Bhatti,

 

What relevence is the BHT statement to your argument? Now that H&W also offer FUE , there are not many recommended FUSS only surgeons that I am aware of. Most surgeons can now offer FUT until stripped out, and then FUE no?"

 

There are probably many FUSS only surgeons you are not aware of, as well is the case for me but of course I do not know with any certainty. I'm sure there are many hold outs of the procedure in North America but with time the exclusive nature of these clinics diminishes. Also understand that FUE is different from BHT and just because the tools are similar does not mean the procedure is the same. There are additional challenges that should not be attempted until scalp FUE confidence can be established.

 

"See the link below where Dr Feller extended an offer to Blake.

 

http://www.hairrestorationnetwork.co...-feller-2.html'>http://www.hairrestorationnetwork.co...-feller-2.html'>http://www.hairrestorationnetwork.co...-feller-2.html'>http://www.hairrestorationnetwork.co...-feller-2.html

http://www.hairrestorationnetwork.co...-feller-2.html"

 

Unfortunately an offer of training is only that, an offer and one that is buried in a thread unrelated to the subject.

 

Let us move on now to questions about FUE if my involvement is to continue. However, I think it best to move on to new threads where I am happy to engage and share. I no longer wish to participate in this thread as I believe it has not only run it's course but it is counter-productive to the spirit of this forum.

 

Good day.

[adonix]

That's all it takes for you to declare a "nail in the coffin" gotcha? Really?

 

Could I have seen more FUT failures as opposed to FUE failures back in 2002 because FUE had literally only been introduced into North America less than a year before?

 

You couldn't figure that one out for yourself ?

 

 

So predictable "dr." Feller, so predictable. Acting smart and being condescending.

[Dr. Alan Feller]

So predictable "dr." Feller, so predictable. Acting smart and being condescending.

 

 

So let's get this on the record so it can be quoted 9 to 11 years from now:

 

1. FUT yields are better than FUE yields and this disparity increases in direct proportion to the increase in FUE case size.

 

2. I've seen far more FUE failures than I have FUT failures.

 

3. I have rarely seen an FUE hairline that compares to an FUT hairline in fullness or naturalness.

 

4. I have yet to see a properly performed FUT injure the donor area as much as an equivalent FUE.

 

5. No matter how well or poorly an FUE case grows, the equivalent FUT would have grown better.

Edited September 5, 2015 by Dr. Alan Feller

[newbie33]

What happened to the 'Ask Dr Bhatti' thread. I can't find it. In any event, Dr Bhatti - can you tell us what your typical yield is for an FUE procedure. Also, how you calculate the yield.

 

Thanks.

[newbie33]

 

3. I have rarely seen an FUE hairline that compares to an FUT hairline in fullness or naturalness.

 

Dr Feller, when it's all grown out, do you believe you can a) tell when someone's had a HT and if so, b) what procedure they had (strip or FUE)? I'm not going to test it - just curious to know if you believe you can tell.

[TakingThePlunge]

What happened to the 'Ask Dr Bhatti' thread. I can't find it. In any event, Dr Bhatti - can you tell us what your typical yield is for an FUE procedure. Also, how you calculate the yield.

 

Thanks.

 

voxman requested that the thread be temporarily removed as it was posted prematurely. Dr. Bhatti will be traveling over the next couple of weeks or so.

[Dr. Alan Feller]

Dr Feller, when it's all grown out, do you believe you can a) tell when someone's had a HT and if so, b) what procedure they had (strip or FUE)? I'm not going to test it - just curious to know if you believe you can tell.

 

As far as telling if someone had an HT there is a 90% chance I will be able to tell in person right off the bat. I play a game in my office sometimes in that I will walk through the waiting room looking at the waiting patients heads and try to guess if they had an HT, how long ago, and with whom. Certain clinics perform the same exact procedure on everyone so patients are often amazed that I could tell them where they had their last surgery and even when.

 

As far as telling the difference between FUT and FUE, the FUE patients are almost always thinner for the number of grafts they report they received, and their hairline are almost always very sparse compared to the FUT counterpart. There is also very often an increased "kinkiness" to the hair. This also happens in FUT, but not as much in my opinion. But, let's say the FUE yield was on the high side, then it could be indistinguishable.

 

I want to reiterate that I think FUE is a great procedure, I am just not a fan of FUE megasessions at least until the donor area has been "stripped out". After that everything is gravy as long as enough donor area is left to conceal the scars (FUT and FUE).

[lileli]

As far as telling if someone had an HT there is a 90% chance I will be able to tell in person right off the bat. I play a game in my office sometimes in that I will walk through the waiting room looking at the waiting patients heads and try to guess if they had an HT, how long ago, and with whom. Certain clinics perform the same exact procedure on everyone so patients are often amazed that I could tell them where they had their last surgery and even when.

 

As far as telling the difference between FUT and FUE, the FUE patients are almost always thinner for the number of grafts they report they received, and their hairline are almost always very sparse compared to the FUT counterpart. There is also very often an increased "kinkiness" to the hair. This also happens in FUT, but not as much in my opinion. But, let's say the FUE yield was on the high side, then it could be indistinguishable.

 

I want to reiterate that I think FUE is a great procedure, I am just not a fan of FUE megasessions at least until the donor area has been "stripped out". After that everything is gravy as long as enough donor area is left to conceal the scars (FUT and FUE).

 

 

Why hasn't more work been done in order to conceal the appearance of the linear scar, or is that one of those things that is impossible to do since you are removing a piece of tissue from the back of the head.

[Dr. Alan Feller]

Unusual that you would pick out this issue among the rest. Dr. Feller, you have my most sincere and whole hearted apology for saying that you have been making baseless rantings. I had no idea how this would be misinterpreted and cause you so much distress.

 

"Respectfully, EVERYTHING written on these chat sites are informal opinion."

 

Then we are done here. Nothing you have presented is a fact, just your "informal opinion" according to your own words spoken here.

 

Dr. Bhatti,

Why is it "unusual" that I would pick out the issue of you attacking me on this forum? Wasn't it you who wanted to look back into the history of negativity on this thread from your prior post? So I did and showed by page and post that you had in fact started the negativity with a personal attack. Until then I had never heard of you.

 

I asked you in my response why of all people on the planet you assumed I would not take offense at you coming at me with both barrels blazing when you had no idea who I was nor had ever met me ? I'm still waiting for that specific answer and do not consider your last post an apology until you do. You also still owe Dr. Bloxham an apology, too.

 

I don't care for your dismissiveness in your last post that "we are done here". If you wish to leave, then leave, but don't do so with false accusation that I haven't presented any facts to support my positions. Yes, we may be offering opinions, but mine at least are based on facts:

 

I claimed that the detrimental FUE force of TRACTION exists. You claim that it does not and that I don't have any facts to back up my claim nor proof. Does the link to the video clip below qualify as proof of its existence ? Can anybody doubt the existence of this detrimental FUE force as seen in this video?

 

http://www.youtube.com/watch?v=BKfaYG5BRhs

 

https://youtu.be/BKfaYG5BRhs

Edited September 5, 2015 by Dr. Alan Feller

[newbie33]

Thanks David, Dr Feller.

 

Dr Feller, the kinky hair from FUE - that's down to the 'skeletonisation' of the grafts?

And when you say it's always a lower yield, would I be right to assume that includes results you've seen from what you and most of us on this forum would consider the 'best' fue practitioners?

 

And if you'll permit me a third, why do you think some doctors report no difference from their strip and fue results, or only a marginally lower yield from fue? A few have told me this face to face.

[Dr. Alan Feller]

Thanks David, Dr Feller.

 

Dr Feller, the kinky hair from FUE - that's down to the 'skeletonisation' of the grafts?

And when you say it's always a lower yield, would I be right to assume that includes results you've seen from what you and most of us on this forum would consider the 'best' fue practitioners?

 

And if you'll permit me a third, why do you think some doctors report no difference from their strip and fue results, or only a marginally lower yield from fue? A few have told me this face to face.

 

I'm not sure what causes the more kinky appearance. It could be skeletonization or it could be the compression/traction. If could just be amateurs performing the surgery. I believe that when one "side" of the follicle is injured with respect to the other "side" the hair shaft that is produced can also be lopsided resulting in a kink. It may also be that distortion of the graft in the skin upon healing actually kinks the graft and thus the resulting hair grows out kinked as well.

 

I do not comment on results of specific patients of specific doctors unless they present them during discussion/debate specifically to be critiqued by others like Dr. Bhatti has with his video. It is far better, more educational, and objective to discuss the actual techniques used, rather than subjectively look at photos of results.

 

I have no idea why some doctors say what they say, newbie. When you figure it out, make a new post here.

 

Thanks.

[lileli]

Dr. Bhatti,

Why is it "unusual" that I would pick out the issue of you attacking me on this forum? Wasn't it you who wanted to look back into the history of negativity on this thread from your prior post? So I did and showed by page and post that you had in fact started the negativity with a personal attack. Until then I had never heard of you.

 

I asked you in my response why of all people on the planet you assumed I would not take offense at you coming at me with both barrels blazing when you had no idea who I was nor had ever met me ? I'm still waiting for that specific answer and do not consider your last post an apology until you do. You also still owe Dr. Bloxham an apology, too.

 

I don't care for your dismissiveness in your last post that "we are done here". If you wish to leave, then leave, but don't do so with false accusation that I haven't presented any facts to support my positions. Yes, we may be offering opinions, but mine at least are based on facts:

 

I claimed that the detrimental FUE force of TRACTION exists. You claim that it does not and that I don't have any facts to back up my claim nor proof. Does the link to the video clip below qualify as proof of its existence ? Can anybody doubt the existence of this detrimental FUE force as seen in this video?

 

http://www.youtube.com/watch?v=BKfaYG5BRhs

 

https://youtu.be/BKfaYG5BRhs

 

Dr. Feller,

 

Taking a piece of his video and using it is a low blow. I don't think this was wise of you to do.

[Melvin- Admin]

Alright this has to stop the slander this keeps escalating and nothing good will come of it, seriously Dr. Feller, using another physicians video in the way you did is classless. Regardless, of the differences in opinion, there should be mutual respect in agreeing to disagree.

[Dr. Alan Feller]

Alright this has to stop the slander this keeps escalating and nothing good will come of it, seriously Dr. Feller, using another physicians video in the way you did is classless. Regardless, of the differences in opinion, there should be mutual respect in agreeing to disagree.

 

Are you kidding?! This video strikes at the very heart of the debate. And you stoop to calling it slanderous and classless in an effort to discredit it? Where were you and your moral outrage when Swooping dug up posts of mine from 11 years ago and laughably posted them as a fallacious "gotcha". After you look up the word "slander," perhaps you should look up the word "hypocrisy".

 

Facts are stubborn things, aren't they? This has nothing to do with opinion.

 

Dr. Bhatti made a factual assertion that the grafts he pulls are not subject to traction forces during extraction-because, he says, they don't exist. His own video, without one word from me, is the most elegant proof one could offer refuting his implausible claim; little else could be classier or more persuasive.

 

Remember, he offered his video as evidence in the debate he began for the explicit purpose of convincing me, and you, that his procedure was without any of the detrimental forces I claim obviously exist.

 

Of course, that video says otherwise.

 

Now that you have baselessly attacked the messenger, again, how about getting back to the message: Look at his video and ask yourself, is dr bhatti's claim that his FUE procedure does not contain traction forces true or false? Does this video indeed constitute proof of my assertions? Is it not a fact that there is a tremendous amount of traction observable?

 

We await Dr. Bhatti's direct response.

 

http://www.youtube.com/watch?v=BKfaYG5BRhs