Regrowth percentage

[SunSeeker]

I dont understand the discussion? I thought everybody thought growth from fue was worse but the advantage is the different scar?

[Wwiizzkkiidd24]

I dont understand the discussion? I thought everybody thought growth from fue was worse but the advantage is the different scar?

 

it is but by how much is the question. I think it's just marginally close. fut still has the edge but not by much if done correctly that is.

[Melvin- Admin]

I dont understand the discussion? I thought everybody thought growth from fue was worse but the advantage is the different scar?

 

There aren't any studies on growth for FUE vs FUT so we can only go based off of physicians popular opinion, that is that yield from FUE is lower. However, the elephant in the room that no one discusses is visibility. Allow me to explain, we know hair loss does not become visible until roughly 50% hair has been lost, that's a huge margin, now let's say you get FUE by a top physician, let's say your yield is 5% lower than it would be if you got FUT, do you think that 5% is going to make a visible impact all? I don't think it would, the difference is so minuscule that it does not make a difference really in the overall outcome of the result, this is my opinion, just using logical common sense. Dr. Feller and other FUT physicians will say the difference is more like 20-30%, this is based off of their own experience with the procedures. Surgeons are not created equal, there are surgeons who are simply better at performing FUE, so they close the gap between FUE and FUT the most important thing is choosing the right physician.

[esrec]

Isn't it also suggested that an FUT/FUE combo produce the best long term yield, and that starting with FUT is preferred when subsequent surgeries are likely? This is at least what several doctors have explained to me.

 

"Scarring" is an interesting topic within this debate. Most seems to care (or not care) about the final scar. Perhaps due to hair length or just in principle.

 

As I prepare for surgery, I can say that a small linear scar that'll never be seen (I dont wear my hair short) is much less a concern for me than the that slightly greater downtime caused by an incision. Recovery time was really the only aspect of scarring at play for me.

 

Of course, I respect everyone's circumstances vary thus no perfect answer.

[Dr Blake Bloxham]

Sunseeker,

 

Actually, I'm glad someone brought up the mathematics of a visibly thinner result.

 

Let's look at that a bit deeper:

 

Per Janna's comments above, the "top" FUE doctors she has spoken to say their yield is between 70-90%. So, let's average that out and say the overall average these FUE doctors are getting is 80%.

 

Now, we know that thinning is visible when the density of your hair drops below 50% of your natural density. Natural hair density is 80-120 follicular units (FU)/square centimeter (cm2). So let's, again, take the average of that and say most people have around 95-100 FU/cm2. This means you have visible thinning at around 40 - 45 FU/cm2

 

Most hair transplant doctors will vary in the density they transplant based upon where they are working in the scalp, the area they are trying to cover, the perceived blood supply/density of the existing hair of the patient, and the overall goals. However, most seem to fall between 45 FU/cm2 on the low end and 60 FU/cm2 on the high end.

 

So, let's say a doctor is working on two identical patients: one done via FUE and one done via FUT. Again, per Janna's statement above the yield for FUE average is around 80% and FUT is 98%.

 

So say the doctor transplants at 55 FU/cm2 in the micro and macrohairline and 50 FU/cm2 in the less visible frontal and midscalp regions behind it.

 

The FUT patient's yield is as follows: 55 FU/cm2 * 98% growth = 54 FU/cm2 in the hairline and 49 FU/cm2 in the rest of the frontal and midscalp. These numbers are all greater than the lower limit of visible thinning (40 - 45 FU/cm2) and the result is substantial.

 

The FUE patient's yield is as follows: 55 FU/cm2 * 80% growth = 44 FU/cm2 in the hairline and 40 FU/cm2 in the other areas of the scalp. Now, you have a problem. Now you DO in fact have visibly thinner results. And keep in mind that these aren't my averages I'm using here. These are averages coming from another FUE/FUT clinic AND the averages given by "top FUE" doctors.

 

These small numbers seem trivial when discussing these things online, but they absolutely matter in the reality of hair transplant surgery. Again, I'm not saying all patients should run from FUE because of a lower growth average. They simply need to be aware of the REALITY of the growth averages and that they can result in a visibly thinner result (and this isn't even going into the quality of the growth from FUE; simply the quantity). If they understand this and would still prefer this method, that's just fine! But there is no point trying to downplay the reality of the potential differences in yield. Janna provided input from top FUE doctors above, and at least two other Coalition hair restoration physicians -- Dr Wesley and Dr Beehner -- have evaluated the situation and found statistically significant differences:

 

 

(And a funny additional comment on the Beehner study: the skeletonized grafts were actually extracted via more gentler methods than traditional FUE grafts, and additional detrimental forces that would have reduced the yield further were actually negated because of this. This means, theoretically, the averages would have likely been lower if the grafts would have been removed by some of the less gentle/meticulous protocols used in some instances today. Some have misunderstood this.)

Edited September 27, 2015 by DrBlakeBloxham

[Melvin- Admin]

Never fails to see Blake comment on these threads claiming 80% yield for FUE, where are these numbers coming from ask yourself? when renowned physicians like Shapiro themselves have stated that most of the time i.e 80% of the time yield is comparable, im fairly certain comparable is more like 90-95%. He also fails to even recognize the picture that was originally posted shows 98%.

[esrec]

The potential for equivalent yield and the consistency of equivalent yield is where the divide really exists IMO.

 

I've surveyed probably 10-15 doctors at this point including both FUT and FUE specialists. They seem to fall into 1 of 3 groups:

 

A) FUT provides superior yield and density

B) FUE can often achieve equivalent yield and density as FUT

C) FUE does not provide equivalent yield or density

[Dr Blake Bloxham]

Again, the 80% number comes from Janna at SMG's (Shapiro medical group) direct quote:

 

"as I [Janna] stated before, 70-90% range is what few of the top fue clinics were telling me was their typical yield rate."

 

70 + 90 / 2 = 80%.

 

These aren't my numbers. What's more, I didn't share the information from Janna. It was shared by someone else on the thread.

 

I'd be very much interested to review any objective, empirical data showing anything different. I'd love to speak with these doctors to see what they are doing differently too.

Edited September 28, 2015 by DrBlakeBloxham

[Wwiizzkkiidd24]

Never fails to see Blake comment on these threads claiming 80% yield for FUE, where are these numbers coming from ask yourself? when renowned physicians like Shapiro themselves have stated that most of the time i.e 80% of the time yield is comparable, im fairly certain comparable is more like 90-95%. He also fails to even recognize the picture that was originally posted shows 98%.

 

you forgot about the second one I uploaded which was 97% and here's another one that's close to fut percentages all three pictures different people with different characteristics and still got near enough the same level growth rate as FUT. I don't think you can place these three different types of people in the lucky group.

[Wwiizzkkiidd24]

it didn't attach in the last post

[Wwiizzkkiidd24]

and for the scar argument he's the gentlemen above after a 3k+ fue procedure. hardly noticeable. obviously he's a good scarer.

[Dr Blake Bloxham]

Wwizz,

 

How are they estimating yield here? That last shot looks like an immediate post-op, but there is a growth rate percentage on the image? Or are those dots they put over where the grafts grew?

[Wwiizzkkiidd24]

the guy had a ht with them 3k+ procedure and came back to add more. so I guess they have shaved it for the second procedure and then counted the grafts(maybe by machine I'm not sure) they put in from the first procedure and that's how they get there growth rate I guess.

[Dr Blake Bloxham]

Yeah. I can't tell if it's an immediate post-op and they are estimating or using software (this does exist) or if they put dots over all the grafts that grew.

 

Also, were these posted on a clinic website?

[Wwiizzkkiidd24]

that picture is 16 months later

[Wwiizzkkiidd24]

I think they must of marked them with a pen or something I'm not to sure.I do think they have a counting machine I'm sure I've seen a picture idle it somewhere. no not on there website it's on the bald truth website. Google the image I'm sure it will come up.

[Wwiizzkkiidd24]

it's on page 53 on the that website I just said. have a look.

[Dr Blake Bloxham]

I dug around and couldn't find it. But the count and presentation was clearly done by the clinic -- I think I can tell which one too -- and makes me believe that those presentations floating around the web are their best growth percentages. Just like clinics don't release unimpressive grown out results into the internet ether, a clinic isn't going to do differently with their counting results.

 

Again, I'm not trying to be negative or dissuade you or anyone else from any surgical procedure. But I do think this information needs to be out there for the sake of transparency and informed consent. Unless you have a specific set of characteristics (which are both known and unknown to the surgeon until the procedure is running full speed), you aren't likely to fall into the 98% growth rate category with FUE. The overall averages simply aren't near this. Even the most popular FUE clinics don't make these claims. Look at what Janna said earlier: "top" FUE doctors told her growth was 70-90% on average. Just know this going into it so you have realistic expectations and won't come out disappointed. That's all I'm trying to get across!

[delancey]

Again, the 80% number comes from Janna at SMG's (Shapiro medical group) direct quote:

 

"as I [Janna] stated before, 70-90% range is what few of the top fue clinics were telling me was their typical yield rate."

 

70 + 90 / 2 = 80%.

 

These aren't my numbers. What's more, I didn't share the information from Janna. It was shared by someone else on the thread.

 

I'd be very much interested to review any objective, empirical data showing anything different. I'd love to speak with these doctors to see what they are doing differently too.

 

 

 

I feel that it is important to point out that Janna clearly stated that the FUE yield at SMG is between 90-95%. If SMG is able to achieve high yield FUE results on a consistent basis, wouldn't it be fair to assume that there are other top clinics around the world that get the same FUE yield?

 

 

Janna from SMG said, "We've always felt our strip yields approx. 98%+ and fue is now closer to 90-95%. We will keep trying to achieve 98% or better with our fue."

[Wwiizzkkiidd24]

I appreciate your concern we all do. it's things us as future patients should be aware of. but what I interpret that as if you go with a tech run clinic you will more then likely fall in the average that's stated but if you go to a reputable doctor the chances are you will get somewhere if not very close to the average in the pictures I've posted. I'm not saying everyone falls in that category because surgery can go one way or another but the chances of getting that growth rate (90-95 sometimes higher) is more likely with a top fue clinic then going to a tech run clinic. at least that's how I'm taking it anyway.

[Dr Blake Bloxham]

Delancy,

 

I must disagree slightly. She didn't clearly state that the FUE yield at SMG is between 90-95%. She said the FUE yield is "getting closer" to 90-95% and they are "trying" to achieve better yields.

 

And remember that Dr Ron himself told one patient he sees FUT-like results 5/10 (50%) of the time, and in another video states that he sees equivalent yield 80% of the time. This means that somewhere between 20-50% of the time, their yields are NOT at 90-95%. What's more, he also said that he notes results that are visibly thinner 1/3rd of the time.

 

This leads to the same conclusions I, 'top FUE clinics' who have spoken to Janna, and Dr Ron have come to regarding average yield. It's not clearly 90-95%. I really don't want the average patient going into surgery thinking this because it's simply not accurate.

[Dr Blake Bloxham]

Wwizz,

 

Nicely stated! Going to a top clinic with a LOT of doctor involvement is crucial in FUE. However, yields can still be variable even in the best of hands. This is simply a reality of FUE. It's just the nature of extracting FUGs in this manner. You can absolutely maximize your chances by going to one of these top clinics, but don't assume you'll naturally fall into the 95% growth category. Just go into it knowing the reality and you'll come out happier. I promise!

[hairshopeing]

Blake

I agree that them percentages are not your average yield but you talk as if they are the average for strip surgery which is were we disagree, from the years of research iv done and thousands of examples iv seen of both types of surgery your average yield vi a strip is also not 90-95% iv seen some which are WAY below that from both non recommended and recommended surgeons! So I think a fair statement is not matter which type of surgery you elect to have don't expect 90% plus yield as an average because that's simply not the case! I believe strip is more consistent but certainly not in the realms of what yourself and Dr feller were quoting early on in the thread about fut being more popular! Originally you were both making out fue yields were MUCH MUCH lower than 90% but strip was above 90% this is where out opinions differ! Each to their own though!

[delancey]

Delancy,

 

I must disagree slightly. She didn't clearly state that the FUE yield at SMG is between 90-95%. She said the FUE yield is "getting closer" to 90-95% and they are "trying" to achieve better yields.

 

And remember that Dr Ron himself told one patient he sees FUT-like results 5/10 (50%) of the time, and in another video states that he sees equivalent yield 80% of the time. This means that somewhere between 20-50% of the time, their yields are NOT at 90-95%. What's more, he also said that he notes results that are visibly thinner 1/3rd of the time.

 

This leads to the same conclusions I, 'top FUE clinics' who have spoken to Janna, and Dr Ron have come to regarding average yield. It's not clearly 90-95%. I really don't want the average patient going into surgery thinking this because it's simply not accurate.

 

Dr. Ron Shapiro also stated the following in a video interview available on Youtube:

 

"a good FUE transplanter should be able to get at least very close to the same growth rate (as FUT) at least 80% of the time."

 

Janna from SMG said, "We've always felt our strip yields approx. 98%+ and fue is now closer to 90-95%. We will keep trying to achieve 98% or better with our fue."

 

I do agree with you on this: each patient should do his due diligence and understand that there is always a risk with cosmetic surgery. Research, research, research.

 

Finally, in your expert opinion, do you believe that the very best FUE clinics are only getting 80% yield on average via FUE?

 

Dr. Maras

Dr. Erdogan

Dr. Feriduni

Dr. Bisanga

Dr. Mwamba

Dr. Vories

Dr. Lorenzo

Dr. Ron/Paul Shapiro

[Dr Blake Bloxham]

Hairshopeing,

 

I actually don't think there is much controversy over FUT yield. This has been studied many times and the consensus (pulled from the textbook) shows average yields in the 95%+ range. And I do think FUE yields are lower than 90% on average. Like I've said before, I think the overall averages are in the high 70s to low 80s. You can always pull specific examples that fall on the outskirts of the standard bell curve, but I contest that the OVERALL averages above are accurate.

 

And yes, there will always be opinions on certain aspects of the procedure. But there are also more objective, scientific observations that lend themselves less to opinion. And this is why patients needs the facts and opinions in order to weigh all the "pros and cons" and make an informed decision.