Feller and Bloxham

[TrixGlendevon]

Hi!

 

I have been watching Youtube videos produced by Doctors Feller and Bloxham this evening. I found them very informative and I also appreciate Dr Bloxham's comments on this site. However, I was quite taken back when I heard how against FUE they are. I was all set for FUE and now I am starting to have, at least some, reservations.

 

I do not want to start an FUT vs FUE debate but I would like to know if anybody has had a successful (series of) hair transplant(s) with just FUE i.e. several thousand grafts (5,000+, maybe) or how common this type of patient/case is?

 

Thanks

[Melvin- Admin]

I have done only FUE and I've had around 5,300 grafts, I'm very happy with my results. I think it's very common to find patients with up to 6-7K grafts done exclusively with FUE in Europe. FUT is still the gold standard in the U.S. IMO most surgeons in North America haven't past the learning curve yet unlike their European colleagues, however several FUT clinics such as H&W have begun offering FUE, so I Imagine in another 10 years most clinics in North America will eventually catch up to Europe. But I don't think Feller and Bloxham will be one of those clinics based on their philosophy.

 

Below are some photos of what the donor looks like after 5,300 grafts at a zero guard, the scars are there definitely but not very noticeable.

[Mick50]

I had 4200 FUE grafts 2 years 3 months ago have to say it's been a life changing experience .Posted some recent pics below 2 outside ones with direct bright sun on my head , Galaxy s6 if you check back on my threads I have some high def pics up , and it still looks good .

The strange thing is it the crown seems to be filling in even at this stage which I don't know how it's possible as I am not on Fin OR mix

I am 54 so my hair is in pretty good shape, of course I will need a second transplant for total coverage but I think 2500 or so grafts will do it.

Edited April 22, 2017 by Mick50

[Mick50]

Here are some more pics, sorry about the quality ,first pic pre -op as you can see just some whispy hair on top and a bald crown no hair on crown really , second pic 2 weeks post op as you can see typical NW 5-6 pattern more of a 5 because good sides but still

a large crown to be filled. third pic how my donor is now , fourth pic about 2.5 moth mark again shows the large bald crown .

 

Had the procedure in Turkey cost me 1750 pounds including PRP AND 2 nights hotel and transfers , regarding the FUE debate

all I can say as soon as the hair started to grow I was amazed how strong the new hair felt even at the early stage it had a life and energy in it , I hope this gives other guys hope that its possible to have a good result even if you cant afford the 10,000 Pounds plus [if you're high NW ]

it would have cost me if I had gone elsewhere, and can anyone tell me I would have got a better result ?.

 

I guess it begs the question was I just lucky or are techs/nurses under a Doctors' supervision knocking these results out on a regular

basis in Turkey? Discuss!

Edited April 22, 2017 by Mick50

[chris39]

I guess it begs the question was I just lucky or are techs/nurses under a Doctors' supervision knocking these results out on a regular

basis in Turkey? Discuss!

 

Good question and debatable if it can be answered .I think sometimes it is pot luck , but also sure there are experienced and knowledgeable tech's out there who can spin out results at least equal to the surgeons.

 

As far as the old FUSS / FUE debate , I still find it strange that surgeons who only undertake one technique or the other are son defensive of their own technique without appreciation of the other .

 

Just seen your latest pics above - still looking excellent. I know you had your reservations similar to me about possible delayed shock loss . Don't think you need to have those concerns anymore .

[Dr. Alan Feller]

Trix

 

Thank you for watching our videos.

 

If they made you think twice about having a large session of FUE then we did our job.

 

I would advise you stay away from FUE megasessions and avoid looking to lay online posters for guidance or confirmation of FUE. While their intentions may be good, they simply don’t know what they don’t know.

 

The professional consensus by the experts that perform BOTH procedures is that FUE is an inferior procedure that should be used sparingly and on a limited basis.

 

Consider this: On HTN the 60 member doctors are required to post one patient case study per month. This means before/after photos. Yet, when you look at the photos the doctors themselves chose to post you almost never see any megasession FUE cases. Instead their large cases are almost exclusively FUT.

 

You may confirm this for yourself by picking any doctor that claims to do both FUT and FUE and go to their Profile page. There you will see their submissions over at least the past five years. Virtually none are of FUE megasessions.

 

To expand on this, note that the International Society of Hair Restoration Surgeons (ISHRS) has over 1,000 hair surgeons within its ranks. Pick any random ten and you will see the same thing: almost no megasession results to present.

 

 

Dr. Alan Feller

Edited April 23, 2017 by Dr. Alan Feller

[TrixGlendevon]

@Dr. Alan Feller - Thanks for the reply. I didn't know you posted on here too. Shame you're not based in Europe.

 

What you say makes sense and I will look into it/investigate, especially for my shortlist of doctors.

 

I would ask what your response would be to @HTsoon who says it is a difference with progressiveness between European doctors and their American counterparts? I am not sure I believe that to be the case because you said in your videos that you have about 12 (+/-) years of experience with FUE. However, his hair looks amazing with 5,300 grafts all done by FUE as does the next poster, @Mick50, with 4,200 grafts also done by FUE.

[Dr. Alan Feller]

 

I'm glad they received good results from their FUE megasessions and are happy but they are in the severe minority. If you want to go by FUE cases that "show up" on this site, don't exclude those FUE posters who are very upset with their growth rates and final results. They are legion and they are not likely to come onto a thread like this one.

 

If you want purely scientific evidence of the FUE procedure as compared to FUT look to Drs. Rassman and Bernsteins seminal paper where they introduced the FOX test. Fewer than 20% of patients produce grafts intact enough to be expected to perform as well as FUT grafts. Identifying these patients is impossible prior to actually performing the procedure. So, let's say 1,000 people get FUE surgery. 200 will have good looking results. That seems like a lot, until you take into account the other 800 patients who got poor results and can't get those grafts back.

 

Think of standing outside of Las Vegas Casino. How many people do you have to interview before you find someone who beat the house ? But if you only advertise the winners you can mislead the public into thinking just about everyone will be a winner.

 

There is no difference between the skill level of European FUE doctors over American ones. The only difference is the brute force European doctors are willing to apply. Brute force means simply going as fast as you can. Score the graft and rip it out quickly.

 

This has been going on since 2002. To call this "progressive" is naive. As I said, lay posters don't know what they don't know. There is absolutely no significant difference between the different manual FUE procedures across the world. The only real difference are the individual physiology of the patients and the NUMBER of patients they perform the procedure on. The more patients you perform the procedure on, the more good results you can present. But make no mistake, most results are poor compared to FUT. By far.

 

When you read that an FUE clinic got out 4,000 FUE grafts, what you don't know is how many ATTEMPTS were made to get that number. If it was 5,000 attempts you just lost 1,000 grafts you could have used in the future forever. It also explains the massive donor damage associated with FUE as well as donor hair thinning. See Dr. Paul Rose's article in the last publication of the International Hair Transplant Forum.

 

The documentation and evidence against large FUE sessions is unequivocal.

 

A "progressive" clinic would offer BOTH FUE and FUT. Most of the European FUE mills do not offer both because an FUT clinic requires more staff and overhead. Simple as that.

 

Also, the medical malpractice laws are far more lax outside of the United States allowing

European clinics to allow unlicensed technicians to perform entire procedures in practice or de facto.

 

 

[Melvin- Admin]

I want to make an important distinction I never had an FUE megassesion, it's important we distinguish what a mega session is, I consider a megasession a single session of 3,500+ grafts, I have had 5,300 grafts done over three procedures first surgery was 1,850 grafts, second surgery was 2,120 grafts and last session was 1,300 grafts. I have never been a proponent of megasessions period regardless of the procedure, the reason being is that NO surgery is guaranteed and poor results can occur and have occurred from both procedures. Doing a mega session is placing all your chips on one bet so to speak to stay with the Las Vegas analogy.

[Sean]

Also, you want to look at how some docs comb their patients hair in videos and pics. They may try to comb preexisting hair with recipient hair to maximize the look of their work. Be very very wary. There are even docs that may have their results look more impressive due to hair concealers applied.

 

Look at the quality of the pics too. What is so crazy is that some docs will even say their FUT matches their FUE. It is deception at its finest.

 

If their procedure goes downhill,, they may make you sign papers to try to shift any responsilities away from them after theyve done harm that could be more damaging long term that no one stated. Or the only way they may help is if you sign papers as if nothing happened.

 

Hypothetically speaking, Imagine a rape victim, having to sign a piece of paper that you must not hold the rapist responsible even though he or she did rape you and they will pay less for you to get help instead or some stuff. Wouldn't that be ludicrous, wouldn't it? It may cause harm that may be long lasting and you may need different routes to get help.

 

Protect yourself and keep surgery as a last resort. You do not want to chase repairs. Right now, I can say there are a lot of things to be upset about. I do not know what the future holds right now and if anything will ever be better. Only time can tell.

 

So just be careful and try to make the best steps. Both procedures have their place.

Best of luck.

[Sean]

By the way, I think Feller and Bloxham are doing a great service educating interested parties. Also, putting out some decent work across forums.

[chris39]

Dr Feller ,

 

Without getting in to the debate about FUSS and FUE , just interested why you chose to bang the FUSS drum against FUE mega sessions when that was not the question posed by the OP ?

[TrixGlendevon]

Dr Feller ,

 

Without getting in to the debate about FUSS and FUE , just interested why you chose to bang the FUSS drum against FUE mega sessions when that was not the question posed by the OP ?

 

It wasn't my question but they are interesting/helpful points he has raised. Any surgery, necessary or cosmetic, requires that the doctor gives the patient all the information they need to make an informed decision. This is ethical. The thing is, patients aren't doctors so unless we have a medical degree we can't make informed decisions. Even though I didn't want to ignite this debate, it is still helpful to have more information for both me and other forum members (I assume/hope).

 

I plan on visiting several doctors in Europe over the next couple of months. I shall be asking them about this too now.

[TrixGlendevon]

 

I'm glad they received good results from their FUE megasessions and are happy but they are in the severe minority. If you want to go by FUE cases that "show up" on this site, don't exclude those FUE posters who are very upset with their growth rates and final results. They are legion and they are not likely to come onto a thread like this one.

 

If you want purely scientific evidence of the FUE procedure as compared to FUT look to Drs. Rassman and Bernsteins seminal paper where they introduced the FOX test. Fewer than 20% of patients produce grafts intact enough to be expected to perform as well as FUT grafts. Identifying these patients is impossible prior to actually performing the procedure. So, let's say 1,000 people get FUE surgery. 200 will have good looking results. That seems like a lot, until you take into account the other 800 patients who got poor results and can't get those grafts back.

 

Think of standing outside of Las Vegas Casino. How many people do you have to interview before you find someone who beat the house ? But if you only advertise the winners you can mislead the public into thinking just about everyone will be a winner.

 

There is no difference between the skill level of European FUE doctors over American ones. The only difference is the brute force European doctors are willing to apply. Brute force means simply going as fast as you can. Score the graft and rip it out quickly.

 

This has been going on since 2002. To call this "progressive" is naive. As I said, lay posters don't know what they don't know. There is absolutely no significant difference between the different manual FUE procedures across the world. The only real difference are the individual physiology of the patients and the NUMBER of patients they perform the procedure on. The more patients you perform the procedure on, the more good results you can present. But make no mistake, most results are poor compared to FUT. By far.

 

When you read that an FUE clinic got out 4,000 FUE grafts, what you don't know is how many ATTEMPTS were made to get that number. If it was 5,000 attempts you just lost 1,000 grafts you could have used in the future forever. It also explains the massive donor damage associated with FUE as well as donor hair thinning. See Dr. Paul Rose's article in the last publication of the International Hair Transplant Forum.

 

The documentation and evidence against large FUE sessions is unequivocal.

 

A "progressive" clinic would offer BOTH FUE and FUT. Most of the European FUE mills do not offer both because an FUT clinic requires more staff and overhead. Simple as that.

 

Also, the medical malpractice laws are far more lax outside of the United States allowing

European clinics to allow unlicensed technicians to perform entire procedures in practice or de facto.

 

 

 

Thanks again for the response.

 

I agree there may be some doctors who allow technicians to do all the work but all of the doctors on my short list show consistently good results and at least 2 do the whole procedure themselves. One of of whom only does 500-700 grafts a day too. 4 use the manual tool too. Given all this, would you still be against FUE over FUT? A top surgeon, with a good reputation and consistently good results?

 

I am yet to look into what you have suggested but I will do before I go for my in-person consultations.

[chris39]

The thing is, patients aren't doctors so unless we have a medical degree we can't make informed decisions.

 

No offence intended , but the quote above is an incredible statement. Get this nonsense out of your head and your research will prove far more beneficial.

 

It's good you're going to do your research to make the most informed decision you can .Forums such as this are all about debate and discussion , but beware of the misinformation that exists .

[TrixGlendevon]

Thanks again!

 

No - this is actually a topic in most top medical schools' ethics classes and is a well-written about theme too.

 

Amen to the second part!

[Dr. Alan Feller]

The thing is, patients aren't doctors so unless we have a medical degree we can't make informed decisions..

 

Trix:

This is absolutely correct and an immutable fact that many in the online community simply can't and won't accept. In fact they will reject it loudly.

 

Until an online poster can get a medical license, perform the FUE procedure and take responsibility for it they are uninformed. Being the recipient of a hair transplant procedure does not make a laymen into an expert-no matter how bright, motivated, and enthused he may be. And, no matter how much time he spends on a lay hair transplant forum. So you should weight their input accordingly.

 

If you are rejecting FUT for whatever reason. This means you are putting the actual growth of the graft secondary to some other concern. That is your business and it is fine in my book IF and only IF you have been properly informed about the risks of FUE compared to FUT. I am not a hair transplant cop, so you do what you think is in your own best interest.

 

May I ask, Trix, why you are interested in FUE over FUT ?

[Mick50]

The OP asked to hear from people who have had large FUE transplants that's why I posted my results

I have had a mega FUE hair transplant of 4200 2 years 3 months ago ,and as I have stated my result is amazing by any standards .

I really was hoping it wouldn't kick off the whole FUE/'FUT debate but Dr Feller as usual has felt threatened and decided to wade it with his usual heavy handed manner regarding this issue .

The bottom line is European Docs, we all know who they are, are producing amazing FUE results

maybe more grafts are needed to produce these results , but you can counter that with no worry about a nasty scar or nerve damage etc.

Dr Fellers claim that FUT is more Popular than FUE may be true in America but in the rest of the world

this is obviously untrue .

If you look at my pics I was a difficult case but the transformation is incredible, but of course I am just one of the lucky 20 per cent ,yea sure tell that to Dr Erdogan who is a world respected Doctor on this site.

I seem to remember Dr Feller /Bloxham stating the best a large FUE patient could hope for is a 60 per cent yield ,in all honesty

would 2520 grafts have given me the coverage I achieved as a NW 5-6

Edited April 22, 2017 by Mick50

[chris39]

 

Trix:

This is absolutely correct and an immutable fact that many in the online community simply can't and won't accept. In fact they will reject it loudly.

 

Until an online poster can get a medical license, perform the FUE procedure and take responsibility for it they are uninformed. ?

 

I am absolutely staggered by this comment ! This is loudest case of God Syndrome I've come across in a good while , which is saying something .

 

Read back on your post and reflect on it . Immutable fact indeed ?

 

( Posted in large font red for added significance ?)

 

[chris39]

Thanks again!

 

No - this is actually a topic in most top medical schools' ethics classes and is a well-written about theme too.

 

 

 

So you'll blindly walk into any procedure if a Dr tells you too ? If that was the case , go with the first surgeon you consult with - as we all know , all results are equal and all possess equal competence ! Why even ask questions if this is your mind set ?

 

Always amazes me when Drs display unquestionable arrogance , and even more so the blind unquestioning of patients.

[Mick50]

Good question and debatable if it can be answered .I think sometimes it is pot luck , but also sure there are experienced and knowledgeable tech's out there who can spin out results at least equal to the surgeons.

 

As far as the old FUSS / FUE debate , I still find it strange that surgeons who only undertake one technique or the other are son defensive of their own technique without appreciation of the other .

 

Just seen your latest pics above - still looking excellent. I know you had your reservations similar to me about possible delayed shock loss . Don't think you need to have those concerns anymore .

 

 

Hi Chris good to hear form you again,actually my concern wasn't so much with shock-loss as such ,just I remember some posters saying their FUE grafts fell out 12 month post op

luckily this doesn't seem to be too common and my hair improved up to the 18 mont mark ,

and if anything it is still improving.

hope you are still happy with your result .

[chris39]

Hi Mick - yep , that's what I meant really . Result looks great . Are you going FUE or FUSS next surgery ( Haha ! )?You went FUE and I went FUSS - we should be boxing each other !

 

I'm good with my result - was intending a 2nd HT last December , but lets just say the initial surgery has had a huge beneficial impact and taken away the urgency for a 2nd HT at the moment . Also gives me a period to reflect if any additional hair loss may occur.

[Melvin- Admin]

So you'll blindly walk into any procedure if a Dr tells you too ? If that was the case , go with the first surgeon you consult with - as we all know , all results are equal and all possess equal competence ! Why even ask questions if this is your mind set ?

 

Always amazes me when Drs display unquestionable arrogance , and even more so the blind unquestioning of patients.

 

I have to agree, insurance carriers are required to pay for second opinions for a reason, the biggest reason is there's more than one "right" treatment. For example if you're diagnosed with Prostate Cancer, you may go to one Urologist who feels that having a prostatectomy is the best course of action, whilst another Urologist may feel active surveillance is the best course of action, the choice a patient makes would dictate the quality of their life moving forward, and ultimately its the patient who must do adequate research and weigh the pros and cons themselves prior to making a decision.

 

Although elective surgery is much different, the method and approach should remain the same, the notion that "doctor knows best, I better do as they say" is a naive and dangerous stance in my opinion. Because hair transplant surgery is not a perfect science there are several trains of thoughts within the hair transplant community, there are differences in opinion within in doctors themselves, ranging from the method of extraction, tools, and placement of the grafts. You may have one surgeon who favors creating recipient sites the day before donor harvesting or extraction, you may have some surgeons who favor the "stick and place" method (making the incision and placing the graft immediately) some surgeons favor blades for creating recipient sites, other surgeons favor pens. Different methods work for different doctors, like the saying goes there's more than one way to skin a cat.

 

A quick search in to the "hair transplant review" section of this forum will provide some much needed guidance, look at 20 FUE cases look at 20 FUT cases, look at different surgeon reviews, this is invaluable information, members like myself share our stories so that other guys can make informed decisions, and yes doing research and consulting with several surgeons will allow you to make an informed decision which does not require you to have a medial degree.

[Dr. Alan Feller]

Mick and Chris,

 

You both immediately descend to name calling and vitriol. That doesn't add to your credibility or your position.

 

So I ask again, with 60 HTN recommended surgeons, worldwide, contributing to this website every month as a requirement, why are there virtually NO examples of megasession FUE ?

 

The answer is because they are not being performed OR the ones that are being performed are producing results no doctor wants to post online to be seen by the world.

 

Trix took the time to watch my videos about FUE myths and facts. You both should, too. If you have any questions I'm happy to answer them.

[chris39]

Mick and Chris,

 

You both immediately descend to name calling and vitriol. That doesn't add to your credibility or your position.

 

So I ask again, with 60 HTN recommended surgeons, worldwide, contributing to this website every month as a requirement, why are there virtually NO examples of megasession FUE ?

 

The answer is because they are not being performed OR the ones that are being performed are producing results no doctor wants to post online to be seen by the world.

 

Trix took the time to watch my videos about FUE myths and facts. You both should, too.

 

Name calling and vitriol ? Really ? Please point this out and I will rescind the comment if such is reciprocated .

 

I've merely commented on the fact that you assume anyone who does not possess a medical degree does not hold a valid ( or any ) opinion in the HT procedure .

 

I've no axe to grind with anyone , but will certainly defend my position to comment as I see fit , as you yourself do .

 

I have had a FUSS procedure , and constantly read all the tiresome posts from the entrenched on either side . The goal from the patients perspective is usually the same irrespective of the procedure undertaken , so why the enmity on the part of some surgeons ?

 

Like I say , I'm not against one or other of the procedures , but will check out your videos and will certainly get back to you with any questions I may have .