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Dr. Alan Feller

Why NOT to get an FUE- Interview with Dr. Willaim Reed- by Dr. Feller and Bloxham

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1. It's very simple. I asked you for your phone number three times and three times you didn't send it. And that was starting back on May 20th.

 

2. You also disappeared but now say that you were away on business ? Your smart phone had no internet connection ? No computers available ? And even if so you couldn't drop me a PM saying you were going away ?

 

3. Everything you did involved delays and conditions. You were just playing games and wasting my time.

 

4. And even if I did get you on the phone you set conditions that you knew would have prevented me from posting the call online if it didn't go your way. And you repeated them over and over. If I agreed to those terms there would have been no point in doing the interview in the first place.

 

5. All you had to do was send your name and phone number in that first PM. I knew when you didn't that you weren't going to. When you finally felt the pressure to actually do it, you leaned on ridiculous conditions that any reasonable person wouldn't agree to and STILL didn't give me your phone number.

 

6. So I contacted the doctors myself and am waiting for their response.

 

7. So don't try to flip the script here and pretend that I just blew you off. You played games and I had enough of them.

 

Dr. Feller,

 

I never called you names or anything. Even defended you. But this is the 3rd time you calling me out (and only gave one apology for saying that I am working for an FUE clinic secretly).

 

If there is any misunderstanding or any info missing, you always could have contacted me. Instead you did explain yourself only to a third party, after (!) I gave my name but did not apprach me directly or in the forum. Why?

 

1. Wrong: I send my name, offered skype and phone and NEVER EVER heard back.

 

2. Wrong: I said long (!) ago, that I was on a business trip and do not use the company computer for online forums and even more important: I went away after you said you do not accept my conditions. Should I stay online until you change your mind? Unlike you I do not have business in this topic and only spend my freetime here.

 

3. Wrong: I had three conditions, which I never changed from my first post.

 

4. How do you know that I would do that? How could I do actually stop you from posting it, sue you? Why would not mention my name and “playing it clean” reduce the worth of the discussion?

 

5. Wrong: I gave you my name and offered skype and phone as well (just in case you do not want skype. I just assumed most clinics use skype anyway for online consulting). The conditions were there from the very beginning.

 

6. Ok, if this is the truth, it would be great and I appreciate that, but why haven’t you done this a long time ago?

 

7. You blew me off? I gave you my real name, after you accepted in public and I never ever heard back until you chatting with third party over it.

 

Again, If you change your mind, I do not have any problem with it. But then just send me a PM and everything is fine.

 

This is the chronic of our discussion (just corrected some spelling):

 

 

4:24 PM 5/21/2017

Dear Dr. Feller,

 

you are indeed passionate about this topic and I appreciate that. Of course I would be interested in this in such a call, cause it would help many hair loss sufferers including myself. However, I have two conditions which are not negotiable:

 

1. I will send you my name and everything, but I do not want it to be exposed in the net. I am afraid it might affect my career.

 

2. This must be played clean. No slugfest like in the other threat. Especially if the other clinics opt out, I do not want them no be called "cowards" etc. Not everyone is as open as you in the net and this has to be accepted. Also this are currently my best options for a transplant and I do not want to get in a fight with them.

 

I will answer as well in the open forum, but without being as specific about the second topic.

 

Best regards,

Gasth?rer

7:38 PM 5/21/2017

I can't accept any conditions.

Everything and everyone has to be open and transparent or there is no point.

10:33 PM 5/22/2017

Well, Dr. Feller, I am sorry to hear that.

 

From my point of view, this would be an interesting discussion for many forum users. My conditions would not lower the value of this debate. I do not think there is a benefit for other users, when they know my real name, but I see a risk for myself. Hence, I stand by my conditions. Other people in other positions could think differently.

 

Of course I would be happy, if you find some else for this discussion or have the discussion bilateral. Personally, I think an consumer would be additional value for this discussion. I can still send you questions which are interesting from my (consumer) point of view if you are interested. Maybe I post them in the forum on the weekend, when I have more time. Or maybe you can get Spex asking this questions or serve as a moderator.

 

Thanks for the approach,

Gasth?rer

 

By the way: Above was you last PM! After my reply I went on the business trip. There was no (!) evidence for me, that you would change your mind and that I would delay anything by not going online during my business trip. Until when I was back, I saw you had posted in parallel and during my absence:

05-31-2017, 11:03 PM

 

Gasthoerer

Member

Veteran Real Hair Club Member

 

Join Date: Mar 2017

Posts: 65

Last Online: Today 10:00 AM

 

Sorry, I answer in here, cause the other thread was closed. Unfortunately, I have been on a business trip and could not access the forum (as I do not like to use the company computer). Please apologize for the late reaction.

Quote:

Originally Posted by Dr. Alan Feller

And Gasthoerer, PM me your name and phone number and I won't post it online.

Like i mentioned before: If you agree to the conditions which I send by PM and stated in the forum, I would love to be part in this.

Quote:

Originally Posted by Dr. Alan Feller

believe Gasthrower spoke out of turn by claiming that two doctors -who perform FUE and FUT regularly- offered him FUE to the exclusion of FUT. I believe in actuality there is more to his story that he has been omitting. I asked for his real name but he would not give it.

 

 

After that , I gave you my name the next day and never ever heard back: from you:

1:23 AM 6/1/2017

Dear Dr. Feller,

 

as you stated you won't publish my name, I'll send it to you, as I trust you honor you word.

 

If you can "keep it clean" I am happy, if you contact either clinic. If you cannot promise that, then please don't apporach them. You have my name, which hopefully convinces you, that I am not involved with any clinic etc.

 

Furthermore, I can send you the link to my "hair case" which I posted in a domestic forum, if this helps you, to judge the answers of the other clinics. But I fear that the pictures, will not to the case justice. All clinics have said that the status of my crown is difficult to judge on a picture. If you need specific pictures, let me know.

 

Best regards,

XXX (My full name)

 

P.S. Rather than a phone call I would prefer skype, but phone would be also possible.

 

P.P.S. You find me on Linked in (old profile) or XING (new profile) as well.

 

https://www.linkedin.com/in/XXX/

 

 

By the way, you have made the same offer before in 2015. You could easily contact the clinics before approaching me.

06-08-2015, 03:15 AM

 

Dr. Alan Feller

Senior Member

Celestial Follicle Club Member

 

Join Date: Oct 2002

Location: Great Neck, NY

Posts: 2,058

Last Online: Today 07:10 PM

 

Hairweare,

 

...

 

Tell you what, why don't you PM me your real name and phone number. Then I can make a three way call between you, me, and Dr. Lorenzo and you can hear first hand …

 

You know what? We can keep discussing or both man up and call it a misunderstanding. Even though I do not like your style/behavior, I still like your passion. I will send you my phone number (if you do not like skype) and we go forward. Only condition from my side: My name is not being published. Nothing else.

 

I would ask the same questions anyway in my next consultation with Feriduni in August and give insight here. But your opinion shared with Feriduni would improve the value dramatically.

Edited by Gasthoerer

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Abosolutely no reason why Gasthoerer real name needs to be made public.just because a poster asks questions to a Doctor why should he reveal identity , most guys want to keep

it quiet theyve had a transpant thats why clinics obscure the face of patients inculding

Feller/Bloxham .

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Dr. Bloxham,

 

please keep this interesting discussion ongoing. Finally, we have some value in here.

My questions are as follows:

 

a) Is this the study you are refering too? hair transplant: Dr. M Beehner’s Study about FUE and FUT There are some numbers given, which are very low (survival rates). FUE is way (!) lower than FUT. But also FUT survival rates are much lower than what Dr. Feller and you typically mention. Why is that?

 

No. Dr. Beehner has completed many landmark studies in our field -- and this is one of them -- and I have referenced this study many times before, but it's not the one I'm referring to. The one I'm referring to is a study specifically looking at the amount of supportive tissue around grafts and survival rate. As predicted, there is a statistically significant positive correlation.

 

b) I think you didn't specifically adress that Dr. Lupanzala was claiming that singles made from doubles or tripples in FUT are skeletonized. Are the FUT grafts you are showing including typical singles gained from multis? If not, could you adress how they would look (and grow)?

 

I don't think he was being specific about "splitting;" and if he was, I hope there is a follow-up clarification because it is not how it read.

 

Regardless, the splitting of multis to smaller multis or multis into singles is not industry standard for FUT. In fact, it's very much frowned upon save for very rare situations. Not only because it was a practice used in the day to claim you were doing more grafts or charge for more grafts, but survival rate decreases when you try to split a natural follicular unit (FU) down into smaller pieces. The same way it decreases if you only get part of a FU during FUE or if you skeletonize a graft beyond it's natural comfort zone during FUE.

 

c)This might go to Dr. Lupanzala: Is the quality of the FUE grafts shown by Dr. Bloxham, similair to the grafts you typically score? Do you get less skeletonized grafts, which you can show? Or do you think there is not much of a effect on growth anyway (when proper care is taken).

 

I purposely tried to include fair examples. There are obviously very bad pictures of FUE grafts out there, and these have been used for various purposes in the past -- draw your own conclusions here. While the quality and appearance of grafts removed via FUE is highly variable, I didn't think it was fair to include obvious bad examples. So I picked pretty fair ones. What's more, if you look at the video I included in my initial reply, you'll see live graft examples that have the same appearance: a healthy amount of supportive tissue to the level of scoring and a stripped appearance below. There is simply no way around it when performing minimal depth scoring with sharp punches.

 

Thanks to Dr. Lupanzala again for joining the discussion.

 

Agreed.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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1. No. Dr. Beehner has completed many landmark studies in our field -- and this is one of them -- and I have referenced this study many times before, but it's not the one I'm referring to.

 

2. I don't think he was being specific about "splitting;" and if he was, I hope there is a follow-up clarification because it is not how it read.

 

3. Regardless, the splitting of multis to smaller multis or multis into singles is not industry standard for FUT. In fact, it's very much frowned upon save for very rare situations. ...

 

4. I purposely tried to include fair examples. ... What's more, if you look at the video I included in my initial reply, you'll see live graft examples that have the same appearance: a healthy amount of supportive tissue ...

 

 

Thank you very much for the detailed answers.

 

1. If you still have (if there is an online version) a link to the other study, I would be really happy to read it. I see the same for all other users. Do you have an idea why both survival rates are so low in this study? FUE is terrible (61.4 %), but FUSS (FUT) is also frightening with 86 %.

 

Side topic: The math is wrong in this study ("The difference is 24.6 %"). It is 24.6 %-points...which makes FUE Survival rates 29 % worse than FUSS in the study I have linked.

 

2. Maybe was also a reading compehension error on my side.

 

3. Never the less, you answer to my question was still interesting. This is a much talked about topic, so it appeared ito me, that it is more common to split grafts.

 

4. Just to make sure: That was no pick on you or a way to give the impression you showed "bad" FUE grafts. It was an really open question. My assumption was:

a) The grafts of Dr. L do have more surrounding tissue by advanced methods of scoring and extraction (just like some guitar players are better than others, even if they use the same guitar, to use an analogy).

b) The grafts do look similiar, but there is no (or a small) effect of the surounding tissue, on growth if grafts are properly treated before and afterwards.

c) ...everyone can guess the third opion :-)

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Gas,

 

I'm glad you like my passion. You've written that a few times and I appreciate it. This is my business and I happen to love what I do and enjoy sharing it. I volunteer my time on this site and take a lot of abuse because in the end I enjoy speaking my mind and cutting through the BS that get's thrown around far too often-especially when it comes to FUE.

 

You can chalk up the phone interview, or lack thereof, to a misunderstanding. I have no intention of going around and around. But it is all seems very clear to me.

 

Summary:

1.I asked for your name and phone number and you would not give them.

2. You made conditions I could not accept.

3. I never agreed to conditions in the first place.

 

Timeline:

I asked for your name and phone number. Plain and simple. But you didn't send them. Instead you posted online that you WOULD give them, but that I would have to agree to conditions that no reasonable person could accept especially if the goal was to do a recorded and transparent interview.

 

So already the games began.

 

I ignored your conditions and immediately posted what my questions would be limited to. Which were nothing sinister by the way. Just basic FUE questions.That should have been enough. But rather than PM me your information right away so we could move forward you PMd your conditions again saying you didn't want the call to turn heated and that if the doctors refused to participate that I couldn't report it.

 

First, how can I be expected to control which way the conversation goes ? In an interview the discussion goes where it goes. I certainly had no expectations of an emotional phone call, but apparently you did.

 

And second why should I not report online that the doctors refused to participate if that's what they choose to do ?

 

And third, if I posted the recording on a thread how can I control what other posters will say about the doctors? I am not a moderator.

 

Your conditions were unreasonable.

 

I immediately PM'd you back that I don't accept conditions. Either the call would be totally open and transparent or it would be pointless.

 

You should have dropped your conditions and let me make the call and just let it go where it goes. But you wouldn't do that. Instead you went back online and simply posted that Dr. Feller wouldn't accept your terms. That was disingenuous. I didn't agree to terms in the first place and I gave you no reason to believe that call would turn heated or that any thread built around it would become a "slugfest". That was the canard you created.

 

Again, this is game playing and time wasting.

 

I wanted to give you one more chance to allow the phone call to happen so I posted on May 22 that I would not use your name. And you vanished. Until I received a PM from you 9 days later on May 31. More game playing.

 

And in that third PM did I get your name and phone number ? No, only A name and no phone number. To get that I would have to use a linkln url that you attached. I put it into my browser and hit a wall that said I would have to sign up for an account. More game playing. I had enough and wrote you off.

 

If you were serious about the phone call happening you would not have stretched it out so long and you would have simply sent me a single PM saying "Hi Dr. Feller my name is Mr. John Doe and my phone number is XXX-XXXX I live in X country and I am available at XX:XX your time for the phone call"

 

But you didn't do that. You played games and wanted me to fish for every piece of information and then prevent me from using it if things didn't go according to your "conditions".

 

If you want to call that series of events a misunderstanding that's fine, I'm not going to continue going around and around with you, but the events seem clear to me.


Feller Medical, PC

Great Neck, NY

 

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

 

Providing FUT, FUE, and mFUE

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Guys,

 

11. Dr. Feller and Dr. Bloxham can speak based on their own expertise and surgical experiences. However, they cannot speak for all doctors and what they experience in their surgery room. Yes, there are some universal truths and hindrances that make FUE more challenging in some ways, in particular regarding getting growth yield to be as consistent as strip. However, other surgeons may have experiences that differ from Dr. Feller and Dr. Bloxham where consistency in their hands may be higher. On the other hand, some may see even lower consistency. While I truly appreciate and encourage Dr. Feller and Dr. Bloxham to continue posting their experiences, opinions and facts, I'd like to hear from other leading surgeons who regularly perform FUE such as Dr. Erdogan, Dr. Bisanga, etc. It would be interesting to hear what some other top notch surgeons say and see what they do and don't agree with related to what these two surgeons say.

 

Best wishes,

 

Bill

 

Bill,

 

I have visited Dr. Bisanga in Brussels on Monday. I was very impressed, to say the least.

 

Anyway, we also talked about FUE. I did bring up the question of growth yield to Dr. Bisanga.

 

He doesn't think there is any difference in growth yield between FUT and FUE in his practice.

 

Hope that helps,

 

Damian.


Proud to be a representative of world elite hair transplant surgeon Dr. Bisanga - BHR Clinic.

Hairtransplantelite.com

YouTube

Online consultations: damian@bhrclinic.com

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1. Summary:

1.I asked for your name and phone number and you would not give them.

2. You made conditions I could not accept.

3. I never agreed to conditions in the first place.

 

2. Your conditions were unreasonable. I immediately PM'd you back that I don't accept conditions. Either the call would be totally open and transparent or it would be pointless. Instead you posted online that you WOULD give them, but that I would have to agree to conditions that no reasonable person could accept especially if the goal was to do a recorded and transparent interview.

 

 

3. I ignored your conditions and immediately posted what my questions would be limited to. Which were nothing sinister by the way. Just basic FUE questions. That should have been enough. …

4. First, how can I be expected to control which way the conversation goes ? In an interview the discussion goes where it goes. I certainly had no expectations of an emotional phone call, but apparently you did.

And second why should I not report online that the doctors refused to participate if that's what they choose to do ?

 

Dr. Feller,

This is my last post on this, as I made everything transparent and clear.

1) Timeline is clearly given by screenshots

 

a) You first sent a PM that you cannot accept my conditions. This is fine and your choice.

 

b) I answered, that I am sorry to hear and went away to a business trip.

 

c) Then you stated in the forum that you accept not making my name public and I should get in touch. You even called me out for it.

 

d) After being back I immediately answered you with my name and a link which should help you to verify my background (especially as you have accused me wrongly before). I even apologized for being away.

- You could have answered to that PM

- You could have answered in the forum

- You could make a proposal for a timing

- You could answer if you like skype or phone

- Why is this all my task? Why did you all of sudden ignored everything I wrote?

 

? My name is much more precious than my phone number (which I can easily change when you publish it). So why should I give you my name if I am not serious? If you think I was not serious? Why don’t you ask? You had the time to send a PM to a third person but you could not contact me.

 

2) If the conditions are unreasonable, why asking for my name again after first declining and claiming we would go through? I just do not get that?

 

3) So you can make conditions and define questions and I cannot? Why? We all have questions which we would like being answered.

 

4) Please, Dr. Feller, you have been in numerous fights in here: With other users, with other clinics (which you mock, month after the discussion is over), threads got closed etc. You are (to say it positive) very emotional about this. Is my request not to mock the other clinic or start calling people out, really that unreasonable? I do not think so.

 

Well, finally, you have now everything you wanted (with the only exception, that you shall not publish my name). You have my name, you have my phone number, you can verify my background, I can show you pictures of my case if you want (as the response of other clinics to my case started all this), I dropped any conditions but my name being public, you have my first questions,…

 

If you want also dates, I am available at the following times (all at the evening so it is more convenient for you because of the time delay):

- Sa 17th of June any time from 6-10 pm (Berlin time)

- Su 18th of June any time from 6-10 pm

- Tu 20th of June any time from 8.30 to 10 pm

- Fr 23rd of June any time from 8.30 to 10 pm

 

If all these times are to short notice or not possible for anyone, please send other suggestions. So after making the claim twice to different Users in this forum that you would do this call: Do it or drop this entire thing for the sake of this discussion.

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Bill,

 

I have visited Dr. Bisanga in Brussels on Monday. I was very impressed, to say the least.

 

Anyway, we also talked about FUE. I did bring up the question of growth yield to Dr. Bisanga.

 

He doesn't think there is any difference in growth yield between FUT and FUE in his practice.

 

Hope that helps,

 

Damian.

 

Damian,

 

Obviously I wasn't there to hear your conversation, so I won't make assumptions. However, if we look at what Dr. Bisanga has actually put into print for the entire world to see on his own website, I don't think it's as simple as: there is no difference.

 

If you read through his website, you'll note two very important things:

 

1) He states that FUE is best suited for cases below a NW IV. FUE is only appropriate in candidates NW IV and higher when they have a higher than average donor area.

 

So, how do I interpret this? FUE is best suited for smaller cases unless the patient has an excellent donor.

 

Here's the quote:

 

Larger areas of thinning say NW4 and higher can be treated with FUE but the person has to have better than average donor hair density and good hair characteristics to ensure sufficient FU numbers can be safely extracted and leave options for the future.

 

2) He further states that "hair characteristics" and "FU constitution" play a large role in how suitable a patient is for FUE. It is "misunderstood" that FUE is suitable for all hair types.

 

So how do I interpret this? Not all patients are candidates for FUE.

 

Here's the quote:

 

Hair characteristics and FU constitution can play a large part in how suitable FUE can be; it is misunderstood that FUE is suitable for all hair loss stages and hair types and some may not have the right attributes to ensure a solid result.

 

So, what does it really mean when you break it down? Not all patients are candidates for FUE, and the doctor needs to SCREEN patients and intervene with FUE only when they are good candidates.

 

So I do believe that Dr. Bisanga believes that a good candidate for FUE will have a pretty similar result to one of his FUT patients -- and he is excellent at both -- but this is not the same as saying "they are about the same" if we are to use his written website as his philosophy.

 

As I've said before: what is actually the "best" FUE tool? A good screening tool.

 

Source: https://en.bhrclinic.com/technique/follicular_unit_extraction/


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Damian,

 

Obviously I wasn't there to hear your conversation, so I won't make assumptions. However, if we look at what Dr. Bisanga has actually put into print for the entire world to see on his own website, I don't think it's as simple as: there is no difference.

 

If you read through his website, you'll note two very important things:

 

1) He states that FUE is best suited for cases below a NW IV. FUE is only appropriate in candidates NW IV and higher when they have a higher than average donor area.

 

So, how do I interpret this? FUE is best suited for smaller cases unless the patient has an excellent donor.

 

Here's the quote:

 

Larger areas of thinning say NW4 and higher can be treated with FUE but the person has to have better than average donor hair density and good hair characteristics to ensure sufficient FU numbers can be safely extracted and leave options for the future.

 

2) He further states that "hair characteristics" and "FU constitution" play a large role in how suitable a patient is for FUE. It is "misunderstood" that FUE is suitable for all hair types.

 

So how do I interpret this? Not all patients are candidates for FUE.

 

Here's the quote:

 

Hair characteristics and FU constitution can play a large part in how suitable FUE can be; it is misunderstood that FUE is suitable for all hair loss stages and hair types and some may not have the right attributes to ensure a solid result.

 

So, what does it really mean when you break it down? Not all patients are candidates for FUE, and the doctor needs to SCREEN patients and intervene with FUE only when they are good candidates.

 

So I do believe that Dr. Bisanga believes that a good candidate for FUE will have a pretty similar result to one of his FUT patients -- and he is excellent at both -- but this is not the same as saying "they are about the same" if we are to use his written website as his philosophy.

 

As I've said before: what is actually the "best" FUE tool? A good screening tool.

 

Source: https://en.bhrclinic.com/technique/follicular_unit_extraction/

 

Well, yes, Dr. Bisanga does screen every patient meticulously. So if you are not a suitable FUE candidate he will tell you. Hence, I was only talking about the survival yield he has observed in all patients that were indeed suitable FUE patients and underwent surgery with him.


Proud to be a representative of world elite hair transplant surgeon Dr. Bisanga - BHR Clinic.

Hairtransplantelite.com

YouTube

Online consultations: damian@bhrclinic.com

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Damian,

 

 

So I do believe that Dr. Bisanga believes that a good candidate for FUE will have a pretty similar result to one of his FUT patients

 

 

Source: https://en.bhrclinic.com/technique/follicular_unit_extraction/

 

Do you agree with this assessment Dr Bloxham? I know Dr Feller thinks FUT is a superior procedure in all cases except where the patient is not a candidate for it, but would you say that with a great donor, skilled surgeon, and proper protocol the yields are comparable and it is a reasonable risk to take (ignoring future loss and less total donor supply from FUE)?

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Damian,

 

1. Obviously I wasn't there to hear your conversation, so I won't make assumptions. However, if we look at what Dr. Bisanga has actually put into print for the entire world to see on his own website, I don't think it's as simple as: there is no difference.

 

If you read through his website, you'll note two very important things:

 

2. He states that FUE is best suited for cases below a NW IV. FUE is only appropriate in candidates NW IV and higher when they have a higher than average donor area.

 

So, how do I interpret this? FUE is best suited for smaller cases unless the patient has an excellent donor.

Dr. Bloxham,

 

1. Be careful, a similar topic started the entire “recorded phone call” discussion ;-)

 

2. Honestly, I think you missing the point in this particular case. There are two topics: Liftetime available grafts and yield. The quote of Bisanga by Swooping was clearly about yield and your quote refers (as well or even mainly) to available grafts.

One could easily say, that Bisanga thinks FUT(+FUE) gives more lifetime available grafts than FUE even when yield is different and hence is better suited for higher NW.

 

However, I have a hard time someone saying that yield is exactly the same. I have heard a “minor difference” in yield, or “no visible difference” in yield. No difference sounds like a stretch.

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Well, yes, Dr. Bisanga does screen every patient meticulously. So if you are not a suitable FUE candidate he will tell you. Hence, I was only talking about the survival yield he has observed in all patients that were indeed suitable FUE patients and underwent surgery with him.

 

Excellent to hear that he screens meticulously. He's clearly an ethical doctor. My interaction with him has been limited, but he's always come across as a gentleman.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Do you agree with this assessment Dr Bloxham? I know Dr Feller thinks FUT is a superior procedure in all cases except where the patient is not a candidate for it, but would you say that with a great donor, skilled surgeon, and proper protocol the yields are comparable and it is a reasonable risk to take (ignoring future loss and less total donor supply from FUE)?

 

I agree with Dr. Feller's assessment. Based upon both what I have seen in clinical practice and the initial findings of the FOX testing -- this study really deserves a second look from the HT field because it correctly predicted a lot of things and gave sound reasoning as to why.

 

A great donor, a skilled surgeon, and proper protocol are paramount to maximizing your prospects at a good FUE. However, even a "good donor" doesn't take into account how well your skin will want to let go of the grafts and how accepting your follicles will be to the FUE process. Everything can look great on paper and still not proceed as hoped.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Dr. Bloxham,

 

1. Be careful, a similar topic started the entire “recorded phone call” discussion ;-)

 

2. Honestly, I think you missing the point in this particular case. There are two topics: Liftetime available grafts and yield. The quote of Bisanga by Swooping was clearly about yield and your quote refers (as well or even mainly) to available grafts.

One could easily say, that Bisanga thinks FUT(+FUE) gives more lifetime available grafts than FUE even when yield is different and hence is better suited for higher NW.

 

However, I have a hard time someone saying that yield is exactly the same. I have heard a “minor difference” in yield, or “no visible difference” in yield. No difference sounds like a stretch.

 

I understand what you are referring to, but I'm not sure Dr. Bisanga was stating the same. However, it's not worth getting into too deeply because for me, it doesn't change the crux of the argument:

 

Dr. Bisanga -- who has the ability to offer both high quality FUT WITH an appropriate staff and FUE -- states that not all patients are candidates for FUE and meticulous screening is necessary.

 

Despite the belief of some, Dr. Feller and I are not "against" the FUE procedure. I do them all the time. But it must be done under the right circumstances. And this is what Dr. Bisanga touches upon. Now, I will take it one step further and state that even under the best conditions, the outcome is still MUCH more variable compared to an FUT of similar size. But what we have spoken out against heavily is the practice of "FUE for all," and even worse is "FUE megasessions" for all. This we take issue with.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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No. Dr. Beehner has completed many landmark studies in our field -- and this is one of them -- and I have referenced this study many times before, but it's not the one I'm referring to. The one I'm referring to is a study specifically looking at the amount of supportive tissue around grafts and survival rate. As predicted, there is a statistically significant positive correlation.

 

 

 

I don't think he was being specific about "splitting;" and if he was, I hope there is a follow-up clarification because it is not how it read.

 

Regardless, the splitting of multis to smaller multis or multis into singles is not industry standard for FUT. In fact, it's very much frowned upon save for very rare situations. Not only because it was a practice used in the day to claim you were doing more grafts or charge for more grafts, but survival rate decreases when you try to split a natural follicular unit (FU) down into smaller pieces. The same way it decreases if you only get part of a FU during FUE or if you skeletonize a graft beyond it's natural comfort zone during FUE.

 

 

 

I purposely tried to include fair examples. There are obviously very bad pictures of FUE grafts out there, and these have been used for various purposes in the past -- draw your own conclusions here. While the quality and appearance of grafts removed via FUE is highly variable, I didn't think it was fair to include obvious bad examples. So I picked pretty fair ones. What's more, if you look at the video I included in my initial reply, you'll see live graft examples that have the same appearance: a healthy amount of supportive tissue to the level of scoring and a stripped appearance below. There is simply no way around it when performing minimal depth scoring with sharp punches.

 

 

 

Agreed.

 

Dr. Beehners studies on FUE are a joke and for any serious doctor to reference these is laughable.

 

A study of his on survival rates from July 2016 to the ISHRS of which the opening lines criticise FUE and labels FUT the "gold standard" does not even mention the holding solution used for grafts, and mentions that although he considers himself an above average FUE physician, he has only conducted EIGHTY FUE PROCEDURES IN OVER 8 YEARS. How can you possibly conduct a study like this without mentioning holding solution? He also says he is only experienced in FUE procedures averaging around 500 grafts.

 

There are also multiple photo sets in the study of a set skeletonized FUE grafts in contrast to chubby FUT grafts. I have had an FUE procedure and seen the grafts, and they look absolutely nothing like the destroyed grafts in this study.

 

Studies and patient graft counts by Dr. Erdogan and a small experiment with Dr. Keser achieving over 95% yield with FUE exist for any to see. As suggested by Swooping and Dr. Lupanzula prominent FUE doctors that also are heavily experienced in FUT don't feel they achieve a significant difference in yield.

 

Anyone can throw around studies to prove their point, and it is extremely telling that anti-FUE doctors cite studies by doctors like Beehner who are totally inexperienced at FUE when expressing their views. Why cite a study on FUE by a doctor who has performed less than 10 FUE procedures per year and doesn't do more than 600 grafts at a time on average and biggest FUE procedure was 1300 grafts? None of that to discredit Dr. Beehner as a highly competent FUT surgeon, however you can't take a study by someone inexperienced with FUE to compare FUT results seriously.

 

A legitimate study requires an exclusively FUE doctor who believes their work equals FUT such as Lupanzula with a doctor like Feller and comparing yields on the same patients in the same facility with controlled variables. Data comparing results by a single doctor with a single set of controlled variables (and in this case not a legitimate FUE doctor) is just that, results of a single doctor, under their own conditions with non-standardised tools.

Edited by JeanLDD

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FUE (changed by me) must be done under the right circumstances. And this is what Dr. Bisanga touches upon. Now, I will take it one step further and state that even under the best conditions, the outcome is still MUCH more variable compared to an FUT of similar size. But what we have spoken out against heavily is the practice of "FUE for all," and even worse is "FUE megasessions" for all. This we take issue with.

 

I think almost anyone in this forum and elsewhere could agree with this assessment. From my standpoint it is thought through and sums up almost the entire story.

 

However, I have a hard time to align this content with the posts of Dr. Feller and with the numbers you (Feller and Bloxham) quote (Average growth rates).

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Well, yes, Dr. Bisanga does screen every patient meticulously. So if you are not a suitable FUE candidate he will tell you. Hence, I was only talking about the survival yield he has observed in all patients that were indeed suitable FUE patients and underwent surgery with him.

 

Then we are in fact mostly on the same page here and right back where we started.

 

The popular hype is that FUT is being replaced by FUE. However, if any doctor who can do both has to screen their patients for one or the other then obviously both procedures are not going anywhere. And, indeed, history has shown this to be the case as FUE has now been around for over 17 years and nobody has come up with a novel way to perform FUE of any significance.

 

The misinformation fired at me during these online discussions has always been that I am anti-FUE. This is false. I am pro-FUE but for SMALL cases that have been well screened. For everything else I prefer Strip and perhaps even a strip/FUE combo, or mFUE of course.

 

But physician competency, experience, and goodwill are not at the core of the issue here. The issue is the mechanics of the FUE procedure itself when compared to FUT. Not the doctor who performs it.

 

When you compare the two procedures independent of the doctor or even the patient, FUE is downright brutal to the grafts. Graft trauma is the number one predictable reason for graft growth failure. And if our textbooks and meetings and lectures emphasized one thing over and over it is that safe and delicate graft handling is essential to graft survival and overall result. Mishandling grafts is a sin. And the trauma inflicted on FUE grafts, no matter who performs it, is orders of magnitude greater than for FUT.

 

FUT does not inflict nearly the level of damage on grafts and donor area that FUE clearly does and has no analogue to FUE in terms of detrimental forces.

 

I know Dr. Bisanga. Lovely and genuine man and surgeon with great experience and skill, but even in his hands the disadvantage of FUE over FUT are simply not addressed. Is he better than the newbie FUE surgeon ? Of course. Does he have a better body of work because he meticulously screens patients for FUE instead of willy nilly taking anyone for FUE surgery who requests it ? No doubt. He has maximized the potential of FUE. And if you are going to have FUE done you better get it done with him or a surgeon like him. Of which there are not many. But the limitations of FUE still exist in frightening proportions are not something he can overcome as they are inherent to the very procedure itself.

 

Until and unless a doctor creates a brand new way of performing the FUE procedure that does not inflict the three detrimental forces of FUE ,and does not thin out the donor area, then they cannot claim parity with FUT. This isn't debatable.

 

A doctor can maximize their chances of getting a good yield with FUE, but in each and every circumstance, without exception, performing that same procedure with FUT will always end with a consistently better result. Not sometimes, EVERY time.

 

I don't have to look at any particular FUE doctor's photo gallery to know that no matter how good their results may look it was attained at a higher physiological price compared to FUT. Look at all of the poor FUE results posted on this site to date. All of them would have had a much greater chance of growing well if they had opted for and were given FUT first because their grafts would not have been injured nearly so much.


Feller Medical, PC

Great Neck, NY

 

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

 

Providing FUT, FUE, and mFUE

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Dr. Feller,

 

I have very limited time to discuss these issues as I have 12 hour work days as well as a young family to tend to so I will address what I can with the short window of time at my disposal. Before I do, I would remind you that my name is not “Dr. L”. My name is Dr. Lupanzula. Thank you.

 

I have heard these same things stated by different FUE doctors for 17 years now.

 

I’m surprised to read this because I was not aware of any surgeons performing FUE 17 years ago with regularity except for one and he was not in North America. It wasn’t even introduced into North America until 2002 which was 15 years ago. Who else was performing FUE seventeen years ago? I do not see the connection between hearing these points before and their accuracy with regards to truth today. Logically, the points would be more valid today than they would have been 15 years ago (or 17) as there would be fifteen years of experience to back it up. In my opinion, this is the case with FUE as the early years could not have logically provided the view that we have today as such experience to give valid conclusions simply did not exist. This is not a slight in any way, but is a common sense. Is it not logical to understand something in life better with fifteen years of experience under one’s belt rather than having only six months of experience?

 

Regarding the studies you cite, I would like to address them both along with the contradictions. In the Beehner study it was noted that everyone involved in the procedure had eight years of experience however the total number of procedures having been performed in those eight years was ninety procedures. This is the equivalent of having performed less than nine FUE surgeries each year. Nine. I appreciate the information in this study but the experience level is not the same as one that does the same number of procedures in eight days as opposed to eight years. In addition, as you stated, a manual punch is

the very best way to perform an FUE
and later
I absolutely agree however that the use of rotary machines has markedly increased the degree of damage due to torsion.
yet this study you reference was using a motorized continuous rotation punch. Furthermore, the author stated
I certainly would concede that some of the very experienced FUE practitioners who have mastered this technique over many years may very well have obtained higher follicle survival percentages than we did.

 

With regards to the FOX test, I think it is safe to say that this falls under the “experience” category that I referenced earlier and I disagree that a paper written with experience garnered from various small scale tests applies to an entire industry after fifteen years of discussion and sharing among peers. With all due respect, to believe that nothing has changed in fifteen years is paramount to walking with blinders. And this begs the question; if we have a study that shows something is problematic, do we simply give up, thereby creating a truth that validates the study through inaction and lack of effort to improve? I do not know you, but from your comments, you do not appear to be one that allows studies by third parties dictate how you run your practice.

 

My comment about torsion is not incorrect as you are assuming the follicle to be completely rigid, which it is not. I specifically said that torsion is not an issue if the distance traveled in the oscillation is short. This is why manual oscillation that is controlled from an experienced practitioner is the superior method compared to continuous rotation. There is a difference.

 

The “hand over hand” method you reference does not by definition require significant compression to be applied at all points of contact. In fact, your incorrect assumption is the point of contact itself. I can go into detail but I did not intend for this to turn into a tutorial and these are points that I teach to my students that must spend a minimum of six months in my clinic, many times up to a full year, learning the correct FUE method.

 

Skeletonization is unique to FUE, and the way it is produced is exclusive to FUE. There is no process in FUT that leads to skeletonization and no analogue.

 

Interesting.

 

Comparison of survival of FU grafts trimmed chubby, medium, and skeletonized

Beehner-2010

 

This study was designed to help explore whether there was a difference in FU graft survival when grafts were trimmed “chubby,” “medium”, or “skinny” (skeletonized).
(Their terminology, not my own)

 

In the spirit of sharing research I found this information to be particularly interesting.

 

I don't think that these scars should be the cause of such concern. After all, they are the normal result of elective (or any) surgery. Most of my patients have normal scars, although you absolutely will get someone who will stretch or have some unique complicaiton. By and large, however, the strip method is excellent and doesn't deserve the "villification" it has been receiving.*

 

With respect to FUE, I am not studying, researching, and performing this procedure simply to avoid the strip method. I am doing this because it may ultimately offer HIGHER follicular yields than a disected strip. In fact I have already proven this in my office and have documented this in photos and video. I suspect other less vocal practitioners of this technique have also noticed this and may attribute their excellent results to this phenomenon.

- Dr. Feller, November 16, 2002

 

http://www.hairrestorationnetwork.com/eve/145487-another-question-dr-feller.html

 

attachment.php?attachmentid=108878&stc=1&d=1497541527

 

What has changed since your own research showed a yield that is "higher" than "a dissected strip"? This is largely a rhetorical question.

 

 

Dr. Feller, I appreciate your passion in this subject and it is this type of vigor that translates well to believing in your craft as you present it to your patients. If you do not believe, you are not genuine and this is against our oath. However, I wish to be clear. I am not here to convince you of anything as it is clear that you are steadfast in your beliefs and I do not believe I am the one to change your mind, nor do I wish to be. I recently heard of you and of your position and comments and felt that some balance should be presented to the issue. Do we have enough raw data for conclusiveness across the field? No, because the field itself is rife with misrepresentation of the highest degree along with a multitude of inconsistencies for an equal multitude of reasons. In this absence we must rely on our own experiences and those of our colleagues that are willing and eager to share, and in turn learn themselves, and this is what I do with my own teachings to my students. I do not conduct weekend seminars and I do not hold video workshops. I take the art of FUE and my oath very seriously, and make no mistake, proper FUE is an art indeed. Physicians that wish to learn from me must reside in Brussels for a minimum of six months if they are already experienced hair restoration physicians, and one year if they are physicians that are not experienced in hair restoration surgery. This procedure is infinitely more difficult to perform compared to strip surgery thus it requires an understanding, dexterity and touch that cannot be achieved with anything short of extreme repetition, practice and passion and these are the forces that are , in my opinion and that of my colleagues, far more powerful than torsion, compression and traction. Good day.

5b32f44baf1da_drfellerfuecomment.jpg.33ad6ba104be3f8957a6b07d3b664a64.jpg


Dr Lupanzula E.

MeDiKemos Hair Transplantation

 

Dr. Emorane Lupanzula is recommended on Hair Transplant Network

 

Email: info@medikemos.com

Telephone: + 32 2 535 55 40

Website: http://fuehairdoctor.co.uk/

Youtube: http://www.youtube.com/user/MHairTransplantation

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I think almost anyone in this forum and elsewhere could agree with this assessment. From my standpoint it is thought through and sums up almost the entire story.

 

However, I have a hard time to align this content with the posts of Dr. Feller and with the numbers you (Feller and Bloxham) quote (Average growth rates).

 

How so? I stated that it's "MUCH" less predictable and more variable in nature.

 

Which is the truth.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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How so? I stated that it's "MUCH" less predictable and more variable in nature.

 

Which is the truth.

 

Yes it is the truth indeed, but what you mention say now is totally different than the sound of what Dr. Feller (and maybe partly you, I am not sure though) say otherwise.

 

Remember: That Thread is not listed as "Before FUE you should find a great FUE clinic which screens meticulously" it is called "Why not have an FUE".

 

And typical quotes are not "If you are a good candidate and chose a clinic you can have results close to strip". The typical quotes are:

 

"Growth rates from FUE usually start at 75% that of FUT and go well down from there. That hardly counts as marginal"

"What I can't understand is how the poorer growth guaranteed with the FUE procedure is NOT a deal breaker"

"just as fair to describe your scarring from your FUE procedures as a massive amount of shotgun holes"

I assume you see the difference between your statement and the typical statemens in this thread.

By the way:

- Dr Lupanzula and JeanLuc gave some arguments why the FUE results in the "Beehner studies" might (!) have been so low. I am not saying this is the only reason.

- Do you have an idea why his strip results were so poor. Or do you think 86 % growth for FUT/FUSS is normal?

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Dr. Feller,

 

I have very limited time to discuss these issues as I have 12 hour work days as well as a young family to tend to so I will address what I can with the short window of time at my disposal. Before I do, I would remind you that my name is not “Dr. L”. My name is Dr. Lupanzula. Thank you.

 

 

 

I’m surprised to read this because I was not aware of any surgeons performing FUE 17 years ago with regularity except for one and he was not in North America. It wasn’t even introduced into North America until 2002 which was 15 years ago. Who else was performing FUE seventeen years ago? I do not see the connection between hearing these points before and their accuracy with regards to truth today. Logically, the points would be more valid today than they would have been 15 years ago (or 17) as there would be fifteen years of experience to back it up. In my opinion, this is the case with FUE as the early years could not have logically provided the view that we have today as such experience to give valid conclusions simply did not exist. This is not a slight in any way, but is a common sense. Is it not logical to understand something in life better with fifteen years of experience under one’s belt rather than having only six months of experience?

 

Regarding the studies you cite, I would like to address them both along with the contradictions. In the Beehner study it was noted that everyone involved in the procedure had eight years of experience however the total number of procedures having been performed in those eight years was ninety procedures. This is the equivalent of having performed less than nine FUE surgeries each year. Nine. I appreciate the information in this study but the experience level is not the same as one that does the same number of procedures in eight days as opposed to eight years. In addition, as you stated, a manual punch is and later yet this study you reference was using a motorized continuous rotation punch. Furthermore, the author stated

 

With regards to the FOX test, I think it is safe to say that this falls under the “experience” category that I referenced earlier and I disagree that a paper written with experience garnered from various small scale tests applies to an entire industry after fifteen years of discussion and sharing among peers. With all due respect, to believe that nothing has changed in fifteen years is paramount to walking with blinders. And this begs the question; if we have a study that shows something is problematic, do we simply give up, thereby creating a truth that validates the study through inaction and lack of effort to improve? I do not know you, but from your comments, you do not appear to be one that allows studies by third parties dictate how you run your practice.

 

My comment about torsion is not incorrect as you are assuming the follicle to be completely rigid, which it is not. I specifically said that torsion is not an issue if the distance traveled in the oscillation is short. This is why manual oscillation that is controlled from an experienced practitioner is the superior method compared to continuous rotation. There is a difference.

 

The “hand over hand” method you reference does not by definition require significant compression to be applied at all points of contact. In fact, your incorrect assumption is the point of contact itself. I can go into detail but I did not intend for this to turn into a tutorial and these are points that I teach to my students that must spend a minimum of six months in my clinic, many times up to a full year, learning the correct FUE method.

 

 

 

Interesting.

 

Comparison of survival of FU grafts trimmed chubby, medium, and skeletonized

Beehner-2010

 

(Their terminology, not my own)

 

In the spirit of sharing research I found this information to be particularly interesting.

 

- Dr. Feller, November 16, 2002

 

http://www.hairrestorationnetwork.com/eve/145487-another-question-dr-feller.html

 

attachment.php?attachmentid=108878&stc=1&d=1497541527

 

What has changed since your own research showed a yield that is "higher" than "a dissected strip"? This is largely a rhetorical question.

 

 

Dr. Feller, I appreciate your passion in this subject and it is this type of vigor that translates well to believing in your craft as you present it to your patients. If you do not believe, you are not genuine and this is against our oath. However, I wish to be clear. I am not here to convince you of anything as it is clear that you are steadfast in your beliefs and I do not believe I am the one to change your mind, nor do I wish to be. I recently heard of you and of your position and comments and felt that some balance should be presented to the issue. Do we have enough raw data for conclusiveness across the field? No, because the field itself is rife with misrepresentation of the highest degree along with a multitude of inconsistencies for an equal multitude of reasons. In this absence we must rely on our own experiences and those of our colleagues that are willing and eager to share, and in turn learn themselves, and this is what I do with my own teachings to my students. I do not conduct weekend seminars and I do not hold video workshops. I take the art of FUE and my oath very seriously, and make no mistake, proper FUE is an art indeed. Physicians that wish to learn from me must reside in Brussels for a minimum of six months if they are already experienced hair restoration physicians, and one year if they are physicians that are not experienced in hair restoration surgery. This procedure is infinitely more difficult to perform compared to strip surgery thus it requires an understanding, dexterity and touch that cannot be achieved with anything short of extreme repetition, practice and passion and these are the forces that are , in my opinion and that of my colleagues, far more powerful than torsion, compression and traction. Good day.

 

Dr. Lupanzula,

Your response is disappointing.

 

You didn't address any of the substantive FUE issues. You simply attacked me.

 

But I will not take the bait and allow the thread to get off track.

 

Let me ask you this...

 

Which graft suffers less injury ?

 

A graft that was removed via strip that was divided under a microscope.

 

Or a graft that has been grabbed hand over hand along its length with a forceps while under compression and traction powerful enough to literally rip it free from the dermis ?

 

Thank you.


Feller Medical, PC

Great Neck, NY

 

Dr. Alan Feller is a member of the Coalition of Independent Hair Restoration Physicians

 

Providing FUT, FUE, and mFUE

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Yes it is the truth indeed, but what you mention say now is totally different than the sound of what Dr. Feller (and maybe partly you, I am not sure though) say otherwise.

 

Remember: That Thread is not listed as "Before FUE you should find a great FUE clinic which screens meticulously" it is called "Why not have an FUE".

 

And typical quotes are not "If you are a good candidate and chose a clinic you can have results close to strip". The typical quotes are:

 

"Growth rates from FUE usually start at 75% that of FUT and go well down from there. That hardly counts as marginal"

"What I can't understand is how the poorer growth guaranteed with the FUE procedure is NOT a deal breaker"

"just as fair to describe your scarring from your FUE procedures as a massive amount of shotgun holes"

I assume you see the difference between your statement and the typical statemens in this thread.

By the way:

- Dr Lupanzula and JeanLuc gave some arguments why the FUE results in the "Beehner studies" might (!) have been so low. I am not saying this is the only reason.

- Do you have an idea why his strip results were so poor. Or do you think 86 % growth for FUT/FUSS is normal?

 

Again, I must disagree. We're arguing semantics or different writing/speech styles. The crux is the same.

 

Of course FUE doctors should -- and the good ones already do -- screen heavily, and patients should be fully aware of the pitfalls before committing. To do so without this understanding constitutes a lack of informed consent.

 

But even with meticulous screening and a trained hand, it's still more variable and less likely to give you the rich, thick, dense results that made the HT industry what it is today -- IE FUT megasessions. How much more variable? 75% growth rate on average.

 

They should also know that it does cause diffuse skin changes in the back and limits the number of lifetime grafts. It's a much, much worse use of the donor compared to FUT.

 

So this should confirm that I stand by the claimed differences. My stance hasn't changed at all.


Dr. Blake Bloxham is recommended by the Hair Transplant Network.

 

 

Hair restoration physician - Feller and Bloxham Hair Transplantation

 

Previously "Future_HT_Doc" or "Blake_Bloxham" - forum co-moderator and editorial assistant for the Hair Transplant Network, Hair Restoration Network, Hair Loss Q&A blog, and Hair Loss Learning Center.

 

Click here to read my previous answers to hair loss and hair restoration questions, editorials, commentaries, and educational articles.

 

Now practicing hair transplant surgery with Coalition hair restoration physician Dr Alan Feller at our New York practice: Feller and Bloxham Hair Transplantation.

 

Please note: my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician.

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Again, I must disagree. We're arguing semantics or different writing/speech styles. The crux is the same.

 

Of course FUE doctors should -- and the good ones already do -- screen heavily, and patients should be fully aware of the pitfalls before committing. To do so without this understanding constitutes a lack of informed consent.

 

But even with meticulous screening and a trained hand, it's still more variable and less likely to give you the rich, thick, dense results that made the HT industry what it is today -- IE FUT megasessions. How much more variable? 75% growth rate on average.

 

They should also know that it does cause diffuse skin changes in the back and limits the number of lifetime grafts. It's a much, much worse use of the donor compared to FUT.

 

So this should confirm that I stand by the claimed differences. My stance hasn't changed at all.

 

You didn't address the fact that you made up the 75% number or simply took it from Dr. Feller's quotes. You didn't address the fact that you quoted a study on FUE by a doctor who has only done 80 FUE procedures over 9 years.

 

Your stance hasn't changed IN SPITE of the evidence. You'll continue your tune no matter what unfortunately, even if that means making things up or quoting bad data by an FUT surgeon who opens his study stating that FUE is a poor procedure and doesn't state a number of important controlled variables such as holding solution.

 

The crux of your argument is backed up by evidence; FUT grafts are of a higher quality and have less force ultimately inflicted upon them, and these will on average yield higher. FUT for the average patient will also yield more lifetime grafts than FUE.

 

Beyond this, why do you have to make things up and quote bad data on FUE that's either fifteen years old or by a surgeon who has barely done FUE? Why make up the 75% figure when European surgeons such as Lupanzula, Feriduni, Erdogan and Keser have studies and results counting yield to confirm this is not the case? Hasson + Wong even state on their website that they believe they can "cherry pick" grafts with FUE and that the yields are equivalent. They also noticeably studied and learned FUE techniques from Dr. Erdogan, not Dr. Feller for example.

 

Everyone here who has researched and looked at hundreds of results from doctors across the world is aware that you are exaggerating on your criticisms of this debate, whether or not the principle is correct. It sounds ridiculous because people only have to look at the FUE section of this website from the past year to see that your claims are unfounded. It isn't a good look.

 

The fact is that there are FUE doctors yielding over 90% on a consistent basis and more and more doing cases moving up into the 6-7-8000 graft numbers through FUE across multiple procedures. 5000 FUE in a single pass is visible on various forums on a daily basis and from surgeons like Erdogan not only does the average donor look pristine a few months post surgery, 95% look pristine, totally at odds with claims that more than 1500 is unsafe or that FUE isn't suited to megassessions.

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