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

[Gasthoerer]

A question for the proponents of FUT - if I currently have long hair that's tied into a ponytail, will that have to be cut off or can be FUT be carried out without shaving the donor area?

 

If the latter is the case, won't FUT be the superior option for those who don't want to have their donor area shaved?

 

Yes, this is a big plus. A lot of women go this way (FUT with partial shaving) for very similiar reasons.

[Gasthoerer]

 

You share a case where 100 grafts were extracted via FUE, re-implanted with an implanter pen, and a 99% regrowth rate was observed. I am not surprised by this data. As has been said many times before, slow, meticulous small FUE sessions are the best way to minimize trauma and maximize growth. Although forces are present on all grafts during FUE, it is truly the "brute force speed" utilized during FUE mega sessions that causes real problems on a large scale.

 

Dr. Bloxham,

 

are you serious with this answer? So the three forces will not apply for small sessions and/or when going slow? In this case 99 % growth would be the norm for you? Much ado about nothing? (Cause if you find a solution for 100 grafts there are simple solutions for 1000 as well).

 

It is again very hard to align this with what Dr. Feller (and you) have stated in this very thread before.

[Mcgregor82]

There's famous clinics performing manual FUE megasessions on a daily base, they are well documented in this same forum and consistent with it. The results are clearly showing high regrowth ratios.

Edited August 16, 2017 by Mcgregor82

[tofur]

A question for the proponents of FUT - if I currently have long hair that's tied into a ponytail, will that have to be cut off or can be FUT be carried out without shaving the donor area?

 

If the latter is the case, won't FUT be the superior option for those who don't want to have their donor area shaved?

 

Yes FUT is the clear winner if not shaving the donor is important. They tape the hair above the chosen strip up out of the way and put a gauze pad down around the bottom then shave the strip itself and maybe a little bit on either side to make the incisions easier. Once it's done and sutured up your hair on top covers it.

[JayLDD]

Mav, I would just like to repost the following that you wrote because I believe it is important for Dr. Feller to answer.

 

"1) your position on FUE seems to just be based on your own experience performing the surgery

2) I understand that you have not attended an ISHRS or other conference in person in years

3) you appear to be unaware of who exactly the new and upcoming FUE surgeons actually are. Dr Lupanzula is a well respected FUE surgeon recommended by this very site and who actually presented/gave a demonstration at a FUE conference hosted by Erdogan in 2015 and which was attended by some heavy hitters like Shapiro, Wong, Feriduni, Lorenzo and others. Yet, you yourself admitted you had never heard of Dr Lupanzula until he posted on this thread.

4) I am not even convinced you have seen a live FUE from one of these top FUE surgeons in recent years. I could be wrong on this point. "

 

Not being aware of Erdogan and Lupanzula as a hair transplant doctor in 2017, especially considering their work on the research and FUE conference circuit is outright shameful. Not only is it a terrible look, but it looks very, very hard to believe. It looks like desperation, particular considering Dr. Feller's claims that FUE isn't popular or growing in popular. Clearly an outright lie or pure ignorance of what the available ISHRS data about the growth in FUE procedures indicates. Shouldn't a top doctor be paying attention to facts and statistics? One would hope so.

 

Again I think everyone agrees with the crux of Dr. Feller's argument as to why FUT is the better procedure for most, however there is clearly a lot of dishonesty and inflammatory, unrealistic rhetoric going on. There are FUE surgeons like Erdogan and Lorenzo who are consistently producing better results than 90% of FUT surgeons when looking at similar graft counts and hair textures, regardless of whether FUT is the better procedure.

[Dr Blake Bloxham]

Dr. Bloxham,

 

are you serious with this answer? So the three forces will not apply for small sessions and/or when going slow? In this case 99 % growth would be the norm for you? Much ado about nothing? (Cause if you find a solution for 100 grafts there are simple solutions for 1000 as well).

 

It is again very hard to align this with what Dr. Feller (and you) have stated in this very thread before.

 

Gas,

 

Regardless of what I post and how many times I genuinely have answered your questions, you continue to twist my words and post falsities.

 

I never said detrimental forces don't apply when going slow. In fact, I said the EXACT opposite. I stated that the forces are always apparent during FUE extraction. However, the best way to minimize trauma is to go slow and focus on small cases. Do you really think you can't be slower and more careful when you have to remove 100 grafts in a set amount of time versus 2,500 grafts in a set amount of time? If I told you that you had 2 minutes to walk 10 yards holding an egg on a spoon without dropping it, do you think you would break less if you could make several slow, careful trips with only a couple of them; or do you think you would break less if I said you had to rush as fast as you can and move dozens of them?

 

And sure you can extrapolate the same care with 2,500 grafts if you can do it with 100. All you need is about a month do to the surgery.

 

I'm very disappointed in your last few responses, and therefore this will be my last one to you.

[Dr Blake Bloxham]

Again I think everyone agrees with the crux of Dr. Feller's argument as to why FUT is the better procedure for most.

 

Excellent. Sharing this truth was the objective the entire time.

[Gasthoerer]

Dr. Bloxham,

You make it really hard to believe, that you are interested in a discussion. Your 180 ° turnaround doesn’t help either.

 

1. I'm very disappointed in your last few responses, and therefore this will be my last one to you.

In a discussion where several threads had to be closed and the mods had to step in several times, (and your own partner being the centre of all that) my words are now so “harsh” that you do not want to answer? Sound like a big time excuse to me.

 

Either you do not want to answer cause the answer does not fit your agenda or you do not know the answer.

 

2. Regardless of what I post and how many times I genuinely have answered your questions…

Regardless how often you repeat it, you do not have answered any of my questions (in this particular topic, in other topics you well have). These questions happened to be not only my own, but a collection from several users including Dr. Lupanzula. The key questions are so few, you could answer in 5 minutes. You just refuse to do it. Here are the (main) questions again:

 

Why is the FUT growth so low (86 %) in these studies. Why can you claim 98 % if the study you refer to claims much less?

 

Does the Beehner studies involve an automated fully rotating device (which would be the worst one can do, according to your own words)? Would this affect the FUE results, which were at terrible 61.4 %? Are the other “issues” like wrong storage of the grafts?

 

From the many numbers which Dr. Feller and you have posted. Which one do you finally see as average for FUE for a good candidate in a good clinic? Where does this number come from?

 

Does FUT (just by removing the strip) thins out the donor or will the density remain the same (which many members believe due to your statements)?

 

Is the reason that there are no FUE-mills in the US the “Failure to disclose damaged graft percentage” like posted from Dr. Feller?

 

3. … you continue to twist my words and post falsities. I never said detrimental forces don't apply when going slow. In fact, I said the EXACT opposite. I stated that the forces are always apparent during FUE extraction. However, the best way to minimize trauma is to go slow and focus on small cases.

Come one, I do not spin your clinic’s words. Dr. Feller said it loud and clear so many times (and you happily nodded in the video): The detrimental forces apply in FUE. No one has overcome them so far. These forces are the (major) reason that there is poor growth. Again the quotes of the different values:

 

Feller:“Growth rates from FUE usually start at 75% that of FUT and go well down from there”.

 

Feller:"What I can't understand is how the poorer growth guaranteed with the FUE…”

Feller: “Fut grafts 98% survival rate...fue grafts at best 85 %, more like 50 %”

 

You claim is now: The forces are still there, but the trauma can be minimized by going slow. You then expect (!) 99 % growth. 99 %! Before we were talking ranges between 50 – 70 %.

 

4. Do you really think you can't be slower and more careful when you have to remove 100 grafts in a set amount of time versus 2,500 grafts in a set amount of time? …All you need is about a month do to the surgery.

Honestly? Now, it is the time effect? I thought it is the “force”, which always occur and lead to the bad results? And no, you do not need a “month”: If Dr. Vories required 2 hours for 100 grafts (1.2 minutes per graft), one would need 6 days for 2500 grafts, when working 8 hours a day. Why not ask him how long he took for the 100?

 

And even if you do need that long: One could have several people working in parallel, one could do several sessions or … one could just practice. The Guitar hasn’t changed since decades and yet random teenagers in the internet master their instruments better (faster play with less errors) than the guitar heroes from the past (crazy analogy, but way better than yours about the "eggs").

Edited August 16, 2017 by Gasthoerer

[Rappy]

Thank you everyone. I'm not having a HT because of this thread. I'll just wait until something similar to FUE gets better.

[JayLDD]

Rappy, clearly you haven't understood anything from reading this thread. There will be no alternative to FUE or FUT, it is a physical impossibility.

 

Just get an FUT or go with a top FUE doctor like Lupanzula, Erdogan, Feriduni, Lorenzo etc.

[mav23100gunther]

Mav, I would just like to repost the following that you wrote because I believe it is important for Dr. Feller to answer.

 

"1) your position on FUE seems to just be based on your own experience performing the surgery

2) I understand that you have not attended an ISHRS or other conference in person in years

3) you appear to be unaware of who exactly the new and upcoming FUE surgeons actually are. Dr Lupanzula is a well respected FUE surgeon recommended by this very site and who actually presented/gave a demonstration at a FUE conference hosted by Erdogan in 2015 and which was attended by some heavy hitters like Shapiro, Wong, Feriduni, Lorenzo and others. Yet, you yourself admitted you had never heard of Dr Lupanzula until he posted on this thread.

4) I am not even convinced you have seen a live FUE from one of these top FUE surgeons in recent years. I could be wrong on this point. "

 

Not being aware of Erdogan and Lupanzula as a hair transplant doctor in 2017, especially considering their work on the research and FUE conference circuit is outright shameful. Not only is it a terrible look, but it looks very, very hard to believe. It looks like desperation, particular considering Dr. Feller's claims that FUE isn't popular or growing in popular. Clearly an outright lie or pure ignorance of what the available ISHRS data about the growth in FUE procedures indicates. Shouldn't a top doctor be payingo attention to facts and statistics? One would hope so..

 

He won't answer, defend or address these points because they are valid. Same reason he is complaining about me to the Moderators to get them to silence me. I am not questioning the factual accuracy of the information that he is putting out, but I do think he starts to lose credibility when one considers that it appears he is not following or staying on top of the recent advances in FUE or at least the execution of it, and therefore may no longer be in a position to then argue that FUE surgeons haven't been able to overcome his so called detrimental forces. At some point, basing the argument so heavily on one's own experience performing the surgery without careful consideration to what others may be doing - just doesn't cut it, and one quickly starts to lose credibility. He knows this, and I suspect that the fact I keep bringing it to light is one of the reasons he wants to silence me so badly.

Edited August 17, 2017 by mav23100gunther

[hairlosscpa]

What ever happened to mFUE? Wasn't that the so-called "alternative" to FUE with strip-like results? I'm surprised to barely see it mentioned at all anymore. Can Dr. Bloxham or Feller please expand on their results with mFUE? Thanks

[Dr Blake Bloxham]

What ever happened to mFUE? Wasn't that the so-called "alternative" to FUE with strip-like results? I'm surprised to barely see it mentioned at all anymore. Can Dr. Bloxham or Feller please expand on their results with mFUE? Thanks

 

Stay tuned.

[hairlosscpa]

Stay tuned.

 

Thanks!

[TrixGlendevon]

Stay tuned.

 

Dr Bloxham - I assume this means you or Dr Feller will be responding to this comment in the (hopefully) near future. If that is the case, can you outline exactly what it is please? To my untrained eye, it is just strip surgery i.e FUT. I don't see the difference at all.

[Gasthoerer]

To my untrained eye, it is just strip surgery i.e FUT. I don't see the difference at all.

 

There is an entire Thread about it! Why do we not discuss this topic there were it belongs? This will avoid confusion. There are enough unanswered questions here without mFUE.

[hairlosscpa]

There is an entire Thread about it! Why do we not discuss this topic there were it belongs? This will avoid confusion. There are enough unanswered questions here without mFUE.

 

Yeah a new thread is fine. There is a lot of talk from the clinic that FUE has not advanced at all, but apparently it's already been "modified" to obtain strip-like results - an advancement to remove the three detrimental forces. Therefore I was just surprised it has not been mentioned here.

[JayLDD]

MFue makes zero sense. Why in the world would one not just choose FUT if they were interested in Feller + Bloxham? Tried and true.

[Curious]

I am wondering what set of data Dr. Feller is using when he writes "Indeed, FUE causes 13 times the amount of vascular trauma," as compared to FUT surgery. How did you deduce that FUE causes 13 times the amount of trauma as opposed to say 2X or 5X or 9X, etc. Is it based on information in a peer reviewed medical journal?

[JayLDD]

It's probably cited from another US FUT surgeon pissed off he's losing business to European FUE surgeons, so they made the number up and threw it out there as medical literature.

[Curious]

I'll let Dr. Feller answer the question, as he made the representation.

 

I am also wondering how he came up with "25% sacrifice of grafts during FUE is a more likely optimistic figure."

[Gasthoerer]

Curious said:

I'll let Dr. Feller answer the question, as he made the representation.

 

Good luck, some others (inlcuding myself) wait for month to get some answers 😉

 

I am not sure if there is a study about it, but like HLS2015 said: Based on pure math it is clear that FUE greats more trauma/scarring even when the effects underneath the skin are not considered.

[Edsarn2017]

This has been previously posted- but we performed an FUE procedure into a large scar from a previous MRSA infection. 100 grafts were placed with implanter pens in a test case, and at 6 months we re-evalauted with a hair count. Out of the 100 grafts placed, 99 were actively growing at 6 months- into scar tissue. So while there maybe physical forces placed on the grafts during extraction, they have little impact on graft survival. We went to graft an additional 2500 FUE grafts into the scarring area. Here are the close-up photos of the test case and before and afters 6 months from the 2500 graft case.

 

I know I am just a layperson, but is this not game, set, and match to Dr Vories?

 

It will be interesting to see results of the Shapiro study, although they reported that early results indicated that FUE and FUT yielded the same results. I would take 99 grafts out of 100 all day long....great work Dr Vories!

[Gasthoerer]

I know I am just a layperson, but is this not game, set, and match to Dr Vories?

 

 

This is exactly what I was saying. If this study is "legit "then the "forces" can be overcome! End of story.

 

Only options coming to my mind that this debate is not over are:

- Was there a non-standard method used e. g. very large punch (which helped in yield but cannot be carried over to larger cases)

- This patient was an "outlayer" with very good characteristics

 

But the answer of Dr. Bloxham that he even expected this outcome speaks volumes.

[Gasthoerer]

Some members might remember the story about the “Interview” with Feller, Feriduni (as a FUE/FUT clinic) and myself, which finally never realized.

 

Nevertheless, I went to a second consult with Feriduni. Please be aware, I made an appointment for a consultation and not (!) an interview. Therefore, I only could ask some questions directly related to my case. I also did not record (of course) the discussion, but made notes before and after which I want to share. I also mentioned that I am in an online discussion about strip vs. FUE.

 

- Dr. Feriduni recommended FUE as the right procedure for me (same did Bisanga and Lupanzula but the latter is performing purely FUE so maybe that doesn’t count).

 

- This time I mentioned directly to Feriduni that I am open for strip if the results woud be significantly better

 

- I also mentioned, that in the past I always had my hair long enough to disguise a good strip scar

 

- Feriduni was confident that he could get results with FUE very close (or even similar) to his FUT and I had enough grafts available (which makes the lifetime graft count not a decisive factor for me)

 

- He mentioned that I am (most likely) a good FUE candidate (hair type)

 

- From what I understand it required many years (starting in 2003?) to come from 100-200 grafts a day to the numbers/results he does nowadays

 

- He also mentioned that he would defend his opinion (almost similar results with FUE vs. FUT ) against anyone and actually there is a lot of discussion in the FUE conferences about this topic

 

- Interesting point was that he told that on both sides (pro strip and pro FUE) there are “extremist” in both their opinion and their language (he mentioned the clinics names, but I will not publish them)

 

- He admitted that there is very poor scientific data (FUE vs. FUT) and we had a brief discussion about the scientific articles and how they are edited (would be worth an extra discussion).

 

- Interesting side note: Feriduni briefly explained different FUE extraction methods depending on the patients grafts (which helps reduce trauma but reduces grafts/session)

 

Background to put the recommendation of the clinics into context:

 

- I am 38 years old

- Currently require totally 2500-3000 grafts

- From my age and family history lifetime grafts required are ~ 5000 (if meds stop working)

- All clinics estimated around 10 000 grafts available via FUE (and above average thickness and number of multis)

As I am always suspicious and do not trust any doctor blindly (not Dr. Feller, not Dr. Bloxham nor Dr. Feriduni):

- I used the “coverage value” from Lorenzo/Erdogan to calculate the available grafts myself and also ended up with around 10 000 grafts

- Before I go for a big FUE session, I will do a minor fix for my W-Shape hairline (<300 grafts), which will hopefully tell if I am a good FUE candidate (how easy the grafts can be extracted)

- If I am not a good candidate I will do FUT for the major area (crown)

 

Maybe some will find this summary helpful.