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

[ThickGreenLawn]

Very interesting - thanks Gasthoerer. I've no idea who any of the 'extremists' might be! I was however hoping that this thread might have expired...

[TrixGlendevon]

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.

 

How long did you have to wait for the consultation with Doctor Feriduni?

[mikeyhwk]

Getting lol? suicide bombers are less committed to their cause than Dr Feller is to strip

 

but I would disagree, I think we're getting not just well reputed drs but the top doctors in the world coming down on the side of saying fue survival rates and yields are rivaling fut which DIRECTLY refutes what they're saying.

[JayLDD]

 

Much of the FUE vs FUT literature I have read on both sides is barely high school level and shows utter disdain for the scientific method and understanding of controlled variables. For example the Beehner study on FUE cited by Feller and Bloxham regards a surgeon who considers himself experienced and yet also claims to have performed less than 100 FUE surgeries in a decade. To believe anything a talented surgeon writes even if the work is utter garbage and the evidence does not reflect evidence it is nothing more than an appeal to authority fallacy.

 

We can look at the generalities on the other hand like the hundreds of Erdogan 5000-5500 graft cases on the international forums in which norwood 5s are achieving full coverage and the results are arguably more consistent than any FUT doctor in the world. When this extends beyond the hundreds (and failure rates or low yields below 2-3%) with doctors such as Lorenzo and Erdogan, you can no longer dismiss it as anecdotal evidence.

 

https://www.youtube.com/user/NUFCBLOGS/videos

International Hair Loss Forum - Dr. Koray Erdogan / ASMED SURGICAL CENTER : 5021 FUE

International Hair Loss Forum - Vladimir 83 : 4502 FUE - Dr Erdogan - 14 et 15/05/2014

International Hair Loss Forum - Djeetee: 5500 FUE - Dr Erdogan - 27&28/09/16

International Hair Loss Forum - Vanpierresi & p?re : 3000 & 5000 FUE - Dr Erdogan - 14/02/17

International Hair Loss Forum - XABABA : 3200 FUE - Dr. Koray Erdogan, ASMED

 

 

There are hundreds of these if you would like to look further.

 

Hair transplant surgery is primarily cosmetic, we can deduce that FUT is clearly the better procedure by the nature of dissection under a microscope vs blind removal of tissue, however the results of doctors like Erdogan and Lorenzo show that large megasessions and massive cosmetic improvements that equal and better 95% of FUT surgerons in aesthetics and yield is possible.

 

You cannot explain away all these cases with studies from American surgeons who are clearly having there business hit by superior and cheaper FUE surgeons who offer a more appealing service to the average patient (whether or not it is better). The studies are clearly inaccurate and high school level in many of their claims.

 

Erdogan and Lorenzo have some of the most readily available results to view online, feel free to disprove with evidence of failure rates, poor yield and cosmetic mediocrity by looking at their results. Citing study data done by FUT surgeons who are incompetent at FUE and against it for business reasons is piss poor evidence against genuine results.

 

Why are these and a number of other FUE surgeons such as Couto, Freitas, Lupanzula and Feriduni acheiving these results that so many highly intelligent and skilled FUT doctors claim is impossible? The explanation that it comes down to can be nothing other than competence. Why are doctors like Erdogan and Lorenzo able to get 6000-7000 on a regular basis from patients with no visible damage to the donor even with a fade cut? Why is there not a single case of an Erdogan 5000 with visible donor depletion when Feller claims this is impossible? Competence, experience and use of a manual punch. In regards to FUE, Feller lacks all of these in contrast to some of the top full time FUE surgeons. Either that, or he is simply lying.

 

The claim that FUE cannot rival FUT for high norwood work and achieving similar cosmetic results for similar graft numbers is blatantly disproven.

[tofur]

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.

 

 

The sketchy part of this is your assumption about future loss and how many grafts you'll need (requiring 2.5-3k now but assuming you'll only need 5k total over lifetime which is probably another 40 years of progressive loss), plus it's impossible to guess how bad your hair will get when fin stops working for you (not if, when). My hair isn't following any known family loss, it's earlier and worse. Also you say you don't blindly trust any doc but then seem to trust a doctor's coverage value equation in the next sentence.

 

Also 10k grafts from just FUE is pretty much unheard of, so unless you're in the very tippy top % of men then that's not right, most men get like 5-6k grafts before the donor starts getting that depleted look. If it sounds too good to be true... yeah you might actually be in that top % but I'd be very careful making plans on that.

[JayLDD]

The sketchy part of this is your assumption about future loss and how many grafts you'll need (requiring 2.5-3k now but assuming you'll only need 5k total over lifetime which is probably another 40 years of progressive loss), plus it's impossible to guess how bad your hair will get when fin stops working for you (not if, when). My hair isn't following any known family loss, it's earlier and worse. Also you say you don't blindly trust any doc but then seem to trust a doctor's coverage value equation in the next sentence.

 

Also 10k grafts from just FUE is pretty much unheard of, so unless you're in the very tippy top % of men then that's not right, most men get like 5-6k grafts before the donor starts getting that depleted look. If it sounds too good to be true... yeah you might actually be in that top % but I'd be very careful making plans on that.

 

The burden of proof is on you to disprove the coverage value system of Lorenzo and Erdogan, as they are the one consistently proving they can hit targets of 5000-7500 with FUE on average donors with no visible thinning. Likely over 1000 of these results visible online between them.

 

Provide evidence to the contrary in regards to RESULTS, or you simply come across as incompetent at arguing this. Bringing up Feller's complaints to argue against results is nothing more than an appeal to authority fallacy. It doesn't hold up to reality.

[tofur]

The burden of proof is on you to disprove the coverage value system of Lorenzo and Erdogan, as they are the one consistently proving they can hit targets of 5000-7500 with FUE on average donors with no visible thinning. Likely over 1000 of these results visible online between them.

 

Provide evidence to the contrary in regards to RESULTS, or you simply come across as incompetent at arguing this. Bringing up Feller's complaints to argue against results is nothing more than an appeal to authority fallacy. It doesn't hold up to reality.

 

Lol well the most obvious response is that the men in those countries naturally have thicker hair so those doctors will have more examples to show off. And just because they can get guy's donors to appear non-raped after 5-6k grafts (7k+ is rare) doesn't mean they can double that amount afterward. You provide us with hundreds of 10k graft FUE cases and maybe I'll agree that it's something a man can count on.

[JayLDD]

Lol well the most obvious response is that the men in those countries naturally have thicker hair so those doctors will have more examples to show off. And just because they can get guy's donors to appear non-raped after 5-6k grafts (7k+ is rare) doesn't mean they can double that amount afterward. You provide us with hundreds of 10k graft FUE cases and maybe I'll agree that it's something a man can count on.

 

Very few people require 10k grafts or would want to go through that many due to time and cost constraints so that is a moot, ridiculous point to make. Before it was an appeal to authority fallacy, now a move the goalposts fallacy.

 

The grand stupidity of what you said doesn't count the fact that you can still get an FUT, albeit with a lower yielding strip after you have extracted 5-6k FUE grafts.

 

Regardless, the hundreds Erdogan and Lorenzo 5000-7000 cases (many with Erdogan 5000 in a single two day session) and total lack of misfires prove the hypothesis of Feller wrong. FUE can, and does on a daily basis provide top notch megasession results for high norwood cases and many of the doctors doing so are just as consistent as any FUT surgeon in the world.

 

You can't argue against the results. Many doctors aren't talented or experienced enough to provide successful FUE that stands up to FUT, the problem is these arrogant doctors who blame it on the procedure type, not the procedure itself.

[tofur]

Very few people require 10k grafts or would want to go through that many due to time and cost constraints so that is a moot, ridiculous point to make. Before it was an appeal to authority fallacy, now a move the goalposts fallacy.

 

The grand stupidity of what you said doesn't count the fact that you can still get an FUT, albeit with a lower yielding strip after you have extracted 5-6k FUE grafts.

 

Regardless, the hundreds Erdogan and Lorenzo 5000-7000 cases (many with Erdogan 5000 in a single two day session) and total lack of misfires prove the hypothesis of Feller wrong. FUE can, and does on a daily basis provide top notch megasession results for high norwood cases and many of the doctors doing so are just as consistent as any FUT surgeon in the world.

 

You can't argue against the results. Many doctors aren't talented or experienced enough to provide successful FUE that stands up to FUT, the problem is these arrogant doctors who blame it on the procedure type, not the procedure itself.

 

"Total lack of misfires" lol just lol if you really believe that. They aren't gunna broadcast their failures or the patients who have raped donors and are shit out of luck when they inevitably lose their remaining native hair and need more grafts. And strips are horrible once you've raped the donor with FUE, you can't count on that giving you any appreciable amount of grafts once you've done that FUE damage. Also we are talking about total donor supply, no shit these FUE megasessions show some results, we are talking about when those guys lose their remaining native hair and need thousands more grafts to maintain their look, they aren't getting another 4-5k grafts out of that megasession FUE'd donor. This is especially pertinent for the young guys who Erdogan loaded 4-5k grafts into their frontal 1/3rd.

 

And the 10k graft number came from him hypothesizing that is what he has available and realistically NW 6/7 men need 10k at least to get a good result, every single case I've seen that's less then that would benefit immensely from thousands more grafts and quite frankly should've just shaved the remainder off and moved on, but that's their choice to make. And if you can't afford to move that many grafts you shouldn't have gotten a HT to begin with, no one can predict how bad your loss will get with the passage of time.

 

Finally, Dr. Konior told me that the way to max out donor is to strip out before FUE'ing out. IF you think you know more then that guy then you really are delusional.

[JayLDD]

"Total lack of misfires" lol just lol if you really believe that. They aren't gunna broadcast their failures or the patients who have raped donors and are shit out of luck when they inevitably lose their remaining native hair and need more grafts. And strips are horrible once you've raped the donor with FUE, you can't count on that giving you any appreciable amount of grafts once you've done that FUE damage. Also we are talking about total donor supply, no shit these FUE megasessions show some results, we are talking about when those guys lose their remaining native hair and need thousands more grafts to maintain their look, they aren't getting another 4-5k grafts out of that megasession FUE'd donor. This is especially pertinent for the young guys who Erdogan loaded 4-5k grafts into their frontal 1/3rd.

 

And the 10k graft number came from him hypothesizing that is what he has available and realistically NW 6/7 men need 10k at least to get a good result, every single case I've seen that's less then that would benefit immensely from thousands more grafts and quite frankly should've just shaved the remainder off and moved on, but that's their choice to make. And if you can't afford to move that many grafts you shouldn't have gotten a HT to begin with, no one can predict how bad your loss will get with the passage of time.

 

Finally, Dr. Konior told me that the way to max out donor is to strip out before FUE'ing out. IF you think you know more then that guy then you really are delusional.

 

You can't magically create new grafts by doing strip prior to FUE. Of course FUE may result in a small % (under 5) of transection doing extra damage to the donor, but most FUE doctors will not take more than 30-40% of the donor before they stop to overharvest. If you harvest 30-40% of the donor via FUE, a strip will yield 30-40% less at that point, but nonetheless you can still do strip after FUE.

 

The difference between smart people and stupid people is stupid people evaluate using opinions rather than using facts. Konior can't change the laws of mathematics. Grafts are either there or not, whether you opt for strip or FUE first will not make a huge difference. I agree if we are talking in about absolute maximum then FUT first will provide the best results, but overall it will make little difference if the transection rate is low.

 

"once you've raped the donor with FUE, you can't count on that giving you any appreciable amount of grafts once you've done that FUE damage."

 

A donor being raped is typically to do with an motorized punch and large scarring, in every single one of the Erdogan norwood 5 5000-7200 graft results I posted they could still get a sizeable FUT procedure.

 

If you have a donor supply of 5000 grafts with FUE up to 40% of donor removal, you extract 5000 with a 5% transection rate and then proceed to FUT, you will still get a strip that yields 60% as much. Argue with this all you like, what you're saying is pure stupidity and it makes no logical sense. A child can understand the basic maths here.

 

I don't know how to perform surgery as well as an FUT master like Dr. Feller or Dr. Konior, but I also lack the bias of being part of that industry and having my profits directly impacted by this debate subject.

 

Again, there are over a thousand results between Erdogan and Lorenzo available online, MOST of them patient posted that show FUE over the 5000 graft line and with results comparable to any strip surgeon. Ignore the patient posted results I offered on the last page and doing the research yourself if you like, but you come across like an ignorant idiot. If you think my statement about a total lack of misfires is inaccurate, then find some misfires and prove what you are saying.

 

"And the 10k graft number came from him hypothesizing that is what he has available and realistically NW 6/7 men need 10k at least to get a good result, every single case I've seen that's less then that would benefit immensely from thousands more grafts and quite frankly should've just shaved the remainder off and moved on, but that's their choice to make."

 

And more pure nonsense. I cannot believe you are still going on about this goalposts fallacy. The vast majority of patients aren't norwood 7, and the vast majority of norwood 5s and 6s are happy with results around or under the 5000 graft mark. You're honestly trying to say that FUE isn't a good procedure because it can't get 10000 grafts for the average patient? Why not just make it 20000?

 

FUE can't get 20000 grafts? Must be a shit procedure!

 

Seriously, I feel bad for humanity when I read posts as stupid as yours. Your level of understanding logical arguments and what constitutes evidence is below that of a cucumber. Take an epistemology course for real. All opinions and appeal to authorities, not one FACT.

Edited September 10, 2017 by JeanLDD

[ThickGreenLawn]

I had a feeling resurrecting this thread was a bad idea.

[JayLDD]

I had a feeling resurrecting this thread was a bad idea.

 

A combination of FUE and FUT will maximise donor capacity, the ordering of which not being particularly relevant, and cosmetic improvement, yield and consistency is correlated to the doctor, not the type of procedure.

 

There are more poor cases of FUE and less competent FUE doctors, however this again does not relate to the procedure itself.

 

Many of the surgeons who doubt the efficacy of FUE for megassessions are not skilled at FUE themselves as otherwise why can they not achieve the results of doctors like Couto, Lorenzo and Erdogan with the same consistency. Tellingly,very often those who criticise FUE megassessions utilise a motorised punch which is designed to make the job easier for an inexperienced doctor, not improve the results of the patient.

 

FUT overall will inevitably produce better results as it is not a blind procedure like FUE, however it is difficult to distinguish a difference in yield and cosmetic improvement comparing a top FUE and top FUT surgeon with the same amount of grafts, area covered and hair type. There is little evidence to suggest any top FUT surgeon is more consistent in their work and yield than any top FUE surgeon.

 

Choose based on the doctor and their consistency with getting results that fit your expectations, not specifically the type of procedure, although the higher the norwood, poorer the donor and if unmedicated then the benefits of FUT become more apparent.

 

End of story.

[jjsrader]

I like this thread!

 

Just one thing, those w/fine hair and a bit lower density w/less avg. hairs per follicle (on avg.) and that are losing their hair at age 25 or younger - watch out!

 

I've been on minoxidil since the early 90's and am now using 30% minox compounded from a pharmacy the last 18+ months, been on propecia since about '96 or '97 and switched to avodart in '02. Use a 400+diode laser helmet since June '17 (high quality), been using nizoral 2% shampoo for 15+ years & have had 8,500 grafts done since '91. Last two surgeries were 2250 fut in 2004 and 5000 fut in March '17.

 

I'm 50 and have been losing my hair since probably age 21. It NEVER stops - regardless of how hard you try.

 

It's a progressive disease. Young guys 'hope' they have stabilized, and sure - at times you will.

 

Hair transplants for at least 50% are a lifetime commitment if you want really good results and you don't have thick/dense Spanish or Italian or Mediterranean hair.

 

Ever seen Indian or Asian guy's hair? It's poor in density and thickness and overall quality.

 

It's a long road and MANY guys even w/early hair loss will see what I am writing about once you hit your 40's (hairloss can accelerate no matter what) once you've been on drugs/lotions for 15+ years.

 

Good luck and yea; I'm gonna' do a couple FUE surgeries AFTER my final fut surgery next year. I'm hoping I have another 2-3K left in FUT.

 

peace

[Gasthoerer]

 

ThickGreenLawn said:

Very interesting - thanks Gasthoerer. I've no idea who any of the 'extremists' might be! I was however hoping that this thread might have expired...

Maybe I really made a mistake. The main point of my post was the origin of my discussion with Dr. Feller: Would a reputable FUT/FUE clinic recommend FUE first (only)? The answer is here for everyone to see. Seems everyone is now focusing on this badly chosen word.

tofur said:

The sketchy part of this is your assumption about future loss and how many grafts you'll need … it's earlier and worse. Also you say you don't blindly trust any doc but then seem to trust a doctor's coverage value equation in the next sentence.

 

Also 10k grafts from just FUE is pretty much unheard of ... yeah you might actually be in that top % but I'd be very careful making plans on that.

You are right with your questions. Of course the 5000 FU is just an assumption (maybe I did not made that clear enough). But my hairloss is very a-typical and it is exactly as my fathers. Also, I am almost 40 years old and I responded well to FIN. I know it is an estimate, but let us call it an estimated guess by 3 clinics who saw me in person and also reviewed my family pics.

10 000 FU is on the top end, you are right. But 3 recommended clinics came to this conclusion and I still (!) recalculated it with a tool provided by a 4th clinic (which was presented in an international hair transplantation workshop), based on the measurements by the clinics. What else can I do?

Also, I am above average in density in all 3 areas (~100 FU/cm2) and above in density and number of multis. My donor is soo thick, it makes the rest of the hair look even weaker 😕

TrixGlendevon said:

How long did you have to wait for the consultation with Doctor Feriduni?

6 month!

You are one of the most dedicated an experienced members, but also one of the most “outspoken”. I doubt that I can change your mind and I accept your opinion. We just have to agree to disagree.

IMO Dr. Feller/Bloxham refuted themselves when they said they expect 99 % growth in a minor case. It is simple: Either the 3 forces can be overcome or they cannot. Obviously they can!

[Gasthoerer]

You can't magically create new grafts by doing strip prior to FUE.

 

I like your math approach, especially as some members an even clinics have proven to have some major issues with math (to calculate %, to distinguish between % and %-point, to calculate density). However, in your approach, you might (!) miss the point of e. g. donor laxity. If FUE reducses laxity due to scaring then this could explain the benefit of FUT first and FUE later.

 

It is just a comment, as ifetime grafts is not my main concern, I did not focus on it.

[Gasthoerer]

Finally, Dr. Konior told me that the way to max out donor is to strip out before FUE'ing out. IF you think you know more then that guy then you really are delusional.

 

I personally do agree with this: "FUT first, FUE later" gives you most lifetime grafts.

 

But: Your argument is weak.

 

Ok, Konior says so, but *** says otherwise.

Feller claims sth. and Lupanzula claims otherwise.

Who can we believe? That is the basline of this entire discussion.

 

We have to make our own mind, based on the data we have.

[JayLDD]

Gasthoerer said:

I like your math approach, especially as some members an even clinics have proven to have some major issues with math (to calculate %, to distinguish between % and %-point, to calculate density). However, in your approach, you might (!) miss the point of e. g. donor laxity. If FUE reducses laxity due to scaring then this could explain the benefit of FUT first and FUE later.

 

It is just a comment, as ifetime grafts is not my main concern, I did not focus on it.

 

Definitely, I think overall lifetime grafts isn't as much of an issue for the majority of patients as some people make out though. With competent surgeons and a combination of FUE and FUT the average patient is able to obtain well into the 7000 area, and the potential of BHT and SMP for the illusion of more density makes money the greater issue than just donor numbers. Most people on this forum never get close to reaching their donor potential, even more moving into BHT transplant or SMP.

 

The only times I see that this isn't the case is for abnormally poor donor areas or cases where you have an incompetent technician with a motorised punch doing major damage that wouldn't happen with an experienced surgeon or appropriately sized manual punch.

 

Agree with your laxity comment in regards to FUE too, interested what most surgeons think of this but I've seen a Bisanga rep suggest it isn't a major issue if it is performed competently.

[fortune11]

I like jsrader's post -- HT is a lifelong commitment. Young'uns who can't stop gushing about their latest FUE miracle will have a different story to tell once they hit their late 40s / 50s

 

I have gone through both FUT and FUE and my experience so far (at 10 months post op FUE) -- FUT was much much better growth than my current FUE . I had obviously no choice since my scalp was tight and " stripped out" but would I go through another FUE ? Probably not. My only hope is that my hair stays somewhat. "style-able" and I don't look like a combover freak in the next 10 years.

 

Unless you are absolutely sure you won't progress beyond a NW3-4 - FUT is the only route . I doubt if long term hair loss ever stabilizes at NW4 . People I know for 20 years who I initially thought were a NW3 now look like NW6 - their only option is to shave their head , or embark on a long and obvious HT journey.

[JayLDD]

I like jsrader's post -- HT is a lifelong commitment. Young'uns who can't stop gushing about their latest FUE miracle will have a different story to tell once they hit their late 40s / 50s

 

I have gone through both FUT and FUE and my experience so far (at 10 months post op FUE) -- FUT was much much better growth than my current FUE . I had obviously no choice since my scalp was tight and " stripped out" but would I go through another FUE ? Probably not. My only hope is that my hair stays somewhat. "style-able" and I don't look like a combover freak in the next 10 years.

 

Unless you are absolutely sure you won't progress beyond a NW3-4 - FUT is the only route . I doubt if long term hair loss ever stabilizes at NW4 . People I know for 20 years who I initially thought were a NW3 now look like NW6 - their only option is to shave their head , or embark on a long and obvious HT journey.

 

Tell that to this guy

 

International Hair Loss Forum - Djeetee: 5500 FUE - Dr Erdogan - 27&28/09/16

 

It is purely a numbers game.

[tofur]

I like this thread!

 

Just one thing, those w/fine hair and a bit lower density w/less avg. hairs per follicle (on avg.) and that are losing their hair at age 25 or younger - watch out!

 

I've been on minoxidil since the early 90's and am now using 30% minox compounded from a pharmacy the last 18+ months, been on propecia since about '96 or '97 and switched to avodart in '02. Use a 400+diode laser helmet since June '17 (high quality), been using nizoral 2% shampoo for 15+ years & have had 8,500 grafts done since '91. Last two surgeries were 2250 fut in 2004 and 5000 fut in March '17.

 

I'm 50 and have been losing my hair since probably age 21. It NEVER stops - regardless of how hard you try.

 

It's a progressive disease. Young guys 'hope' they have stabilized, and sure - at times you will.

 

Hair transplants for at least 50% are a lifetime commitment if you want really good results and you don't have thick/dense Spanish or Italian or Mediterranean hair.

 

Ever seen Indian or Asian guy's hair? It's poor in density and thickness and overall quality.

 

It's a long road and MANY guys even w/early hair loss will see what I am writing about once you hit your 40's (hairloss can accelerate no matter what) once you've been on drugs/lotions for 15+ years.

 

Good luck and yea; I'm gonna' do a couple FUE surgeries AFTER my final fut surgery next year. I'm hoping I have another 2-3K left in FUT.

 

peace

 

Yeah I see way too many guys who seem to only care about/focus on the present and the near future when the reality is that they have 40-70 years of life left and this shit is progressive in nature while the transplanted hairs most likely are permanent. It's a recipe for disaster if you go about it the wrong way and I see sooo many young guys dense packing their newfound NW 2.5-3 hairline back to a NW 0-1 with 2500-3k FUE (I see 4-5k too which is really bad). That bitch is gunna keep going and likely the midscalp and/or crown will go as well. The grafts add up quick.

 

 

 

I like your math approach, especially as some members an even clinics have proven to have some major issues with math (to calculate %, to distinguish between % and %-point, to calculate density). However, in your approach, you might (!) miss the point of e. g. donor laxity. If FUE reducses laxity due to scaring then this could explain the benefit of FUT first and FUE later.

 

It is just a comment, as ifetime grafts is not my main concern, I did not focus on it.

 

The guy tried to talk down Konior for fuck's sake. Talk about arrogant, you think you know better then a surgeon of that caliber as a layman then you've got serious issues. There's more to it then just pure graft numbers and %'s, I'm layman as fuck and even I know it comes down to scarring/fibrosis/damage to the existing grafts left behind/etc.

[JayLDD]

Yeah I see way too many guys who seem to only care about/focus on the present and the near future when the reality is that they have 40-70 years of life left and this shit is progressive in nature while the transplanted hairs most likely are permanent. It's a recipe for disaster if you go about it the wrong way and I see sooo many young guys dense packing their newfound NW 2.5-3 hairline back to a NW 0-1 with 2500-3k FUE (I see 4-5k too which is really bad). That bitch is gunna keep going and likely the midscalp and/or crown will go as well. The grafts add up quick.

 

 

 

 

 

The guy tried to talk down Konior for fuck's sake. Talk about arrogant, you think you know better then a surgeon of that caliber as a layman then you've got serious issues. There's more to it then just pure graft numbers and %'s, I'm layman as fuck and even I know it comes down to scarring/fibrosis/damage to the existing grafts left behind/etc.

 

So Dr. Feller is correct when he says the yield of FUE is in the average range of 75% and that no more than 1500 grafts should be extracted on any donor via FUE? Being a doctor doesn't mean they are immune from saying stupid, inaccurate and baseless statements. I didn't talk down Konior either, I said he is correct if we want to talk about absolute maximum donor capacity, but as a generality it doesn't make a huge difference.

 

Finasteride has a multi-decade efficacy and 80-90% respond with maintenence quoted by various studies. You don't care about statistics or facts clearly, but the facts say that if are if you're a norwood 3 and you get on finasteride you won't lose the rest for decades.

 

International Hair Loss Forum - Djeetee: 5500 FUE - Dr Erdogan - 27&28/09/16

 

And please, explain this case of a full blown norwood 6 to a norwood 1 with FUE if graft numbers are such an issue? Very few patients require more than 7000 grafts for full coverage and average density.

 

What can I say though, you have the intellect of a dead goldfish.

[tofur]

So Dr. Feller is correct when he says the yield of FUE is in the average range of 75% and that no more than 1500 grafts should be extracted on any donor via FUE? Being a doctor doesn't mean they are immune from saying stupid, inaccurate and baseless statements. I didn't talk down Konior either, I said he is correct if we want to talk about absolute maximum donor capacity, but as a generality it doesn't make a huge difference.

 

Finasteride has a multi-decade efficacy and 80-90% respond with maintenence quoted by various studies. You don't care about statistics or facts clearly, but the facts say that if are if you're a norwood 3 and you get on finasteride you won't lose the rest for decades.

 

International Hair Loss Forum - Djeetee: 5500 FUE - Dr Erdogan - 27&28/09/16

 

And please, explain this case of a full blown norwood 6 to a norwood 1 with FUE if graft numbers are such an issue? Very few patients require more than 7000 grafts for full coverage and average density.

 

What can I say though, you have the intellect of a dead goldfish.

 

Lmao you're a clown bro. The longest study on fin was 10 years and you're here spouting off "decades" as if there's any evidence supporting that claim and have the balls to call me stupid in the same post. Might wanna look in the mirror, you're projecting.

 

The absolute general consensus is that you will start losing ground around the 10-15 year mark on fin, countless guys have experienced this to the point where it's odd to find a guy who hasn't lost ground by that point. There's also tons of guys who start losing ground after a couple years even though studies show most guys get a nice bump above baseline in the first 2 years then start a slow steady march back to baseline by year 5 or so (guess where they go after that...), it's not a magic bullet medicine it can stop working tomorrow and you're fucked.

 

You won't find me ever defending Feller on his 75% claim and you're trying to run a false equivalency by lumping FUT focused doctors in with ones like Konior who is great at both and does a lot of both, talk about moving the goalposts. We were talking about Konior, a surgeon who does both methods very well and charges out the ass for FUE so he has a vested interest in pushing it but he still will tell a prospective client that they should strip out first if they are looking like they'll need all available donor. Your attempt to minimize the graft difference is pathetic though not at all surprising.

[JayLDD]

Lmao you're a clown bro. The longest study on fin was 10 years and you're here spouting off "decades" as if there's any evidence supporting that claim and have the balls to call me stupid in the same post. Might wanna look in the mirror, you're projecting.

 

The absolute general consensus is that you will start losing ground around the 10-15 year mark on fin, countless guys have experienced this to the point where it's odd to find a guy who hasn't lost ground by that point. There's also tons of guys who start losing ground after a couple years even though studies show most guys get a nice bump above baseline in the first 2 years then start a slow steady march back to baseline by year 5 or so (guess where they go after that...), it's not a magic bullet medicine it can stop working tomorrow and you're fucked.

 

You won't find me ever defending Feller on his 75% claim and you're trying to run a false equivalency by lumping FUT focused doctors in with ones like Konior who is great at both and does a lot of both, talk about moving the goalposts. We were talking about Konior, a surgeon who does both methods very well and charges out the ass for FUE so he has a vested interest in pushing it but he still will tell a prospective client that they should strip out first if they are looking like they'll need all available donor. Your attempt to minimize the graft difference is pathetic though not at all surprising.

 

You're the one who claimed that FUE couldn't achieve 10000 grafts and therefore isn't a good procedure, and yet I'm the clown?

 

You then claim anecdotal evidence about finasteride wearing off means anything? "The absolute general consensus"? You mean what you made up? And how in the world is 15 years of stability not worth it for someone in their 20s as a norwood 3 getting an aggressive hairline procedure?

 

I also never lumped Konior's claims in with Feller, and I asserted this in the last comment very clearly. You lack basic reading comprehension skills.

 

You're a scummy idiot plain and simple. It's bad enough you argue so poorly, but you misrepresent everything I say and move the goal posts every post you make.

[tofur]

You're the one who claimed that FUE couldn't achieve 10000 grafts and therefore isn't a good procedure, and yet I'm the clown?

 

You then claim anecdotal evidence about finasteride wearing off means anything? "The absolute general consensus"? You mean what you made up? And how in the world is 15 years of stability not worth it for someone in their 20s as a norwood 3 getting an aggressive hairline procedure?

 

I also never lumped Konior's claims in with Feller, and I asserted this in the last comment very clearly. You lack basic reading comprehension skills.

 

You're a scummy idiot plain and simple. It's bad enough you argue so poorly, but you misrepresent everything I say and move the goal posts every post you make.

 

You really gotta lay off the personal attacks, makes you sound like a petulant little child.

 

I didn't say it's not a good procedure because it can't achieve 10k grafts, why do you insist on continuing to project your own brand of bullshit onto others? It's a great procedure for the right situations, consistently getting 10k grafts out of a donor is not it's thing, in fact getting more then 5-6k grafts isn't it's thing. It has advantages but total graft count isn't one of them. Of course there are exceptions but it'd be a mistake for guys to assume they are that, rules are rules for a reason.

 

You conveniently ignored my pointing out of the landmark study that showed guys are back at baseline after 5 years of fin, you get around 2 years of a increased hair count then it's all downhill from there. Fin delays and slows down the inevitable, it doesn't stop it. You're one of the lucky ones if you make it 15 years without losing ground. Now hopefully there's something else on the market to replace fin by that point but you can't rely on that potentiality that much, guys 15 years ago probably thought there'd be something else by now but here we are, relying on fin still.

 

15 years (or less) will come and go then all that hair that it's been holding for you behind that NW0-1 dense pack will be vacating your head. The transplants will remain. You now have to match that density across your whole damn head to avoid a really unnatural appearance (basically the opposite of natural balding where the front thins into the middle of your head, you'll have a thick front and thin middle/back). You don't have the grafts to do that, starting the hairline that low increases the surface area to cover dramatically and you've already used a large chunk of your donor. It's not a good situation.

[JayLDD]

You really gotta lay off the personal attacks, makes you sound like a petulant little child.

 

I didn't say it's not a good procedure because it can't achieve 10k grafts, why do you insist on continuing to project your own brand of bullshit onto others? It's a great procedure for the right situations, consistently getting 10k grafts out of a donor is not it's thing, in fact getting more then 5-6k grafts isn't it's thing. It has advantages but total graft count isn't one of them. Of course there are exceptions but it'd be a mistake for guys to assume they are that, rules are rules for a reason.

 

You conveniently ignored my pointing out of the study that showed guys are back at baseline after 5 years of fin, you get around 2 years of a increased hair count then it's all downhill from there. Fin delays and slows down the inevitable, it doesn't stop it. You're one of the lucky ones if you make it 15 years without losing ground. now hopefully there's something else on the market to replace fin by that point but you can't rely on that potentiality that much, guys 15 years ago probably thought there'd be something else by now but here we are, relying on fin still.

 

15 years will come and go then all that hair that it's been holding for you behind that NW0-1 dense pack will vacate your head. The transplants will remain. You now have to match that density across your whole damn head to avoid a really unnatural appearance (basically the opposite of natural balding where the front thins into the middle of your head, you'll have a thick front and thin middle/back). You don't have the grafts to do that, starting the hairline that low increases the surface area to cover dramatically.

 

"Lmao you're a clown bro"

 

nek minit

 

"You really gotta lay off the personal attacks, makes you sound like a petulant little child. "

 

"You provide us with hundreds of 10k graft FUE cases and maybe I'll agree that it's something a man can count on."

 

nek minit

 

"I didn't say it's not a good procedure because it can't achieve 10k grafts"

 

"You conveniently ignored my pointing out of the study that showed guys are back at baseline after 5 years of fin,"

 

*Didn't actually point out a specific study

 

"You don't have the grafts to do that, starting the hairline that low increases the surface area to cover dramatically."

 

Despite the fact that 5500 grafts at 55 microns can give dense and full coverage on a norwood 6:

 

International Hair Loss Forum - Djeetee: 5500 FUE - Dr Erdogan - 27&28/09/16

 

 

I reiterate, you are not a smart person, and it seems not smart enough to argue with. You are a worm.

Edited September 11, 2017 by JeanLDD