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

[Spidey]

This was a low blow and uncalled for.

 

By the way, it is posts just like this that explain why doctors will not participate on chat forums. Congratulations.

 

You're the one that created this thread. You've done it before so you should know what to expect. Other doctors don't need to participate because they let their results speak for themselves. You however, find the need to bash fue over and over in order to try to cling on to as many potential fut clients are possible. Seems like your fue needs refining or else you wouldn't try to promote fut as hard as you are. By no means should any patient who requires less than 2000 grafts and wants to keep their hair at a number 2 or shorter settle for fut. The reason there are lot of bad fue results is because of unethical drs and bargain hair mill clinics who have crap level of accountability and ethics. Just like there are crap fut surgeons out there producing bad scars and unnatural results.

[Dr. Alan Feller]

Other doctors don't need to participate because they let their results speak for themselves.

 

I'm afraid that's not what doctors say behind the scenes. Your doctor included.

 

Should I warn Dr. Lupenzula to remove his thread because, according to you, he should just let his results speak for themselves ?

[Dr Blake Bloxham]

Dr Lupanzula,

 

Thank you for entering the conversation. You're the first doctor to do so in this manner, and it's great to have a second opinion on the debate. I know this will be very valuable for the community.

 

Furthermore, I appreciate that you've clearly outlined a very well thought-out and civil response. Again, thank you. As I'm sure everyone is aware, these conversations can be heated and sometimes unravel far past the point of civility.

 

Additionally, your FUE technique appears top-notch. I've had the opportunity to experiment with a number of different tools, techniques, and approaches, and see the results from the same protocols, and I can say without a doubt that the way you are performing FUE is the same way we advocate it be performed AND it is the best approach possible: slow, meticulous, manual FUE, and gentle two-handed forcep delivery (Dr. Feller also likes a one handed delivery with a needle perforation technique, which I think works well too, but I personally prefer the two handed approach).

 

Because I have worked with this issue extensively in both the online and real surgical world myself, I wanted to take this excellent opportunity to discuss several of the points below. I also fully accept that as you said below, no "man is an island," and I don't claim to know absolutely everything there is to know about FUE. So I do hope my comments are taken in the spirit of true scientific debate and not personal digs, and I truly hope you will indulge me and reply:

 

Dr. Feller is 100% correct that these forces exist during every FUE procedure, on every follicle. I think that it is only common sense that such forces will exist on a follicle during an FUE procedure.

 

Thank you for admitting these. Believe it or not, I believe you are the first to do so. This fact has either been glossed over or blatantly denied in the past.

 

Torsion - This is the reference to how follicular units are subject to the torsional forces of rotation as the punch presses through the skin in order to free the follicular unit from the scalp. I believe that this is a problem mainly with the continuous rotation FUE tools on the market. With an oscillating rotation driven by the thumb and forefinger, torsion is not an issue if the rotational distance traveled is short and performed with an experienced hand. Torsion still exists, but it is greatly reduced in it’s severity thus having an equally reduced degree of trauma.

 

Agreed. Torsion is truly the enemy with full rotary and not oscillary arc tools, and it's exponentially worse with motorized tools. It's also only logical that smaller depth and shorter oscillation time means less torsional damage; however, when one force is reduced it usually necessitates greater force from one of the other two enemies -- compression or traction. In this case, the more minimal the depth, the more attachment of the FU and the more traction necessary to free it. And this includes instances, in my opinion, where the arrector pili muscle is cut.

 

Compression is a very real problem and technicians, and even doctors, will routinely squeeze the graft far too hard, and too far down the length of the follicle, to allow for consistent and healthy growth. This occurs not only with extraction but it is a problem with recipient site placement as well, for both FUE and FUT respectively. When I extract each graft after I score, I use reverse traction by holding the top of the graft at the very upper edge of the tissue thereby avoiding most of the follicle.

 

This does sound like a very effective way to reduce compression forces. But it circles back to something I personally learned when transitioning from writing about FUE online to performing FUE in the real world: sometimes the theoretical doesn't pan out in the real world.

 

In this video, a graft is being delivered at 2:11 (and several right after). As you can see, while the initial grasp of the forcep is very superficial and near the epidermis, as tension is applied to the graft the second forcep grasps lower on the follicle. Even with a gentle grasp, this area is clearly outside of the region defined above. And although it is more superficial, it could still clearly be near the crucial bulge stem cell region (which is around 1.5-2mm deep). The graft is then grasped further and further down -- a sort of "hand over hand" motion -- as it is delivered.

 

 

Now, as I stated above, I think your protocols are about as refined as they come. And what's even better is that YOU are the one actually performing the surgery, but my point is that often times the reality of patient physiology flat out destroys the theoretical approaches in FUE.

 

Traction - This has perhaps the highest chance of causing real damage to the follicular unit but with practice and experience it is not an issue of debilitating circumstance. The bulbs are usually intact as long as the arrector pili muscles have been cleanly severed (best with a very sharp punch) and they come out fairly easily. This is of course not always the case but a proper surgeon will take their time at the beginning of the procedure to properly assess the patient, their grafts, the supporting tissue, and how it all works together. In most cases, the patient is a candidate with very few limiting factors.

 

I completely agree that traction is what causes the most damage. I think the others can be creatively limited, but it's the traction pull that causes the most damage. I also think if we go back to Bernstein and Rassman's original FOX testing papers, that the dermal attachments -- which cannot be known until a few test grafts are performed -- play a significant role in the amount of traction necessary regardless of whether or not the muscle is fully transected. If this wasn't the case, we should see almost no skin tenting or resistance when delivering grafts, but this is clearly seen in even the most gentle delivery.

 

Skeletonization is one stated side effect of traction but I believe that this is no different than the skelontization that occurs from subdividing follicular units (turning multi-hair grafts into singles and doubles) during strip surgery. It is well known in the community that this is routine procedure for some strip clinics, and the pros and cons of such procedures have been debated before, in forums and in the ISHRS.

 

This is the only part where I really disagree. I think it's been effectively proven that "skinnier" grafts grow worse. Dr. Beehner did an excellent study on this. No need to even dive into this. But I think it's a tough sell to state that microscopic dissection of grafts from a strip causes the same amount of skeletonization as FUE delivery. I'm going to include some images below that highlight the difference in appearance.

 

FUE Grafts:

 

 

 

 

FUT Grafts:

 

 

As one can clearly see from the pictures, not only is the amount of skeletonization vastly different, but the distribution is different as well. You can physically see how low each FUE graft was scored and where the punch stopped and delivery began because that's where the correct amount of supportive tissue stops.

 

Now, debating the impact of this is a whole different story, but I do not believe microscopic dissection post-FUT comes anywhere close to mimicking the tissue depletion post-FUE graft delivery.

 

That is why the WFI was formed and it represents the philosophy that I and the other founding members have shared for several years. We share with each other and we learn from each other.

 

While I completely agree with working together and the process of ongoing learning in medicine, this is not why the WFI was formed. And I think every ISHRS member knows that. I'll leave it at that.

 

Again, thank you for sharing. I do hope you will reply.

[Dr. Alan Feller]

Just tried to post my response to Dr. L but caught in the filter.

[Dr. Alan Feller]

I can appreciate that there are opinions about FUE and FUT that vary and the discussions have been quite passionate. I have performed both procedures for over ten years so I understand both sides of the argument quite well. However, the main argument against FUE here and elsewhere, as presented by Dr. Feller, is that there are three detrimental forces that act on the follicle during an FUE procedure that prevent said follicle from growing as well as a follicle harvested with the FUT technique.

 

These forces are:

 

Torsion

Compression

Traction

 

Dr. Feller is 100% correct that these forces exist during every FUE procedure, on every follicle. I think that it is only common sense that such forces will exist on a follicle during an FUE procedure. However, I do not agree that these forces cannot be overcome nor should they automatically be expected to lead to a subpar result when compared to an equal size strip surgery.

 

Torsion - This is the reference to how follicular units are subject to the torsional forces of rotation as the punch presses through the skin in order to free the follicular unit from the scalp. I believe that this is a problem mainly with the continuous rotation FUE tools on the market. With an oscillating rotation driven by the thumb and forefinger, torsion is not an issue if the rotational distance traveled is short and performed with an experienced hand. Torsion still exists, but it is greatly reduced in it’s severity thus having an equally reduced degree of trauma.

 

Compression - This is in reference to forceps and how they are used to pull the follicular unit from the scored tissue. As I see it, you either understand how to handle a graft or you do not. Compression is a very real problem and technicians, and even doctors, will routinely squeeze the graft far too hard, and too far down the length of the follicle, to allow for consistent and healthy growth. This occurs not only with extraction but it is a problem with recipient site placement as well, for both FUE and FUT respectively. When I extract each graft after I score, I use reverse traction by holding the top of the graft at the very upper edge of the tissue thereby avoiding most of the follicle. This is safe to do because we all know that the follicle, even slightly below the epidermis can be safely cut through and regrow without permanent damage, as is seen in trichophytic closures in strip surgery that have been performed for the past decade.

 

Traction - This has perhaps the highest chance of causing real damage to the follicular unit but with practice and experience it is not an issue of debilitating circumstance. The bulbs are usually intact as long as the arrector pili muscles have been cleanly severed (best with a very sharp punch) and they come out fairly easily. This is of course not always the case but a proper surgeon will take their time at the beginning of the procedure to properly assess the patient, their grafts, the supporting tissue, and how it all works together. In most cases, the patient is a candidate with very few limiting factors.

 

Skeletonization is one stated side effect of traction but I believe that this is no different than the skelontization that occurs from subdividing follicular units (turning multi-hair grafts into singles and doubles) during strip surgery. It is well known in the community that this is routine procedure for some strip clinics, and the pros and cons of such procedures have been debated before, in forums and in the ISHRS.

 

As with anything in medicine, practice makes perfect. I believe that no man is an island and that when working together with like minded practitioners, the problems we cannot overcome alone, can be overcome together. This is why in my early career I spent a lot of time working with and observing many other doctors to learn their techniques so that I could incorporate the best of their techniques into my own, along with my own modifications of course. I still make sure to attend every ISHRS annual meeting where improvements and ideas are shared and learned, and now the World FUE Institute (WFI) meetings where we are constantly sharing and pushing to improve not only our tools but our techniques in surgical workshop settings. Our next meeting is this month in Athens, Greece.

 

In the end, good FUE is performed by good hands that understand the challenges inherent to FUE but have worked with peers and colleagues to figure out that these challenges cannot be overcome with brute force, but rather a combination of approaches and ideas to coax each follicle out in the safest manner possible. This is an evolution representative of our current time in history, in that practitioners are no longer toiling away in secret, with the blinds pulled down over their windows, to find the perfect solution, but instead are now collaborating with like minded professionals and industry leaders in the interest of advancing the field as a whole. That is why the WFI was formed and it represents the philosophy that I and the other founding members have shared for several years. We share with each other and we learn from each other.

 

In my practice, I very rarely perform strip surgery as it is no longer indicated for the majority of my patients and, quite frankly, no one wants it. The procedure is scary for patients, of course, but no one wants the linear scar, regardless of how fine it may be because they know that this cannot be guaranteed. I score and extract each and every graft myself as I believe it is my responsibility to my patient. My technicians place into recipient sites I create and they examine and refine all of my grafts under microscopes, as it should be, before they are put into a solution of Hypothermosol. I do not take shortcuts and I have taken the time to learn my craft well. For this I believe my results are just as good as any comparable size strip surgery and I believe I have the track record to support this opinion. Again, I understand and agree with Dr. Feller that these three forces he lists do exist, indeed, but I do not agree that these forces automatically spell disaster of any degree for one’s final result. Thank you.

 

Dr. L, I appreciate you joining me on this thread and this topic. I truly do. Even if we don't agree or find common ground it is beneficial to everybody to have this discussion in the open.

 

I read your post very carefully a few times and have to say with respect that you haven't written anything new nor anything I have responded to in the past. I have heard these same things stated by different FUE doctors for 17 years now.

 

Before I start I want to ask if you classify yourself as an FUE-only clinic or as an FUT/FUE clinic ? That is, are you performing FUT regularly ?

 

I want to thank you very much for acknowledging the three detrimental forces of FUE. In 2002 these forces were not known by the names I've given them but they were acknowledged and addressed by several doctors seeking to overcome them. Then, around 2009 doctors began to deny and seemingly ignore their existence or only referenced them as mere footnotes not worthy of attention. See my thread with Dr. Bhatti.

 

The following quote is where our differences begin:

"However, I do not agree that these forces cannot be overcome nor should they automatically be expected to lead to a subpar result when compared to an equal size strip surgery."

 

I never claimed that the detrimental forces couldn't be overcome. I believe they can. What I said is that they haven't been overcome. And they won't be for the foreseeable future.

 

The very best way to perform an FUE is the very way you describe that you do it in your own clinic: a manual punch for scoring with meticulous and patient delivery (extraction) techniques.

 

Where we differ in this quote is that detrimental forces of FUE should most certainly and automatically be expected to lead to subpar results just based on the common sense alone that you yourself acknowledged in your post.

 

But if that's not enough let's turn to the textbook: Hair Transplantation 4th Edition, U.nger/Shapiro. In Chapter 9 page 261 an entire chapter is dedicated to "Graft Survival, Growth, and Healing Studies" where the delicate nature of the graft is described as well as the importance of careful handling.

 

And again, on page 355 an entire section entitled "Classic Microscope Dissection of Follicular Units" was written by my friend and mentor the late great David Seager who despised FUE. The very first line of the section reads "Follicular unit micrografts are so small and fragile that the aid of microscopes for their dissection from donor hair into micrografts is mandatory to obtain optimal yield, particularly when mniigrafts are used exclusively and in large numbers".

 

If grafts are in danger under the most controlled and ideal circumstances of FUT dissection, can't you just see how much more in danger must they be in during FUE where every cut is blind and the tissue is grabbed and ripped out of the skin ?

 

Careful and delicate graft handling has been hair transplantation orthodoxy since the rise of the HT industry in the early nineties. Indeed it was a law that grafts must be handled with EXTREME consciousness and care for an HT to have the highest yields. Countless articles were published and many lectures given over the years on the best way to handle grafts-but ALWAYS cautiously. And then all of this was just thrown out the window by the FUE practitioners who squeeze, rip, and tear grafts free from the skin.

 

So not only should a subpar result be expected it is easily predictable when you compare it to the equivalent FUT graft. There is no way around it and there are no exceptions.

But if that's not enough let's look at the Beehner study and the Wesley Study where they found individually that only about 70% of FUE grafts survive. And let's not forget the original FUE study called the Fox test study by Rassman and Bernstein. This study didn't even take into account the viability of those grafts that came out because certainly a percentage of those grafts were damaged on the way out even if it wasn't visible.

 

"Torsion - This is the reference to how follicular units are subject to the torsional forces of rotation as the punch presses through the skin in order to free the follicular unit from the scalp. I believe that this is a problem mainly with the continuous rotation FUE tools on the market. With an oscillating rotation driven by the thumb and forefinger, torsion is not an issue if the rotational distance traveled is short and performed with an experienced hand. Torsion still exists, but it is greatly reduced in it’s severity thus having an equally reduced degree of trauma. "

 

This is incorrect. Torsion has been a problem since the introduction of FUE- long before rotary tools were invented for FUE. I absolutely agree however that the use of rotary machines has markedly increased the degree of damage due to torsion. No doubt. But even with a manual punch there is a significant amount of damage being done.

 

If I have you sit in a stationary chair and clamp your pelvis down to it so that it couldn't move then start twisting your body 90 degrees from your shoulders downward the force of torsion in the last third of your body above the pelvis would be enough to snap your spine. This is what happens during FUE but you don't always see it because the dermis is flexible and rubber like and will snap back SEEMINGLY unharmed.

 

Try it with a piece of spaghetti. Hold the bottom and twist the top 90 degrees on it's long axis. It will just snap. It is this torsion force transmitted from the top down that causes the decapitation of the graft. The harder the skin, the worse the torsion damage will be. That's why second FUE surgeries are so much more difficult than the first on average.

 

"When I extract each graft after I score, I use reverse traction by holding the top of the graft at the very upper edge of the tissue thereby avoiding most of the follicle. This is safe to do because we all know that the follicle, even slightly below the epidermis can be safely cut through and regrow without permanent damage, as is seen in trichophytic closures in strip surgery that have been performed for the past decade."

 

I do agree that the graft is safer if gripped from above for the reasons you mentioned. Absolutely. But FUE grafts are not removed with just one grasp of the forcepts. To do so would put incredible traction on the graft along it's entire length for absolutely no reason.

 

When you pull something up on a rope do you yank it up as far as your arm can go, or do you slowly pull the load up in a hand over hand fashion under controlled circumstances thereby distributing the force over the entire length as much as possible?

 

I'm sure you are not saying you just grab the graft at the top and rip it out. It looks like, from your video, you are using the hand over hand technique that every manual FUE doctor uses.

 

In the two forcepts method the top is grabbed and traction is applied, but then a hand over hand method using the forcepts is employed to work your way down. You must necessarily squeeze hard to be able to grip the graft with enough force so that it won't slip free when traction is applied. There is no way around it. Years ago Dr. C of Atlanta invented a device that leaves a space in the forcepts for the graft when squeezed to minimize compression but I didn't think it could work and sure enough I don't think he uses it and I've never seen it on the market. Compression and traction go hand in hand. No way to separate them.

 

Now compare this to FUT where there is no compression force at all because there is no traction force at all.

 

"Traction - This has perhaps the highest chance of causing real damage to the follicular unit but with practice and experience it is not an issue of debilitating circumstance. The bulbs are usually intact as long as the arrector pili muscles have been cleanly severed (best with a very sharp punch) and they come out fairly easily. This is of course not always the case but a proper surgeon will take their time at the beginning of the procedure to properly assess the patient, their grafts, the supporting tissue, and how it all works together. In most cases, the patient is a candidate with very few limiting factors."

 

Traction damage is not a function of practice and experience. It exists independent of it.

 

Sure, a beginner who yanks the graft out at odd angles can learn to control what they are doing and improve, but even the most experience doctor is not going to be able to tear a graft free without cost. If you view the video Dr. Bloxham and I made called "plastic surgery" we show with a piece of plastic what is happening at the level of the bullb, and it is very disturbing.

 

Bulbs and dermis may look like separate entities, but in reality they are not. Dermis is like tape and the follicle is like a noodle that is attached to the tape. When you tear the noodle from the tape serious damage occurs. Now think of taking a bandaid off your skin. The skin and the bandaid really are separate entities but we all know how much that hurts. It's orders of magnitude worse for FUE grafts which have no epidermis to protect it at the level of the bulb. It's twisting, squeezing, and pulling an eyeball. How well will it work after a forcepts has finished doing that to a human eye ?

 

The problem with assessing a patient at the beginning of a procedure is that once you move a half a centimeter away you may be dealing with a completely different set of physiological circumstances. That was the one problem with the Fox Test in my opinion.

And while grafts may release SEEMINGLY easy, it doesn't mean that those grafts haven't been harmed in the process. I believe fewer than 15% of patients are in the "easy" extraction category according to the Rassman Bernstein study which is seminal and is as valid today as the day it was published.

 

" Skeletonization is one stated side effect of traction but I believe that this is no different than the skelontization that occurs from subdividing follicular units (turning multi-hair grafts into singles and doubles) during strip surgery. It is well known in the community that this is routine procedure for some strip clinics, and the pros and cons of such procedures have been debated before, in forums and in the ISHRS."

 

This is just not true. And I must vehemently oppose your quote. In fact, it is a fantastic statement that I have never heard from any HT practitioner in the past- doctor or technician.

 

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. FUE owns skeletonization lock, stock and barrel and it is by far the most obvious disadvantage of FUE when compared to FUT.

 

While the pros and cons of dividing FUT grafts down from 3-4 to 1-2 may be debatable, it lends no support to the claim that it causes anything like the damage caused by FUE in the production of a skeletonized graft. I, the case of FUE the graft was blindly scored and then blindly ripped out with great force. In FUT the grafts are split from the side on a solid surface, in full view, under a microscope, with ideal lighting. No comparison. (By the way, I am against splitting down FUT's into 1-2 hair grafts unless I absolutely have to which is maybe one to times per year).

 

 

I will address the rest of your post but will have to do so in another posting. Thank you for your input and participation.

[Spidey]

I'm afraid that's not what doctors say behind the scenes. Your doctor included.

 

Should I warn Dr. Lupenzula to remove his thread because, according to you, he should just let his results speak for themselves ?

 

You can warn whoever you want.

[Dr. Alan Feller]

Tried posting response again to Dr. L, but caught in filter again. Dave can you discard the first filtered draft and just post the second one ?

Thank you,

Dr. Alan Feller

[andy_+_+]

Finally a FUE doctor defended the procedure.

 

Congratulations to Dr.Lupanzulas for posting his detailed response/rebuttal.

 

The forum members can now see that there is two sides of this conversation and presented/debated by two good doctors.

 

More FUE doctors and FUE/FUT doctors should be sharing their thoughts on this subject no matter if their FUE, FUT or a FUE/FUT clinic.

[mav23100gunther]

Feel free to prove me wrong then. If you produce recordings of the interviews or Gas confirms to all of us that he was on the 3 way call where you made a good faith attempt to conduct the interviews, then I will retract and post an apology in bold on this thread and ask the moderators to delete my previous statements on the matter or delete them myself. And no, I will not disclose my real name when I do so.

 

All, Dr Feller just sent me a very curtious and professional private message that explained and went into detail the full context behind why he has not been able to accept all of Gas's conditions. He also stated that he is attempting to conduct those interviews without Gas. I believe him. I really hope that Dr Feller will share with everyone what he has shared with me as I think it adds the context that has been missing. Looks like it could turn into a he said vs she said situation between Dr Feller and Gas if he did, but I still feel that he does himself justice by posting what he sent me. With that being said, I believe that Dr Feller is in fact making a good faith effort to conduct the interviews, and I am therefore retracting my previous statements on the matter. I have already deleted the relevant posts on this thread, and request that the moderators delete the one in the locked thread. Finally, although Dr Feller wrote that he doesn't expect an apology, I AM GOING TO FORMALLY APOLOGIZE TO HIM.

Edited June 14, 2017 by mav23100gunther

[TakingThePlunge]

Tried posting response again to Dr. L, but caught in filter again. Dave can you discard the first filtered draft and just post the second one ?

Thank you,

Dr. Alan Feller

 

Dr. Feller, I have approved the second post and deleted the first as you requested.

[spitfire uk]

Having had both FUT ( Dr Feller 2007) and FUE ( Dr Hakan 2014) I find this debate a fantastic read , credit to all Drs involved.

One good point I've read is about people not wanting the scar , totally get that but like all aspects of Hair work I think it depends on the surgeon. I have a scar from Dr Feller , Id sooner not have had it or the staples etc and frankly straight post op it looks far worse than fue. Fact.

However , I'm 10 years out....I've been to countless barbers , not one has mentioned it. Ive had short hair with no trouble .I've sweated at the gym , not been noticied. My wife struggles to find it if I ask her to look.

Sometimes I even forget I have it in all honesty , as I said earlier nobody wants a scar but I believe you get an ethical result with strip and a little less gamble than with FUE.

Fue can be wonderful with the right Dr , even though I had a failed result I do believe with the right Dr you can get a good enough result.

If I was considering another HT and needed enough grafts to justify it I'd be very tempted to lean towards FUT again scar or not.

[Gasthoerer]

All, Dr Feller just sent me a very curtious and professional private message that explained and went into detail the full context behind why he has not been able to accept all of Gas's conditions. He also stated that he is attempting to conduct those interviews without Gas.

 

Thank you very much for this information, and bonus point for appologizing to Dr. Feller! I appreciate good behavior.

 

@Dr. Feller,

However, cause the offer was made to me (several times) and I even exposed my name to you (Dr. Feller), I would like to learn the "full context" as well. Not receiving any answer to my posts and/or my personal message is not very polite. Especially, when private discussions take place with a 3rd forum member about me.

 

If the interviews are performed without me, I am of course happy that they take place anyway. I even mentioned this way myself or voted for another moderator like Spex. However, I hope some of my questions (which started all this) are included and (most important) numbers are dicussed (not just: fuss is better than FUE).

 

In general, I do not understand why you (Dr. Feller) asked me anyway, if you plan to procede alone. You have made the same offer before to another user long ago. Therfore, you had plenty of time to procede alone.

[mav23100gunther]

Thank you very much for this information, and bonus point for appologizing to Dr. Feller! I appreciate good behavior.

 

@Dr. Feller,

However, cause the offer was made to me (several times) and I even exposed my name to you (Dr. Feller), I would like to learn the "full context" as well. Not receiving any answer to my posts and/or my personal message is not very polite. Especially, when private discussions take place with a 3rd forum member about me.

 

If the interviews are performed without me, I am of course happy that they take place anyway. I even mentioned this way myself or voted for another moderator like Spex. However, I hope some of my questions (which started all this) are included and (most important) numbers are dicussed (not just: fuss is better than FUE).

 

In general, I do not understand why you (Dr. Feller) asked me anyway, if you plan to procede alone. You have made the same offer before to another user long ago. Therfore, you had plenty of time to procede alone.

 

Gas, I completely agree with you, and I strongly encouraged Dr Feller to make public the message he had sent me. I think it is unfair to the community for him and you to have started something on a public forum and then to suddenly take it offline without keeping us updated on the happenings behind the scenes as well as the final conclusion and reasoning behind it. That is what set me off in the first place and more transparency probably would have killed off the whole mess before it escalated. Us laymen expect transparency, especially when something was started on a public forum. it is for this reason that I hope Dr Feller will relay to this community what he relayed to me.

 

Additionally, Gas, it is also possible that you yourself may not have been 100% transparent with us either. Perhaps you can start by sharing with us the full reasoning, if any, that Dr Feller provided you initially as to why he could not accept some of your conditions? Also, interesting that you are now mentioning Spex. I thought you always agreed to participate in the interview yourself. Why all of a sudden are you mentioning that you recommended someone else take you place?

 

Finally, as has always been my position, it is unclear why Dr Feller needs a 3rd party involved in the interviews when he always planned to record the conversation. I am glad that he has decided to proceed without a 3rd party nonetheless, and look forward to seeing if he has success.

[Gasthoerer]

1. Additionally, Gas, it is also possible that you yourself may not have been 100% transparent with us either. Perhaps you can start by sharing with us the full reasoning, if any, that Dr Feller provided you initially as to why he could not accept some of your conditions?

 

Also, interesting that you are now mentioning Spex. I thought you always agreed to participate in the interview yourself. Why all of a sudden are you mentioning that you recommended someone else take you place?

 

2. Finally, as has always been my position, it is unclear why Dr Feller needs a 3rd party involved in the interviews when he always planned to record the conversation. I am glad that he has decided to proceed without a 3rd party nonetheless, and look forward to seeing if he has success.

 

 

1.

No it is not possible. I was completely clear from the beginning. I send my conditions to Dr. Feller and told I will publish them here. Which I did. Dr. Feller said in a PM that he would not accept any (!) conditions. I answered, that I am sorry to hear that, but that I still would not publish my name openly. I alsosaid, that I would be happy if this would we a bilateral discussion (between the clinics) or that as an option (!) Spex could be the moderator. Spex is familiar with all parties involved and I thought that he could serve as “our forum voice”.

After that Dr. Feller first published (in the closed threat) “Quote:

Originally Posted by Dr. Alan Feller

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

 

 

I understand this as an acceptance of the other conditions of mine. Why should I send my name, if that would not be the case? When I didn’t reply fast enough (was on a business trip), he even gave the impression in this forum that I didn’t want to give name after his request and if I would he would go through. 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 I was back, I send a PM with my full name and a link to my Linkedin Profile for verification. I mentioned again a reminder, that one condition was “to keep it clean”.

After that I never heard back neither personally nor in public. Even after I posted again about this topic I was ignored.So there is obviously, no time to answer me (which is ok), but to discuss this with a third party (you). By that behavior, the impression was given, that I didn’t stand by my word or told the untruth: This is not OK. I was always open, transparent and clear.

2.

I do not know it either, even though I know the following:

- Dr. Feller made the same offer before in another thread to another user, so it seems “important” to him. There was enough time in between (this old offer and the offer to me) to contact any clinic in the world

- From my point of view a moderator would be a benefit for this discussion (this is the reason why Spex came into my mind as a replacement for me).

 

Summary:

- I do not give my name easily to anyone in an online forum

- I did this in good faith and trust as I understand, we (Dr. Feller and myself) had an agreement

- If Dr. Feller changes his mind afterwards, this is ok, but I think an explanation (to me and the forum) would be the normal way to go

- To talk to a third party and by that give the impression that I was “not transparent” is a big no go

- I am happy to proof all my words, if Dr. Feller or the mods let me publish all PM here (with only my name whipped out).

Edited June 14, 2017 by Gasthoerer

[Bill - Seemiller]

Dr. Lupanzala,

 

Dr. Lupanzula, I genuinely appreciate you joining in and participating in this relatively controversial discussion. As you can see from the topic, there are some very strong opinions posted by some very bold personalities, Dr. Feller included. Dr. Feller has been providing his opinion regarding his experience with FUE for some time so it's nice to get another doctor's opinion, especially one that differs to some extent.

 

I agree with Dr. Feller that even if you two don't see completely 100% eye to eye that it's good to have an open, transparent discussion that's out and open to the public.

 

I have been hearing and posting about the three forces placed on the follicle during the FUE donor excision process for years ever since Dr. Feller explained these to the community years ago. Though I am an educated patient, I have no direct experience with performing surgery, nor should I as a layperson. However, conceptually, I know a lot and I do happen to agree that the three forces (tension, torsion and traction) placed on the follicular unit during extraction can and even has been overcome. Dr. Feller seems to agree with your assertion that they "can" be overcome but dismisses that they "have".

 

If you have the time, the community would love to hear how you believe these three forces have been overcome in your experienced hands during an FUE hair transplant procedure.

 

Keep up the great work!

 

Bill

[Gasthoerer]

 

This is the only part where I really disagree. I think it's been effectively proven that "skinnier" grafts grow worse. Dr. Beehner did an excellent study on this. No need to even dive into this. But I think it's a tough sell to state that microscopic dissection of grafts from a strip causes the same amount of skeletonization as FUE delivery. I'm going to include some images below that highlight the difference in appearance.

 

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?

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)?

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).

 

Thanks to Dr. Lupanzala again for joining the discussion.

Edited June 15, 2017 by Gasthoerer

[Dr. Alan Feller]

Dr. Lupanzala,

 

However, conceptually, I know a lot and I do happen to agree that the three forces (tension, torsion and traction) placed on the follicular unit during extraction can and even has been overcome. Dr. Feller seems to agree with your assertion that they "can" be overcome but dismisses that they "have".

 

If you have the time, the community would love to hear how you believe these three forces have been overcome in your experienced hands during an FUE hair transplant procedure.

 

Keep up the great work!

 

Bill

 

This question is at the crux of the entire FUE controversy.

[Dr. Alan Feller]

 

 

1.

No it is not possible. I was completely clear from the beginning. I send my conditions to Dr. Feller and told I will publish them here. Which I did. Dr. Feller said in a PM that he would not accept any (!) conditions. I answered, that I am sorry to hear that, but that I still would not publish my name openly. I alsosaid, that I would be happy if this would we a bilateral discussion (between the clinics) or that as an option (!) Spex could be the moderator. Spex is familiar with all parties involved and I thought that he could serve as “our forum voice”.

After that Dr. Feller first published (in the closed threat) “Quote:

Originally Posted by Dr. Alan Feller

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

 

 

I understand this as an acceptance of the other conditions of mine. Why should I send my name, if that would not be the case? When I didn’t reply fast enough (was on a business trip), he even gave the impression in this forum that I didn’t want to give name after his request and if I would he would go through. 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 I was back, I send a PM with my full name and a link to my Linkedin Profile for verification. I mentioned again a reminder, that one condition was “to keep it clean”.

After that I never heard back neither personally nor in public. Even after I posted again about this topic I was ignored.So there is obviously, no time to answer me (which is ok), but to discuss this with a third party (you). By that behavior, the impression was given, that I didn’t stand by my word or told the untruth: This is not OK. I was always open, transparent and clear.

2.

I do not know it either, even though I know the following:

- Dr. Feller made the same offer before in another thread to another user, so it seems “important” to him. There was enough time in between (this old offer and the offer to me) to contact any clinic in the world

- From my point of view a moderator would be a benefit for this discussion (this is the reason why Spex came into my mind as a replacement for me).

 

Summary:

- I do not give my name easily to anyone in an online forum

- I did this in good faith and trust as I understand, we (Dr. Feller and myself) had an agreement

- If Dr. Feller changes his mind afterwards, this is ok, but I think an explanation (to me and the forum) would be the normal way to go

- To talk to a third party and by that give the impression that I was “not transparent” is a big no go

- I am happy to proof all my words, if Dr. Feller or the mods let me publish all PM here (with only my name whipped out).

 

Gas,

 

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.

 

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 ?

 

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

 

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.

 

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.

 

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

 

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.

[Gasthoerer]

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):

 

 

Gasthoerer

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

Dr. Alan Feller

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.

Gasthoerer

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:

Gasthoerer

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 June 15, 2017 by Gasthoerer

[Mick50]

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 .

[Gasthoerer]

Phone numbers send via PM.

[Dr Blake Bloxham]

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.

[Gasthoerer]

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 :-)

[Dr. Alan Feller]

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.

[Swooping]

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.