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Fuck strip scars!!! Why did i ever!


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2 hours ago, bismarck said:

This has been discussed extensively on these forums.

Greater donor depletion with FUE and lower yields are generally recognized issue. I have heard this stated to me in person by both Konior and Cooley, who both have a strong track record with both procedures. The limited studies comparing the two that I've seen are also uniform about this point (unless there's been a new study I haven't read). 

Those are essentially the only reasons anyone would do FUT over FUE (outside of cost). I have my procedure scheduled in a few months with a surgeon who is comfortable with both and am still constantly going back and forth about the issue. I'm a Norwood 3/early v at 38 ears and have been on Avodart for the last 5 years. I anticipate greater loss down the line, especially if I discontinue Avodart when for having children, and am not sure if I should 'burn the ships', as it were.

Ultimately, there is no clear cut answer until after the fact, and even then there is uncertainty.

OP: I feel your pain. If you could let us know who the surgeon was it would be deeply appreciated.

I never denied that FUE the vast majority of the time will result in greater donor depletion and scarring magnitude, the difference is that you with small manual punch work you don't end up with the 1/10-20 who have significantly worse results due to bad scarring for whatever reason, even with top surgeons including issues elevated scarring, excessive width and permanent shockloss that are visible after a full month of growth. I can point to multiple cases from virtually every single major US and Canadian strip surgeon that regularly has patient and clinic FUT results posted with bad scarring that would have put the patients off from the surgery to begin with. Recent ones too, it's not up for debate unless you bury your head in the sand.

"The limited studies comparing the two that I've seen are also uniform about this point"

I can't remember exact details but Keser and Vories have had FUE test cases with close to 100% yield, including Keser implanting at 70 FU/cm2. The only studies that claim a significantly lower yield are those by surgeons who are in the United States who have business interest in supporting FUT over FUE due to higher labour costs, are by doctors past their prime including one by a surgeon claiming he was an expert because he had done over 100 FUE surgeries over 10 years (lmfao) and didn't cite a significant number of controlled variables impacting results.  Not even highschool level work.  This was the study constantly cited by Feller and co who were always the most adamant on that side of the FUT vs FUE debate.

 

To act as if the risk of excessive scarring of permanent donor shockloss via FUT doesn't exist is just silly, even if for the vast majority its not a problem and they'll have better results than if they went FUE.  The question in 2018 should always be "Do I NEED to do an FUT over an FUE?" because the reality is that the vast majority can achieve their greatest hair-restoration goals without it.

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This was one of the reason I avoided FUT, But my case is little different since I do not want to take propecia ( i take rogaine and other tablets) and that may result in shaving my head to minimum cut in the future (if wanted). I have seen some results in FUT that are really good as well but I did not want to risk it. My FUE was done really well by my doctor and donor area really recovered and happy with my call for FUE.

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I feel like you have to pick your poison. Some FUT scars are bad-no doubt about it.

This week at a movie I saw THE WORST single FUT scar I have ever seen-wide, stretched, glaring. He sat right in front of me and I spent more time looking at his head than I did looking at the screen.

Last week at a restaurant I saw THE WORST single FUE overharvest I have ever seen as well-a large rectangular box of overharvested donor scalp that was just glaringly bad. 

Both of these pts were clearly far from their original surgery.

IMHO, most FUT scars are pretty hard to detect/easy to cover and most FUE pts have a good looking donor area after surgery, but these surgeries all come with risks and I do not see how you can have hair moved from your donor without some risk of the surgery being detectable. 

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Louisjams is pretty spot on. 


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This is bull and it irritates me.  I feel for densedream as that scar is not pencil thin.  The most dangerous things anyone can say is that there are more thinner then thicker scars.  This is how folks researching surgery end up getting into trouble and confused with what is listed on any piece of paper.  Being a repair patient, ive had my fair share of folks that do not post that seem to believe the contrary.  There are thousands of patients from various clinics, chains and mills that have unsatisfactory results.  Ive seen crazy strip scars, zigzag scars, donor depletions, scar tissue and ridging and cobblestoning issues dissucssed with me by other patients(even in person).  Ive even spoken to guys tht had Necrosis.  Yes, some are from known docs.  Most folks do not post.  Out of non profit and goodwill gestures, Ive assisted folks file complaints with powerful agencies, get repairs, get refunds, etc etc etc, as a result.  

In this case, it is clear of what densedream is facing and it is complete bullshit he has to go through this.  He has every right to voice his concern whether he does this without anger or with anger.  There is an indentation in his scar and it does look distinct.  That is a fact and most folks could tell it is a hair transplant scar when they see it.  Right now what matters most is he gets his issue resolved.  

Ive heard good things about Dr Wong by some folks too and I hope you get this sorted.   He seems to be an honest doctor from what was described.  Best of luck man. Im hoping things turn out well so you can be at peace.  

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On 7/23/2018 at 10:20 PM, JeanLDD said:

I never denied that FUE the vast majority of the time will result in greater donor depletion and scarring magnitude, the difference is that you with small manual punch work you don't end up with the 1/10-20 who have significantly worse results due to bad scarring for whatever reason

The FUE risk is having poor yield and a chewed out ratty appearing donor area with widespread fibrosis and poor outcome/low yield. With FUT its a bad scar. The amount of scar tissue will be significantly less with strip because of geometry -- a single line leaves less collagen behind than thousands of circles. 

"I can't remember exact details but Keser and Vories have had FUE test cases with close to 100% yield, including Keser implanting at 70 FU/cm2."

This is a common assertion, but I really don't care what doctors claim unless they publish their data in peer reviewed journals (not cherry picked cases on their websites). I do trust the opinion of Konior more, as he seems to surpass those two with his patient posted FUE results, but there is no way to be certain. For the European doctors, there is a financial interest to promote FUE because they can have their techs do the surgery and make more money that way. The techs usually do not make much, but having to support the extra staff evens out the numbers to a degree. In America, FUT is less labor intensive, while FUE is very physically demanding. They charge more to accommodate for this so finances are usually not the issue, it's the labor.

Don't kid yourself Jean -- it's not that people that agree with you are open minded and unbiased and those that disagree have financial motives. There are risks and benefits with both procedures. Until surgeons man up and publish their data, the discussion comes down to opinion and cognitive dissonance.

Think about how insane the people that deny global warming sound -- it's hard for a man to understand change if his income depends on his remaining the same. Certainly this applies to FUT, but of course it also applies to FUE. Everyone, EVERYONE has financial interest and bias. As Louis said, you have to pick your poison.

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16 hours ago, bismarck said:

The FUE risk is having poor yield and a chewed out ratty appearing donor area with widespread fibrosis and poor outcome/low yield. With FUT its a bad scar. The amount of scar tissue will be significantly less with strip because of geometry -- a single line leaves less collagen behind than thousands of circles. 

"I can't remember exact details but Keser and Vories have had FUE test cases with close to 100% yield, including Keser implanting at 70 FU/cm2."

This is a common assertion, but I really don't care what doctors claim unless they publish their data in peer reviewed journals (not cherry picked cases on their websites). I do trust the opinion of Konior more, as he seems to surpass those two with his patient posted FUE results, but there is no way to be certain. For the European doctors, there is a financial interest to promote FUE because they can have their techs do the surgery and make more money that way. The techs usually do not make much, but having to support the extra staff evens out the numbers to a degree. In America, FUT is less labor intensive, while FUE is very physically demanding. They charge more to accommodate for this so finances are usually not the issue, it's the labor.

Don't kid yourself Jean -- it's not that people that agree with you are open minded and unbiased and those that disagree have financial motives. There are risks and benefits with both procedures. Until surgeons man up and publish their data, the discussion comes down to opinion and cognitive dissonance.

Think about how insane the people that deny global warming sound -- it's hard for a man to understand change if his income depends on his remaining the same. Certainly this applies to FUT, but of course it also applies to FUE. Everyone, EVERYONE has financial interest and bias. As Louis said, you have to pick your poison.

 

"Don't kid yourself Jean -- it's not that people that agree with you are open minded and unbiased and those that disagree have financial motives."

FUE proponents don't have the same amount to gain or lose in the sense that most of the top options are in Europe and due to significantly lower rent and staff costs can provide surgery at low enough prices that people will come regardless of whether they think they are getting the absolute best results. Its not a conspiracy, its basic economics and its how the world works. The stats also show that FUE is already extremely very popular (the majority performed procedure) and getting even more so, with FUT only hanging on primarily in the US. Saying "EVERYONE" has financial interest and bias is the same as saying that the risks across both procedures are somehow comparable or equatable, it's just oversimplification for the sake of it. On the statistics its clear that FUT purists have been fighting a losing battle at least in the marketplace and that it is losing ground, not the other way around.

 

I agree that peer reviewed studies rom some of the names taken more seriously in FUE and impact of various techniques (Stick and place, implanter pen vs forceps) would be worthwhile, but a reasonable judgement at this point can be made from doctor and patient posted results considering how common FUE is at this point.  Saying you don't care doesn't suggest someone as objectively minded as you're trying to portray yourself as; the earth doesn't revolve around the sun because scientists say so in a peer reviewed journal, rather It's because the data itself shows it to be the case. The experience and claims of surgeons like Vories, Erdogan and Lorenzo aren't just "opinon" because they haven't been published in an American peer reviewed journal, more specifically.

 

"I do trust the opinion of Konior more, as he seems to surpass those two with his patient posted FUE results,":

 

The second point just isn't accurate, Konior has less than 20 FUE results patient posted or otherwise online. Vories and Keser equally have probably 5x more, certainly a significant number above.  Also I don't disagree with anything Konior has said about the benefits of FUT over FUE, for the vast majority that aren't unlucky enough to have significant scarring or permanent donor it is the better procedure. What goes unmentioned are the people that go to top end FUT clinics and still get horrible donor results that can be seen on this forum for example on a regular basis. I have never seen a result where a person went to a top FUE clinic and came out with a situation where their donor looked awful after a full month of growth beyond the initial healing period. There are endless FUT examples of that situation.

 

I do agree that ultimately it is a matter of picking your poison, they both have individual benefits and risks that can't be equated and will appeal to different people.

 

 

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7 hours ago, JeanLDD said:

 

"The stats also show that FUE is already extremely very popular (the majority performed procedure) and getting even more so, with FUT only hanging on primarily in the US. Saying "EVERYONE" has financial interest and bias is the same as saying that the risks across both procedures are somehow comparable or equatable, it's just oversimplification for the sake of it.

I have never seen a result where a person went to a top FUE clinic and came out with a situation where their donor looked awful after a full month of growth beyond the initial healing period. There are endless FUT examples of that situation.

 

Please look through the forum backlog more carefully. Having spent over a thousand hours here and on the foreign language forums I can assure you that almost every "elite" FUE doc has had a few horrible patient submitted results, certainly including Vories and Keser (some of the most concerning and inconsistent results have come from the Turkish docs, Keser has had some real whammies). The FUT docs have as well, but less often.

Lorenzo is consistent, but his hairlines are very high. Spain has had the most impressive results overall (Couto and Freitas on recuperar are real standouts), but they decimate the donor area. Konior has not had a bad outcome that I could find for either FUE or FUT (though other elites like Gabel and Cooley have). You are right that Konior has a lower total quantity of FUE cases posted, but still his results are uniform and his FUE extractions are considerably less bloody and stay in higher yield areas of the donor zone relative to Couto/Freitas.

Note that my conclusions are not based on memory--I actually went through and made a catalog of everyone's patient submitted cases for the past 10 years (including threads that were later removed or censored). I am not going to point out the individual patients, but spend some time with the search function, you will be surprised.

"The experience and claims of surgeons like Vories, Erdogan and Lorenzo aren't just "opinon" because they haven't been published in an American peer reviewed journal, more specifically."

They haven't been published in ANY journal. This is concerning and there is no way around this. So yes, they are still opinions. Medicine is rife with examples of well meaning and charismatic physicians who talked many patients into taking the wrong course of action because they believed they were doing the right thing.

"Saying "EVERYONE" has financial interest and bias is the same as saying that the risks across both procedures are somehow comparable or equatable, it's just oversimplification for the sake of it."

I don't agree. Unfortunately, everyone is biased, even us. That is the nature of life. We are not Vulcans. We can mitigate this through careful reflection, emotional detachment and peer reviewed statistical analysis, but even then it is inevitable.

Also: I would be extremely cautious in deciding that something is better because it is more popular. The popularity could be related to cost, marketing or the perception of reduced risk. But the fundamental bottom line is that the highest lifetime yield for transplants is strip first followed by FUE because you are minimizing scar tissue with early grafts for better repeat harvests down the line.

I worry that you have already made up your mind about this subject and are tending to highlight points that support your foregone conclusions, which reminds me of Mickey's old posts from years ago. I'm not going to get into this discussion again because we are rehashing an extremely old debate that has been done to death. I appreciate your perspective, but I don't think there is any objective evidence that supports your assertions, only marketing and individual doctor's claims. Even my catalogue is only based on pictures, but it is my best attempt at a litmus test. Let us be cautious Jean, the plural of anecdote is not evidence.

One thought to leave you with: from a technical standpoint, just be aware that there is no way that a blind punch could provide the same results as a stereoscopic dissection. You are going to cut the stem cell, and follicular caliber and yield will suffer. The European docs compensate for this by overharvesting, which gives good initial results but screws you for repeat procedures because of the insane amount of scar tissue and fibrosis left behind relative to strip. Unfortunately even this assertion is based on inductive not deductive reasoning, and I acknowledge its limitations. Still, if that's where you want to go with it, have at it, but your long term yield will diminish.

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32 minutes ago, bismarck said:

Please look through the forum backlog more carefully. Having spent over a thousand hours here and on the foreign language forums I can assure you that most "elite" FUE docs with horrible results, certainly including Vories and Keser though probably the most concerning results have come from the Turkish docs. Lorenzo is okay, but his hairlines are very high. Spain has had the most impressive results (Couto and Freitas on recuperar are real stand outs), but they decimate the donor area. Konior has not had a bad outcome that I could find for either FUE or FUT (though other elites like Gabel and Cooley have). Note that my conclusions are not based on memory--I actually went through and made a catalog of everyone's patient submitted cases for the past 10 years (including threads that were later removed or censored). I am not going to point out the individual patients, but spend some time with the search function, you will be surprised. You are right that Konior has a lower total quantity of FUE cases posted, but still his results are uniform.

"The experience and claims of surgeons like Vories, Erdogan and Lorenzo aren't just "opinon" because they haven't been published in an American peer reviewed journal, more specifically."

They haven't been published in ANY journal. This is concerning and there is no way around this. So yes, they are still opinions. Medicine is rife with examples of well meaning and charismatic physicians who talked many patients into taking the wrong course of action because they believed they were doing the right thing.

"Saying "EVERYONE" has financial interest and bias is the same as saying that the risks across both procedures are somehow comparable or equatable, it's just oversimplification for the sake of it."

I don't agree. Unfortunately, everyone is biased, even us. That is the nature of life. We are not Vulcans. We can mitigate this through careful reflection, emotional detachment and peer reviewed statistical analysis, but even then it is inevitable.

Also: I would be extremely cautious in deciding that something is better because it is more popular. The popularity could be related to cost, marketing or the perception of reduced risk. But the fundamental bottom line is that the highest lifetime yield for transplants is strip first followed by FUE because you are minimizing scar tissue with early grafts for better repeat harvests down the line. 

I worry that you have already made up your mind about this subject and are tending to highlight points that support your foregone conclusions, which reminds me of Mickey's old posts from years ago. I'm not going to get into this discussion again because we are rehashing an extremely old debate that has been done to death. I appreciate your perspective, but I don't think there is any objective evidence that supports your assertions, only marketing and individuals doctor's claims. Even my catalogue is only based on pictures, but it is my best attempt at a litmus test. Let us be cautious Jean, the plural of anecdote is not evidence.

One thought to leave you with: from a technical standpoint, just be aware that there is no way that a blind punch could provide the same results as a stereoscopic dissection. You are going to cut the stem cell, and follicular caliber will suffer. The European docs compensate for this by overharvesting, which gives good initial results but screws you for repeat procedures because of the insane amount of scar tissue and fibrosis left behind relative to strip. If that's where you want to go with it, have at it but your long term yield will diminish.

I think you misinterpret what I'm actually saying because despite the very contrary tone I agree with virtually everything you said and haven't said anything especially the the contrary. The specific point that you seem to miss is that there are virtually no singular FUE cases by top surgeons (show one if I'm wrong) where someone can grow their hair out for a month (post healing) and there is significant evidence of a procedure or scarring. This simply isn't true for FUT for which regularly on this site and others there are scars from top surgeons where the scar elevation and width makes it visible even after a month of growth. I'm not talking about bad recipient results either, of course every top FUE surgeon has plenty.

All you have said in regards to a blind punch vs stereoscopic dissection, yields, and most efficient use of the donor I agree with you on, the only point that I don't think is raised enough is just how regularly singular FUT procedures with top surgeons result in scarring is well out of the range of acceptability. The numbers are incomparable in terms of people that end up with the same level of cosmetic donor damage via reasonably sized manual FUE punches. Again that isn't to say that for 19/20 people that FUT is in a technical sense the best option and will do the minimal damage to the donor, but that the magnitude of the risk for a single procedure of FUT is larger.

Also you can say it all you want but assertions don't suddenly go from opinions to facts because they're in peer reviewed journals. On top of that if you've read the current published studies the level they're at is absolutely juvenile. They lack basic controlling of variables and note an extremely limited amount of hours of experience in FUE prior to their testing.

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52 minutes ago, bismarck said:

1. .. almost every "elite" FUE docs has had a few horrible results, certainly including Vories and Keser (though probably the most concerning results have come from the Turkish docs).

2. Lorenzo is consistent, but his hairlines are very high. Spain has had the most impressive results (Couto and Freitas on recuperar are real stand outs), but they decimate the donor area.

3. Konior has not had a bad outcome that I could find for either FUE or FUT (though other elites like Gabel and Cooley have). ... You are right that Konior has a lower total quantity of FUE cases posted, but still his results are uniform.

4. They haven't been published in ANY journal. This is concerning and there is no way around this. So yes, they are still opinions. Medicine is rife with examples of well meaning and charismatic physicians who talked many patients into taking the wrong course of action because they believed they were doing the right thing.

5. One thought to leave you with: from a technical standpoint, just be aware that there is no way that a blind punch could provide the same results as a stereoscopic dissection. You are going to cut the stem cell, and follicular caliber and yield will suffer. The European docs compensate for this by overharvesting, ...

Personally, I do agree that in average yield of strip is better  with strip and in the best case FUE is close. I recommend strip regulary for big cases. But I have a hard time follow this post. What is your message exactly? Europe is bad, US is great? ;-)

1. Every (!) clinic has bad results independent of method (FUE or strip).. Just look at this horrible H&W case recently discussed in here.

2. Which role do Lorenzos hairlines play in this case? I think non and I also think it is not true. Why does Couto and Freitas decimate the Donor? Actually, Couto has a lot of cases online with a great result using low graft counts. Actually, he is praised a little to much for it, cause a lot of patients of his just have thick donor hair due to their heritage.

3. I though every elite Doc has bad results (your word)? So Konior is not elite? Or is he beyond elite? The truth is: Of course he has some bad cases, there are just so few online that you can see them. He himself admitted that every (!) clinic has bad results (explecitely not excluding himself). And yes, I have seen bad results of Keser like I did from everyone else.

4. Interesting point, but actually also the pro-strip brigade (or should I say Dr. Feller) has no scientific data to back up that strip is superior. We had this discussion on literally 300 pages. And even Feller and Bloxham did went down like a "led zeppeln" trying to back up their point with data ;-)

5. "The Europeans" again...of course Konior or Diep do not do this. Tell me: Do they just use lower density or are they just superior? What about Canada? Are their clinics Europe like (overhavesting) or US like (flawless) when performing FUE? Keser is actually known for doing more with less in german forums.

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On 8/10/2018 at 3:34 PM, JeanLDD said:

I think you misinterpret what I'm actually saying because despite the very contrary tone I agree with virtually everything you said and haven't said anything especially the the contrary. The specific point that you seem to miss is that there are virtually no singular FUE cases by top surgeons (show one if I'm wrong) where someone can grow their hair out for a month (post healing) and there is significant evidence of a procedure or scarring. This simply isn't true for FUT for which regularly on this site and others there are scars from top surgeons where the scar elevation and width makes it visible even after a month of growth. I'm not talking about bad recipient results either, of course every top FUE surgeon has plenty.

All you have said in regards to a blind punch vs stereoscopic dissection, yields, and most efficient use of the donor I agree with you on, the only point that I don't think is raised enough is just how regularly singular FUT procedures with top surgeons result in scarring is well out of the range of acceptability. The numbers are incomparable in terms of people that end up with the same level of cosmetic donor damage via reasonably sized manual FUE punches. Again that isn't to say that for 19/20 people that FUT is in a technical sense the best option and will do the minimal damage to the donor, but that the magnitude of the risk for a single procedure of FUT is larger.

Also you can say it all you want but assertions don't suddenly go from opinions to facts because they're in peer reviewed journals. On top of that if you've read the current published studies the level they're at is absolutely juvenile. They lack basic controlling of variables and note an extremely limited amount of hours of experience in FUE prior to their testing.

I think those points are fair, that's where I would leave it. Scar vs yield with the quality of the surgeon minimizing but not eliminating the issues on either side of the equation. The one caveat is that I haven't seen a bad scar from Konior (and a few others) but certainly even in his hands it is possible. I also haven't seen a low yield result from Freitas, Couto, Lorenzo or Konior but again, anything can happen. Also, even a pencil thin scar is more visible than a well done FUE on a shaved head, I acknowledge there is no way around this basic observation.

 

On 8/10/2018 at 3:48 PM, Gasthoerer said:

Personally, I do agree that in average yield of strip is better  with strip and in the best case FUE is close. I recommend strip regulary for big cases. But I have a hard time follow this post. What is your message exactly? Europe is bad, US is great? ?

1. Every (!) clinic has bad results independent of method (FUE or strip).. Just look at this horrible H&W case recently discussed in here.

2. Which role do Lorenzos hairlines play in this case? I think non and I also think it is not true. Why does Couto and Freitas decimate the Donor? Actually, Couto has a lot of cases online with a great result using low graft counts. Actually, he is praised a little to much for it, cause a lot of patients of his just have thick donor hair due to their heritage.

3. I though every elite Doc has bad results (your word)? So Konior is not elite? Or is he beyond elite? The truth is: Of course he has some bad cases, there are just so few online that you can see them. He himself admitted that every (!) clinic has bad results (explecitely not excluding himself). And yes, I have seen bad results of Keser like I did from everyone else.

4. Interesting point, but actually also the pro-strip brigade (or should I say Dr. Feller) has no scientific data to back up that strip is superior. We had this discussion on literally 300 pages. And even Feller and Bloxham did went down like a "led zeppeln" trying to back up their point with data ?

5. "The Europeans" again...of course Konior or Diep do not do this. Tell me: Do they just use lower density or are they just superior? What about Canada? Are their clinics Europe like (overhavesting) or US like (flawless) when performing FUE? Keser is actually known for doing more with less in german forums.

1, 3 & 5. As I stated above, I have seen bad recipient results from every clinic except Konior, Freitas, Couto and Lorenzo. That being said, there are a number of docs on both sides of the duck pond that are very close to flawless, but these few are the most consistent from patient submitted cases I've observed online. Anecdotal statement at best.

2. Lorenzo's hairlines are too conservative IMO but if they work for you then go with god. Couto and Freitas have remarkable yields, but the donor looks bloodied and ravaged afterwards. I believe it is related to the caliber of their harvest punches. Better yield, but at the cost of more scar tissue.

4. There certainly are published peer reviewed articles indicating higher yields for strip. The FUE advocates will state that these studies were not done by "Dr. X" and so don't apply, but it is what it is.

 

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5 hours ago, bismarck said:

1, 3 & 5. As I stated above, I have seen bad recipient results from every clinic except Konior, Freitas, Couto and Lorenzo. That being said, there are a number of docs on both sides of the duck pond that are very close to flawless, but these few are the most consistent from patient submitted cases I've observed online. Anecdotal statement at best.

2. Lorenzo's hairlines are too conservative IMO but if they work for you then go with god. Couto and Freitas have remarkable yields, but the donor looks bloodied and ravaged afterwards. I believe it is related to the caliber of their harvest punches. Better yield, but at the cost of more scar tissue.

4. There certainly are published peer reviewed articles indicating higher yields for strip. The FUE advocates will state that these studies were not done by "Dr. X" and so don't apply, but it is what it is.

 

1/3/5 I have just not seen enough result of Konior, Freitas or Kouto to make this a statement of real worth. And for Konior I think no one has seen more than a handfull of reports. I have seen bad results of Lorenzo though, but he has signifikantly more reports online.

2. Let us not diskuss Lorenzo hairlines, it is a non topik. I have never heard this komplains about Kouto or Freitas but I have heard them about Diep. --> All have a lot of klients with extremely thik hair by the way.

3. This is just your opinion, but you state it as a fakt. We had a diskussion of around 300 pages with Feller/Bloxham and they kould not bring a peer revied publikation, outside of the beehner studies (I do not remember if they were peer revied). But there where serious flaws in this studies, highlighted by many user and surgeons. And Feller and Bloxham Kould never answer this questions. Remarkable was amongst others: the very poor strip (!) yield, the mix up of % and %-point, or (most likely) the fully rotating punh. The latter would be a big no go and has nothing to do with the wrong surgent performing the proedure. It is just bad work.

Summary: If you bring some researh, we are all happy to read it. We really do. But so far no one (!) not even Feller/Bloxham found sth.  

Sorry, my "zee" is not working^^

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1 hour ago, Gasthoerer said:

1/3/5 I have just not seen enough result of Konior, Freitas or Kouto to make this a statement of real worth. And for Konior I think no one has seen more than a handfull of reports. I have seen bad results of Lorenzo though, but he has signifikantly more reports online.

2. Let us not diskuss Lorenzo hairlines, it is a non topik. I have never heard this komplains about Kouto or Freitas but I have heard them about Diep. --> All have a lot of klients with extremely thik hair by the way.

3. This is just your opinion, but you state it as a fakt. We had a diskussion of around 300 pages with Feller/Bloxham and they kould not bring a peer revied publikation, outside of the beehner studies (I do not remember if they were peer revied).

Hard to follow your posts because of your limited English but I will finish with this and then not discuss the matter further:

-All because you have not seen enough results does not mean they are not online. Freitas and Couto have a high number of before and afters, look for yourself instead of arguing off the cuff. Specifically go to the Spanish language forums. 

-Konior has a large database of strip and his patient posted FUE results have been uniform (I have seen about 20 as opposed to 50-100 with the other guys). There are fewer in quantity but still no misses. 

-Beehner was peer reviewed. Until something better comes along that's what we have. The absence of a study showing anything to the contrary is deeply troubling. Surgeons that do both procedures acknowledge higher yields with strip. Surgeons that only do one procedure or the other will argue their procedure is better. If you can't do the math on this, I don't know what to tell you.

- Lorenzo's hairlines are aesthetically displeasing -- this is an opinion held by many on here and one that I share. His yields are strong however.

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4 hours ago, bismarck said:

Hard to follow your posts because of your limited English but I will finish with this and then not discuss the matter further:

-All because you have not seen enough results does not mean they are not online. Freitas and Couto have a high number of before and afters, look for yourself instead of arguing off the cuff. Specifically go to the Spanish language forums. 

-Konior has a large database of strip and his patient posted FUE results have been uniform (I have seen about 20 as opposed to 50-100 with the other guys). There are fewer in quantity but still no misses. 

-Beehner was peer reviewed. Until something better comes along that's what we have. The absence of a study showing anything to the contrary is deeply troubling. Surgeons that do both procedures acknowledge higher yields with strip. Surgeons that only do one procedure or the other will argue their procedure is better. If you can't do the math on this, I don't know what to tell you.

- Lorenzo's hairlines are aesthetically displeasing -- this is an opinion held by many on here and one that I share. His yields are strong however.

The fact that you think so highly of peer review suggests that you've probably never even been to university or analysed what it actually is. It's the stupidest point you make and is quite frankly an embarrassment against the intellectual persona you try to portray. It means that a few people looked at it on a Sunday morning, wrote a few sentences and ticked a box, it has absolutely nothing to do with trying to replicate data, corresponding with the author about what actually occurred, or the quality of the study. All it means is that someone simply looked at it and potentially was paid to do so. Don't forget this study was performed at a time where external information about FUE vs FUT was very low so extensive cross-referencing was not a genuine possibility.

If you had the basics of academic research down, you for example would see the lack of controlled variables in the Beehner study, the fact that it openly admits less than 100 hours of FUE experience prior to the undertaken research and instantly dismiss it. Instead you resort to an undeniable appeal to authority fallacy and say "Well I'm an idiot who doesn't know how to read data myself, so I'll leave it to the peer reviewer who I know nothing about, isn't even a full time hair transplant surgeon, didn't replicate the data and potentially spent less than half an hour looking at this and pretend its the greatest thing in the world".  Take a look at ANY or the best Beehner FUE result, and compare it to the worst result of Freitas, or Couto, IT IS STILL WELL BELOW THIS LEVEL. Please take a philosophy 101 class and study how logic works, reality isn't dictated by a biased idiot spending 30 minutes on a peer review of a pre-school level scientific study ( because what else is a study that doesn't list extensive controlled variables in a field such as hair transplantation?)

Also on top of this you keep saying there is no other peer reviewed data, actually there is and if you understood the industry you'd be aware of organisation such as FUE Europe and the World FUE institute encompassing the majority of the best FUE surgeons globally that present data and hold workshops amongst themselves on a regular basis. The idea that the Beehner study is the be all and end all, no other data exists (you haven't looked) and that peer review is some magical fairy land standard that is the greatest thing since sliced bread is laughable, moronic and shows a lack of research and understanding of the academic process.

 

On Lorenzo, I agree the majority of his hairlines are not among the most pleasing aesthetically but I have to question the suggestion that you've done extensive documentation and research when you conclude this. He does not conventionally do single procedures for aggressive, very youthful hairlines but there are a number like this and they reflect he is not limited by an inability to produce one. Of course there are others that I would prefer over Lorenzo for hairline design and aesthetics, but it isn't accurate to say they are all "high" like you suggest.

 

 

 

 

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Jean,

While I agree with the points you made, I think you could make these points without name calling. I understand as patients we can become passionate, I have been guilty of this myself, but we should not resort to name calling. 


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12 hours ago, bismarck said:

1. Hard to follow your posts because of your limited English but I will finish with this and then not discuss the matter further:

2. All because you have not seen enough results does not mean they are not online. Freitas and Couto have a high number of before and afters, look for yourself instead of arguing off the cuff. Specifically go to the Spanish language forums. 

3. Konior has a large database of strip and his patient posted FUE results have been uniform (I have seen about 20 as opposed to 50-100 with the other guys). There are fewer in quantity but still no misses. 

4. Lorenzo's hairlines are aesthetically displeasing -- this is an opinion held by many on here and one that I share. His yields are strong however.

5. Beehner was peer reviewed. Until something better comes along that's what we have. The absence of a study showing anything to the contrary is deeply troubling. Surgeons that do both procedures acknowledge higher yields with strip. Surgeons that only do one procedure or the other will argue their procedure is better. If you can't do the math on this, I don't know what to tell you.

 

1. Well, sorry that my language skills cause you so many trouble. So far no one had an issue, but maybe it was really the effect of my "c" not working properly yesterday.

2. You misquote me: I mentiond only Konior which I assumed no one has seen enough reports.

3. I doubt that there are 20 patient (!) reports of Konior FUE in here. Even then: Add 1 - 2 bad results and this would directly equal 5-10 % failure rate. That is much worse than the failure rate from most top clinics. Hence my conclusion: The statistics do not allow to make the assumptions you are taking. That is why math is better than stomache feel.

4. If you write it like that I have no issue. It is your opinion which I respect. You can like a BMW or a Mercedes more, that doesn't make one of the superior to the other. I do not like the hairlines of Hattingen, but I still recommend them regulary for strip in europe.

5. I never denied that it is peer revied. But I have revied many papers myself and I know reviewed doesn't mean "without failure" or "top level". Like mentione by Jean there is data available which suggest this data of Beehner is poor.

Do not misunderstand me. I believe (!) that strip has higher yield in general. And I would be happy to know how big the difference is before I make a decision about my crown. But the where serious questions regarding the Beehner paper. This where serious questions and much more than just "it wasn't the magic dr. X who perform the surgery" as you suggest. No one (!) could answer these questions. If you can I would be pleased. Some questions again:

- Why is the yield of strip so low in this paper ( 86 % and that is without considering transected grafts in the donor)? Is it realistic?

- Was a motorized fully rotating punch (!) used and did this effect growth from FUE. For me this was one of the biggest issues.

- Which holding solution was used and under which temperature were the grafts kept

- The author and the reviewer obviously do not understand the difference beween % and %-points. As the claim 24.6 % different but it is 29 % (24.6 % points). Are the further errors in math?

- If the surgeon had almost no FUE experience (<80 prcoedures in 9 years) could this affect the survival rate?

- ... many more ...

 

By the way: There are many (!) clinics performing FUE and FUT who say yield is almost similar. We had this dicussion before. 

I think we actually are not that far apart in our opinions as it appears.

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On 8/20/2018 at 7:56 PM, JeanLDD said:

 

Peer reviewed is better than doctor submitted cases. The only other study I was able to find was Wesley. I agree that the Beehner study had serious limitations. Wesley's data was a bit more thorough, but small sample size.  If you're aware of other studies that compare FUT/FUE head to head I'd be glad to see them. Certainly peer reviewed data is not the final truth, but it is our best attempt at using the scientific method to separate truth from marketing. Certainly better than surgeon submitted cases. I do believe that patient submitted cases are a slight improvement in that they are less filtered, but still obviously limited.

Man, I keep trying to leave this discussion but get pulled back in. Listen -- we all are aware that this topic has been discussed extensively in other threads, and a final conclusion never really was settled upon as far as I recall. I really don't appreciate the personal attacks either. Best of luck to you Jean.

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On 8/21/2018 at 5:00 AM, Gasthoerer said:

I doubt that there are 20 patient (!) reports of Konior FUE in here. Even then: Add 1 - 2 bad results and this would directly equal 5-10 % failure rate. That is much worse than the failure rate from most top clinics. Hence my conclusion: The statistics do not allow to make the assumptions you are taking. That is why math is better than stomache feel.

By the way: There are many (!) clinics performing FUE and FUT who say yield is almost similar. We had this dicussion before. 

I think we actually are not that far apart in our opinions as it appears.

I haven't found a bad result from K, but please direct me if you have. The only one that might qualify is the physician who had his hairline packed with intentionally less density because of his crown. You're right though, it is a very low quantity to make assumptions from, even if adding in the cases posted by Konior himself, which obviously will have selection bias.

Cooley and Konior told me when I visited them in person that their FUT yields were stronger than FUE. The Belgian docs I have spoken with favored FUE. But again, I really have trouble trusting anyone's individual opinion  because money talks -- even when it whispers.

 

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Bismarck,

I can agree almost 100 % with your last two statements and if you send me a link to the Wesley studies I am happy to read it.

Unfortuantely I do not have seen better studies myself. Vories presented a single test case with great growth (well above 90 %) even though it was on scar tissue. It is far from representativ, but shows that it is possible to achieve high yield with FUE (wheras F&B always claimed it is impossible). End of story was: F&B told us nonsense (%-numbers, three forces) but we still do not know the real values. I think 99 % agree that FUT has better yield in average. "The belgians" claimed to me they are close with FUE.

I have not seen a bad result from Konior yet, but I haven't seen one of Feriduni either  ... until I did in here.

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1 hour ago, Gasthoerer said:

Bismarck,

I can agree almost 100 % with your last two statements and if you send me a link to the Wesley studies I am happy to read it.

Unfortuantely I do not have seen better studies myself. Vories presented a single test case with great growth (well above 90 %) even though it was on scar tissue. It is far from representativ, but shows that it is possible to achieve high yield with FUE (wheras F&B always claimed it is impossible). End of story was: F&B told us nonsense (%-numbers, three forces) but we still do not know the real values. I think 99 % agree that FUT has better yield in average. "The belgians" claimed to me they are close with FUE.

I have not seen a bad result from Konior yet, but I haven't seen one of Feriduni either  ... until I did in here.

The three forces argument itself is psuedo-scientific nonsense also drawn from no data or testing. I can grab someones arm and put a variety of forces on it, that doesn't in any sense mean it is going to be damaged just because force is applied. There would need to be a test on different types of forces application on graft and resulting yield and effect on the hair itself. Erdogan did something similar presented at the World FUE Institute.

And again,  anyone who has done their research on FUE would know it is largely factional among the World FUE institute, FUE Europe and American groups such as the ISHRS.  These regularly present data among colleagues and there are plenty of studies and tests that are visible on Youtube relating to these, for example an afforementioned study by Erdogan on effect of a variety of scenarios on yield (which again just shows a lack of research because Bismark just blindly pretends they don't exist) Suggesting that there are only a few studies just reflects a lack of understanding where the data is being recorded and presented. It is within these institutions between surgeons of the same group, there is no incentive to release through mainstream journals these reports as they have reason to support their own internal community.  It's just incredibly dishonest and ignorant to look past this and the public scientific data, presented studies and group discussions they have put out because they aren't in "peer reviewed journals". On top of that we have extensive  number of patient posted results from a number of surgeons to make judgements with.

Do a basic Google search on this and you'll find a lot more information than a trashy, primary school level study by Beehner who had done less than a tenth of the training of one of Lorenzo's techs on FUE and doesn't know what controlled variables are or how to follow the scientific method. Directing this at Bismarck mainly.

And Bismarck, I do not take anything personally in any case where I am annoyed it is fully at when I see facts being wilfully shredded, a lack of research, an expressed intellectual persona without proper research, understanding of peer review actually is, how to read a scientific study, or how the scientific method works. By the way I'll say again that I mainly disagree with your methodology in analysis, not your conclusions which we seem to differ only slightly on.

Also aside point, I've seen a LOT of bad Feriduni results, and on Konior there was a case he did in conjunction with Gabel presented on the Gabel website that I wouldn't call a failure but was clearly below par. Very surprised Bismarck that you would place Doganay in any list of top FUE surgeons, he certainly has talent and has an extensive portfolio of phenomenal results, but there isn't a certain at that level of infamy in the world with as many awful results. Would almost go as far as to suggest its close to a majority.  I would place Freitas, Couto, Baubac and Keser at the absolute  for small to mid sized FUE sessions, and Lorenzo and Erdogan (both being at a similar level imo) for mid to larger sessions but their hairline work not quite at the same level.  Konior is likely at that level in terms of surgeons for smaller sessions but there isn't enough of his work to say conclusively imo. Below this I would put the Belgians and HnW at a similar level. 

 

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Well now you're starting to sound as evangelical as F&B. I agree with many of your points, but I do not take YouTube videos or internal data from meetings as seriously as published & reviewed data. No one does.

The absence of research on the two techniques is very troubling to me, we are still in the wild, wild west. Nothing to do about this but look through patient submitted cases and patiently wait for the field to develop, or take a leap of faith.

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23 minutes ago, bismarck said:

Well now you're starting to sound as evangelical as F&B. I agree with many of your points, but I do not take YouTube videos or internal data from meetings as seriously as published & reviewed data. No one does.

The absence of research on the two techniques is very troubling to me, we are still in the wild, wild west. Nothing to do about this but look through patient submitted cases and patiently wait for the field to develop, or take a leap of faith.

If you don't take data and studies presented by top surgeons such as Erdogan or Shapiro in organisations which include members such as Rahal, Cooley, Lorenzo and Feriduni for example then there is nothing more to say to you, you're willfully ignorant and I feel sorry for you because I'm sure it bleeds into other areas of your life too.

There isn't an absence of research, you are refusing to look at it. You blindly accepting a single study from a decade ago that doesn't mention controlled variables and was done with less than 100 hours FUE experience is faith, doing actual research and looking at all available data on the subject in 2018 is not. End of argument.

Edited by JeanLDD
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13 hours ago, JeanLDD said:

If you don't take data and studies presented by top surgeons such as Erdogan or Shapiro in organisations which include members such as Rahal, Cooley, Lorenzo and Feriduni for example then there is nothing more to say to you, you're willfully ignorant and I feel sorry for you because I'm sure it bleeds into other areas of your life too.

There isn't an absence of research, you are refusing to look at it. You blindly accepting a single study from a decade ago that doesn't mention controlled variables and was done with less than 100 hours FUE experience is faith, doing actual research and looking at all available data on the subject in 2018 is not. End of argument.

Straw man arguments have no place on here. Peace.

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On 8/21/2018 at 7:00 AM, Gasthoerer said:

3. I doubt that there are 20 patient (!) reports of Konior FUE in here. Even then: Add 1 - 2 bad results and this would directly equal 5-10 % failure rate. That is much worse than the failure rate from most top clinics. Hence my conclusion: The statistics do not allow to make the assumptions you are taking. That is why math is better than stomache feel. 

Stupid comment. So you are saying 1-2 bad results would make it a horrible rate.....that's great except there has not been one bad result posted by him, EVER....and he has been doing this longer than 95% of the surgeons left. The guy is just that good.

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4 hours ago, matt3480 said:

Stupid comment. So you are saying 1-2 bad results would make it a horrible rate.....that's great except there has not been one bad result posted by him, EVER....and he has been doing this longer than 95% of the surgeons left. The guy is just that good.

 

Except there are still less than 20 FUE results of Konior online. Probably about 15ish. That's 15 FUE results since he started performing it available to see online. Who cares if it's "Ever", there are other surgeons that have close to 50-80 patient posted results a year, 15 in over 5 years is meaningless.

The only stupid comment is yours. That's not knocking Konior because almost every result I have seen of his is great, but you can't compare a Lorenzo or Erdogan with above 50 patient posted results a year to only Konior who has 15 in five years.

 

https://www.gabelcenter.com/galleries/patient-1721/

 

Also this result which was performed by both Konior and Gabel is by no means top tier, it's not a failure but the angles don't appear natural and contrast with the native hair, and density is clearly very poor. There's no secret sauce to avoid bad results.

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