Are modified forms of FUE really that different in their results or is everything the same?

[Gabreille Nelson Mukhia]

We come across so many techniques that are termed as modified or enhanced versions of FUE. It can get overwhelming most times. 

However, as most of the members in this forum are well informed and experts in the field of hair transplantation, this question would be apt to raise here.

Experience, instrumentation, add on therapies and conjured hairstyles aside: does it make a difference when modified versions are performed? Or is it basically the same as a normal FUE procedure with no difference in the output?

[Wendell]

Hi, I have been reading about FUE. What I found about your topic was the so called modified FUE (mFUE) but not everyone is talking about mFUE. I dont know the reason because I am just a humble HT candidate. For me as a teacher and a HT CANDIDATE I think in my case it is good because I have many locks of hair like african caucasican hair and maybe as my hair growth pattern is like that a fut strip is not proper for me. So I am planning to talk to my doctor about having FUE first and then that mFUE or FUT as convient.

 

[LonelyGraft]

Personally, I feel there’s a lot of marketing that clinics do to try and bring in more customers. As long as the end result is good, survival numbers are high, and donor is not compromised, it shouldn’t matter. I don’t think there’s much difference. I’ve seen excellent results from clinics using manual punches as well as motorized. I’ve seen excellent results from clinics using implanters/pens as well a traditional pre made incisions. Same can be said for stick and place as well as mega sessions where grafts are extracted in one step and implanted after.

 

I think what matters most is going to an ethical surgeon who will be realistic with expectations and who also has surgical and artistic skill. Their surgical team as a whole must have talent as the doctor is only a part of the entire process.

[DrTBarghouthi]

This is a very “hot” topic!! Thanks for bringing it up. 

I do think that a lot of the modified names are purely made up for marketing reasons. 

Hair transplant clients come in two categories: the really well researched and those who are not.

The well researched would know the main difference between the procedures and the fact that there are several extraction and placement techniques that can equally produce great results. It comes down to what works well for the surgical team as a whole. 

As for the non researched group, (which is consistently growing as HT surgery is becoming more and more main stream due to some cost cutting providers) they will simply go after any name advertised. We often get enquiries asking for a HT procedure that I haven’t even heard of. This phenomenon of new names is made to target this segment. I dont think anyone on this forum belongs to this group. 

[hairlossPA]

i’m more interested in the implantation method. forceps seem to be old technique but can still produce good results. It just makes sense to use a “pen” or something similar to make sure the graft is protected upon entry of the scalp and not bent/squeezed/damaged when placed. I’ve raised this topic before but didn’t get much conversation besides “focus on the results”

[DrTBarghouthi]

I do think it all comes down with what works well within the team. It is not an easy thing to switch to a new implanting technique if the previous one is working well and the team is experienced in it. Implanters do have a faster learning curve though and can offer a safer option for new or less experienced techs. I personally like some implanters out there that offer the combined use of premade sites, an implanting device and the use of forceps at the same time. But again, each practice goes for what works for it. 

[gillenator]

I would also concur that most of it is marketing hype to draw patients in.

JJ is spot on and let's face it...the patient has to analyze and compare documented long term results regardless of the labeling.

[elduterino]

https://www.swisshairdoctor.ch/fileadmin/content/newsblog-haarverpflanzung-vonalbertini/2017-05-fue-haartransplantation-implanters/Hair-Transplant-Forum-Implanter-FUE-Artikel-Juni-2017.pdf

According to this study, the implanter pen method is superior 

 

Edited May 8, 2019 by elduterino

[DrTBarghouthi]

This is a very nice study indeed. Nonetheless, it does not aim to compare forceps with implanters. Its objective was to assess the various injury levels of grafts placed using an implanter, which is quite slim. Remember that if a practice is used to one method, then they are likely to produce less damage using that method. 

[Markee]

Here's an interesting video from Joe Tillman on the different types of FUES 

 

 

[elduterino]

Top docs like Dr Couto - booked 3 years in advance - are using the implanter pen with top notch results 

The tech driven mills are using the older lateral slit method since the doc can only do a very small portion due to time constraints, as they need to rotate patients on the same day, so that is usually only the incisions job 

 

Edited May 8, 2019 by elduterino

[DrTBarghouthi]

I totally agree that implanters (various types) are getting increasingly popular and produce nice results. However, it is a bit of generalization to assume that anyone using implanters will produce great results and anyone using forceps produces sub par results. There are many excellent clinics that are still producing amazing results with forceps and at the same time there are tech driven mills that are using implanters and producing bad results. I use both personally and at the end it comes to respecting the grafts from the moment its extracted to the moment it is implanted. 

Edited May 8, 2019 by DrTBarghouthi

[elduterino]

which tech driven clinics are using the implanter? 

 

 

[DrTBarghouthi]

Well from what I see being advertised many clinics in Turkey (with no associated doctor) are advertising using choi implanters. I wouldnt be surprised as it could be easier /safer to train someone on implanters rather  than forceps. Nonetheless, they advertise it heavily. Whether they are genuine or not I’m not sure. But it seems most of these are tech run clinics anyway. 

[Gabreille Nelson Mukhia]

On 5/6/2019 at 7:42 AM, jj51702 said:

Personally, I feel there’s a lot of marketing that clinics do to try and bring in more customers. As long as the end result is good, survival numbers are high, and donor is not compromised, it shouldn’t matter. I don’t think there’s much difference. I’ve seen excellent results from clinics using manual punches as well as motorized. I’ve seen excellent results from clinics using implanters/pens as well a traditional pre made incisions. Same can be said for stick and place as well as mega sessions where grafts are extracted in one step and implanted after.

 

I think what matters most is going to an ethical surgeon who will be realistic with expectations and who also has surgical and artistic skill. Their surgical team as a whole must have talent as the doctor is only a part of the entire process.

So true. Thank you for providing your insight. It is such an important factor for the Doctor to be genuine and artistic. 

[Gabreille Nelson Mukhia]

On 5/6/2019 at 11:09 PM, hairlossPA said:

i’m more interested in the implantation method. forceps seem to be old technique but can still produce good results. It just makes sense to use a “pen” or something similar to make sure the graft is protected upon entry of the scalp and not bent/squeezed/damaged when placed. I’ve raised this topic before but didn’t get much conversation besides “focus on the results”

Thank you for sharing your insight. I too have similar beliefs that the use of forceps for implantation seem to leave scope for damage to the grafts. The use of Implanters reduce the risk to a massive extent.

[Gabreille Nelson Mukhia]

12 hours ago, elduterino said:

https://www.swisshairdoctor.ch/fileadmin/content/newsblog-haarverpflanzung-vonalbertini/2017-05-fue-haartransplantation-implanters/Hair-Transplant-Forum-Implanter-FUE-Artikel-Juni-2017.pdf

According to this study, the implanter pen method is superior 

 

Thank you so much for sharing the link with us. 

[Gabreille Nelson Mukhia]

18 hours ago, gillenator said:

I would also concur that most of it is marketing hype to draw patients in.

JJ is spot on and let's face it...the patient has to analyze and compare documented long term results regardless of the labeling.

It is a very unethical practice though, if the marketing technique promotes false information. Even I am so skeptical of the hype that is created with no scientific literature or results to back it up with.

Thank you for sharing this important point. Marketing tactic really is something we tend to overlook nowadays because there is so much of it and it is considered a norm.

[gillenator]

On ‎5‎/‎8‎/‎2019 at 10:27 AM, Gabreille Nelson Mukhia said:

It is a very unethical practice though, if the marketing technique promotes false information. Even I am so skeptical of the hype that is created with no scientific literature or results to back it up with.

Thank you for sharing this important point. Marketing tactic really is something we tend to overlook nowadays because there is so much of it and it is considered a norm.

I could not agree more.

[DrTBarghouthi]

Yes it is quite unfortunate how penetrating those marketing “terms” have become. In certain regions and for certain individuals it seems like completely brain washing them. For most doctors it is unethical to claim something that doesn’t exist or to make false promises such as your donor will regrow itself!!! However, when several non medical practitioners get into a trade (which is the case in many tech only practices where non medical individuals actually perform procedures), then the ceiling for “selling” becomes quite high that they will provide you with false promises in order to close the deal. Extremely sad and unfortunate. In the HT business, a bad reputation driven by a bad clinic could affect many good practices unfortunately.

  

[gillenator]

Regardless of the instrumentation being used, it is only as good as the skill level of the individual using them...in the wrong hands or less experienced, the results can be disastrous.