Why would FUE result in a reduced shock loss?

[herbert]

Hello,

 

I've browsed a lot of posts about shock loss, and read that FUE is a good way to work in thinning areas in order to prevent shock loss...

 

Why???

 

As far as I know, FUE is a new harvesting tech, which of course produces more skinny grafts compared to the average chubby strip-harvested grafts.

The skinny grafts can be placed in smaller incisions on the scalp, thus reducing the trauma and harm for existing hair.

 

But I know there are some strip surgeons that prefer to work their grafts skinny before transplanting.

According to the considerations of FUE and shock loss, placing these skinny strip grafts should achieve the same improvement in terms of shock loss prevention... or am I missing something?

 

Now my doubt is: is there any difference between FUE skinny grafts and strip skinny grafts, to justify the more famous FUE benefits in reducing shock loss?

 

thanks for any clarifications.

[herbert]

Hello,

 

I've browsed a lot of posts about shock loss, and read that FUE is a good way to work in thinning areas in order to prevent shock loss...

 

Why???

 

As far as I know, FUE is a new harvesting tech, which of course produces more skinny grafts compared to the average chubby strip-harvested grafts.

The skinny grafts can be placed in smaller incisions on the scalp, thus reducing the trauma and harm for existing hair.

 

But I know there are some strip surgeons that prefer to work their grafts skinny before transplanting.

According to the considerations of FUE and shock loss, placing these skinny strip grafts should achieve the same improvement in terms of shock loss prevention... or am I missing something?

 

Now my doubt is: is there any difference between FUE skinny grafts and strip skinny grafts, to justify the more famous FUE benefits in reducing shock loss?

 

thanks for any clarifications.

[Dr. Glenn Charles]

There is no evidence that there is less shock loss following FUE grafting vs strip grafting. I perform both procedures and have found no reason other than in most cases when FUE grafting is used there is generally only 400-600 grafts vs 1500-2000 grafts used in strip grafting techniques. If you place more grafts in a smaller area there is a greater chance of causing shock fallout of pre-existing hairs.

[Franklin]

Well I am just giving my opinion.I had 3 small strip procedures in the past and did notice some shock loss.I then went in January 2003 to add 1100 frafts to my density in a lot of exsiting hair.Dr.Woods buzzed down my hair used a very high powered microscope(zeiss scope)and used 23 gauge needles for my procedures.I had more grafts placed in smaller area this time around and the doctor took his time placing every graft in the recepient area that I was able to watch myself.I also chose the doctor that has been doing Fue for over 15 years so I had great confindence in my descion.To me it made all the difference in the world.I had a great result and great experience.

[nile]

Dr. Glenn,

How does the no. of grafts make a difference in terms of shockloss. I was made to believe that if proper care were exercised, there is less chance of damage to existing hair roots and so there is less shockloss.

I ask because I am planning for a 4000 fue with lots of body hair in my next surgery.

[arfy]

Nobody knows exactly what causes shock loss (except when it is caused by directly damaging the existing hair with recipient site incisions).

 

According to Dr. Bernstein (and scads of anecdotal reports from patients) shock loss can happen even in the areas where no grafts were placed. In other words, you could theoretically get grafts placed in the hairline only, and have shock loss in the crown.

 

Some of the guesses why shockloss occurs:

the numbing agents cause it

the saline used to expand the scalp causes it

general surgical trauma causes it

 

Much of the reputation for 'no shock loss with FUE' seems to originate with Dr. Woods' practice (although other FUE docs seem to report "less" shock loss, if I recall correctly). Also, this is not to say Dr. Woods has never had a patient report shock loss... he has had one or two, to my knowledge. However it seems that generally his patients do NOT have shock loss issues. As Franklin noted, Dr. Woods uses a Godzilla-sized microscope to place the grafts, which guarantees that no existing hairs are damaged directly from new incisions. Other doctors do not use the same level of magnification as Dr. Woods. His microscope makes your grafts look like the size of tree stumps (he has a video feed coming from the microscope, you watch him place the follicles on a TV monitor). There is no chance of accidently damaging an existing hair, as far as I can tell.

 

Franklin is a good case study for shock loss and FUE via Woods, as Franklin had a whole lot of pre-existing hairs that were grafted in and around, with no shock loss reported. I am certain that the microscope used in graft placement must have played a part.

 

Shock loss has never been studied, it is controversial and not fully understood. For example some doctors say there is no such thing as shock loss, and some doctors say that they 'never' have a problem with it. Also, it can sometimes be hard to say what is "shock loss" and what is just garden-variety "continuing progression of hair loss" that could have happened even if you didn't have surgery.

 

Also, IF shock loss is sometimes a result of "general surgical trauma" then you could argue that FUE results in less shock loss because FUE is less traumatic than a traditional strip surgery. (Yes, technically the 'square inches' of incisions may be mathematically larger with FUE, but in my opinion the body tolerates hundreds of tiny incisions better than one very BIG incision-- the strip excision).