FUE or FUT ?

[M Law]

I am so confused by the different hair transplant procedures. Which is the better solution that will deliver a more natural looking result?

[TeeJay73]

Hey M Law, I am not a doctor by any stretch of the imagination, but I have had the FUT method with Doctor McAndrews. I believe naturalness is driven by the fact that the hairs are transplanted in their naturally occxuring groupings (called follicular units), and not by the method type (FUT or FUE). I believe the key difference between FUT and FUE is the scarring that results from the procedure. FUT leaves a thin linear scar which is covered by even a short haircut. FUE leaves less of a scar as I understand it. Definitely talk to a doctor about any other differences.

[M Law]

Thanks TeeJay for your reply. I suppose my next question is if the the FUT would deliver more density. I don't shave my head anyways, So I'm not really that concerned with a small visible scar. I care more about having more density on my hairline.

[TeeJay73]

Hey M Law,

I don't believe the FUT method (otherwise known as the "strip" method) has any significance as it relates to density, but, again, I'm not a doctor. The FUT and FUE methods simply refer to how the grafts are harvested from your donor region (back of your head).

With FUT, an entire strip of tissue is removed from the back of your scalp, which contains hundreds or thousands of follicular hair units. Your scalp is closed shut and sutured. This is what produces a thin linear scar. Then the doctor and his/her staff dissect the excised strip of tissue into individual follicular units, and transplant them one-by-one into tiny incisions into the area of your scalp to be transplanted.

With FUE, inidividual follicular units are extracted from your donor region, and transplanted into the tiny incisions in your scalp. I believe this is why there is substantially less (or even zero) scarring with FUE. The follicular units are just pulled out of the back of your head and relocated.

I'm not sure of all the pros and cons of either method, but I don't believe either has a profound affect on your density outcome. Density is related to how many grafts you pack into a given area, and this is irrespective of the type of hair transplant surgery performed (FUT or FUE). I'm not sure if there is a difference in yield between either method (i.e., how any grafts survive the transplant and grow in their new area), but, if there is, then this may affect your density outcome.

Just stick with the IAHRS doctors and your hair transplant will look like a million bucks (but won't cost that much!). I had an original hair transplant with a big name clinic, and it was not good. When I found the IAHRS, my path of bad luck turned around.

Hope this helps -- TeeJay

[JustJoe]

I am so confused by the different hair transplant procedures. Which is the better solution that will deliver a more natural looking result?

My opinion:

1. Want to keep your hair a little bit longer and get bang for your buck: FUT or STRIP.

2. Want to keep you REAL hair short and have little or no scar. Cost more for less hair. : FUE.

(small touch up work.....FUE)

[Dr. Feller]

The difference between FUT and FUE are simple and obvious.
FUT, for the most part, enjoys consistently high yields of over 90%.

FUE, on the other hand, has wildly varying yields, sometimes as low as 50%.

Why?

Because FUE grafts are subjected to three detrimental forces that FUT grafts are not:
1: Torsion- Twisting of the graft
2: Traction- Pulling of the graft
3: Compresion-Squeezing of the graft

There are a few more minor detrimental forces associated with FUE, but those are the important ones.

Now, that's not to say that FUE doesn't have it's place. It most certainly does:
1. Patients who CAN'T have any more strip surgery due to prior procedures
2. Patients who simply DON'T want strip surgery for whateve personal reason
3. Patients who need a limited amount of grafts as in a "fill-in" procedure or a "touch-up" procedure.

There have been some exceptionally impressive FUE results over the years. However, the number of these impressive results compared to the number of FUE procedures performed simply does NOT compare to strip surgery.

My recommendation is that if you are going for more than say 1,200 graft, go for a strip surgery as it is still the best bang for the buck.

[M Law]

Hey M Law,

I don't believe the FUT method (otherwise known as the "strip" method) has any significance as it relates to density, but, again, I'm not a doctor. The FUT and FUE methods simply refer to how the grafts are harvested from your donor region (back of your head).

With FUT, an entire strip of tissue is removed from the back of your scalp, which contains hundreds or thousands of follicular hair units. Your scalp is closed shut and sutured. This is what produces a thin linear scar. Then the doctor and his/her staff dissect the excised strip of tissue into individual follicular units, and transplant them one-by-one into tiny incisions into the area of your scalp to be transplanted.

With FUE, inidividual follicular units are extracted from your donor region, and transplanted into the tiny incisions in your scalp. I believe this is why there is substantially less (or even zero) scarring with FUE. The follicular units are just pulled out of the back of your head and relocated.

I'm not sure of all the pros and cons of either method, but I don't believe either has a profound affect on your density outcome. Density is related to how many grafts you pack into a given area, and this is irrespective of the type of hair transplant surgery performed (FUT or FUE). I'm not sure if there is a difference in yield between either method (i.e., how any grafts survive the transplant and grow in their new area), but, if there is, then this may affect your density outcome.

Just stick with the IAHRS doctors and your hair transplant will look like a million bucks (but won't cost that much!). I had an original hair transplant with a big name clinic, and it was not good. When I found the IAHRS, my path of bad luck turned around.

Hope this helps -- TeeJay

Teejay - Thanks man for taking the time to share your thoughts on this.

My opinion:

1. Want to keep your hair a little bit longer and get bang for your buck: FUT or STRIP.

2. Want to keep you REAL hair short and have little or no scar. Cost more for less hair. : FUE.

(small touch up work.....FUE)

Hey Joe - Thats 2 for FUT being more bang for the buck, I know Dr. Feller said the same thing. I am thinking that is a better route for me if I decide to go forward with it. Thanks.


Because FUE grafts are subjected to three detrimental forces that FUT grafts are not:
1: Torsion- Twisting of the graft
2: Traction- Pulling of the graft
3: Compresion-Squeezing of the graft


Hi Dr. Feller - Many thanks for replying to my question. That really helps to clear things up and makes sense. I am curious why torsion, traction, and compression can occur during FUE. Is this based on the skill of the surgeon or something that can just happen no matter how skilled he/she is?

[Dr. Feller]

Those three dertimental FUE forces are inherent to EVERY FUE procedure no matter who is performing it.

The problem is that many FUE doctors, especially the "grandstanders" omit this information from their promotional materials. By the way, failure to disclose this information is considered medical malpractice in some states as such omission can be considered a failure to provide informed consent.

In my clinic, I have minimized these detrimental forces through the use of custom made tools and protocols. All my tools have been disclosed publicly and have even been described in the leading textbook "Hair Transplantation" 4th edition.

[JustJoe]

Those three dertimental FUE forces are inherent to EVERY FUE procedure no matter who is performing it.

The problem is that many FUE doctors, especially the "grandstanders" omit this information from their promotional materials. By the way, failure to disclose this information is considered medical malpractice in some states as such omission can be considered a failure to provide informed consent.

In my clinic, I have minimized these detrimental forces through the use of custom made tools and protocols. All my tools have been disclosed publicly and have even been described in the leading textbook "Hair Transplantation" 4th edition.


Yeah, Dr .Feller, you're pretty good at the dense packing FUE procedure, I'll give you that. You're outspoken too, I'll give you that. Your laser video was a little lame thou. LOL! Just kidding....kinda. I don't use a laser anymore, but I do think it has some merit. I would not tell anyone to go out any buy one, but there is something to the laser. I don't think it grows hair, but it does have some effect. I can't prove it, so I'll have to drop the topic. :)

[Dr. Feller]

VIDEO: Short version
http://www.fellermedicaldata.com/Video/laser2.wmv

VIDEO: Long version
http://www.fellermedicaldata.com/Video/laser1.wmv

What makes the video "lame"? I am genuinely curious as to what you didn't agree with.

As the video shows, laser light cannot pass to the follicle. It is an inarguable fact of physics, and one that the LLLT industry overlooked when hyping their products.

That's why no industry representative nor LLLT doctor bothered to respond to the video or to the discussions that took place afterward. Doesn't that raise a very big red flag in your mind as a consumer?

But hey, if Mr. Michaels, his crack laser staff, or any LLLT doctor wants to debate the merits of the video on Spencer's radio show, I'm up for it. Are they?

[Chaos]

Yeah, Dr .Feller, you're pretty good at the dense packing FUE procedure, I'll give you that. You're outspoken too, I'll give you that. Your laser video was a little lame thou. LOL! Just kidding....kinda. I don't use a laser anymore, but I do think it has some merit. I would not tell anyone to go out any buy one, but there is something to the laser. I don't think it grows hair, but it does have some effect. I can't prove it, so I'll have to drop the topic. :)

I saw the video, I didn't think it was lame at all. I know you were only joking Joe right? Where you looking for a hollywood production that included the use of lightsavers 34 to be cast as the "Lasers" The lightsaver probably will work just as well on your head for regrowth as does the lasercomb. In fact I wonder if I can swap out my lasercomb for a lightsaver on ebay. Then I could at least twirl it around the house, and if I get the urge I could rub it on my head to for some good hair luck.

Anyways, Dr. Feller, I would love to hear you debate Mr. Michaels. I love a good smackdown. Send him my lightsaver regards.

[Dr. Feller]

Chaos,
I think you mean lightSABER???

I have already debated David Michaels on Spencer's show and believe I demonstrated the problems with LLLT in a very articulate and forceful way. He will not debate me again on the radio, that's for sure.

But perhaps Spencer can arrange a live debate between me and ANY LLLT doctor listed on the Hairmax "medical advisory board"? How about it Spencer?

I would just settle for any doctor or LLLT industry rep who would just respond to the video in a chat forum. I would love to see how any of these doctors deal with the now obvious fact that laser light CAN'T make it to the follicles.

You see, these doctors didn't know the fact that laser light can't hit the follicles when they started offering LLLT to the public for pay (or other forms of compensation). But NOW, they do- and they have ALL been very very quiet. Interesting, isn't it?

But this isn't just an academic expose on the LLLT industry. Despite the unopposed proof I've offered that laser light doesn't and can't bath the follicles as advertised, the LLLT industry is STILL selling their products and LLLT doctors are still selling their Laser services. This must be addressed and publicized before more people throw their money away on LLLT.

[Chaos]

LOL!!! Yes I Mean LIGHTSABER :D That sure explains a lot as to why I had a hard time finding images for the "lightsaver" ! I would have edited my post after you pointed it out, but it's a lot funnier this way.

Thanks.

[SpencerKobren]

But perhaps Spencer can arrange a live debate between me and ANY LLLT doctor listed on the Hairmax "medical advisory board"? How about it Spencer?

But this isn't just an academic expose on the LLLT industry. Despite the unopposed proof I've offered that laser light doesn't and can't bath the follicles as advertised, the LLLT industry is STILL selling their products and LLLT doctors are still selling their Laser services. This must be addressed and publicized before more people throw their money away on LLLT.

I think I can arrange something.
We'll talk:)

[TeeJay73]

I don't know anything about the lasercomb or its possible effectiveness. I have never tried it and I don't plan on doing so, especially in light of its current controversy.

But, in my mind, what stands out more than anything else is Doctor Feller's confidence is his knowledge/opinion of the ineffectiveness of the lasercomb and his willingness to come forward, publicly, with free-to-see scientific data/rationale/experimentation, and to publicly debate the issue with lasercomb advocates/doctors. But there seems to be no reciprocity on the lasercomb side at all --- have they done a Criss Angel Mindfreak and disappeared on us?

I think Doctor Feller's sternness in his knowledge/opinion speaks to his quality as a doctor and care for his patients and literally all of us suffering with hair loss. His underlying message seems simple to me: "It doesn't work -- Don't waste our money!"

TeeJay