Good FUE and Bad FUE- Dr. Feller of Great Neck, NY

[Dr. Feller]

I have been facinated by the potential of FUE since 2001 and have been striving since then to identify and address the main problems associated with this delicate and often unforgiving procedure.

At the same time I have been trying to educate the public as to the REALITIES and limitations of this excellent procedure, all the while battling with those who would over-hype it for reasons known only to themselves.

As I scan forums like this one, I am discovering that these efforts are paying off and the public is finally getting a perspective on what FUE can and cannot CONSISTENLY achieve. In other words, FUE is finally finding it's proper place within the HT industry.

With FUEs newly established foundation, credibility is beginning to grow and more and more practitioners are striving to learn how to perform proper FUE and to offer it to their patients as a viable ADJUNCT to strip surgery.

This is fantastic and I hope this trend continues, but to protect the growth and credibility of this procedure I want to continue to remind the public that FUE still sufferes from disadvantages that strip does not have to deal with.

Furthermore, I want to make it clear that NOT all FUE procedures and practitioners are the same. It is up to YOU, the potential patient, to do your HOMEWORK to find out who offers FUE competently, consistently, and transparently. Reading forums like this one are the very BEST place to start your research.

Remember, there are three detrimental forces unique to FUE procedures:
1. Torsion
2. Traction
3. Compression

They may not seem like much, especially when you think of the tiny scale of Follicular Unit Extraction. But don't be fooled, these forces are THE obsticles to a good final result.

The first photo below demonstrates what happens to a follicular unit when all three detrimental forces are at their maximum (the left photo); and at their minimum (the right photo)

The second photo shows two perfect follicular units. One was extracted via proper FUE, the other was from strip dissection. Can you tell which is which?

The third photo are all FUE grafts.

Now the twist:

It's easy to look at the first photo and see which graft was mangled during extraction, and there is little question that this one will not grow well (if it grows at all). The problems begin when you realize that even the graft on the right side of the photo may NOT grow either. While the graft may LOOK intact, it simply MAY not be.

You see, the three detrimental forces described above do not always leave VISIBLE evidence. That's why many mega-FUE clinics have many VERY impressive IMMEDIATE post op photos, but an obvious dearth of impressive "final result" photos- the ones that truly count.

Patience, dedication, and instrumentation are the perspective patient's clues as to whom to pick for their FUE evaluation and surgery. And to my mind, utter and absolute TRANSPARENCY is a must.

[cjason]

Thank you Dr. Feller for that valuable information. I'm new to this site and just begining my investigation. I've visited with three practioners asking each to have a couple of satisfied patients contact me. I was contacted by only one physician's patient. What questions do you recommend asking a physician to determine if he or she is proficient at FUE?

[Dr. Feller]

That is a GREAT question, and of course it's not easy to answer, but here is what I think would be good qualifying questions to ask and things to look for:

Just ask your perspective FUE doctors for photos of their patients during the surgery and just after surgery.

Even an untrained eye can tell what's proper and what's not.

Also, just scan internet forums like this one and there should already be a few of their patients posted along with observations and critiques.

Ask if they use a two step FUE process or three. I prefer the three step process myself.

Another indicator is if they perform good STRIP surgery. IMO, if a doctor doesn't perform consistenly good STRIP surgery, then the chances of performing excellent FUE procedures are lower. This is not a hard and fast rule set in stone, but a very useful guideline.

Finally, make sure that they NEVER, EVER, use punches greater than 1mm for their extractions unless you understand that it will leave more scarring in your donor area and that they must have your permission to do so if need be.

[Dr. Feller]

Here are photos of one of my patients of the type I mentioned in the last post. I don't know if I or spex has made a proper presentation of this FUE patient on this site yet, if I haven't I will do so in another thread.

But this, in my opinion, is a classic example of how to present FUE patients. It shows before, after, and DURING the procedure.

[HelpROGER]

Hello Dr. Feller. Thank you for giving us such an in-depth education of the FUE process. Since I found this website my entire perspective on hair transpalnts has changed. Just so I don't repeat myself I’ll link to my story on this site. http://www.baldtruthtalk.com/showthr...=1041#post1041

If it were not for my mother doing some last minute research I might have been an unhappy MHR person and would have never known about the IAHRS and you doctors. I have scanned some of the other forums as you suggested but I must admit that I gravitate back here because of the vibe I get from the members and the doctors here. It feels better and more honest here and I am so thankful for this site and all the work doctors like yourself do to help educate us. I can not belive I was this close to falling for MHR.

I just wanted to say thank you Dr. Feller and keep up the good work.

Roger

[Zao]

Great post Roger. I think it’s outstanding that a busy person like Dr. Feller would take the time to write such educational posts and since we are sharing stories here’s mine Dr. Feller. http://www.baldtruthtalk.com/showthr...=1392#post1392

I want to thank you also Dr. Feller!

[Dr. Feller]

Glad to help Roger and Chris. If you keep posting and staying involved, I will too.

Take care,
Dr. F

[Kendog133]

Hello Dr. Feller... I am new to this forum and considering some work to be done... with FUE, how is the donor area affected and will there be regrowth in that area? I like to wear my hair pretty short and want to know if I could continue to do so should I elect to have work done.

Also, what from your experience is the average cost of an FUE procedure for hairline restoration and slight thickening?

Thanks!