FUE and the short hair cut

[topcat]

After getting a chance to listen to that last segment of the show dated 01/5/12 I realize why some of the comments I heard got me so heated. Regardless of how heated I was I should have showed more restraint especially with the name calling as I know more than most it’s not necessary when just addressing the questions, statements or concerns is all that is required.

Jotronic you refuted the comment that fue could be used to give the shadow of a hairline with the rest of the hair shaved fairly close to the scalp as it does not exist and seems to just be an internet rumor. This is clearly false as I have seen results such as this and better in person and several such cases have been posted to the internet. To say you have not seen these cases might very well be true but it does make me wonder when I hear that statement coming from a strip only clinic.

Spencer also stated that he has not seen this type of result but just previous to your response he is the one who brought it up as being an option but then was relegated to saying it was just theory.

Jotronic I would disagree with your statement about density being the main concern when avoiding scarring in the donor area. Most of the scarring I have seen has not been so much from reducing density from its original so much but using punches that were too large along with a very poor extraction pattern. Of course density matters but I would be more concerned with these two issues firstly.

How can anyone believe FUE in not definitely beneficial for many cases after it’s been out close to 10 years now? But it can only be beneficial in the right hands of which there are probably less than 5 and of those 5 even fewer that can offer everything else one should be looking for in a clinic.

Jotronic why may I ask does your clinic have all these FUE tools, what is the purpose?

A guarantee of growth which states a full refund if it does not grow is not necessarily a guarantee of growth. It’s a guarantee of getting your money back. I have seen my share of strip cases where there was a failure of growth or full yield. I’m not blaming it on the clinic or the procedure itself as sometimes it’s just the patient for whatever reasons unknown. This is why in my opinion a small FUE procedure is always the safest way to dip your toe in the water and I don’t think this fact can be argued.

When you say you don’t offer FUE because it can’t give the same result you should be more specific. Your clinic does not seem to have the necessary skill to offer it which is still good as they are good at what they do offer. As far as mega sessions of course strip would make more sense but that should be clearly stated as a reason why strip would be preferred. If we are talking about a young guy that needs 2000-3000 grafts why on earth would someone push them into having a strip procedure? It’s unconscionable in my opinion.

Some clinics do offer both procedures and they are equally highly skilled at each. They also have the ethics to advise the patient on the best course of action without the bait and switch. Let’s not blanket them all into one neat little group because of several bad players.

When I stated I was no one it was meant to make a personal statement. Most prospective patients make the mistake of just listening to those that work in the industry or have credentials that seem impressive to them. It’s a pet peeve of mine as I know that this is simply not true and it is not unique to the HT industry. The fitness and nutrition industry as well as many others industries work the same way. Over 90% of what you read about fitness and nutrition is complete bullshit as the only way to make money in that business is by selling the lie and those that do it best wear the white coat or flash the credentials. My own experience and knowledge in this area makes those experts look pathetic. But people still buy into the aura of the expert in the white coat.

Jotronic I think you are a good guy and certainly not a scumbag. You’re above some of the comments you made but maybe you truly believe them. If that’s the case I think you are completely wrong. I will try to stop speaking in code, I guess I get that from what I perceive as an industry that is filled with dark secrets and only those that work in the industry know exactly what I’m am saying, while many posters are just perplexed by my messages.

It is not my goal to try and hurt someone or take away their right to make a living and I could care less how much they make. I’m just tired of seeing young guys getting screwed over for a few dollars. I mean really is the money that GD important.

As far as some of these FUE clinics that are doing poor work I have the following list of questions prospective patients should be asking which should be included to their current list of questions. It bears repeating.


Have you ever been sued by a patient if so how many times and please provide details.



Have you ever sued a patient if so how many times and please provide details.



Have you ever sued a forum if so how many times and please provide details.



Have you ever sued an employee or former employee, if so how many times and please provide details.



Will I need to sign a lengthy non disclosure statement regarding my own procedure and if so why.

[topcat]

I would agree shaving to the bone might present a problem so small sessions over time while constantly evaluating the donor area is the safest way to proceed.

Speaking from my own experience I have had approximately 500 beard hair extraction by way of fue from an area approximately 10-12 sq cm around the chin which is a fairly concentrated space. I have no visible scarring to my face. Everything looks perfectly normal and the yield was extremely high.

Does this mean your result will be the exactly the same? This can only be determined by actually having the procedure and assessing your own results and I would suggest going very, very small in that first procedure.

My personal opinion is that clinics performing fue on the face and chest have taken the procedure to a higher level because most but not all already have the natural skill to perform the procedure. Not everyone has this ability and many should not be practicing this technique because these are the results with low yields and white dotting in a high percentage of cases.

Always ask about any non disclosure statements that need to be signed.

Ask the clinic if they have ever been sued.

Ask the clinic if they have ever sued a patient.

Ask the clinic if they have ever sued a forum.

Ask the clinic if they have ever sued a current or former employee.

Just a few of the uncomfortable questions that need asking before and not after you procedure.

[Spex]

To clarify - rather than have my words twisted any further in reference to my comments here and the other day which were in context of the subject. This guy seems to want to take my words out of context for some reason..Maybe its cause he simply is very confused..

I was referring to shaving all your hair down to the bone in your topic after a HT and informed that this is not a recommended or an advisable approach if the aim is to get a HT and invest 10, 000 's of £ only to only then shave it all off very short or to the bone.The fact of the matter IS a HT needs length to do its job and create the 'illusion' so having a HT and shaving it all off is absolutely pointless in my honest opinion as there WILL be scaring with any type of surgery. Be aware.

In relation to the other topic started by Topcat, i simply was clarifying what was meant by his post as with FUE surgery when performed correctly and extractions form a relatively small surgery are distributed appropriately hair in the donor region in fact can be worn short on a grade 1 0r 2 for example as shown. However there is scaring! FACT. This was from only 1500 FUE. You cant just keep going in again and again without clear evidence especially on this grade after surgery.

Your confusion possibly is the fact FUE patients can wear the donor hair short on a grade 1 and 2 and some even shorter when appropriate surgery and size surgeries are performed but be aware scaring will still reside, its there. How visible the scaring is depends on numerous factors.

A HT shaved down in the recipient area on a grade 1 or 2 can look unnatural in my honest opinion ( all depends on the individual, all their variables and their HT design and approach) and most definitely when a patient shaves his head to the bone after any surgery which is what i ACTUALLY said if you read my comments. If you want that risk, you take it but at least you are now informed.

FUE causes scaring. It does, its surgery. Can you wear your hair shorter with FUE than strip, YES. ( generally speaking) Can you wear your hair to the bone after multiple FUE surgeries NO, in my opinion. If your goal is to have multiple surgeries via FUE and shave all your hair off, pointless in my opinion and THAT was the point i was making in your topic.

I think you need to see patients in person who have had EXACTLY what is is you are aiming to achieve.

Might i ask:
1. How old are you?
2. What NW level are you?
3. Please can you upload pics of recipient and donor region?
4. Are you on medication to prevent further loss?
5.How long have you been researching HT's?
6. How many HT's have you seen in person live in the flesh ?

[sausage]

In fairness Sausage that's only 1500 but I must admit it looks phenominal. It seems to me Dr. Feller takes a smart conservative approach with FUE. If you do a max first time session of FUE of say 1500 and you get only 60% yield well you've only wasted 600 but if you were to go straight in and blast out 3000 and got a 60% yield you're looking at double the hair lost for good at around 1200 FU.

I fairness.....

Spex wrote:

"Im confused too. Where has this been mentioned that you cant cut your hair short via FUE ?"

This clearly states he thinks short haircuts + FUE DO NOT go together.

Here he does not mention number of grafts and in the other post on the other thread he does not mention grafts numbers:

"You clearly have not seen FUE/ HT surgery shaved down in person . Its evident that 'something' has been done - its not 100% natural and when shaved to the bone especially a HT can create more issues than you realise. FUE CAUSES scaring whether you want to believe it or not. HT causes scaring minimal in most cases but scaring can be evident"

So clearly he has contradicted himself.

Anyway even if he was talking in numbers of grafts, from what he wrote in the other thread FUE causes scarring so even if you have a smaller amount of grafts your still going to get scarring, it is not going to stop scarring if you have 1500-2500 grafts. + if a large amount of grafts looks bad shaved down then a smaller amount of grafts will obviously look bad shaved down, its the same FUE procedure.

I think Spex needs to explain why he has written opposing thoughts on whether he thinks FUE and the short haircut works........

[topcat]

Sausage your result will be determined by the clinic that you choose. With a top clinic you should experience yield of 90+% most importantly speak with patients that have had the procedure performed and ask them about their experience. Ask them about their yield and any visible scarring.

Of course it’s good to ask those that work in the industry but speak to the actual customers.

[Follicle Death Row]

In fairness Sausage that's only 1500 but I must admit it looks phenominal. It seems to me Dr. Feller takes a smart conservative approach with FUE. If you do a max first time session of FUE of say 1500 and you get only 60% yield well you've only wasted 600 but if you were to go straight in and blast out 3000 and got a 60% yield you're looking at double the hair lost for good at around 1200 FU.

If you did 1000 on a norwood 2 and it gave poor yield you could change to strip next time and you would only have lost 400.

Personally I'd love to have FUE not so I could shave down all over but so I could have the back and sides really short which is the way I like it. Kind of like how Sean who had 3000 FUE done by Dr. Rahal likes to keep his hair. Unfortunately I think I'll probably need all the hair I can get down the line which would mean stripping out for 8000-9000 would make the most sense and then looking to add 2000 FUE afterwards. The really sucky thing is my father had a full head of hair until 35 and then it started to go and by 45 he was a nw5/6 and has remained that way since. I'm 26 in April and a nw2.5 I'd say so I anticipate heading towards a 6. Unfortunately I think I have my mother's fine greying hair. My father has thick donor hairs so I just seem to lose on every front hair wise. Worst hair genetics ever.

Joe and Spex, what sort of yield do you guys think is typical of the best FUE docs? I know it depends on the patient but ballpark? 80%? 85%? 90%? I often hear it's about 95% for FUT with 6000 available by FUE alone and 8000-9000 by strip alone.

[sausage]

Im confused too. Where has this been mentioned that you cant cut your hair short via FUE ?

Here is a good solid example of FUE donor shaved to the bone after 1500 FUE.

Completely baffling....

Spex in another thread has just written a long post about how you should NOT cut your hair short after having FUE because of scarring etc.

Yet 2 days ago he wrote the quoted post above claiming that FUE does not leave noticeable scarring.

This is very concerning.

[topcat]

The fact is there are plenty of fue results out there and have been for several years with the hair shaved close to the head. The yields have been very high. But just like strip clinics that achieve low yields and massive stretched strip scars or even multiple stretched strip scars there will always be those that do not have the skill.

With the knowledge and experience I have obtained over the years I stand firmly behind the approach of a patient having a small fue procedure as the most risk free approach in deciding if a hair transplant procedure is right for them.

A small FUE procedure is the key phrase here. Anyone that disputes this statement I believe is not doing what’s in the best interest of the patient.

[sausage]

The only thing that concerns me when any HT is buzzed down is the hairline, I have seen a few examples on here which I thought would look unnatural shaved down.

[HelpROGER]

Oh, so sorry King Topcat. You’re right, you know it all and the rest of us forum peasants should just bow down to the great KING Topcat. You offer nothing, but your bitterness and hatred to prospective patients. Jotronic is a person who should be respected not you!
You could only wish you had a wonderful mother like I do. It's says a lot that you would stoop so low to go there. Sad!

[topcat]

Roger you offer zero in the way of anything of value for prospective patients and I have no problem standing in someone face and letting them no exactly what I think. It's also what I hate about the internet so much as it allows those such as yourself to pretend.

Does your mother even know that you are posting or does she only do the research?

[HelpROGER]

Have some balls Topcat! You call Jotronic a scumbag and don’t have the balls to tell him to his face. Now you apologize cause you were caught. Man that is weak! You’re a fool!

[topcat]

My apologies on the scumbag comment Jotronic it was over the top and uncalled for as I was just a bit heated. My own experience where I had my scalp donor shaved down had no signs of fue surgery nor anywhere on my face or body. I have also seen a few cases up close where the hair was cut close to the scalp and once again it was amazing. Does this mean that it can be guaranteed no, but it is possible. I will have to listen to the show a second time. Of course I do take comments personally at times as I don’t make money from this industry and this same industry has caused me and many others a great deal of harm.

I was not trying to be cryptic I just have no reason to personally attack you by mentioning your name I was attacking the message.

[Jotronic]

Topcat, buddy, chill with the cryptic postings. If you have something to say, come out and say it. Wasn't it just a few weeks ago you were hammering Spencer for not naming names. Pot, meet Kettle.

Folks, what Topcat is referring to, as far as I know, is my participation on Spencer's show last night. We were talking about scalp tattooing and our mutual position that it just isn't a good idea and that while Dr. Rassman seems confident enough to offer it we just don't like the idea of it and think it is iffy at best. My thought was that maybe he's offering tattooing for those that aren't HT candidates due to a lack of donor hair or maybe he knows something we don't. Spencer said in that case maybe these guys could get just enough FUE to create a hairline and a bit on top for coverage and then just shave down to have what appears to be hair but just shaven very short.

I've seen this response a lot but what I haven't seen are a lot of people actually doing this. So, just like that, I asked Spencer if he'd ever seen anyone that had done this; had FUE then shaved to get the appearance of hair or the "less is more" look. He said, and I'm paraphrasing here, that he actually had never seen this and that he did not know in fact if this was a good idea or not. I think something was mentioned about how shaving isn't always possible but NOTHING was said about how it is never possible. Not from me and not from Spencer so somehow, for some reason, this has been grossly twisted and misrepresented. This wasn't even really part of the discussion.

My position is that FUE is fine for those that want, at all costs, to avoid a strip scar. However, there are those clinics and FUE cheerleaders that will tell you that anyone can shave as low as they want and no one will be able to tell. There will not be any visible evidence of surgery as long as they are in the hands of a good doctor. They will tell you that the survival rates are just as good just as often and that one can get as many grafts with FUE as can be had with strip. This just isn't the case and pointing to two or three cases to justify the position against hundreds of strip cases simply does not compute. More people talk about the benefits of FUE than there are actual results so of course because everyone wants to avoid the big bad strip scar the consensus grows further.

To date, there is not one single clinic that performs both procedures that will tell you that their FUE grafts are consistently as good as their strip grafts. I know from actually speaking to the reps from some of these clinics, or the doctors themselves, that they are up front with their patients about the differences in survival rates, which they should be. One would argue that it is because they are not as skilled as those that dedicate their practice full time to FUE. That is a valid point but then those that dedicate their practice full time to FUE have every reason to say that FUE grafts always grow as well as strip grafts because to say otherwise would jeopardize their business model. Hmm, seems to be a catch here. Whom to believe? That part is easy. No one, just believe the results. The results should speak for themselves. Not debates. Not postings. Not robots. Not vacuum cleaners ( *cough* Neograft *cough*).

So no, this rep from a strip only clinic did not say that FUE does not allow a shave down. It does, usually shorter than strip, BUT not always and just like you won't get a guarantee about a strip scar you sure as Hell won't get a guarantee that you can shave as short as you like with FUE. Not. From. Anyone.

So before you go calling me a scumbag, Topcat, check your facts and listen to the show a bit more closely. I've said it before and I'll say it again. I think your heart is most likely in the right place. You and me are a lot alike and we both have motivations to do good but instead of calling me a scumbag maybe you should point your energies toward more worthwhile endeavors such as the new breed of clowns signing up to use Neograft. Or the joker in South Florida that uses a double blade scalpel while telling patients that using bigger grafts of 8 hairs means less transection or some sort of other BS. Really, man. there are a LOT of other things that have REAL potential to screw people up but one guy talking about anything on a call in radio show is NOT one of them.

[Follicle Death Row]

Truth is FUE is a little more hit and miss in terms of graft yield but I think it's getting better with Acell (I know Dr. Shapiro and Dr. Feriduni are making use of it).

Nice example by Spex. Check out this vid guys. Now I think at nw6/nw7 it may not have been the best choice going for FUE and the fact that the choi implanter pen was used might have affected the yield. I'd say it looks about 7,000-8,000 grew rather than 11,770 but in this video this guy has his donor shaved down after 11,770FU by FUE. I actually think the donor looks damn good considering they must have extracted 40-50% of all donor FUs. No significant dotting to my eye anyway. Now I don't think it's the best HT in terms of hair angulation or yield because the implanter pens are a bit rubbish but I think it's a nice example of a shaved donor after almost 12,000 FU. The doc is Dr. Jose Lorenzo btw.


I would love to see pics of Dr. Feriduni's 10,000+ FUE patients. Thoughts on the donor appearance guys?