Dr. Lindsey Strip repair of FUE low density

I've posted lots of cases and threads on the pros and cons of FUE vs Strip. Without rehashing all of that...this case illustrates the main problem with FUE (done by a reputable surgeon) in my opinion. Note that I am not referring to the HUNDREDS of angry patients we see each year that got some kind of automated FUE by a doctor who has added hair as an additional "profit center" to his existing plastics or ent or derm practice....that is an entirely different can of worms!



So this fellow got 3 FUE cases done by a well respected FUE doctor. And as my friend Dr. Feller states, the U in FUE is for unpredictable! So like trees and plants...fue is essentially digging up each plant and moving it to a new location. AND like plants, you shovel, or FUE incise the skin and dermis, but at some point you have to lift the plant or hair out of the scalp. It's that avulsion that stresses hair roots. Sometimes not much, sometimes severely...and that accounts for the unpredictable return of FUE vs strip (again assuming you have a reputable doctor not transecting roots and planting rootless hair).

And like plants, fat hair roots PROBABLY can tolerate more stress during the removal than skinny ones. See the video attached where I'm working with plants in my back yard showing this.



So this guy has fine hair, definitely had growth, but had paid for 3000 FUEs, when maybe 1800 strip grafts at one session should have solved his problem. He travelled in and we took a small strip and packed his recipient area. He returned at 10 days...due to travel issues, and his postop pics show a normal postop appearance. Hopefully we'll get a followup in 18 months when he's all grown in to illustrate this further.


I suspect that a fair number of his fine hair fue's simply didn't make it OR didn't grow well due to the fragile root bulbs I reference above. Hopefully we've finished off the front for him.

Lastly, note that we pack AROUND the hairs he's paid for, trying not to damage their roots, but many will experience short term shockloss. AND that his donor strip has lots of FUE donor depletion scars. Not a problem but FUE is not scarless surgery that I see marketed in the airplane magazine!


Dr. Lindsey McLean VA



The plant video is: http://www.youtube.com/watch?v=lAq7sWpdxmU