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  1. #1
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    Default A FUE Question For All Top Doc's

    Ive unfortunately been around the block with this whole field and now feel the only way FUE should be done is by adding body hair as you remove a follicle from the donor.

    I think the only way FUE should be done is to do a 1 to 2 ratio for the first 3000 FUE grafts then a 1 to 1 for the rest

    In other words 1 body hair graft for every 2 FUE scalp grafts for donor recharging

    Then a 1 to 1 for every graft after 3000 .....So in total the max amount of FUE's that should be taken from anyone without recharging should be 1500!

    (However if this was the case there would be less candidates for the procedure as not everyone is gifted with the correct texture body hair to pull it off)

    And thats only if no scars from past work are present!........If there are scars from past work then it should only be 1 body hair graft for 1 FUE scalp graft....!

    Otherwise the whole FUE idea can be detrimental as the area will thin to the point of very shallow density in anyone with a norwood 3 and beyond.......

    I also agree that there should be no or at least a minimal charge for the recharging technique......All FUE Dr's should follow this guideline in my opinion......

    My Question .........Why aren't more FUE specialists offering this technique?

  2. #2
    Senior Member CIT_Girl's Avatar
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    Body hair transplantation is still only practiced by a handful of surgeons worldwide because it requires special instruments and techniques, is extremely time consuming, and the results and yield can be quite unpredictable. Though it would be wonderful, I don't foresee a point in the near future where doctors will offer donor recharging for free, or even at a minimal charge. In addition to the fact that many doctors don't have the experience or desire to perform BHT to begin with, even those who are comfortable working with it feel that there are many limitations to the medium, and find the extraction process extremely tedious and labor-intensive. For this reason, most BHT doctors discourage patients from using body hair unless it's a last resort, and when they do perform procedures with body hair, they charge a premium.

  3. #3
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    Hi CITGIRL

    Well its a shame that only a few Dr's offer this technique because FUE alone in my opinion will not work on larger norwood scales...!

    And yes I know Cole's motto of "LESS IS MORE"

    I personally use a rule of thumb that states each norwood scale needs around 1250-1750 grafts depending on the hair shaft diameter and overall density in the donor area

    So in a nut shell ....
    A norwood 2 would need 1250-1750 grafts
    A norwood 3 would need 2500-3500 grafts
    A norwood 4 would need 3750-5250 grafts
    A norwood 5 would need 5000-7000 grafts
    Ext......

    So without recharging with body hair or some other means then how can any FUE doc feel they could help a norwood 3 and beyond BY fue ALONE!

    If that many grafts were to be taken out of anyone's donor area it will at some point start to become extremely thinned out and wispy regardless of the starting density

    Also If there is an existing scar in the donor that's well hidden what do you personally think will happen at that point?........Yes it will stand out like a sore thumb

    Listen all im trying to say is I'm not an advocate of strip ether especially in the wrong hands but FUE can be the better option if done correctly (proper sized tools) and donor recharging

    If it comes down to a Dr not wanting to do what should be done for the esthetic result and for the patient due to BHT being a more tedious and tiring procedure then he should think again!.......And that goes for all Doc's

    Telling a future norwood 6 who is at a norwood 3 that he is in good shape with a 2500-3000 graph donor area is in my opinion being lied to.

    Don't get me wrong this has nothing to do with Dr Cole personally as a matter of fact I think Dr Cole is extremely artistic and does fantastic work but if i'm not mistaken he only does CIT now ......and does not like to do strip anymore ether.....

    And that's ok but he needs to fill the larger needed numbers in some other way

    This should also go to all other FUE practitioners in the business...BHT RECHARGING IS A MUST WITH THIS TECHNIQUE!.........PERIOD!!!

    Its just simple math!!

    FUE HAS POTENTIAL TO BE A MUCH BETTER TECHNIQUE BUT NOT AS IS....

  4. #4
    Senior Member CIT_Girl's Avatar
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    I understand what you're saying but I still think there are just too many limitations and challenges to using body hair for donor recharging for it to become more commonplace.

    Men who are at later stages on the Norwood Scale, and opt for hair restoration surgery, simply cannot (at this point in time) expect completely pristine donor areas- whether they opt for strip or FUE procedures. However, even without donor recharging, I believe the donor aesthetic post-FUE harvesting is superior to strip because you are not dealing with the linear scar and distorted hair grow angles along the closure. Dr. Cole's objective in performing FUE is to achieve an overall appearance whereby the density on top of the head is similar to the back- he does this by thinning out the back subtly and uniformly, while improving density on top and up front. Whereas, with a strip procedure, youíre clearing out a center section of scalp but leaving a dense section of hair above and below the scar- permanently limiting your hair length and styling options.

    FUE with donor BHT recharging is fabulous in theory, and we have had great success using it on certain patients, but it is still too unpredictable of a procedure to be more widely adopted, or to be a standard part of FUE work. It is further complicated when we get patients who have already had strip procedures who want to hide these scars in addition to desiring further work in front or up top. We do a lot of scar grafting procedures but, again, grafts to not 'take' to scar tissue as well as they do to virgin scalp and it can therefore take more than one pass (and additional donor scalp or body hair) to achieve desired coverage.

    So, essentially, there is not yet an 'ideal' solution which allows hair to be transplanted to the recipient area while still maintaining a 100% pristine donor area in the back (and if this is someone's goal, we'd advise them never to get started with hair restoration surgery). However, we have come a long way already and we continue to study how we can make further improvements with the use of new technologies, such as ACell.

  5. #5
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    What type of results can more or less be expected then?

    Can you show some more before and after photo's from your clinic?
    Im sure most on this site are interested in seeing more!

    There are only 2 pictures of BHT on the site and only 1 of recharging....

    My question is also if the idea is talked down to only a very very rare few why does the clinic recommend it the first place as a viable option on the site?

    As this would be my procedure of choice at this point........Several smaller sessions of 350-500 scalp CIT with the same number BHT replenish .....So that's several sessions of 700-1000 grafts

    The technique does work as Dr Umar is doing more and more BHT FUE and only started a few years ago....

    Cole on the other hand has been progressing the technique for up to 7 years!

    Unfortunately, In my case it would be the only way to go........ a 1 for 1.....

    And I regret not using Cole as I think Cole does very good work on hairline reconstruction,,,....

    As far as Acell Dr Cooley is doing some ground breaking research with actual follicle regeneration ....As of now its only single haired grafts but is starting to test larger numbers for scar coverage...

    He's testing follicular plucking .....A hair would be plucked/tweezed then set in Acell then planted into a scar .........Acell has been shown to regenerate a complete follicle .....The end result looks like a FUE scar grafting session was done....Though its not 100% it seems like a great start.....

  6. #6
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    CIT Girl...

    What type of results can more or less be expected then?

    Can you show some more before and after photo's from your clinic?
    Im sure most on this site are interested in seeing more!

    There are only 2 pictures of BHT on the site and only 1 of recharging....

    thanks

  7. #7
    Senior Member CIT_Girl's Avatar
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    I cannot generalize about what results can be expected when it comes to body hair because, as I've mentioned, it tends to be unpredictable and success will vary from person to person. For this reason, Dr. Cole will not agree to perform large BHT procedures on anyone until they undergo a small test procedure with him to see what sort of yield they will achieve, and to ascertain whether they will be pleased with the results of a larger case.

    We can only post photos of patients who have signed photo releases allowing us to post their photos. A lot of patients simply want to enjoy their new hair and move on with their lives after undergoing a procedure, and do not want their photos to be posted online (even if we only show them from their eyebrows up). We understand this and do not encourage anyone who doesn't feel comfortable to share. BHT patients, in particular, tend to be more private and, therefore, we do not have a lot of photos we are authorized to share. Those that are available are posted on our website.

  8. #8
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    Check this link out !

    I just found it on the net regarding an FUE patient and Acell!!

    Acells Matristem (powder +sheet) application in FIT

    FIT (Follicular Isolation Technique ) is a procedure in Hair transplant surgery.
    It consists of removing each follicle individually with a small punch .In donor area it creates multiple wound which heals faster .Collagen fibers( scar tissue) fill those empty spaces during the healing process.
    Acells Matristem technology is a naturally occurring bioscaffold derived from porcine tissue .When Matristem is placed onto a wound ,it is resorbed and replaced with new native tissue where scar tissue would normally be expected.
    With this characteristics ,the A cells Matristem should fill our donor wound and regenerates terminal hairs ;rending our donor resource infinite.

    We applied the Acell powder and cover it with the Acell sheet as described in our study protocol.
    We would like to present the first observations we made

    http://www.mywhtc.com/forum/index.php?topic=341.msg385

  9. #9
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    Thumbs up

    This is very exciting. I read that Dr. Jerry Cooley and Dr. Cole are working with ACEll too. CIT girl do you know much about this?

  10. #10
    Senior Member CIT_Girl's Avatar
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    Dr. Cole offers ACell at cost to all of our CIT patients. We havenít done any official side-by-side studies so we canít make any official claims about regrowth or healing in the donor area at this point in time. From what we know, ACell can regenerate skin tissue and promote faster and improved healing following a hair transplant procedure. Dr. Cole's primary goal in using ACell is to further improve the appearance of donor areas following follicular unit extraction by his CIT method. Weíve received feedback, from veteran patients, reporting that the healing process is much faster with the application of ACell.

    Dr. Cole would like to further explore whether ACell might reduce the appearance of hypopigmentation that follicular unit extraction can sometimes leave in the donor region. He is also looking into whether ACell may be able to stimulate stem cells left behind when he performs follicular unit extraction. Stimulation of these cells could potentially induce the development of new hair growth. Again, however, we havenít yet completed the studies needed to fully evaluate such possibilities.

    I believe Iíve read that Dr. Cooley has some further findings that he will be presenting at the ISHRS Meeting in Boston in October- so that should be very interesting.

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