FUE vs Strip

[Zao]

I’ve been a fan of The Bald Truth since the beginning and I will tell you that I have followed the entire Dr. Woods story over the years.
This is my story. I have listened to practically every show and have recorded many since 1998 so I know from where I speak.

http://www.baldtruthtalk.com/showthread.php?t=435

I would say that what Dr. Woods wrote is not true. I remember Spencer talking about Woods and his technique on his radio show in like 1999 and I remember him interviewing a guy from Rhode Island who had very bad plugs from the 1980’s and Spencer suggested on the air that he check out this guy in Australia since everyone else had turned him away. I think this is the poster Timetested that you are referring to.

That was the first time I heard about Woods and FUE. I also remember Spencer having a Italian (heavy accent) guy on the show around the same time or maybe in early 2000 who Spencer personally sent down to Australia to have FUE with Woods and Spencer said it was one of the cleanest hair transplants he had ever seen, so what Woods wrote is not true. I also remember Spencer saying something about Woods was unwilling to share his technique with other doctors so I guess anybody can try to re-write the history of things to fit their own agenda, especially if Woods felt he had something to lose since by that time other doctors were trying to do FUE. Woods had always seemed like a whacky guy to me. I also remember hearing Woods and his sister themselves on Spencer’s show and Dr. Rassman called in so who knows why Wood's would write these lies? You can’t always believe what you read on a forum Topcat. You of all people should know that!
Maybe Spencer can go over the true history of FUE on his show? Now that would be interesting!

[Follicle Death Row]

Here's something I came across recently. Here's a gentleman that progressed to a norwood 6.5 maybe almost 7. Now I would not advise HT but this man had 11770 FUE over 4 procedures. What? 11770 FUE! He's probably dealing with 300cm2 of baldness. If we're dealing with cases of 200cm2 or less, maybe norwood 6 or norwood 5 and less than you probably could pursue FUE alone if you had the financial resources.

But what about donor thinning? Well I have worried about that but maybe Dr. Cole was right with the 50% thinning thing. If you look at this man's donor shaved down after 10,000 FUE it looks pretty damn good if you ask me. I believe an extraction tool of 0.8mm was used.

I'd never pursue HT if I was going to go this bald but what do yoou guys make of that donor after just over 10,000 extracted? Remarkable I'd say. I couldn't go strip after seeing this. They start shaving him at around 2 minutes.

https://www.youtube.com/user/injertocapilar#p/u/25/kjoHgkzKsXw

[topcat]

Zao I was not there in the room when these conversations took place. What you wrote could very well be the truth but only those that were there really know and I certainly don’t believe everything I read on the internet. I am always open to changing my view when presented with evidence and using common sense. To be honest it really doesn’t matter. I’m letting the thread get off topic by responding to a statement of who I should be thanking that FUE is available. Like any other argument that involves history we could go back forever and always credit someone that came before others just as much as anyone else. It becomes a pointless argument. Everyone in this business gets a start from someone else and they all know that. Those that are interested can research the posts that were made back then. Regardless of what they conclude in can only be beneficial.

This thread is about honesty in the industry. It’s not about HM and it’s not about who invented FUE. If somebody wants to start a thread on who should be thanked than by all means go ahead and start one, but it is argument that cannot be won. I can only be thankful to BHR and what I learned over the years and most of it was from speaking and meeting real people who were a wealth of information. I learned early on the forums were corrupted with a little too much bulls*it and I posted those thoughts many years ago. The forums were valuable for making real world connections mostly.

As far as the mistakes I made in the past choosing a clinic it was long before the internet and information was simply not available. People were and still are conditioned to believe their doctor. Even with all the information available today people still choose to trust doctors. All one needs to do is look at the bottom line of Big Pharma to get a clue, but they choose to ignore it. So I hardly feel alone in making a bad decision a very long time ago and I am much wiser for it. I think many misunderstand my postings. I am not angry about my past experiences, I will just not simply sit idly by and let others be misled. Those that make their money from the industry sometimes need to temper their comments, I don’t. I can tell you exactly what I have see.

The topic of this thread is that for someone to make a blanket statement that FUE results in low yield is complete misinformation. No different than me stating strip always results in huge scars, multiple scars, damaged nerves, numbness, headaches, tightness in the scalp, expanded bald area in the crown, poor growth, unhappy patients etc. Does it happen yes, does it happen all the time, no and even though I don’t work in the industry and have strong feelings about FUE I would never make such a statement.

I don’t get it the previous week everyone was all giddy about a robot performing fue, make up your mind you can’t have it both ways. Maybe it is just the strip only clinics not being able to be completely honest until they can have a seat at the table so in the mean time they just sell them what they got.

[Jotronic]

Topcat,

Before I begin I wish to say that I hope your repair is going the way you want it to. While your starting point for repair is worse than mine I know you understand that each degree of repair is relative in how it affects the patient. I wish you all the best.

And for this to not be a strip vs. fue thread you might have titled it something other than "Strip vs. FUE", lol!

You've made some statements that I'd like to discuss so I'll do my classic line by line quote and response for easy digestion.

Yes FUE in the wrong hands does result in low yield and that is why so few are able to offer it but it doesn’t mean they haven’t tried. Maybe those clinics that are consistently getting low yields with FUE should give up offering the procedure but unfortunately that is not how this industry works as all the strip hacks have shown us, so prospective patients have to weed through the sh*t FUE doctors.

I think this can be said for any surgery, HT related or not. Strip has been around for years and years, over twice as long as FUE, and there are hundreds of clinics doing subpar work. There are few things I would like to see more than the majority of clinics "give up" and lay down their scalpels. It will allow the better clinics to clean up the work of the subpar clinics and to ultimately help advance the field MUCH further. It is the clinics that put marketing above the needs of the patient that are causing the problems we see today AND preventing the field as a whole from being more respected.

The fact is FUE has nothing on the sheer numbers of completely crap results out there from strip with the hideous scarring, nerve damage, and often poor growth. The amount of damage that strip is responsible for pales in comparison when held up against the FUE procedure.

I think a correction is in order here. Did you mean to say that FUE damage pales in comparison to strip damage? While I agree with this I think we need to look at the reason why this is so. FUE has been around, at least in North America, since 2002 and the number of clinics that have taken it on has grown very slowly. I don't know when it was exactly but only in the past few years has there been an exponential expansion of clinics offering FUE because it is much easier for the non-educated patient to buy into. Whether or not these clinics believe in the technique or not is another matter altogether but the reason why you see so many more bad results via strip is not because it is so much worse as a procedure but rather there are so many more clinics performing strip in general and have failed to take the time necessary to truly understand just what it is that they are doing. Strip has more than a ten year head start for adoption than FUE does so naturally there will be more bad results. The way you said it you make it sound like there are more bad results from strip because it is a bad technique when that is obviously not the case.

It’s funny how some of same strip clinics that will tell you how inferior the FUE procedure is are the same ones that spoke so highly of the potential of the ARTAS system recently. When will truth and honesty come to this industry. Let’s be real, someone either works in the industry or they are a patient advocate rarely can they be both.

I don't really see any clinics speaking "so highly" of ARTAS. A few have spoken up about it but I don't care for it because I think it is simply an expensive automated punch. I think it is a really cool machine but as I thought before I even saw the thing it does not go far in replacing proper surgical technique by hand. Think about it. ARTAS is not an FUE machine or FUE robot because FUE stands for "follicular unit EXTRACTION" where ARTAS does not extract at all. It simply scores the graft in order for the technician or doctor to come along later and remove the grafts with common forceps. For 200,000.00 and a fee per graft AND an annual support contract I'd fully expect ARTAS to wipe my tail and fetch me a beer (not exactly in that order). Sadly, it does neither.

If I were you I'd be talking more about Neograft. It costs far less than ARTAS at 80 grand and is being marketed to even non HT clinics in order to maximize profits. Have you seen their website? At the bottom of the homepage they have a rotating testimonial that shows a bunch of bozos that own spas and facial rejuvenation clinics that no one has ever heard of. THIS is the real danger for FUE and in my opinion will do more damage to how FUE (and hair restoration in general) is perceived than ARTAS ever could. You can now walk into a day spa, have facial toning, a pedicure and a hair transplant.

Strip has it’s place as long as the patient is fully informed but FUE with very small punches and small sessions is more often than not the best approach for most.

I'm not sure how FUE would be the best approach for most. You said in a subsequent post that strip only clinics are the ones saying that FUE gets a lower yield. Isn't it safe to say that FUE only clinics say similar things against strip? I know of one FUE doctor that says his form of FUE actually offers a HIGHER survival and growth rate than the best of strips. In fact, they've gone so far as to say so publicly on the forums. So who do we believe? Strip only clinics or FUE only clinics?

I also see FUE only clinics using photos of the worst of the worst donor scars from back alley hacks to convey what the "typical" hair transplant patient can expect with strip but if a patient chooses their form of FUE then they will have ZERO scarring, be able to shave to the bone with zero evidence of surgery, and have a full head of hair based on funky camera angles, flash photography and fuzzy focusing. Oh, and world peace usually ensues afterwards. You know this goes on so I'm curious what your opinion is on this practice.


Thing is, I see bad work from all kinds of sources; strip, FUE and obviously all kinds of plug work, flaps, scalp reductions ects. Bad work is bad work no matter what technique is used. I personally would like to see your crusade switch to targeting bad work in general. FUE is not the end all be all solution and neither is strip. They work very well together however and I think that if we can both work on educating patients about this then more patients will understand the REAL reality of hair restoration.

The things I try to fight against are photos that misrepresent the real result. Lies by one clinic to misrepresent the work of another clinic. Cheer leading shill posters on various forums that are clearly compensated by their favorite clinic. See what I'm getting at here? These are the basics and are what lead people down the wrong path to begin with, technique aside.

[topcat]

Jotronic I do agree on the title, bad choice as I tend to just write my thoughts very quickly but that is only due to time. Of course being a repair patient I feel very strongly but I am also very reasonable. I tend to write thinking most understand what I am trying to say but I should be a little clearer.

I meant to say strip has more casualties because of sheer number of procedures performed when compared to fue. I agree with most of what you have written and I would add that I would like to see some of these clinics that are ethical and doing good strip work to fully advise patients of the fue option even though that do not offer it. Too many clinics that are getting poor results with fue give the rest a bad name, no different than strip but fue can very often be a better option. Fue can achieve very high yield but only in the right hands. As a patient I want to be fully informed and that is one of my biggest gripes with this industry as too many leave out information that is critical.

This industry has only cost me personal expense and regrets as it has for many others. But as I have often posted in the past it was also an eye opener and had a huge positive effect on my life. I have received nothing from this industry except one pro bono offer that I had to work to win. I contacted every person I knew that was familiar with my situation and asked them to vote for me and I barely won. I then gave away half of the offer even though I wanted the whole 2 days. I couldn’t bear to see someone else lose out knowing perfectly well their position and how they felt. For me it didn’t have anything to do with getting something for free. As corny as it sounds I felt it was a sign pushing me to take that step giving me the courage to go to a clinic on the other side of the world that I thought was the best.

I just want patients to have access to as much information as possible so that they can make a good decision. Heaven knows that I was not given that opportunity in the past and I feel a moral obligation to try and help others.

[topcat]

After having a little more time this morning I would like to respond to some points I missed.


I have personally spoken out against fue clinics that perform mega sessions, using drills, have posts deleted or for whatever reason just do not seem to be truthful at times. As far as photos I would hope most that are researching are aware of this and so I don’t comment on angle and lighting too much but it is a very valid point. I take my own photos under the brightest and harshest lighting possible. In fact I just presented a photo the first yet of which is very early on in my repair using concealer and specifically stating that this is what my hair looks like in lighting that is more flattering, so we are in complete agreement. I am completely against deception in any form. The best approach is to fully explain the procedure to prospective patients and to make sure they fully understand what they can expect. We both know a full thick head of hair is simply not possible and those just starting to research need to understand only so much should be expected and that yes scarring is possible even with fue so it is best to go slow.

Thing is, I see bad work from all kinds of sources; strip, FUE and obviously all kinds of plug work, flaps, scalp reductions ects. Bad work is bad work no matter what technique is used. I personally would like to see your crusade switch to targeting bad work in general. FUE is not the end all be all solution and neither is strip. They work very well together however and I think that if we can both work on educating patients about this then more patients will understand the REAL reality of hair restoration.

I have targeted bad work in general both strip and fue. In particular these clinics performing fue and giving very young patients the only ones they seem to market to very low hairlines. We both know these young guys are like shooting fish in a barrel. What are they going to do 10 years from now? Doctors have an obligation to advise the patient not just sell them a procedure and this includes these fue clinics.

The things I try to fight against are photos that misrepresent the real result. Lies by one clinic to misrepresent the work of another clinic. Cheer leading shill posters on various forums that are clearly compensated by their favorite clinic. See what I'm getting at here? These are the basics and are what lead people down the wrong path to begin with, technique aside.

I feel I have done the same and have been ferociously attacked for it one shill even referring to me as a rapist. I will admit it did have me questioning myself and why I am trying to help others, but I always bounce back and don’t plan on just letting it be. I have pointed out clinics that have misrepresented photos although I always leave out the names. It just not my aim to bash a particular clinic, but to point it out and let others know that we see what is going on. One patient in particular that I know was a complete failure with bodyhair as it grew for one year and then all mysteriously fell out. The clinic portrayed him as a complete success case years afterwards with photos from very early on. They knew very well it was a failure yet they chose to portray it as something else. Why couldn’t they just have been honest I would have respected that. Again we are in agreement.

I don't really see any clinics speaking "so highly" of ARTAS. A few have spoken up about it but I don't care for it because I think it is simply an expensive automated punch. I think it is a really cool machine but as I thought before I even saw the thing it does not go far in replacing proper surgical technique by hand. Think about it. ARTAS is not an FUE machine or FUE robot because FUE stands for "follicular unit EXTRACTION" where ARTAS does not extract at all. It simply scores the graft in order for the technician or doctor to come along later and remove the grafts with common forceps. For 200,000.00 and a fee per graft AND an annual support contract I'd fully expect ARTAS to wipe my tail and fetch me a beer (not exactly in that order). Sadly, it does neither.

Well I have heard doctors who just can’t wait to get their hands on the ARTAS system and patients that can’t wait to jump into the chair without even understanding the procedure. I have spoken up about the NEOgraft. Giving more doctors the opportunity to get into this business is a very bad idea. People just don’t seem to understand this is more than a medical procedure it is a form of art and not everyone can be an artist.

Hopefully we will see more honesty in this business but with so much pressure from clinics that seem not to care about that aspect along with others that work in the industry it does make it somewhat unlikely.

[ejj]

I think at the moment there is a definite shift taking place towards fue . The problem with this is the Drs need ` test ` patients , the question is do the patients know they are ` test ` patients

If a patient has 50 or so grafts from his arm or chest and states the scarring is unnaceptable is it down to the patient physiology or the Dr who has done the procedure say ` once ` or possible ` twice `? and has the Dr admitted to the patient that he is the ` second` or ` third ` patient the Dr has performed the procedure on ?

Unfortunatly with all the ` scribes ` .. super duper extra sharp punches , and now ` arty ` the robot they all need willing patients to perfect there art on ! and some Drs will never get to grips with it !

So my view is choose a Dr who has consistent results over a long period of time not one who is selling a procedure over results ( if that makes any sense ).. I wish the net was around 20 years ago , for me I would have FUE , 2 inches back from my receding hairline into the frontal third only in a crescent shape ! say 1000 fue in total , get the option to assess growth , healing and future loss of hair, and income needed, for the many future procedures that will be definantly needed as mpb advances !

Anyway wheres all the PRP ... ACELL ...REPLICELL...AST ...results