FUE is all the rage these days, so I figure I'd start another topic about it. Many say that a surgeon can perform extrordinary session sizes (3k, 4k+) in a single day, not by virtue of any revolutionary tool, but by amassing tremendous experience and having great dedication to the craft; and, in time, they find themselves in such a position where they can successfuly perform such sizes without concern for poor yield.

True or False? Fact or Fiction?

False.
Fiction.
and a surgeons hands can become quite "delicate"
if they are on fin according to JW34...

If the FUE docs with he most experience were doing it regualrly with documented proof/RESULTS then maybe. I personally have not seen enough evidence myself. Nothing clear cut anyway. I think there are enough experienced FUE docs out there who ALL seem to understand FUE has its place and its not for mega sessions and especially not in one day - Something is going to get missed.

Spex,
yeah dude but you know NO *respected* docs in the FUE field are moving 3K,4K+ in one SINGLE session, no?

I concur - that was my point bro

Figure this.

It takes 3000+ strip megasessions to become a respectable strip doc.

If you do 3000+ FUE grafts you become an unrespectable doc ?

Not sure if my interpretation is correct, please explain ?

Depending on the final yield. I would say possibly. Anybody can rip out 3000 grafts. That doesnt make them respectable,but if those 3000 grow thats a different story.

I should have clarified -- for sure most anyone can "rip out" (i.e. brute force) 5k FUE in a single day, but it is the yield that is important. And it proponents of FUE-megas seem to espouse more and more that it can be done: the more FUE you perform, the better you get at it, and in time you are capable of performing larger and larger sessions in a given day. That is their logic.

The central question to me, is: does a "ceiling" exist (~2k...?) given the current generation of tools and tecniques that docs can utilize.

Personally, my thought is that being able to perform what is truly *extrordinary* FUE session sizes (~3k+) on *most anyone* in a given day requires something akin to superhuman power; and, in turn, to believe such a thing requires a great deal of evidence. Not just in before/afters (which are important), but in actually explaining AND showing how the precious, delicate follicles are being extracted.

quote:

Depending on the final yield. I would say possibly. Anybody can rip out 3000 grafts. That doesnt make them respectable,but if those 3000 grow thats a different story.

I would say as well as yield as a main factor, also the possible damage to the donor from the FUE extraction method. I'm not an expert but the way I understand it, it's not that simple. For example, if the patient has a very thick donor area I would think FUE becomes even more difficult with respect to collateral damage to the surrounding units that "aren't" being extracted. You can get the grafts your after, but your possibly destroying several in its wake.

If you use a smaller punch to protect against this, you might damage the ones that are being extracted. Which I suppose would directly relate to yield.

I would imagine that cutting a strip you lose a small share of good units in the donor too by default, but recipient yield shouldn't suffer as a result from strip extraction. So maybe yield "is" the primary issue? as opposed to lost donor grafts?

.

quote:

Originally posted by bverotti:

If you do 3000+ FUE grafts you become an unrespectable doc ?

Not sure if my interpretation is correct, please explain ?

We're discussing this in terms of one SINGLE session; meaning one SINGLE day. What is the most amount of grafts you guys have moved in one DAY? You guys always advertise one SESSION, but we later discover it was spread out over several days, and even then have you guys ever moved 3K in FUE over two days? If so, how was the yield?
Even *if* the yield was acceptable I personally wouldn't put my donor through the excessive trauma & scarring in the event that I needed a significant # of grafts in the future because of future loss.

quote:

Originally posted by thanatopsis_awry:
FUE is all the rage these days, so I figure I'd start another topic about it. Many say that a surgeon can perform extrordinary session sizes (3k, 4k+) in a single day, not by virtue of any revolutionary tool, but by amassing tremendous experience and having great dedication to the craft; and, in time, they find themselves in such a position where they can successfuly perform such sizes without concern for poor yield.

True or False? Fact or Fiction?

Also, it is worth while noting that Armani is both claiming this AND at one and the same time that ANY of his 'trained' physician underlings can perform his mega FUE. He literally has hair mills all over the place now. So, if his claim for having the ability to perform Mega FUE's is sheer experience and dedication to the craft, how can this be said of ALL of the docs performing under him?

An incisive point to consider. Indeed, indeed....

quote:

Originally posted by notgoing2gobald:

quote:

Originally posted by bverotti:

If you do 3000+ FUE grafts you become an unrespectable doc ?

Not sure if my interpretation is correct, please explain ?

We're discussing this in terms of one SINGLE session; meaning one SINGLE day. What is the most amount of grafts you guys have moved in one DAY? You guys always advertise one SESSION, but we later discover it was spread out over several days, and even then have you guys ever moved 3K in FUE over two days? If so, how was the yield?
Even *if* the yield was acceptable I personally wouldn't put my donor through the excessive trauma & scarring in the event that I needed a significant # of grafts in the future because of future loss.

Dr. Ilter and his team perform up to 3000 grafts in a single day on virgin scalps.
Dr. De Reys largest sessions by now is about 2300 grafts in a single day. By the end of the summer we expect to increase our official maximum per day to 2500.

Ps : I am talking unsplit grafts.

That is impressive to say the least.
You guys do show us VERY good pics as well. I was just under the impression that you weren't moving that many grafts in a single day.
I stand corrected.
Neither of the docs feel that yield is compromised when moving such a significant # of grafts via FUE in a single session?
Care to post some pics on this thread?

Bart,

quote:

Dr. Ilter and his team perform up to 3000 grafts in a single day on virgin scalps.

If I am correct however, even as you admitted, not ALL virgin scalp patients can have 3000 graft sessions in a single day. Though I know you reject that there is such thing as an FUE "candidate", you have admitted that some patients take longer than others and therefore would need multiple sessions (or days) to accomplish the same number of grafts. Do you agree?

Falc

Ex strip patients have already a large chunk of donor area removed, meaning the donor area is smaller to start of with.
Secondly our surgeons often find that the natural angle of the grafts is often very distorted by strip surgery (unterneath the skin, not visible), making extraction more difficult.

On the other hand, all virgin patients will get the numbers paid for, be it 2000 or 3000 in 1 day.
These numbers are created for the 'worst' case. In fact we could do more in a day, but we need to know in advance that what we offer is achievable.

A French patient was very sceptical about our counting a couple of weeks ago. So we agreed that his father would sit next to the counting assistant and verify everything.
As promised he got 2000 grafts (2043 to be exact).

quote:

On the other hand, all virgin patients will get the numbers paid for, be it 2000 or 3000 in 1 day.
These numbers are created for the 'worst' case. In fact we could do more in a day, but we need to know in advance that what we offer is achievable.

A French patient was very sceptical about our counting a couple of weeks ago. So we agreed that his father would sit next to the counting assistant and verify everything.
As promised he got 2000 grafts (2043 to be exact).

Bart, this certainly sounds exciting on paper, assuming high hair growth yield. I hope that you will continue to post compelling evidence that will convince us of this reality.

Falc

quote:

Ex strip patients have already a large chunk of donor area removed, meaning the donor area is smaller to start of with.

First off,
I really don't see how this is relevant, as ALL of the "donor" area that is absent post-strip is used in the recipient area.

Second,
if were using these points to compare strip vs. FUE, in the case of FUE *ALL* of the donor area is subject to scar tissue equating to TEN TIMES that of a comperable strip procedure; making ANY subsequent procedure more difficult to successfully extract FUE, let alone attempting to go in and get a strip on a patient who has previously had FUE, Im sure there would be considerably less laxity compared to a patient who had strip performed.

All in all,
Im convinced that the *only* patients who truly benefit from FUE are those who have minimal hair loss, restricted to the hair line only,
-AND-
are a of a relatively more mature age; 40+.

That in and of itself excludes many candidates.

bverotti,
I'm interested in what you have to say.

To everyone,
This guy has not made any "wild claims". Consider that the FUE session gains a few hours because there is no strip removal and closure. If the team works for 12 hours, then 3000 grafts would be four every minutes. With two techs working, that would be one every 30s. I suppose this is realistic.

I am a big fan of the work advanced by the best strip clinics, dont get me wrong, but this could be a valid option for some patients.

With strip you do scalp exercises, get a huge chunk of flesh removed, have significant downtime, having to deal with shock loss, red scar, potential stretching, scalp tightness, etc. Then if you need a second procedure, you need to wait 12 months to get some elasticity back, will probably get a smaller graft#, and deal with potentially tighter scalp and wider scar.


The FUE approach, not quite as much is moved, but the negative impact of the surgery is less. A guy could get 1000 done every month for a period of 7-8 months! So FUE could actually have potential to have a more dramatic improvement in less overall time, with less negative healing.

FUE also has the abilty to provide the "less is more" look, where the patient can get thin/shadow coverage on top and shave down everywhere else. This look is dicey with strip because the visibilty of the scar is a variable.

Taking out the wild claims of one of the clinics, of course the BIG BIG BIG remaining question is yield (and to a lesser degree cost).

Does it get 100% yield? 98%? 95% 75% 50% 25%???

For that matter, what are the yields of strip patients? Does everyone really get 95%+
gowth? Are the documented strip results more cosmetically significant because of greater yield, or because they are drawing from a larger pool of surgeries, and larger graft counts (correlated with lower cost?)

I dont have the answers, (and I'm not sure anyone does) but I think it would benefit everyone to review the possibilites here with an open mind, for if FUE can get reliably 80%+ yield, and the cost come down some more, then it would drasticaly change the approach to HT, and this would benefit the patient.

Also try to imagine improved tools that would improve extraction and further enhance the success rate.

quote:

So FUE could actually have potential to have a more dramatic improvement in less overall time, with less negative healing.

Emperor, while I agree w/you w/respect to the VISIBILITY of the scar is an upswing for FUE when compared to strip, that is in my mind the ONLY upswing...
I too would like to have an open mind about this, and Im not going to post on this thread about this any more because I already did quite a bit on that other one. But Im just wondering *ONE* single thing, if you could answer this for me:
QUESTION:
did you *read* that thread by Feller, who is a proponent of both FUE AND strip, in which he stated the complications of FUE
-AND-
specifically, the excessive trauma FUE places on the donor area as a whole, which is equivallent to TEN TIMES that of strip?

You keep insisting on the "scar" w/respect to ONLY the visibility of it. While Feller's point, which is clear on that thread, is that the "scar-TISSUE" which effects the entirity of the donor area in ALL subsequent procedures limits the amount of grafts which can be successfully extracted from the donor area....(?)
Did you read that?
If so, then what are your thoughts? I would like to have an open discussion about it too, but I haven't heard you directly respond to this...