FUE – Page 28 – Balding Blog

May 30, 2006

Hair Loss InformationImproved FUE Procedure? – Hair Loss Information – Balding Blog

Dear Dr. Rassman,
A few months ago I visited you and you mentioned you were right on the edge of creating an improved tool for Follicular Unit Extraction procedures.

Are we there yet?

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There have been recent improvements in technology related to the tool used in the FUE process and I personally believe there is room for even more improvements. There are still some patients who do not make good candidates for FUE and if it is possible to get around whatever the limitations are that we are experiencing with hopefully better instruments. As the instruments improve, then the FUE technique may become more common place. Unfortunately, it is now a limited offering by a very select few physicians who have invested the time and put their skills to the test to become good at it. It is the curse of a perfectionist to always try to improve from the status quo, but clearly as some people are still not candidates for FUE, the present has another surgical option that is already good, reliable and replicable (the Follicular Unit Transplant with strip harvesting). What is needed for FUE is an instrument that works in other than God’s hands, like the mortal surgeon I am, trying 100% of the time to be better.

May 24, 2006

Hair Loss InformationDoctor Blasted the FUE Technique – Hair Loss Information – Balding Blog

Dr. Rassman,

Thank you for your fantastic website and exciting blog! I am currently looking to find the best way to address my hair loss situation. It appears that I am, on the Norwood scale, a Type III vertex. At this time, I am seeking to have the FUE procedure done, however, I continue to find all kinds of conflicting information on the Internet, and was hoping you could give me a breakdown of what are the most important things to look for when choosing a clinic/doctor to do the procedure.

Additionally, I am confused by the various FUE methods, such as the FUE plus, FUSE, etc. I just don’t understand much about the differences and what is best for me.

Furthermore, I read an article in 2002 (http://www.hairlosstalk.com/newsletter/article181.htm) and found that Dr. Limmer, the creator of the Follicular Unit Method, blasted the FUE technique saying that it is “the equivalent of looking like you were shot in the back of the head with a shotgun.” This obviously is pushing me to reconsider any procedure since I will not consider the FUT. Please help!

Note: If possible, please e-mail me your response as well. Thank you!

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There is much on this blog about FUE and I would suggest that you take a look at the FUE category to see what I wrote here in great abundance. Follicular Unit Transplantation was first introduced by our medical group, not Dr. Limmer, but with that said, Dr. Limmer made wonderful contributions on the value of the microscopic dissection which led us to the discovery referenced here. I have great respect for Dr. Limmer, but it takes time to change and adapt. He originally did not like the megasession and made statements against them — now he does them. He waits until the technology is well tested and safe before jumping on to any new bandwagon and I agree with him that it may not be the best approach for many doctors doing this work and their patients who might look like their head was exposed to a shotgun. But with that said, I do not think that in good hands, this will be a problem. You are rightfully confused, because the doctors who push these techniques often promote rather than educate, inventing marketing terms to claim notoriety for themselves rather than teach and all of this just confuses people. I am a little guilty of this myself, as I did create the name FOX Procedure as the type of FUE technique that I use — but at the time the name was coined, there wasn’t all of these various terms out there because I was the first. Although I also coined the term FUE procedure, when you sound it out, it sounds terrible, so to make the name more respectable I came up with FOX. But, to clear up some of the confusion, I use the term FUE on this blog to hopefully make it clear to people looking for information. This is a wonderful procedure in the right hands by honest doctors who have mastered the procedure. The patients who I have performed FUE surgery have loved it.

Read, read, read what is on this blog and you will learn what you need to know. We show patients off at our open house events who had the FUE procedure to help assure people like you see that you will not look like a leaking, sinking lifeboat.

May 9, 2006

Difference Between FUT and FUE – Hair Loss Information by Dr. William Rassman

Hi Dr. Rassman,
Thank you for the very informative blog. My question: what is the difference between FUE and the strip surgery? What are the advantages and disadvantages to each? And do you perform both procedures?

Briefly, FUE is more expensive and time consuming and will yield less hair grafts due to the longer procedure time and technical complexities. FUE, however, does not leave a linear scar seen in the “strip” surgery. The traditional “strip” surgery is more suited for large hair transplant sessions. It does produce a linear scar, but with new scar reducing techniques such as the trichophytic closure, it is a great surgery for patients who want the most hair in one session.

Finally, our surgeons at NHI are very proficient and well trained in the FUE and the “strip” procedure. In fact we wrote the pioneering medical article on Follicular Unit Extraction (FUE). And way back in 1998, Dr. Jae Pak (with his engineering background) and I had developed an automated video FUE technique, which was awarded a U.S. Patent.

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April 26, 2006

Lose 10% of My Hair From Shock Loss After Hairline Lowering? – Balding Blog

Hi, I would like your opinion on lowering my hairline (I’m female).Dr. ‘X’ in Australia stated that i may lose 10% of my hair from the shock loss due to the new implanted hairs? Why do some say there won’t be any shock loss and others say there will be? It is the only reason delaying me to proceed with the procedure. Dr do you travel to Sydney etc or could give any recommendations? Also would you suggest i get the fox procedure rather then the traditional way? Is there any benefits of this procedure over the conventional way? Thank you. Kindest Regards.

The answer is, “It depends.” If you have genetic female hair loss (which actually usually maintains the frontal hairline in women) shock loss is possible and when it occurs in women, it is rarely permanent. If you are trying to lower your hairline because you have had a forehead/brow/face lift then hair transplants work very well (see Female Hairline Restoration After Brow Lift). If you don’t like how your face is framed, because you were genetically programmed to have a high hairline and have no other underlying medical conditions, then a hairline lowering procedure is a good surgery to fix this. Shock loss is rarely a problem in this type of surgery.

As for the other, FOX/FUE may or may not be a better option for you, again just depending on your reasons for getting it done in the first place. These FOX/FUE procedures are fairly expensive. I would suggest that you send me photographs and tell me something about yourself so I can give you direct advice that fits your agenda.

April 25, 2006

Hair Loss InformationDishonest Doctors and FUE – Hair Loss Information – Balding Blog

I have published an article recently in the Hair Transplant Forum International (an industry newsletter, see below) that warns of doctors who perform Follicular Unit Extraction and produce a Follicular Holocaust, killing off many of the hair follicles and then charging the patient as if all of the follicles were actually transplanted. This process is unfortunately more the rule rather than the exception, because doctors just do not count what they actually deliver. This is a double ‘insult’ to the patient who pays for 100% of what the doctor says he is transferring and actually receiving something in the order of 25-50% of that quantity. The second part of the insult is the loss of the hair which may be irretrievably lost from the patient’s limited donor supply for life. So, the surgeons who engage in this process are cheating the patient and at the same time destroying valuable donor hair.

I have just participated in a Regional Workshop for the International Society for Hair Restoration Surgeons where I was one of the faculty, teaching the FUE technique on patient volunteers to some 25 doctors from around the world. A few of the better known self promoted doctors were invited to attend, but they did not take up the invitation. Most of the doctors who attended the course came with an open mind to learn state of the art FUE technology from more experienced physicians who have been doing FUE successfully for years. I learned that the reports of dishonesty that I reported in the article I wrote continue to be a real problem. I received confirmation of what I discussed in the article, which appears to be widespread, over much of the world. I applaud doctors who take formal approved courses to learn or enhance their skills for new technologies by spending the time and the money to come from Korea, Japan, Western and Eastern Europe, North America and the Middle East, but I continue to be disgusted by physicians who would rather develop experience by experimenting on patients and damaging/cheating fellow human beings. I admire the courageous balding people who want to get the benefits of new technologies, but when dishonest doctors promote their expertise with no real basis, they behave like hucksters, only distinguishing themselves from other crooks selling products or services by having an M.D. after their name and a ‘doctor’ for a title. Clearly, for the FUE buyer, the buyer must beware!

Here is the editorial I wrote addressing problems of ethics in hair transplantation surgery, which was published a few months ago in the Hair Transplant Forum International, January/February 2006, Volume 16, Number 1:

Are All Grafts Created Equal?

April 11, 2006

How Does a Doctor Get FUE Training? – Hair Loss Information by Dr. William Rassman

I see that many HT docs are offering FUEs and claiming how great they are. Where did they learn this and how can the consumer know what we’re getting is really quality work and not just a publicity scam?

It is best to ask to see the doctor’s patients and meet them directly. Do not accept photographs alone, for they may not be what they appear to be. FUE is becoming the ‘hip’ thing to offer patients to start to build a practice. It takes about 8 months from the time of the surgery until the results are known. For the dishonest doctor, that could become the ‘funding’ for a new venture and claims of expertise are easily made throughout newspaper ads and internet websites. Training is almost impossible to obtain unless you have a large hair transplant practice and are willing to practice on a dozen or so FUE grafts on every patient you perform a strip surgery upon. That is how I learned how to do them, 1-2 at a time per patient over 9 years. The main difference between me and others is that today’s self proclaimed expert can reference the standard I set and published. For me it was more complex than that, because I never knew it was really possible to obtain consistency until I had been doing it for years. The question you did not ask is about claims of success are measured. Self-proclaimed success in harvesting is clearly dependent upon ’self reporting’ without audits. Trust is everything and integrity is at the core of the surgeons being. I can not advise upon this point for the buyer has responsibilities to research it heavily (please see The Truth About Cheap Hair Transplants for more info). As I always end these types of comments, let the buyer beware.

March 23, 2006

Removing Transplanted Hair for Corrective Procedure – Hair Loss Information by Dr. William Rassman

What are the options in dealing with transplanted hair that you no longer want-is there any procedure that would remove the transplants but still athestically feasible?

The second related question is what is the effectiveness of corrective procedures that thin down some transplanted areas, moving the hair to other parts of the scalp that now need it.

As you can guess, I am dealing with a transplanted “head” of hair that is actually mostly comb-over because I have lost so much hair behind my orignal transplant. I can fake it at the present time but I am getting tired of being the world’s biggest user of hairspray and worrying about the wind

I have written extensively on the subject of repair and have many patient examples of repairs on our website. Also see Dean’s Story for a good example of things that can be done and how it was done on this particular patient. Removing grafts is usually the best thing to do if the grafts are in the front.

Heavy rows of grafts may be best removed just like a ‘brow lift’ surgery and then 2-3 months later, you can transplant the area and create a completely normal frontal hairline like the patient example above. I have also found the FUE / FOX Procedure to be very effective in thinning out transplanted hair and moving them to other locations to produce better coverage. However, not every patient can be a candidate for this procedure. I would need to see you first (or you can send photos, which will be treated confidentially). For FOX redistribution, I need to test each patient to be sure that this approach will work.

March 22, 2006

Follicular Unit Extraction Tool For Sale? – Hair Loss Information by Dr. William Rassman

i have run out of donor area and as a result of this i have developed a thick scare at the rear of my head, my doctor would like to try and use a folicular extractor and use my body hair as the donor. Could someone please advice us on where this FUE can be purhased from, as australian doctors have not used this before.

Tool? Even if you could buy an FUE tool, do you really trust a doctor who has never done this procedure before? This is without a doubt the most difficult surgery that is in the hair transplant arena. It took me many years to master it. Few doctors worldwide can do it well. If you and he decide to go forward with this, there is one word to describe you -rather than call you “foolish”, I shall call you “brave”.

Please note that the above photo is not used in the FUE procedure, in case you were curious.

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March 20, 2006

I Have Limited Donor Area, Am I an FUE Candidate? – Hair Loss Information – Balding Blog

I had 2 transplants from your clinic around 12 yrs ago each session you transplanted around 900 grafts because of limited donors from the back of my head. Do you do fox method from the sides of my head and transplanted it at the top without any danger ? I also want to know the cost of it.

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In order to have an FUE / FOX Procedure, you needed to be tested first. Not all patients are candidates for this procedure (see this page for more info). I recommend that you make an appointment to see me for a FOX test. On the day of the test, we will discuss the procedure fees. I have made many breakthroughs in this procedure and am very excited about its applications in the appropriate patients.

March 17, 2006

Hair Loss InformationEyebrow Transplant Scarring – Hair Loss Information – Balding Blog

Dear doc, I am okay with balding and keep my head shaved (i’m a bouncer by profession). But i’ve been losing eyebrows too. actually i sweat a lot on the eyebrows and thats why im probably losing it…(age=26)

Now, I understand that scarring is something thats unavoidable. But i guess eyebrow transplantation would require fewer hairs right? Will there still be scarring if I transplant hair from back of my head to eyebrow? Im asking this because i wish to keep my head shaved.

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You may be a candidate for an FUE procedure. The minimal scarring associated with an FUE procedure will allow you to keep your head shaved without a noticeable scar.

See these links for more info about eyebrow transplantation and FUE: