Category: FUE

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Hair Loss InformationFUE / FIT – Minimally Invasive Hair Transplants – Hair Loss Information – Balding Blog

Hello Dr Rassman,
Firstly I would like to congratulate you on this website. Its very helpful. I am due to have a FUE transplant (1000 follicles) next month at DHI in Athens. I have read your comments relating to DHI and the importance of a good surgeon.

I know that you normally refrain from doing this but I would really appreciate it if you could please recommend a paticular doctor (whose work you know of) at DHI. I am really freaking out now about getting an incompetent surgeon working on me. I realy dont want to make a wrong decision. I will not dislose your recommendation in any way at all to anybody. Thank you.

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I do not know any of the doctors at DHI, so unfortunately I can not help you with that. I am told that they have switched completely to FUE and away from strip harvesting. Frankly, that makes me nervous, because of the complete absence of biopsies to qualify patients. DHI was taught by Dr. Cole, who calls his procedure Follicular Isolation Technique (FIT), which is a sub-set of what I call FUE. Dr. Cole, along with DHI, tell me that 100% of patients qualify. The FUE techniques are a series of processes that are fine tuned in each patient, as each process works uniquely in different patients. Dr. Robert Bernstein and I just wrote a chapter in a new text book on this very subject (due to be published shortly). FUE is an intricate process that requires a series of approaches, each matched to the patient’s tissue characteristics. Last week, for example, I performed an FUE procedure and prior to that procedure on an earlier visit, I used four different methods to optimize the process. One tool worked consistently at 100%, while others methods had failure rates in the same patient ranging from 90-20%. At the time of the surgery, the actual success rate was 88% based upon hair counts. For this very reason, I am absolutely convinced that biopsies are needed to qualify patients and match the techniques that work on that patient prior to the actual FUE surgery. On a few patients, FUE surgery is either not possible or so inefficient (taking a few hours per hundred grafts harvested) to make the process not a reasonable alternative to strip harvesting. Depending upon the technique used, patient eligibility ranges from as high as 95% of all patients in some doctor’s hands (very few doctors fit into this category and this group includes those patients who may not be efficiently harvested) to less than 30% in others.

What bothers me is that some doctors have a loose definition of FUE success. Some doctors may classify 100% success as his/her ability to extract at least one hair in an FUE graft. That does not cut it for me, because I classify success by hair count. That means that if a 3 hair graft was excised with FUE, some doctors would call a single hair extracted and two hairs killed off as 100% success while I would call it 33% success (actually this does not quantify the loss of hair, the negative value of hair that is lost forever). Probe the doctor’s definitions here and get an accurate count of what he did when he does the procedure, as you are entitled to that as part of your medical record. If the doctor does not give it to you or tells you that it does not matter, run for the hills. It may sound like technical talk, but the realities of what you get and what you pay for and what is destroyed by the process all come into the value equation. Again, as I always say, let the buyer beware!

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Hair Loss InformationCole’s FIT and BHT Procedures – Hair Loss Information – Balding Blog

What are your opinions on the techniques and procedures of Dr. John Cole, such as his FIT procedures which he acknowledges was developed from your FUE. However, the FIT is allegedly an improvement. Also, what do think about his claims regarding Body Hair Transplants. I know you have made previous comments regarding BHT’s. However, I am asking specifically about Dr. Coles procedures regarding BHT.

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FUE and FIT is exactly the same procedure, with some technique variations. There are a number of technical ways to do it and FIT is a proprietary brand name developed by Dr. Cole to show some unique identification for him. Body hair transplants are new with not much validation from other doctors. There are only a few patients with any history to the process and we do not know much about success rates in, let’s say, 100 patients overall. I am not surprised that they may work, but body hair is limited in numbers, usually growing as a single hair unit although there are some two-hair groups. The hair has a different character than scalp hair, but Dr. Cole’s claims have no real science with them, although I am not saying that it is not true, just not proven scientifically. I would not jump into it just yet. It is, in my opinion, still an experimental procedure.

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Hair Loss InformationFUE After Strip Surgery – Hair Loss Information – Balding Blog

I had a few strip surgeries, decent results but still a bit thin for my liking. I have realistic expectations and don’t think I need that many more grafts to achieve satisfaction (about 500 3-hair grafts perhaps?), but I’m done with strip (my doc said I shouldn’t have any more and I wouldn’t want to anyway). My donor hair on sides and back is decent, not real thin or see-through. Given my thumbnail profile does it sound like FUE can get me to the promised land of being satisfied? Have you seen cases of other guys who could only get down to the 10 yard line with strip and FUE got them into the end zone? I know you’d have to examine me for a full and accurate assessment, but I would appreciate your best answer based on the info I have provided.

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When the scalp is too tight, the only option to extract hair is by using the FUE technique. I have done some patients with FUE as the last option with good results, but it is very difficult to evaluate you without at least some photos (personal consultation is always best). Since you’ve indicated that you are in New York, I highly recommend that you contact my colleague Dr. Robert Bernstein in Manhattan at 1-866-576-2400.

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Hair Loss InformationPost-Operative Care and Scalp Flaking – Hair Loss Information – Balding Blog

Dr. Rassman, I think you are running a brilliant blog. After reading several posts, I am encouraged to share my own views and ask a question. I recently got a FUE megasession done in Europe and am pleased with the results, atleast till now (just 2 weeks post-op). While going through this website, I personally felt that it would be a great idea to start a new category called ‘Post-Operative Care’ since I am going through this phase myself and can feel the need to interact with others out there on the topic. Don’t worry, I don’t think it will scare away any prospective patients. It will only lend credibility to the transplant procedure.

On that note, I also have a question. I am using Minoxidil 5% to help with the growth of new hair. But my scalp in the recipient area shows considerable dryness / development of flakes when the scalp is dry. I was recommended to apply a hydrating lotion on the scalp. Would you agree with this advice and can you recommned a good hydrating cream /lotion meant for hair?

Thanks in advance.

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Thanks for your kind words and for the new category idea. I’ll add a Post-Operative category now.

The results of the FUE will take 5-8 months to show, so then and only then, will you know the value of what you had done. Minoxidil does cause dryness and flaking. Any non-alcoholic creams will work. Also, try a variety of hair conditioners as well. Take risks until you find the right one. Ask your hair dresser, as they may know the best that is available in your country.

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Using FUE to Fill In Old Donor Scar – Hair Loss Information by Dr. William Rassman

Some 5-6 weeks ago, i had my first FUT procedure for about 1600 grafts that were harvested by removing a donor strip from the back of my head, but this time its not because my hair is thinning but to increase the facial hair density. I must say that i’m now very concerned since i begun seeing those infinitely many cases who had bad experciences with the donor scar visibility(detectibility) even at this early stage of my procedure. I would like to know the validity that successful FUE could be used to conceal the donor scar so that i can wear my hair short assuming that my scar is (2-3)mm wide and not raised plus that am a good candidate for FUE. Thanks

One of the particularly good uses for Follicular Unit Extraction (FUE) is to address the donor wounds of the traditional strip harvesting methods used in standard hair transplantation. The frequency of significant scarring (a width equal or greater than 2-3 mm) is about 5% in the first procedure and 10% in the second. FUE works well to fill in these scars if you are in the unfortunate few that get significant scarring.

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Hair Loss InformationRecapeen, FUE Plus & Lasers for Hair Loss? – Hair Loss Information – Balding Blog

As creators of the FUE method, I presume you know what the FUE Plus method is? There is a clinic in my country that claims to have been able to boost the traditional FUE method by using a smaller tools when inserting the transplanted hair. (1) They claim that the increase in density is miraculously high, but still the improvement is impressive. Do you know more about this? (2) A new hairloss treatment called Recapeen, has been realeased. The “engine” in this package claims to be the unique pollen extract the substance is full of. Comments? And finally, 3) What is the strongest reason why to spend money on a hairtransplant rather then a laser treatment?

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I looked at the site referred to in your question. There is not enough information for me to judge what FUE plus is. When I purchase a bottle of shampoo and the company comes up with a new version of the shampoo they may add the term ‘plus’ to the name. The detergent market for washing clothes, made the most popular product in the early 1900s. That product was ‘Tide’. Then as they were improving the product, sales did not rise fast enough, so they came up with New Tide. The adjective NEW turned out to be the most popular advertising word in capitalistic history. Everyone came up with a product and then made up a NEW version of that product. I, knowing this, called my company the New Hair Institute and purchased the phone number 800-NEW-HAIR before anyone else thought of it. I was, at the time, an old fashioned marketing person, so NEW did it for me. The modern iteration of this is the term PLUS. I guess, if you did not invent FUE, then the best way to grab onto market presence is to invent FUE Plus, or at least the name. I respect the marketing brain that thought of it. The choice of doctors, of course, should have little to do with PLUS or NEW, but rather who you can trust to do the FUE on your head. Experience and judgments are critical to this choice and you sound (at times) like you are making such choices.

I did look at Recapeen and see that this miracle cure is listed with many other such potions and lotions on the respective websites. If Recapeen worked so well, one might ask why other products are listed there? I call it good marketing and diversification of strategies. Spread out well, and more people will get some part of the message. What are you really looking for?

I agree with you that hair transplants should be obsolete if these miracles worked, but then again, first I would want to see the studies and the scientific evidence that it works, because I am a cautious buyer. Every day that you chase the magical cure for balding is another day that you will continue to lose hair and progress further down the pattern of hair loss buried in your genetic cards.

With regard to laser treatments click here Low Laser Light Therapy for Hair Loss for more details.

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Hair Loss InformationEuropean Office? BHT? FUE? – Hair Loss Information – Balding Blog

Do you do Body Hair Transplants (BHT), FUE, and do you have an office in Europe?

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New Hair Institute has offices in Northern and Southern California. Sorry, we do not have a location in Europe.

We do perform Follicular Unit Extraction (FUE), and in fact, we invented it. See our site for information about FUE.

Body Hair Transplants (BHT) are still experimental. I do not do them because I want 100% predictability and I am not sure that this will be achieved with BHT. Some past BHT posts include:

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Hair Loss InformationHair Transplants for the Short Hair Look – Hair Loss Information – Balding Blog

Hello Doc,
I am 48, an NW4 and pretty stable. I don’t think I’ve lost much (or maybe any) hair in the last 5 years. I am interested in a “minimalist approach” to hair restoration. I have grudgingly accepted this level of baldness — no hats, no pieces etc. I keep it buzzed down very short, to at least a #2 on the clippers. I am not, at my age, looking for a young man’s hairline or density. I am not even interested in reconstructing a hairline, per se. All I would like is just an even sprinkling (or “dusting” — choose your own word) of grafts from front to back to give me a hint of stubble when I buzz it down, cut *some* of the shine in the places that are totally slick, etc. I am not trying to give the appearance that I have a normal head of hair, that’s long gone … yes, I know my scalp will still be visible….no, I am not trying to conceal my balding … everybody already knows that I have lost hair! All I want is a random, sprinkled “suggestion” of stubble from front to back in the bare areas, if possible using FUT’s, which I will then buzz down and keep very short. When I went to one of the high-volume hair mills a few years ago and suggested this, they were very discouraging: “No, you need our Super Ultra Mega Session where we will cram 6K grafts in the front half inch to give you the hairline of a 16 yr old.” Well, that’s not what I’m interested in and, to be frank, if that’s all the industry can offer me, then I’ll stick with what I’ve got. So, Doc, what do you think off the above “Minimalist Approach?” Is this something you’ve ever done before and/or would consider now?

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What you are asking for is not unreasonable. The best way to get this would be Follicular Unit Extraction (FUE), where single small, naturally occuring follicular units are extracted one-by-one directly from the donor area with a tiny punch. This leaves minimal scars and can support a super short hair cut. Send pictures and I will get back to you, privately if you prefer.

For information and photos of the FUE technique, please see:

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Hair Loss InformationFUE Harvesting Limit? – Hair Loss Information – Balding Blog

What is the approximate limit for FUE harvesting, e.g. at what point does taking out individual grafts one at a time start to noticeably thin the hair in the back?

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The answer here varies with the many attributes of hair that include:

  1. density
  2. hair thickness
  3. hair character / texture
  4. hair color and contrast to skin

You can use possibly 90% of the donor hair if your characteristics from the above are good. If they aren’t, the actual number may be well below 50% of the donor hair before you start to look noticeably thin. We have had a few patients who have had as many as 25,000 hairs taken from the donor area without any detectability. These were fairly bald men or those who were perfectionist. I recently saw one of these men and even though the original donor density was reduced by significantly more than 50%, the donor area looked good, even under close inspection.

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Hair Loss InformationHarvesting More Grafts with FUE – Hair Loss Information – Balding Blog

I’ve had two procedures with your group and I just read your posting about the progressive nature of hair loss. My hair is really thin now and getting worse.

With the new procedure FUE, is it possible to extract more grafts than the old method all things being equal? If so, could you please explain.

Thanks.

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To answer this question would be mostly speculation, as each case is different. If you already had strip harvesting, then at some point if you needed more hair, FUE can harvest hair above and below the point where the strip was harvested. So, yes there should be more hair that can be harvested in combination with the strip harvesting you had. Also, make sure you are on Propecia to slow down or stop the hair loss. If you are not on this drug, you should be.