All we can do is hope that the Docs that are using FUE & more importantly BHT as a means of saving peoples lives continue to invent ways to improve & enhance their techniques & tools to a point where dots & regrowth are not an issue.The quest to improve the FUE/BHT technique will seperate the genuine docs who use these techniques to help people from the dcos who use these techniques merely because they cannot milk a patient out of more money due to his inability to have a strip.
Hopefully with time the cost of this technique will go down as well so many more people can be resurrected.FUE/BHT is our only REAL solution for now.HM in the near future is just a fantasy,instead of attacking FUE/BHT we should be working towards improving our only hope.
» All we can do is hope that the Docs that are using FUE & more importantly
» BHT as a means of saving peoples lives continue to invent ways to improve
» & enhance their techniques & tools to a point where dots & regrowth are
» not an issue.The quest to improve the FUE/BHT technique will seperate the
» genuine docs who use these techniques to help people from the dcos who use
» these techniques merely because they cannot milk a patient out of more
» money due to his inability to have a strip.
» Hopefully with time the cost of this technique will go down as well so
» many more people can be resurrected.FUE/BHT is our only REAL solution for
» now.HM in the near future is just a fantasy,instead of attacking FUE/BHT
» we should be working towards improving our only hope.
I agree with you.
Above a couple of posts up… Is this “the” Franklin? Woods patient Franklin?
Yes it is.
» Yes it is.
DUDE!!!
Do you remember meeting me in Washington, DC back in 2003? I drove you to the store when you were having a consult. You burned your head in the sun right after your transplant. Do you remember?
Jessica,
There is a bunch of math here… Your great at math… Will you tell me what is going on? My math is minimal.
Hairtech yes I do now I remember. Thomas yes. Thank god the sun burn did not effect my growth from ht. I just read your working for Dr. Harris now. Good luck in your new job. Hey how come you are not at the Rockies Yankees game now?
» Jessica,
»
» There is a bunch of math here… Your great at math… Will you tell me
» what is going on? My math is minimal.
It’s easy. Instead of 230% like some posters said, the surface area is larger by 78% if you use a 1 mm punch, almost twice the size of a .75 punch.
» » Jessica,
» »
» » There is a bunch of math here… Your great at math… Will you tell me
» » what is going on? My math is minimal.
»
» It’s easy. Instead of 230% like some posters said, the surface area is
» larger by 78% if you use a 1 mm punch, almost twice the size of a .75
» punch.
Thanks stitch!!! I am a dumb ass in math. Science yes… but math no.
Franklin buddy! How the hell have you been? DUde how are the grafts? I have gotten so much experience since we met when I was a green stick in 2003. Times have certainly changed. Drama, good things… not so good things, you know. What the hell are you doing with yourself. How is Ray Woods?
“Franklin buddy! How the hell have you been? DUde how are the grafts? I have gotten so much experience since we met when I was a green stick in 2003. Times have certainly changed. Drama, good things… not so good things, you know. What the hell are you doing with yourself. How is Ray Woods” Good thanks . Grafts are doing just fine. No more hair worry’s for now. Just check in from time to time now. I have been traveling to South America and visiting girfriends family a lot in last 2 years. Don’t see Ray post here much so I guess he is keeping busy these days. And sometimes I get a mail here and there from D.J. say’s he doing ok. Take it easy.
And sometimes
» I get a mail here and there from D.J. say’s he doing ok. Take it easy.
DJ… Well I speak to DJ about once every two weeks. He has been busy with his father and all. Call him sometime… He doesn’t post much any longer. I feel bad because he was done wrong by people you know… but that is another thread for another day.
Ray had a good thread going a couple months back in BHT but then the hairsite changed. Anyway nice talkin with ya.
» Jessica,
»
» There is a bunch of math here… Your great at math… Will you tell me
» what is going on? My math is minimal.
Sorry, I’m not going to help you with your math homework. If you post things without backing them up, don’t cry to me to do the “hard part” for you and bail you out. Its not calculus. Its arithmetic, and you are a so called “expert”. Use common sense. Look at the picture you posted. Does one look 236% larger than the other?
What is worse, a minimally larger punch that can extract a 6 hair graft in one punch, or a smaller punch that requires 3 holes to get the same impact for the recipient? You have to pay per graft, too.
» » Jessica,
» »
» » There is a bunch of math here… Your great at math… Will you tell me
» » what is going on? My math is minimal.
»
» Sorry, I’m not going to help you with your math homework. If you post
» things without backing them up, don’t cry to me to do the “hard part” for
» you and bail you out. Its not calculus. Its arithmetic, and you are a so
» called “expert”. Use common sense. Look at the picture you posted. Does
» one look 236% larger than the other?
»
» What is worse, a minimally larger punch that can extract a 6 hair graft in
» one punch, or a smaller punch that requires 3 holes to get the same impact
» for the recipient? You have to pay per graft, too.
for 1mm punch sq mm is …78mm2
for .75mm punch sq mm is …44 mm2
Increase would be 78 -44 = 34 mm increase
34/44 = .78 = 78 percent increase
» » » Jessica,
» » »
» » » There is a bunch of math here… Your great at math… Will you tell
» me
» » » what is going on? My math is minimal.
» »
» » Sorry, I’m not going to help you with your math homework. If you post
» » things without backing them up, don’t cry to me to do the “hard part”
» for
» » you and bail you out. Its not calculus. Its arithmetic, and you are a
» so
» » called “expert”. Use common sense. Look at the picture you posted.
» Does
» » one look 236% larger than the other?
» »
» » What is worse, a minimally larger punch that can extract a 6 hair graft
» in
» » one punch, or a smaller punch that requires 3 holes to get the same
» impact
» » for the recipient? You have to pay per graft, too.
»
» for 1mm punch sq mm is …78mm2
» for .75mm punch sq mm is …44 mm2
»
» Increase would be 78 -44 = 34 mm increase
»
» 34/44 = .78 = 78 percent increase
Thanks Hangin…math skills are hot.
1mm punch gets a 6 hair = 78 mm2
.75 punch gets 3 2-hairs = 44*3 = 132 mm2
$7 per graft 1mm 6 hair = $7
$7 per graft .75mm 3 2-hair grafts = $21
» » » Sorry, I’m not going to help you with your math homework. If you
» post
» » » things without backing them up, don’t cry to me to do the “hard part”
» » for
» » » you and bail you out. Its not calculus. Its arithmetic, and you are
» a
» » so
» » » called “expert”. Use common sense. Look at the picture you posted.
» » Does
» » » one look 236% larger than the other?
» » »
» » » What is worse, a minimally larger punch that can extract a 6 hair
» graft
» » in
» » » one punch, or a smaller punch that requires 3 holes to get the same
» » impact
» » » for the recipient? You have to pay per graft, too.
» »
» » for 1mm punch sq mm is …78mm2
» » for .75mm punch sq mm is …44 mm2
» »
» » Increase would be 78 -44 = 34 mm increase
» »
» » 34/44 = .78 = 78 percent increase
»
»
» Thanks Hangin…math skills are hot.
»
» 1mm punch gets a 6 hair = 78 mm2
» .75 punch gets 3 2-hairs = 44*3 = 132 mm2
»
» $7 per graft 1mm 6 hair = $7
» $7 per graft .75mm 3 2-hair grafts = $21
Don’t get the size and numbers up too high or you end up with a punch graft. That would be funny because then the world would have gone in a full circle 
Guess what it what already proved by people who know math better. You were a tad late. But thanks for coming out and showing your skills.
Thanks Hangin…math skills are hot.
1mm punch gets a 6 hair = 78 mm2
.75 punch gets 3 2-hairs = 44*3 = 132 mm2
$7 per graft 1mm 6 hair = $7
$7 per graft .75mm 3 2-hair grafts = $21
Wait a second. Now you are straight up telling a fib… or you have not had experiences with 0.75 punched grafts. Answer this:
-
How many patients have on average have six haired grafts… What a farce. Come on why would you even say that. It is rare.
-
It is a common knowledge here and other sites that 3 and 4 haired grafts are EASILY extracted by a 0.75mm punch AND unharmed. People like Dr. Cooley, Dr. Rose, Dr. Bisanga, etc.
Can this picture please remain up for a while please David… Below are punched grafts by 0.75mm AND it is clear what the grafts are.
- Plea
Dr. Harris read the post and had to chime in… These are his words.
"I have to say Jessica’s logic about the use of a 1mm punch to get 6 hair follicular units is way off base. Just how many 6 hair units does she think exist on someone’s head? I can tell you not many. Is she suggesting that it is better to use a 1mm punch for 1000 grafts just to capture the 10-20 grafts that may be 6 hair units? In the case we did the other day we had 26 4-hair units, 208 three-hair units and the rest 1’s and 2’s. The average hair per unit was 2.3 which still gives us above average density as compared to a strip case. I don’t believe that the use of a larger punch (if it can be avoided) to capture a limited number of 6 hair units is justified. If it came down to it, I would refund the money to the patient for the extra 5 FUE grafts that I had to extract to make up for the 10 total 6 hair units that we could have extracted had I used a 1mm punch. I do agree in general that if you use a larger punch that the average hair per follicular unit extracted increases, but as everything else in life there is a tradeoff. If someone said to me that they wanted to maximize the density and didn’t care if I used a 1mm punch I would certainly consider it as an option for that particular patient. I think you have to exercise your judgment on the proper instrument based on the patient, and not on some theoretical argument that may or may not apply.
Income is certainly not the motivation to use a particular punch; I don’t need the extra $50 that bad. There are many rationalizations and arguments that one can make about why one should do one protocol over another, the fact of the matter is that I can use either punch size and do it for a medical reason (scarring, density, etc) and not just because it’s the only size I have.
"
Dr. Harris
» » if your calc is correct, it is actually more than twice the size of a
» .75
» » mm punch. it’s 236% bigger to be exact, now that’s scarry
»
»
» 3000 FUE at 1mm is about 2400 mm2 removed
»
» That is about 24cm2
»
» that is the same as a strip of 2cm*12cm AND THERE IS NO STITCHES TO CLOSE
» THE WOUNDS
»
» NO WONDER THERE ARE WHITE DOTS.
»
» A complex arguement develops from there about FUE stratergy and explains
» the problems with large mega sessions and the moth eaten look.
I am glad you guys finally come to your senses. I always say for best results, do strip and then if the scar gets really bad, FUE the scar. This is the only way to max out the no. of grafts you can get.
If you do strip, you can use all the follicles in that area. Let’s say if there are 100 follicles per cm2, doing a strip of 2cmx12cm will give you 2400 follicles. But if you do fue over the same area of 24 cm2, you are lucky if you get half of 2400. In the best possible scenario the doctor can only fue every other follicle in that area and that will only give you 1200 follicles.
It’s simple math, there is no gray area, you are losing donor follicles if you do fue. It’s a fact.
Dr. Harris’s Words,
"I agree that strip plus FUE will maximize the total number of grafts that you can harvest from a single patient. That is the general plan for those patients wanting to maximize total grafts. The plan to save money and have great results is a strip. Those that want to avoid pain and linear scar, FUE.
There is a slight problem with the logic about the 2 X 12 cm strip saying that you “use all the units in that area”. The problem is that with strip you no longer have that “area,” it is removed, completely ablating 24 sq centimeters of skin, blood vessels, and nerves. In addition to this it is highly unlikely that you would have 100 units per sq cm over that length, meaning to get 2400 grafts you would likely need more than 24 sq cm. That’s why you have the pain, numbness, and tightness with the strip. FUE of 2400 grafts using a .75 mm punch would remove about 11 sq cm of tissue (granted spread out over a much larger area); less than half of the amount of tissue ablation by strip. That is really the only way to compare the two procedures with regard to use of donor tissue. If I extracted all of the follicular units from 24 sq cm of tissue, I would still remove less tissue than by the strip method, but of course that would leave a 24 sq cm bald patch. By necessity FUE must be spread out, it’s not necessarily bad, just the way it has to be done. Of course we acknowledge that the ablation is three dimensional and that we should add the depth component and that the results should be given in cubic cm, but that proportion remains constant as the depth for FUE is approximately the same as the strip. In other words the calculations above are just “area” estimates when in actuality we should be discussing volume measurements for tissue ablation.
The other problem with the logic is that with strips eventually you will run out of laxity when there are still follicles that could be extracted. I could use the same argument in reverse, that it is best to do FUE first then do strips if the donor area is appearing too thin. Both methods have their limits, neither is “BEST” for every situation."
Dr. Harris
» Dr. Harris read the post and had to chime in… These are his words.
»
»
» "I have to say Jessica’s logic about the use of a 1mm punch to get 6 hair
» follicular units is way off base. Just how many 6 hair units does she
» think exist on someone’s head? I can tell you not many. Is she suggesting
» that it is better to use a 1mm punch for 1000 grafts just to capture the
» 10-20 grafts that may be 6 hair units? In the case we did the other day we
» had 26 4-hair units, 208 three-hair units and the rest 1’s and 2’s. The
» average hair per unit was 2.3 which still gives us above average density
» as compared to a strip case. I don’t believe that the use of a larger
» punch (if it can be avoided) to capture a limited number of 6 hair units
» is justified. If it came down to it, I would refund the money to the
» patient for the extra 5 FUE grafts that I had to extract to make up for
» the 10 total 6 hair units that we could have extracted had I used a 1mm
» punch. I do agree in general that if you use a larger punch that the
» average hair per follicular unit extracted increases, but as everything
» else in life there is a tradeoff. If someone said to me that they wanted
» to maximize the density and didn’t care if I used a 1mm punch I would
» certainly consider it as an option for that particular patient. I think
» you have to exercise your judgment on the proper instrument based on the
» patient, and not on some theoretical argument that may or may not apply.
»
» Income is certainly not the motivation to use a particular punch; I don’t
» need the extra $50 that bad. There are many rationalizations and arguments
» that one can make about why one should do one protocol over another, the
» fact of the matter is that I can use either punch size and do it for a
» medical reason (scarring, density, etc) and not just because it’s the only
» size I have.
» "
»
» Dr. Harris
Dr. Harris is a reasonable person and he has also noticed the limitations of the .75 punch. Like he says, the size punch should be chosen based on a variety of reasons such as the patient’s hair, goals, and preferences.
In a strip, a physician is likely to see 10-20 6 hair follicular units. But one of the great things about FUE is that the physician can pick the largest and best grafts and leave the little ones behind, based on what the patient needs. With strip, the physician is limited to what he can choose to harvest. But with FUE, he has the whole donor area open to him – a field of options.
The average yield for a strip surgery is 2.0 hairs per unit. With an ideal strip surgery – no transection and no fractionation – the average is 2.3 hairs per unit. If the yield from FUE is 2.3, the patient might as well opt for a strip surgery with a good closure. Dr. Cole and Dr. Mwamba average a little over 2.7 hairs per unit, and many cases yield over 3.0.
As surgeons gain experience with FUE, they are likely to come to the conclusion that there is not much, if any difference in the healing of a .75mm and a 1.0mm extraction site. Whenever a follicular unit is removed, the circulation in that area is decreased because it is not needed any more. It is also the follicular unit that produces melanin or pigment to the skin. When the hair is gone, there is no pigment to the area. This will happen regardless of punch size. A physician must assume that with both a .75 and a 1.0 a lighter area will take the place of the harvested follicular unit, unless the patient has very fair skin and lacks pigment to begin with.
Some clinics market the .75 punch to attract business in the absence of proven results. Dr. Cole was the first to use and describe the .75 punch in 2003. He has since noted its pros and cons and improved upon the technology. He still uses a modified version of the .75 when the situation calls for it. Dr. Cole has a variety of punches to choose from with 32 different options that can be adjusted in an endless number of ways. Dr. Cole keeps his punches as a closely guarded secret, even from his surgical staff. He uses code names for everything and only discusses the punches on a need-to-know basis with his engineers and employees of higher ethics. His punches provide him the flexibility to adapt to the patient’s characteristics and goals gives him years of proven results to market, rather than resorting to the .75 buzz words. Other clinics have had since 2003 to use the .75 punch, make it work, and produce the results. But where are the results? Restricting oneself to only the .75 greatly limits the amount of results that can be produced.
Like I said before, Dr. Harris is a reasonable person, and he has also noticed the limitations of the .75 punch. Don’t put him into the group of .75 marketeers. I think you are selling him short. Don’t you think he deserves better than that?
There are no marketeers here Jessica. Just facts. And you stated something… it was disproved by facts. And that is the end of this debate. Please do not try to sway the beginning of the debate that started out like this:
1mm punch gets a 6 hair = 78 mm2
.75 punch gets 3 2-hairs = 44*3 = 132 mm2
$7 per graft 1mm 6 hair = $7
$7 per graft .75mm 3 2-hair grafts = $21
That is what the debate was about. Thank you for your comments.