I can understand one or two complaints at most but FIVE complaints all at the same time???
» I can understand one or two complaints at most but FIVE complaints all at
» the same time???
That is the point; they are not at the same time; all have different time lines but have been deliberately bunched together by Ronald2 on another forum and then linked here when he wanted to. You will have to ask him why he has decided on this campaign against us
» » I can understand one or two complaints at most but FIVE complaints all
» at
» » the same time???
»
» That is the point; they are not at the same time; all have different time
» lines but have been deliberately bunched together by Ronald2 on another
» forum and then linked here when he wanted to. You will have to ask him why
» he has decided on this campaign against us
But you did have five unhappy customers, correct? Even though they spoke against your work at differnt times. This is over how many years? I read your response, the guy who demanded refund or else is outright extortion. But still you have a handful to deal with. It’s inconceivable that they all decided to gang up on you.
» » » I can understand one or two complaints at most but FIVE complaints all
» » at
» » » the same time???
» »
» » That is the point; they are not at the same time; all have different
» time
» » lines but have been deliberately bunched together by Ronald2 on another
» » forum and then linked here when he wanted to. You will have to ask him
» why
» » he has decided on this campaign against us
»
» But you did have five unhappy customers, correct? Even though they spoke
» against your work at differnt times. This is over how many years? I read
» your response, the guy who demanded refund or else is outright extortion.
» But still you have a handful to deal with. It’s inconceivable that they
» all decided to gang up on you.
No it is not correct; the poster put the links together and called them complaints; any one can complain justifiably or not, look at Thread 3 for example, is it justified and certainly his threats were not? As for it being inconceivable that they all decided to gang up, again they did not, this is posted by one person (Thread 4)in foreign languages for you to either read or probably like most look at pictures and decide from there without reading.
If I could tell the entire story behind this it may not be so inconceivable but alas for certain reasons I cannot; because the motivation is not necessarily always from a patient; and as he is still our patient we have to respect that regardless.
You have to remember that those who promote the strip procedure do not have the experience doing FUE or FIT, which allows them to produce high numbers of grafts in a single session. You also need to recognize that most strip procedures producing high counts are a result of follicular unit fractionation. Fractionation is when you break a three or four hair follicular unit into several one and two hair grafts. We’ve done many FIT cases where we produced 4000 or more scalp hair grafts in a single session. Obviously, you need a good donor area to acheive this, but it is certainly possible. Unless you are going to fractionate the follicular unit, you are going to need a dense donor area and a loose scalp to produce 4000 grafts by strip.
We are always more impressed with our FIT grafts than our strip grafts. Also, our FIT grafts average 0.7 more hairs than the strip grafts. You are going to get more hair with fewer grafts, which is why we consistently produce better coverage with fewer grafts by FIT.
Patrick Mwamba is very skilled in FIT and he is located in Brussels, Belgium. He worked in my office as a surgery tech since 1998 before openning his practice in Belgium. If you are going to consider FUE, he is the best option in Europe in my opinion. Bisanga was a surgery tech in my office until 2003, as well. He too is quite good, but he does not have the instrumentation and the experience in FUE that Dr. Mwamba has. I recomend you take a look at Dr. Mwamba too.
Now I’m even more confused. I would like to thank Dr Cole for this very interesting piece of information. However, I feel like some delucidation would further develop our understanding of the situation.
Dr Cole you say that Bisanga is good but does not have the necessary instrumentation to produce high quality results with FUE. What do you mean exactly?
I had a look at Dr Mwamba website. Quite glossy I have to say, and the pictures did not impress me very much. Said that, I read something that caught my eye. It seems that Dr Mwamba performs fue and strip together in order to achieve maximum coverage for the patient.
Is it normal to perform both strip and fue on a patient in a single session?
Thanks for your time and attention
Well, I train them and I tell them how I would proceed, but I have very little control over how they advance going forward. I also have no control over their website or marketing after they leave my clinic. Let me say that it is nothing new for us to offer a strip in combination with FIT. The difference for us is that we never advocate a strip as I really so no rationale reason for them ever. Our strip procedures are carried out on those with prior strip procedures usually. As such, most of them have scarring and a tighter scalp that limits our productivity in terms of numbers. Therefore, we often add a few more grafts to our strip procedures via FIT. In addition, we have offered FIT to over 90% of our patients since 2003. Therefore, if you want to see consistent FUE results, check out our website. Patrick Mwamba was a surgery tech on many of these cases.
My procedure, technique, and instrumentation have never sat still. I have continued to advance them every year. Even today, our instrumentation is about to make a significant change and advancement. Dr. Bisanga worked with us during the infancy of our FIT development. He was there when we developed the first of our patents on the FIT instrumentation. Patrick however continued to work with us as a surgery tech for several years subsequent to this and he has seen a tremendous advancement in instrumentation. He has not seen the latest advancements as he now runs his own clinic in Brussels, but I hope to make these changes available to him over time.
Do not think that Dr. Bisanga is not a good physician. He worked with me as technician for several years during my strip based procedure. He was there for a large number of my 8000 strips prior to adopting FIT. He is an advocate of the strip procedure, as a result. He has not been around to see the remarkable results we obtain from FIT. Therefore, it is no unusual that he advocates strip over FUE. In fact, since he has so passionately advocated the strip procedure, I recommend his strip over Dr. Mwamba’s strip procedure. Dr. Mwamba is more passionate about the FIT procedure and he has predominately performed this procedure since he began practicing in Europe. I think he would agree that the FIT procedure is the Rolls Royce of hair transplant procedures.
With regard to Dr. Bisanga’s affliation with DHI, you should not hold this against him. He was introduced to DHI by me. I knew the people at DHT for several years and did my best to help them improve their results. I wanted to help raise the bar on results in Europe and found DHI open to this interest. I advised them to abandon the no touch technique because I felt it was the reason their results were hit or miss. This subsequently resulted in irreparable differences between the two of us. Dr. Bisanga went there to develop his own surgical technique, but soon left. We had begun training a group in Cyprus called HDC. We recommended Dr. Bisanga to this clinic and he subsequently assisted us in their training. I am certain you have recognized the excellent results produced by HDC as a result of the affiliation with us and Dr. Bisanga.
I always tell individuals that they can always elect to have a strip at any time after FIT without consequence, but if you choose the strip first, you will have a permanent strip scar. I treat at least 10 individuals each month who wish they had never had a strip procedure. Therefore consider this option carefully.
Europe is quite fortunate to have many options available to them today. We are quite happy to have had a hand in training many of them including Jean DevRoye of Belgium. This is not to say that there are not more options available to Europe today.
Having said all this, I would hands down recommend FUE properly done or FIT over strip surgery every day of the week and to every patient. It is not to say that I do not have experience or faith in strip surgery. It is just that the FIT procedure is significantly better.
Any time I combine a strip with FIT, I always ask my staff which grafts they think are better. I have never heard one of them say that the strip grafts are better. I know that Dr. Bisanga saw thousands of strip procedures and results while assisting me as a surgery tech and he saw wonderful results. Dr. Mwamba has seen both and I know that he has always said that the FIT grafts are superior to the strip grafts when we combine the procedures.
Thank you for the very informative (and prompt) reply. I appreciate that Dr Cole.
I have to admit I am very impressed. You illustrated your opinions on FUE and STRIP in a very convincing manner. The problem is that you seem to contradict everything I read so far about these two different approaches to hair transplantation. I’ll elaborate a bit on this one (if hairsite allows me to).
It is my understanding that most HT doctors that post on this board are adamant that STRIP is a far superior technique as far as yield is concerned.
This seems to be due to the extreme stress that follicles are put under when performing FUE.
STRIP however does produce permanent and visible scars.
My question is this. Do you regard FIT/FUE a superior technique just because it does not leave scars OR is it also better in terms of yield?
You see, your post sounded just like a wake up call to me. But now the ‘HT conundrum’ seems to get much more complicated than before.
In a nutshell. Two weeks ago I took a decision. I am going to have a hair transplant. Period.
Just like the rest of the posters of this site I tried my best to find and gather as much info as possible. If you don’t mind I’ll sum up what I found (and understood) so far.
FUE = More expensive than STRIP. It doesn’t leave visible scars when correctly performed. It has on average a poorer yield than STRIP
STRIP = Cheaper. Leaves a permanent scar regardless of thricoptic closure or not. Better yield.
Did I get it right?
Now, the big question.
I have 15.000 euros set aside for my transplant. I am in the process of choosing my HT surgeon. I opted for Bisanga (not so sure now to be honest)
because he seems to be good at both STRIP and FUE.
I’m 28 and a Norwood 5 going for 6. As far as I read, anybody in my position needs to have STRIP (at least 5000 grafts) if he/she wants decent coverage all over the scalp.
Honestly, do you really think I could achieve the same coverage/results with FIT?
Thanks for your time and attention,
Ps
I will look at your site with renovated interest
I did not realize there were many negative comments on this thread. I responded to the initial commentary only without reading the rest. Having said this, I hope that Dr. Bisanga is not unfairly judged. I know him well. We traveled extensively together for several years. We ate together, slept in the same hotel together, ate together, and worked together for years. He was always one of my top surgery techs and at the top of my peeking order during his tenure with me. I never hesitated to give him a responsibility or to entrust him with an important action. He never let me down.
Anyone who ventures out on their own will make a mistake from time to time. They say that only a fool makes the same mistake over and over and expects someone to say it was a good idea. I’ve said for years that the reason people come to me is that I made mistakes but always learned from them so that I don’t make them twice. I came into hair transplant surgery 17 years ago when plugs were the norm. I knew immediately that they look horrible so I modified my technique immediately with fortunate great sucess. I don’t know the details here on these cases, but I remain confident that if any mistakes were made, Dr. Bisanga has learned from them and he will not make it twice. He is a capable and caring physician, whom I recommend and respect with the utmost of confidence for strip surgery.
This thread is getting more and more entertaining 
Dr. Cole, I appreciate all the history and your take on FUE. But don’t you agree that STRIP is the way to go if someone wants to max out the donor? Let’s say over an area of 20 cm sq, the best that you can do via fue is to harvest every other follicle (more like every 1/3 to be realistic), however if you do strip over the exact same area, you can utilize every single follicle with no waste. You can’t deny the fact that you are losing at least half your donor follicles via fue.
Link to Patrick Mwamba website please.
If you are under 30 and headed to a NW 6, you have no business doing a strip…period. Of course there are many different factors or characteristics related to your hair transplant candidacy, but irregardless, you should not have a strip. Why? You may elect later on to shave your head. You can’t take a chance on the scar. If you know this is not an option for you, you might be ok with the strip scar, but how do you really know. You are still too young. I’ve heard it over and over for the past four years. “I wish I could just shave my head, but what about that strip scar?”
Can you achieve the same results with FUE or FIT as you can with a strip? You bet and you can do better. Why is that? Simple….with FIT we choose the best grafts. Suppose you take a strip. You get all the fish in that barrel. With FIT you choose only the best fish in that barrel and then move on to the next barrel. Suppose one barrel has huge Tuna and small ballyhoo. We pick the hug Tuna and then move on to the next barrel to pick the best in that barrel. This is one reason we achieve more hair per graft. The other reason is that our injury rate (transaction rate) is only 3% with FIT. With improved instrumentation and technique we have seen this rate of transaction drop from 8% to 3%. You are going to see a minimum of 2% just only taking the strip alone and then another 2 to 5 % transection rate producing the grafts.
For years, we have noted that our procedures produce better coverage with fewer grafts. The average strip based procedure in my hands delivers 5000 to 7000 grafts with a permanent strip scar and alteration in hair growth angles. You can certainly do this with FIT and avoid these complications. Can you do more with FIT? You sure can. I is simply that the best aesthetic result is going to limit you to 5000 to 7000 grafts. Regardless, you are going to have a better appearing donor area even with 10,000 grafts via FIT than 5000 via strip. Most donor areas have 14000 to 17000 follicular units available. With FIT you can take them all, but then you would be bald in the donor area so we don’t recommend that.
At a class young class 5 to 6, you really need to think about two alternatives. Do nothing or do FIT. Either way, all I want for you is that you be happy. Any way you look at it, DON’T DO STRIP. The latter puts you at too great a risk.
I don’t mind confusing you. I’d rather confuse you to the point you do nothing than have you jump off a cliff ending up in a tiger’s mouth. One of my patients who is an actor once told me that as an actor you jump off the ledge with the expectation that someone has a net to catch you. You can’t afford to do that in cosmetic surgery as the consequences of your actions leave permanent complications.
Remember that a huge percentage of my patient population consists of people who made multiple mistakes. They come to me as the last resort and the last hope. I always wish I had the opportunity to start it right in the first place or tell them there is simply no hope. My work is generally far more complicated as I must often totally undo the previous work and then put it back as best I can. It is similar to remodeling a kitchen but having to use the same boards and nails without access to a new supply at the local hardware store lumber yard. There is nothing worse to a man with hair loss than having someone else recognize that they’ve had a hair transplant. Bald is a much better option. Tread cautiously and good luck. Dor FIT/FUE or nothing in your state. Talk to Dr. Mwamba. Alternatively, I’ll be happy to take a look at you and recommend one way or another.
Ok, you are going to work me a little tonight.
Let’s look at the strip ear to ear. Suppose you are going ear to ear. The average is 30 cm. the average width you can remove safely is about 1.2 cm. The average follicular density is about 80 FU per 1.2 sq cm. Therefore, the average number of intact FU you will extract is 2400 or 80 times 30. You get all the fish in that barrel. Some have 2 hairs, some one hair, some three hairs, some four hair, some five hair and a few have 6 hairs. With FIT you can expand your horizons and get all three or four hair grafts. The average strip yieldS about 2 hairs per graft. Our average FIT graft has 2.7 hair. You can do the math, but I’ll take FIT day in and day out… You also see a lower average transaction rate with FIT
I’ve done over 8000 strip procedures and over 1500 FIT procedures. In 2003 the overwhelming desire was for FUE. We had no procedure, no technique, nor any instrumentation at that time with a staff dedicated to strip surgery. Over night we adapted to FUE because it offered so much more potential. Today we produce far better results with 2000 grafts than we could achieve with 4000 strip grafts. It’s a no brainier for me, but I respect anyone’s opinion with regard to strip surgery or preference to provide it or receive it.
Your thoughts are good so I look forward to any additional comment you might have. If you don’t understand this, please let me know so that I might more rationally explain it to you. The problem is that I have studied it every way possible so I tend to simply it sometimes and I don’t want to leave anyone confused.
The negative to FIT/FUE is shaving the head and cost. You no longer need to shave any part of your head and cost is about to become a non-factor. Our newest technology is going to change those variables for good.
» This thread is getting more and more entertaining
»
» Dr. Cole, I appreciate all the history and your take on FUE. But don’t you
» agree that STRIP is the way to go if someone wants to max out the donor?
» Let’s say over an area of 20 cm sq, the best that you can do via fue is to
» harvest every other follicle (more like every 1/3 to be realistic), however
» if you do strip over the exact same area, you can utilize every single
» follicle with no waste. You can’t deny the fact that you are losing at
» least half your donor follicles via fue.
The yield of FUE grafts is better if not equal to strip grafts when performed by a skilled team. FUE grafts have a higher average per graft, just as dr. Cole discribed in one of his previous replies. If not mistaken I believe dr. Bisanga presented a study about this fact at one of the ISHRS meetings.
I could not agree more with dr. Cole about the fact that soo many patients regret having a scar because of strip surgery. It not only limits their future hairstyle, but it also gives them no way of covering the scar during a large FUE session. Strip has an impact on all future hair descisions.
I am glad to see that more and more surgeons are abandoning strip surgery. It has had its time, now it is time to move forward.
Consultant for Prohairclinic Belgium
FUE only institute since 2004
Specialized in FUE megasessions
Bevrotti, I have followed your passion for this procedure over the years. I am not familiar with the group you are associated with, but I feel confident they produce quality results as I am sure you would not stand for less. Several of us have different approaches to the procedure. It would be a good idea for us to all organize a meeting in due course to compare notes and techniques in order to insure a better result. One of the problems we seem to face is that our colleagues seem to have a negative sentiment to what we are attempting to accomplish. As such it is often difficult for us to cumulatively come together toward the common good. Most organized meetings have the intent to discredit our newer, better approach because it quite simply is more difficult and poorly understood by the hierarchy.
Dr. Cole, while you are here, can you tell me what do you think of using beard hair to fix my strip scar? Both Dr. Arvind and Umar have posted beard hair results, most robust I have seen and appear to be perfect for breaking up strip scars. Your thoughts? I am very tempted to get it done this year.
My thoughts on body hair in general are that it can be quite robust some of the time, but most of the time it is subtle. About half of the patients with subtle results are quite amazed. They return with exclamations regarding how amazing the result it. Others with subtle results seem to say, “Yes it is better, but I’m not sure it was worth the time or effort.” You first need to find out how you respond and how you perceive the results.
With regard to beard hair, I think it has great potential. I’ve used it mostly on the top of the head and the beard area for those with weak beards with good results. I think that Drs. Umar and Arnivd have used it more for scars, but it seems to work well in those areas. Beard hairs tend to be quite coarse and have a high preponderance for the anagen phase. As such they should work quite well as body hairs in the anagen phase tend to do better than body hairs in the telogen or resting phase. I would say that it is a good option and in my hands the beard areas seems to heal flawlessly.
My recommendation to you would be to try a small quantity to see how you respond. I would not dense pack because dense packing seems to negatively affect body hair. Of course it could be that beard hair allows more for dense packing as it may be closer to scalp hair in it’s allowance for dense packing.
All hairs seem to exhibit variable characteristics. Some are quite hardy while others seem to be delicate. Body hairs seem to be more delicate and susceptible to the various physical factors that control yield. Some times densely packed body hair does well, but other times it does not respond as well as we would like. It is possible that beard hair is hardier. One of the other problems with body hair is that up close it looks formidable, but from a distance, it seems to disappear. Beard hair seem more formidable up close and from a far.
Certainly it is not difficult to remove and relocate beard hair, but it seems that Drs. Umar and Arnvid have more experience in scars. I would recommend that it is worth a trial, but start with a smaller session, see how you respond, and take it from there. If you respond favorably, add more. Also, keep us posted on your results. I think it is a good option, but quality data will help us formulate opinions going forward. Personally, I think it offers great potential for scars and the top of the scalp within reason because the quality of the hair is slightly different. Beard hair is more coarse than scalp hair. Scalp hair averages about 68 micrometers in diameter, while beard hair is about 130 micrometers in diameter. Good Luck!
hello dr.cole ,
those are very informative posts .
you mentioned above that “Our newest technology is going to change those variables for good” - when will this particular technology be available to patients , and what does it pertain to - tools / techniques?
i was about to book a procedure with you , but after reading the above posts i now feel that maybe i should wait a while ?
Hello Dr Cole,
I truly appreciate your straight talking attitude. You really are a breath of fresh air around here.
I am a bit shocked to learn that in your opinion I should try to avoid STRIP surgery as I was getting used to the idea that that was my only option.
I will take some pictures today and do my best to send them to you as soon as possible. I am really curious to know your take on my case.
It would be very nice to know how long it will take to benefit from your new instrumentation. In other words when will you be able to use this improved instrumentation on the general public?
I had a look at your website. Very well done and documented. However I have a couple of questions that I would like to ask if you don’t mind.
First off, How come the site shows a substantial number of STRIP surgeries?
Does this mean that STRIP can be a good option for some patients? or is it just a question of money? (Strip being cheaper than FIT that is)
The eastethic result of your HT seems to be very good. However, it seems to me (I might be wrong of course) that in terms of density and coverage FIT does not produce the same pleasing results of STRIP.
Specially with regards to class 5/6 patients I noticed that even with FIT mega sessions the overall density of the HT is not as good as standard STRIP.
This is a consideration purely made on what I have seen from the photos and is not backed by any actual data.
Finally I noticed that you have a center in Belgium. Is this correct? Do you actually operate there?
One final question. Perhaps the most important one. Let’s suppose I decide to have a FIT surgery with you. How many grafts could I get with 15.000 euros?
Thank you
Regards,
Piero