Why I Won\'t Do Strip - nightmares

Hair Transplant
1

This one of the many reasons why I choose to go in for a FUE rather than a strip. Keep in my in mind that there are many more horrorr stories with strip (surgeons show them all the time in their repair cases or FUE into strip-scar cases). Instead of ooooh’ing and aaaaah’ing at how to repair and place FUE into strip, why not add in there “Strip is becoming absolete. FUE is the future.”

Check out this guy…

http://foro.ganarpelo.org/viewtopic.php?t=16591&start=20

2

This is a mess!

3

Oh man, I truly feel bad for this guy.

4

» This is a mess!

5

It’s the risk you take from strip. Even from the best!

6

» It’s the risk you take from strip. Even from the best!

Couldn’t have said it better!

7

I do feel for this guy - I have not come across anything like this… I cant read the language the forum is in so dont know the exact details of the procedure.

8

Have the pictures been yanked? I see no pictures.

9

» I do feel for this guy - I have not come across anything like this… I cant
» read the language the forum is in so dont know the exact details of the
» procedure.

I think within 3-5 years that strip HT is going to be considered a technology of the past.I believe that most top clinics will only offer FUE at that time.

10

Xairyhay, did you scroll all the way down the long thread? I just checked they’re still up.

MMAGUY, you’re probably right but chances are if they haven’t started now then they’re unlikely to start later. Especially if they’re going to specialize in FUE only like Alvi Armani, then they’re going to have to start FUE with their Strip now and once experience is attained, get rid of the Strip altogether.

Hopefully 5-10 yrs from now we’ll have a much more advanced approach to remedy hairloss than even FUE :smiley:

11

» Xairyhay, did you scroll all the way down the long thread? I just checked
» they’re still up.
»
» MMAGUY, you’re probably right but chances are if they haven’t started now
» then they’re unlikely to start later. Especially if they’re going to
» specialize in FUE only like Alvi Armani, then they’re going to have to
» start FUE with their Strip now and once experience is attained, get rid of
» the Strip altogether.
»
» Hopefully 5-10 yrs from now we’ll have a much more advanced approach to
» remedy hairloss than even FUE :smiley:

All I can say is that I have a PhD, I am the managing director of a biotechnology company, I have followed this and other sources of information for many years, I need about 5000-6000 FUE at some point based on my thinning pattern and I will probably get a strip FUE hybrid. I have had numerous consultations and met a lot of patients but If I had to choose only one then it would be strip.

12

Not sure that it is H&W. Could someone who reads Spanish tell us if it was them or did they do a repair???

13

» Not sure that it is H&W. Could someone who reads Spanish tell us if it was
» them or did they do a repair???

there was some major infection. bad luck.

http://translate.google.com/translate?hl=en&ie=UTF-8&u=http%3A%2F%2Fforo.ganarpelo.org%2Fviewtopic.php%3Ft%3D16591%26start%3D20+ &sl=es&tl=en&history_state0=

14

Do elaborate Marco.

» » Xairyhay, did you scroll all the way down the long thread? I just
» checked
» » they’re still up.
» »
» » MMAGUY, you’re probably right but chances are if they haven’t started
» now
» » then they’re unlikely to start later. Especially if they’re going to
» » specialize in FUE only like Alvi Armani, then they’re going to have to
» » start FUE with their Strip now and once experience is attained, get rid
» of
» » the Strip altogether.
» »
» » Hopefully 5-10 yrs from now we’ll have a much more advanced approach to
» » remedy hairloss than even FUE :smiley:
»
» All I can say is that I have a PhD, I am the managing director of a
» biotechnology company, I have followed this and other sources of
» information for many years, I need about 5000-6000 FUE at some point based
» on my thinning pattern and I will probably get a strip FUE hybrid. I have
» had numerous consultations and met a lot of patients but If I had to choose
» only one then it would be strip.

15

» Do elaborate Marco.
»
»

Sorry, that sounded really condescending! I meant that there are intelligent arguments against FUE as well as strip. For a single small session (1000-3000) FUE in good hands has to be the way to go but few candidates will not need more in the long run (3000 grafts will barely cover a type III /area one and two). Once you have to repeat procedures or need more than 4000 total then scalp fue alone is almost not doable for the average scalp. Over the last 6 years I think there are about 4 4000+ scalp fue alone that I can think of.

FUE heals by secondary intention alone and that means that the thinning of the scalp must be more noticeable than by strip.

There is a compound problem of the scars from heavy duty FUE that changes the dermis and direction of underlying follicles.

FUE can and does KILL surrounding follicles except in the very best of hands. That is far more damage than strip.

Adjacent FUs cannot be harvested and that reduces the numbers to 25% of the total with more limited choice of ideal follicles when going for a larger session.

16

A family member of mine from the new york police department had his hair transplant with Armani about 2-3 weeks ago. He said he could have easily opted to go to a local surgeon and get a Strip procedure but chose to come to Toronto. He received, I belive about 3,500 grafts of FUE (Pats if you know about this feel free to correct me on the # of grafts). He went in the first day for a few hours for the first part of the surgery for about 1,800 grafts then came home. Next day he went back at 7am and received the rest of the grafts. This was 2 days in a row. He came back home that day, ordered take-out, watched a movie, then he crashed. Two days later they were up and drove back home to NYC (long driving trip. He convinced me there was absolutely nothing to it.

So to say that large sessions can’t be done is an overstatement. On the other hand his brother had about 2,000 grafts with dr Feller about 5yrs ago and all I remember was him whining about the recovery time, the super noticable scar in the back, and the pain of the staples in the back of his head. Not to mention the risk of infection is very possible too. Imagine having scabs for grafs all over your head in the begining stages, with train-track like staples smiling across the back of your head… now imagine having all that with the staples infected. That has to be one uncomfortable and unimaginable experience.

You said you would combine strip with fue… why would you do that? Why not just choose one? I think that would be the wiser move.

» » Do elaborate Marco.
» »
» »
»
» Sorry, that sounded really condescending! I meant that there are
» intelligent arguments against FUE as well as strip. For a single small
» session (1000-3000) FUE in good hands has to be the way to go but few
» candidates will not need more in the long run (3000 grafts will barely
» cover a type III /area one and two). Once you have to repeat procedures or
» need more than 4000 total then scalp fue alone is almost not doable for the
» average scalp. Over the last 6 years I think there are about 4 4000+ scalp
» fue alone that I can think of.
»
» FUE heals by secondary intention alone and that means that the thinning of
» the scalp must be more noticeable than by strip.
»
» There is a compound problem of the scars from heavy duty FUE that changes
» the dermis and direction of underlying follicles.
»
» FUE can and does KILL surrounding follicles except in the very best of
» hands. That is far more damage than strip.
»
» Adjacent FUs cannot be harvested and that reduces the numbers to 25% of
» the total with more limited choice of ideal follicles when going for a
» larger session.

17

Over the last 6 years I think there are about 4 4000+ scalp
fue alone that I can think of.

Marco,
It is not because you dont see these sessions that they dont exist. Our clinic alone has had much much more than 4 4000+ FUE patients.

»
» FUE heals by secondary intention alone and that means that the thinning of
» the scalp must be more noticeable than by strip.

True, eventually you will run into thinning with FUE. The question is “how much % can you take before it will start thinning at normal 1+ cm hairlength”. Obviously there arent 2 patients alike and all numbers vary.
From our experience up to now we dont see cosmetic visible thinning up to about 5000 FUE grafts on the average patient.
If you look on hairsite you will find some posts we made with examples of 4000 or 5000+ FUE donor pictures.

»
» There is a compound problem of the scars from heavy duty FUE that changes
» the dermis and direction of underlying follicles.

No, this is absolutely false. Our dr. does not find that FUE changes the direction of the underlying follicles. In fact, strip surgery is the number one procedure that changes the direction of the underlying follicles due to enourmous tension than is caused by closing the gaping wound.

» FUE can and does KILL surrounding follicles except in the very best of
» hands. That is far more damage than strip.

If you count the blood vessels, healthy tissue, nerves … that is discarded during a strip operation than you understand why strip is causing FAR more damage. Also it is untrue that FUE kills surrounding follicles provided FUE is performed correctly and with small instruments.

» Adjacent FUs cannot be harvested and that reduces the numbers to 25% of
» the total with more limited choice of ideal follicles when going for a
» larger session.

Not true. Adjacent follicles can be harvest, there is no technical limitation. The limitation is to be discussed with the patient in such that he needs to be aware that crossing the 25-30% limit will cause thinning effect on short hair styles (1-5 mm).

Another consideration why FUE is superior to Strip :

As you know often there are minituarized follicles in the donor area. During a strip surgery they will be used whereas with FUE the doc can select to remove the healthy grafts.

I can understand that people preffered a 1 strip giga session to have all done in 1 procedure. The reality now is that only a handfull clinics worldwide can pull off giga strip sessions. Furthermore giga strip sessions are really an exception and most people will not be able to benefit from then.
On the other hand most patient will be able to benefit from FUE megassesion. Again, up to now there are only a handfull institutes worldwide that can pull of these kind of sessions.

18

» Over the last 6 years I think there are about 4 4000+ scalp
» fue alone that I can think of.
»
» Marco,
» It is not because you dont see these sessions that they dont exist. Our
» clinic alone has had much much more than 4 4000+ FUE patients.
»

Thanks for your answers but it would be interesting to put these in context with the link below, posted by Bisangers clinic BHR. They are also a very experienced clinic. So where does the truth lie???

http://www.hairsite.com/hair-loss/forum_entry-id-44120-page-0-category-0-order-last_answer.html

19

» » Over the last 6 years I think there are about 4 4000+ scalp
» » fue alone that I can think of.
» »
» » Marco,
» » It is not because you dont see these sessions that they dont exist.
» Our
» » clinic alone has had much much more than 4 4000+ FUE patients.
» »
»
» Thanks for your answers but it would be interesting to put these in
» context with the link below, posted by Bisangers clinic BHR. They are also
» a very experienced clinic. So where does the truth lie???
»
»
»
» http://www.hairsite.com/hair-loss/forum_entry-id-44120-page-0-category-0-order-last_answer.html

I think highly of dr. Bisanga. The writeup he presents is his vision and that is perfectly fine. In fact most of the things he describes are very similar to our way of thinking.
The only big difference I see is that we feel that everybody is an FUE candidate, regarless of any hair or skin characteristics.

Secondly we agree to the 25% rule in which an educated harvesting protocol will leave no sign of extraction when performed correctly and with the proper instrumentation. I think both institutes also use more or less that same range of extration puches between 0,7 and 0,8 mm.

Furthtermore we feel going over the 25% rule is possible if the patient is informed about it. One can not expect to harvest 5000 grafts via FUE and have no visible evidence at very short hair length (1-4 mm) … FUE is not magic. However we do know that even after removing lets say 5000 FUE the donor will look in Much better shape at 1 or 2 mm length than any strip scar.

Additionally a lot of patients request some degree of thinning in the donor area to make the contrast between the transplanted area and the donor area less. At first I was not a big fan of this, but over the years I have become to apreciate this eductated request by patients.

I see 3 categories of drs right now in respect of offering FUE

  1. Flat denial
    These drs have set their routines and are unwiling to change. They are stuck in time and therefore have little to no interested.

  2. Those who offer FUE, but only for specific patients or situations. IMHO these docs dont have enough courage to take that extra step. Many of these docs fear that stepping ‘out of the line’ will harm their reputation and/or income.

  3. Those who fully embrace the full potential of FUE. It is these category that makes things move. These drs have the courage to stand up and make a change for the better.

20

Thanks again for your reply!

It seems then that the diference between Bisanga and yourselves are that he sticks strictly to the 25-30% rule wheras you would go higher and it sounds like you would go significantly higher if you are fine with 5000-6000 FUE.

i have looked long and hard at the diference between removing 35%-40% of the safe zone with FUE ves strip and there are big diferences. Not all of these are in favour of FUE (but a lot of them are).

The single issue that stands out is primary and secondary intention. The point is that with FUE there is no “scalp shrinkage” taking up loose tissue and maintaining the prior density of hair on a stretched out piece of tissue. Further more if you look at the pattern of removal of , let’s say 50%, by FUE then it is far from changing the spacing in an manor similar to stretching tissue. That can easily be seen by plotting FU on paper at different densities and then trying to remove hair from the highest density. The result is different.

what you do not end up with using FUE is a big single scar!! That counts for a lot but not everything.

The bottim line is that we need to see these 5000+ FUE consitently. Actually what we need for the tipping point is consistant 6000 FUE then the conversion would be rapind. You only have one 4000+ on your site!!!
Regards,
Marco.