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Hi,
I read about a method called Follicular Transfer [FT] carried out by Harley street hair clinic, London [http://www.hshairclinic.co.uk]. If possible can you please give your valuable comments on this technique as well as on the clinic. Thanks

It is just another name they use for follicular unit extraction (FUE). Their site describes this process as two steps — step 1 is extracting the hairs, step 2 is placing the hairs. There is no novelty or new procedure here.

I do not know much about the clinic other than what you can see on their site. I could not even find any physicians mentioned by name on their site… and that seems a bit strange to me.

Doctors,

So how soon can we expect to see pictures of patients you’ve performed on using the new FUE procedure?

It takes 6-8 months for people to develop enough hair to see the impact of any transplant procedure, and while this technology has been in development for some time, it was only recently perfected and announced. The FUE² is just another way to do FUE (which has been around for 6 years), so I would not expect anything but better growth for the process. I’ll post photos in the coming months, though.

In the post linked — Hair Cloning and Hair Transplant Failures — you discuss “transplant failure”. Does this mean total failure or just poor yield? I am a male, late twenties that has been mapped for miniaturization and found to have Diffuse Patterned Alopecia.

Would minimal yield from two (2) FUE surgeries suggest to you that the patient is in fact actually suffering from diffuse alopecia areata? Or do you believe FUE is unpredictable? I realize you cannot make a personal diagnosis over the Internet, but I would like your initial thoughts to point me in the right direction because I am running out of donor hair and patience with two failed doctors.

You’re right in that I cannot make a personal diagnosis over the Internet. You report Diffuse Patterned Alopecia which does not define what you have. I am assuming that you do not have the diffuse form of alopecia areata which is an autoimmune disease (very rare in young men) and if you had it, it would certainly kill off hair transplants if they were done. To make a diagnosis of alopecia areata, you would need several skin biopsies and an expert dermatopathologist to read the tissue when it was prepared. Have you gone through this? If not, this might be your next step before jumping to the conclusion that you had FUE failure for technical reasons.

I would love to see your results with a good photo or two, a set of slides from biopsies of your skin and then I can give you an opinion. What I meant in that post you referenced is a total or partial failure. Failures with FUE are often partial failures, where so many of the grafts were transected (having many amputated hairs) that the yield will be less than what has been transplanted.

In regard to follicular unit extraction (FUE), in my opinion, it is a procedure that is quite variable in the hands of doctors with different skill sets. Most of the failures with FUE, are probably related to the skill of the surgeon. I couldn’t tell you if you’re experiencing alopecia areata just based on the failure of FUE by your doctor. I recently wrote a new FUE guide that I hope you’ll read — Introduction to Follicular Unit Extraction Techniques.

I was wondering if after having a FOX procedure if you pick off the scabs from the donor area will this cause more significant scarring. I took off a scab 4 days from my procedure and it looks like it left a dimpled hole. I wonder if this will heal?

It is never a good idea to pick at a wound, as it creates the opportunity for infection. If you have eschar/crusts at the donor site from the FUE procedure (which is usually the case) you can wash them off with a good shampoo and a surgical brush. I don’t know what the dimpled hole is without seeing it, but hopefully it healed up for you.

I had Tinea Capitis as a child and i would pick them off of my scalp leaving these scar spots. I was wondering how much it would cost to fill in most of the “bald spots” also if i get them filled in would it be possible for me to cut my hair and the hair that was transplanted will regrow?

Iam 19years old Male, You have permission to use my pictures if needed.

First, thank you for allowing me to publish your photos. This is an extraordinary case, and one that is ideal for follicular unit extraction (FUE), where we can re-arrange the hairs from one place to another.

What I’m wondering, though, is whether you’re going to experience male pattern baldness. There is a genetic test that will tell you if you carry the balding gene, and it would be worth getting tested. If you do not have genetic MPB, then I would perform FUE all over your head, redistributing the hair from one place next to the balding areas, one at a time. If you are carrying the balding gene, then we would have to rethink the strategy. Cost might become an issue, as there is a great deal of cumulative balding, and although the fees are generally charged per graft (group of hairs), I could work with you on pricing due to the unique nature of the case.

I am very interested in getting a HT using the latest FUE2 technique. I have a few questions regarding the technique. I know that performing FUE with longer hair takes more time than standard FUE. If I choose not to shave my hair, I wonder if the fee is higher and how many grafts can be transplanted in one session.

Thank you very much for your response.

The price per graft does not depend upon the amount of hair you allow me to shave. If you look at the photos below, you will see that there is a limited amount of hair that I can take. We might be able to get 500-700 grafts without heavily clipping the hair in the head if your densities are good. Much higher numbers of grafts can be extracted with more hair clipping.

Left: FUE grafts extracted; Right: Hair combed down to completely cover donor area

The fee for follicular unit extraction (FUE) is $8/graft for surgeries done by Dr. Pak in our Los Angeles office — and this is a special rate valid until November 30, 2008. This uses our new FUE² technique.

Are there any hair transplant techniques available that allows you to completely shave your head? Or do all of them leave a visible scar of some kind? If they do, how closely cropped does the hair have to be to hide the scar?

The closest thing available is minimal punctate scars that are produced with follicular unit extraction (FUE). The smaller the punch, the less obvious is the scar, but the missing hair follicles become evident if the density is low. In individuals with high density, the use of a 0.7mm - 0.8mm punch will produce an almost scarless appearance, but if you shave your head, you might see it. The hair should be about 1/8th inch long to hide most FUE scars made with small punches.

I wanted to call your attention to yesterday’s announcement relating to follicular unit extraction (FUE). As the ‘inventors’ of the procedure, publishing the first authoritative article in the Journal of Dermatologic Surgery in 2002, I have taken a keen interest in the way this procedure is delivered throughout the world. Much of what I have been observing has been disturbing. Too many doctors with little experience, and skills that have not been refined, have entered the field with heavy marketing programs offering FUE. My experience, however, has shown that some patients are not good candidates for this procedure and damage to the harvested grafts can be substantial in most surgeon’s hands. The key here is graft yield and unfortunately, this is an assessment made either after the procedure is performed with careful surgical monitoring and record keeping (by recording hair damage within each graft), or 8 months after the procedure when the patient can judge the success or failure of the results on his or her head.

I realize there is a delicate balance between what we want and what we buy. Our progress in reinventing the FUE process is discussed here — new FUE breakthrough. I really hope everyone considering having an FUE surgery (or anyone just curious about how it works) will read our new guide to evaluating Follicular Unit Extraction Techniques.

So what prompted me to write a new FUE guide? A while ago, I had the opportunity to view a well known doctor extract approximately 20 FUE grafts under my direct observation. While he boasted that he had mastered the procedure, what I saw reflected far less than such mastery and the doctor obtained a significant transection/amputation rate of the hairs in the graft. That doctor is prominently offering FUE today.

The surgeon’s technical skills take years to acquire and perfect, and although there are now some very fine doctors who I believe have truely mastered the technique and can deliver a quality service, I believe that they are in the minority of those offering it. There is a substantial worldwide demand for this minimally invasive hair transplant (virtually painless during the post-operative period, the patient can return to full activities in a week including all types of exercises, and there is no linear scarring). The problem for the patient, however, is in selecting a doctor where the FUE technique does not produce a “follicular holocaust” causing a substantial loss of donor hair and a failure of the procedure. This insight seems to be hidden from most buyers, because prospective patients want to believe in the marketing hype that is prevalent on the Internet and they are sold the technique by professional marketing pitches. There is no way to determine in advance, the skills of the doctors offering to perform the surgery.

In our new FUE guide, we have defined a way for patients to examine the various doctors offering this procedure, giving them an idea of what questions to ask and what things to look for. There is no site to offer guidance in the doctor selection process so the consumer must arm himself with the knowledge and skills to make the proper judgments themselves. Hopefully, our writings will appropriately arm the readers interested in this technique.

• Article link: Patient’s Guide to Follicular Unit Extraction

We have made a significant breakthrough in the way to perform Follicular Unit Extraction (FUE) and we have put a substantial effort into giving our readership some practical basis to understand how to evaluate the significance of our breakthrough technology and the FUE process in general. There have been recent claims about FUE that I frankly can’t believe which are now appearing on various websites around the world. Considering that I literally pioneered the FUE field, I believe that I am an authority worth listening to. I have not spoken up about this before, but there is no time like the present to address my concerns publicly.

Please see our latest FUE writings at newhair.com/fue.

Also, we just announced a huge fee discount on our FUE breakthrough, which we’re calling FUE² — or Follicular Unit Extraction Enhanced. See newhair.com/fue2 for more on that.

Hi! Need your comments on the “No Touch Technique”. Is it similar to FUE. The medical group claim it to be better than the strip method. The FAQ section on their website mentions the difference between their technique versus FUE. But I am confused. Only you seem to be the qualified person to clear the doubts. Ultimately, which one is the safest and more result oriented method, which any average hair transplant patient can go through.

Thanks

There is a lot of marketing hype in the industry, because there is big money at stake. Many doctors claim what they think you want to hear. From the time you pay for the procedure until you get the results, the time-span runs 8 months, so you see that if a doctor is not honest and sells hype, then your check clears his bank account before you ever see what you bought.

In this case, it seems that this medical group has a tool that they use that removes the grafts via the FUE technique (no strip) — but at what accuracy? How successful are the grafts to grow out? They don’t state any statistics, so I don’t have any idea how to answer your question. I do not know enough about this group to make any qualitative statement about their work.

Many times tools are used by clinics that seemingly don’t care about growth rates and just want to be able to collect your money and say, “Well, the graft is in your head. — even if it doesn’t grow due to damage from when it was extracted, I did my job.” The consumer can tell how good the doctor is by asking them to discuss the amount of damage to the hairs in the grafts when they are extracted. At our clinic, we count damage per hair in the graft and can not only tell you what we got for hair yield, but show you our records of yield per hair and per graft. In a very recent article published by a Japanese group in the Hair Transplant Forum (a print newsletter), they discuss damage per hair in each graft with FUE. Their paper mirrors our formal publication back in 2002 that says there is considerable damage to the hairs in the graft in a substantial number of patients.

Watch this site over the next week and you will see ways to tell the scam artists from the good guys. You should not believe everything you read. Just because there is a doctor selling you the service, be very careful in your decision to go the FUE route without some proof that the clinic or doctor offering the procedure actually gets good results.