Megasession FUE/strip procedures in the US

[SPimpernel]

Why don't we see more 3000+ graft megasession FUE (or strip, for that matter) procedures performed by US doctors? It seems there would be a market in the US for such procedures.

Do you all believe that we will see more such procedures in the US in the future?

[Mark]

Why don't we see more 3000+ graft megasession FUE (or strip, for that matter) procedures performed by US doctors? It seems there would be a market in the US for such procedures.

Do you all believe that we will see more such procedures in the US in the future?

Hi Spimpernel,

I was just talking with Dr Rassman about this since it piqued my interest too. Short answer: they're not getting 3000+ grafts. Either they're being lied to, or the doctors are cutting multi-hair grafts into single hair grafts to make more money.

The problem lies in the fact that you can only cut so much skin out of the scalp at one time due to the fact that you've got to stitch/staple it back together, and very few people have an elastic enough scalp to be able to cut a strip wide enough to get those high numbers of grafts.

Here at NHI, we typically cut 1.2 to 1.6 cm wide strips on average. Rarely do we see people with an elastic enough scalp to get even 2.1 cm.



So for people to be transplanting that many grafts in one sitting they've got to have an extremely rare level of laxity in their scalp, an extremely dense donor area (also rare), or a magical way of suturing extremely wide cuts in the scalp that most doctors have yet to discover.

Or they're just not being honest in an effort to gain prestige or get more money from patients.

Occams razor should give you an idea which is true.

As a side story, Dr Rassman was describing to me a meeting he was at with a Chinese surgeon who produced three different patients who he claimed to have done 4000ish graft transplants on. The likelihood of that one doctor stumbling upon three guys with a lax enough scalp to do that many grafts is about as statistically improbable as a doctor being able to train baboons to do graft placement for them.

Sorry to be the naysayer here, but the good thing about medical science is that it's always advancing. Who knows what the future holds?

-Mark

[Dr. William Rassman]

I wrote about this many times. There are a great deal of both honest doctors and dishonest ones. If someone is routinely getting 3500-4000 graft averaging 2 hairs each on their patient, this can not be. The laxity of the scalp and the density of the scalp hairs would require a very high density or a very, very, very loose scalp to yield numbers that I read being reported. I suspect come doctors can't count well enough when there are big dollars in it for them to miscalculate the graft numbers.

[He-man]

H+W can do Mega sessions and there is no cutting of grafts, i believe mega sessions are possible due to advances in HT technology. I believe Dr Wong or/and Dr Hassan had a new way of cutting the donor to maximise the number of grafts that can be harvested.

[Dr. William Rassman]

H+W can do Mega sessions and there is no cutting of grafts, i believe mega sessions are possible due to advances in HT technology. I believe Dr Wong or/and Dr Hassan had a new way of cutting the donor to maximise the number of grafts that can be harvested.


I would be a terrible businessman if I hadn't discovered this technique in my years of experience. There aren't many variables when it comes to getting a high number of grafts from a donor strip. You have to evaluate the laxity of the scalp, which will inform you how wide of a strip you can cut while still being able to suture the wound closed. And then you have the density of follicular units in that donor strip.

It's really quite simple. The only way to achieve 3500-4000 grafts in a strip surgery is to have a patient who has an extremely lax scalp, and an extremely dense donor area. Both of those traits are quite rare in combination. Of course, a three hair graft cut into three one hair grafts will increase the graft count but not the hair count as 1+1+1 equals three. One must ask, is that value?

No surgeon in the world has been doing megasessions longer than I have. I reported the first 2000 graft case in 1992, then the first 3000 graft case in 1993 and finally the first 4000 graft case in 1994. If there was a technology that could harvest massive numbers of grafts from a strip, I would know it.

Unless the patients with high densities and lax scalps travel to Vancouver and not to Los Angeles, my logical brain tells me something is wrong with this picture. I do not believe the impossible and I certainly do not consider myself second class to those who claim these illogical graft counts as a routine.

If a patient goes to a doctor who claims to routinely get those high number of grafts, ask them how they do it. I have a feeling you'll find the answer unsatisfying.

[Bverotti]

Hi Dr. Rassman,
I had to pleasure to meet you in San Diego at the IShrs.

As you may know I represent Prohairclinic in Belgium, known for FUE procedures (we do not offer strip).
We are doing 2000-4000 FUE grafts on a daily basis, unsplit of course. I know this may sound quite extraordinary and even may raise some eye brows :)

As a very highly respected member of the Ishrs we would like to invite you over and have a look at our procedures. There is nothing we are hiding, unlike some other institutes or docs :)


Greetz,

Bart

ps : we are about 200 km from Amsterdam where the next Ishrs will be held.

[davidro]

hi,just reading the posts,and i was wondering why FUE is not very popular in USA;i just done a transplant in Turkey,at Kulis Estetic Clinic, 6100 grafts,in 3 consecutive days,with FUE technique;i paid 4000 euros (5600 $),everything being included,accomodation,etc the ytransplant was done 2 months ago,and the new grafts started to grow;there are so many clinics performing FUE,with 2000 grafts on a day,so in few days you can reach to 6-7.000 grafts (12.000 strands);

[Mark]

hi,just reading the posts,and i was wondering why FUE is not very popular in USA;i just done a transplant in Turkey,at Kulis Estetic Clinic, 6100 grafts,in 3 consecutive days,with FUE technique;i paid 4000 euros (5600 $),everything being included,accomodation,etc the ytransplant was done 2 months ago,and the new grafts started to grow;there are so many clinics performing FUE,with 2000 grafts on a day,so in few days you can reach to 6-7.000 grafts (12.000 strands);

It's not as popular for the simple reason that it's much more labor intensive than the strip method is.

Also, did they do 6100 grafts or 6100 hairs?

[namratasnv]

It seems that people in US are more leaned to hair transplant or taking medicines instead of FUE, but what I have heard about FUE is it is really helpful and yet beneficial too.

I have seen many videos of FUE and the needle which is used for taking out hair follicles. This is the best way which is accepted by most of the people.

Thanks

[King]

I hear that the survival of hair folicules in FUE procedure is much less then the strip method. That's why you get better results by strip method.