BHR - FUE - Maximise your Donor! Optimal Healing! Ability to Shave Short!

[Raphael84]

Some individuals may believe that the only factor regarding the amount of grafts your donor can provide is only related to density. Density if of course a key factor, and native density is not something that we are able to increase. We can however avoid ways of destroying or damaging the donor so that it can be optimally utilised to give maximum grafts and minimum visual change. Many are destroying their donors today with poorly planned and executed FUE.

We have seen with quality FUE surgery, including cases with high graft numbers, you can shave your hair very short, if certain protocols are kept to. The problem we see today is really poor technique that will leave excessive scarring and damage the donor considerably, including to surrounding untouched follicles. So, by consequence, the patient will have very limited options in terms of graft availability for further loss and indeed also limited in regard to how they wear their hair.

This video shows footage from 2007 of Dr. Bisanga's FUE and the quality and management in place even way back in FUE infancy when most were new to the technique or indeed had not even learned and performed it at that stage.
Today we see a deluge of problems as these protocols are not kept to, so make sure you research and realise not all FUE is the same. In fact far from it.

 

[Bigmac]

Interesting and educational video that demonstrates the failings I see more and more from the FUE novices. There are many out there that aren’t prepared to put the hours in and have the correct training. FUE surgery is not just about scoring grafts. I hope more people considering FUE watch this video to understand the principals and skill that should be applied.
Thanks for sharing.

 

[sl]

Yes, in many respects it has gone backwards. Strip got bad press but the damage from poor FUE is not to be under-estimated and wholesale now. I see very few clinics that really impress me with the extraction and the aspects mentioned above and many will avoid posting extraction photos altogether for that same reason. The patient really does need to research and question more. Some are very good however and respect the principles needed.

 

[sl]

5 STEPS TO..
MAXIMISING YOUR DONOR!

In the last decade or even longer, we have heard a lot about cloning hair follicles, splitting hair follicles or even regenerating hair follicles by dipping them in Acell..the list goes on. The motivation is good but the outcomes not so. For the patient, the donor, its density, the make up of 1s,2s,3s,4s, the safe zones, the coarseness etc are the cards we have been dealt with in life. We can't change the cards, what we can change however is how we play them.

At BHR we are realists, we are not known for screaming for the new trend, the new injection or Robot or deliberate transection technique. What we are known for is trying to make sure we can maximise your donor with the tools, technology and techniques we have available, and have done since inception.

It is not rocket science and if I as a layman can understand it then probably most on the planet will be able to follow me. What we do implement is a logical approach and as broken down in the video, for us it forms the benchmark for looking after a patient's donor, allowing them to wear their hair as short as possible, not producing over-harvested or moth eaten areas, spreading the extraction to allow both healing and also cherry-picking the right grafts for the right areas to treat. Utilising small punches that will safely encapsulate the follicular unit without damaging surrounding follicles. Having depth control and appreciating the graft depth, angles and even the level of attachment they have under the skin.

Sadly with FUE the above for many are not considerations, it is about getting the number of grafts needed, regardless of where or how you get them, no thought for the future loss that may occur, or the areas taken from. Patterning is ignored and often the FUE holes will be co-joined to others to form blobs of scar tissue and with abrupt linear and very obvious boundaries that offer no blend at all back into the un-touched area, almost square grids of harvesting, like postage stamps.

The result of such approaches is inevitably areas are one stop shopping, you cannot re-visit to get more from them, usually the richer parts are gone for hair-line work and the patient is left with the possibility of future loss and then having to use the finer area of the donor for the recipient areas that would really benefit from the chunkier grafts. The large punches used mean shaving down is impossible and also the collateral damage to surrounding tissue and neighbouring follicles is also evident. These scenarios at best mean no more hair can be taken from the richer areas, or at worse they need SMP or even re- stocking to make the patient look more acceptable. In essence they swapped a problem on the recipient for a problem in the donor, assuming the recipient even went well.

Is FUE a good technique? Yes it is.. but it is really far more complex than many believe and really does take a solid appreciation and grounding to know how to do it well and to really maximise the donor for a patient who like all of us, will have only a finite number of grafts to use.

Don't be a victim, make sure to research, realise hair loss is progressive and you will need to use your donor wisely. Look at the principles in this video and ask yourself, does my clinic of choice appreciate these issues.

Take care and thanks for reading!

 

[Bigmac]

I think a lot of people don’t do enough research with quite a lot believing the hype the FUE leaves no visible scarring. Careful wording on websites fool prospective patients. Donor management is just as important as the recipient areas. Already there is an abundance of people looking for repair but not enough donor to achieve it.
The industry while evolving has gone backwards in a lot of areas.