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Do the old "plugs" yield better than an FUT or FUE?

H

hairtech

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#1
Do the old "plugs" yield better than an FUT or FUE?

More than likely they do. And I hate to even give this recognition to an old school plug. But then we have to figure out why this may be the case.

Bigmac and bullitnut brought up an interesting statement/post in this thread:

http://www.hairlossexperiences.com/view_topic.php?id=1090&forum_id=2

I quote," My Norton plugs are still going strong.;;D"

Why? And more importantly why do we see plug transplants having high yields in terms of growth?

Recently there have been studies that are now providing a more definitive insight to the yields of plugs, minnis, mugs, DFU's, FUT, and FUE grafts. And the yields of each are definitely different. Why?

Let us explore this.

Any clinic, doctor, individual... please give input, theory or hypothesis. No post is stupid. ))N_):)
 
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Bigmac

Bigmac

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#2
Maybe its all to do with how much tissue is surrounding the follicle and protecting it from damage. A bit like a potted plant will grow well when all the surrounding soil is intact when it is re planted.
 
H

hairtech

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#4
Yes a new study came out that described grafts that are fat, mid-size and trimmed tightly. The yield was in the order above. The fatter the graft the higher the yield. This study can somewhat correlate with FUE yields. FUE grafts are highly vulnerable to both mechanical damage and drying out.
 
Bigmac

Bigmac

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#5
Hi Hairtech.

Have you a link to this study.(before this topic is copied and posted elsewhere);)

Thanks bm.
 
janna

janna

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#7
When you think about a HT, a lot of factors determine if transplanted grafts will successfully grow. Yes, it makes sense that if healthy follicles with ample protective tissue surrounding it and is properly planted in the most gentle manner while it's been well hydrated, it should grow as expected. Great results can also be produced with very well trimmed grafts but greater care has to go into the procedure. It stands to reason that they are more vulunerable and they have to be handled with utmost care during each phase of surgery.

I've seen really big plugs grow abundantly but I've also seen plugs grow in every which direction and there are not the number of plugs/hairs that there should be. It results in unmanageable, unnatural, sparse hair. Mishandled grafts during cutting and planting phases for any size grafts (skinny, med, big) determine whether it grows. In Bigmac's and Bullitnut's cases, they have some strong plugs clearly growing, however, they do not have the number of grafts that they believe were planted. Now, this could be a case of some grafts being mishandled during surgery or they were given false graft counts. I suspect some of both.

As for the study, Dr. Ron stated it was very interesting but I have not had time to read it yet. As for results of different size grafts Hairtech mentioned above, and perhaps I misunderstood Dr. Ron, but another aspect of the study is that the skinny grafts tend to take longer to grow. Final results at 18 to 19 months post op rather than the traditional 12 months. So there may be a trade off - you want dense packing with minimal signs of surgery because you have really well trimmed grafts for small incisions but it'll take longer to get the final results. I'll try to dig up the study.

Good subject starter, Hairtech!

 
D

Dr Rogers

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#9
A very controversial topic! Let's start with the punch/plug grafts.

Plug grafts were typically 4mm across, very easy to handle, easy to train the doctors to remove and the big plug of tissue kept the hairs alive until they were rapidly placed into the recipient site.
Mistakes could be made (too shallow and the bulbs were damaged). Sometimes the nutrients didn't get through into the centre of the plug and the inside hairs died (doughnutting - or donuts!).
The punch often damaged the hairs around the outside too but generally, the grafts did grow vigorously because they were protected by all that tissue.

Follicular units are more carefully separated but there is a lot more risk of damage and dehydration. Procedures take far longer too. I suspect that a well performed FUT has a better regrowth rate than an average plug graft but a poorly performed FUT is worse than plugs. Also, a plug of hair is pretty obvious but a natural FU can get "lost" amongst natural hair and not realised to be a transplanted hair.

The problem of the skinny/chubby debate is the definition is somewhat vague. I prefer our grafts to be medium but some clinics would call them obese but some might call them super skinny!

It stands to reason that more protection for the graft is better but it does limit one pass dense packing. However, is it better to have a high regrowth rate in two passes or lower regrowth in one?
 
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H

hairtech

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#10
What a great debate here... And Janna brought up a good point... "The slim grafts may take longer to grow." This is an interesting concept.

IMO I agree with Dr. Rogers... about the dense packing. i'd rather have a 2 pass high yield than a 1 pass mediocre yield...

However no one can actually pin point a yield either way. There are so many variables that go into a yield in general. The skill of the placer in particular is a variable that can make or break a yield... but there are other variables...

What are more variables that one would think to have an impact on yield?
 
M

Mountain

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#11
What's the process of getting an organ to grow in another part of the body? Does the health and vitality of the person have a role in it?
 
Bigmac

Bigmac

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#12
Mountain wrote:
What's the process of getting an organ to grow in another part of the body? Does the health and vitality of the person have a role in it?
Great question.

Maybe this has something to do with patients who experience poor yield,the so called X factor.
 
M

Mountain

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#13
Yes, but what exactly is the X factor, is it poor circulation, mineral deficiency, etc.? I'd like to hear a doctor's opinion on this.
 
H

hairtech

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#14
To be honest Mountain... The X factor that bigmac speaks about is real... In this community (the hair transplant community)... the doctors, the seasoned techs/staff cannot predict the "x" factor.

IMO the X factor is the individual's many variables... health, diet, disease, personal vices, familial history, race, the clinic, the experience of the clinic, AND other factors are what make up the X factor.

Take for instance in general medicine... and an example you might understand:

Cardiac disease is a result of: 1. familial history. 2 poor diet. 3. physical activity or lack there of... 4. vices such as heavy smoking, drinking and/or street drug use 4. stress (only in combination with the above). 5. rare environmental exposures.

Cardiac disease can be predicted highly with these variables. There are a plethora of studies that have proved this:

Hair transplants cannot be predicted... hence the x factor. *nl[):h::'''h;h;;h
 
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D

Dr Rogers

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#15
Absolutely, there are a lot of variables, many of which cannot be completely controlled. However....
There are X factors which even "leading clinics" cannot completely exclude, so these are patient variables, as mentioned above. These may account for 1% of patients. Then there are inevitable losses i.e. the longer the time before reimplantation, the lower the regrowth rate (can be an issue for super megasessions or those clinics not routinely providing this). Finally, there is the "clinic variables," which even in the best clinics, do occur. For example, a tech is having " a bad day," the lead tech is on holiday etc. Modern hair transplantation is a team effort and each cog when working well is great but, everybody is still human.
That's one set of reasons. There's a lot of variability and thats just hair transplants. Correlate that with cardiac (heart)transplants and it's even more concerning!
"Good clinics" minimise these issues but cannot remove them completely.
Hair transplants are more complex than they appear. Many people, including colleagues, do underestimate this initially. No criticism implied, it's a simple truth that applies to many human endeavours. Experience makes things look "simple."
 
H

Hans Zarkov

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#17
Interesting topic as i`ve had poor growth from the hair transplant i had done. When i say poor..... I mean my expectations weren`t met. I`m now waiting it out hoping the meds help me out with growth.

You really need to do your homework before you go down the hair transplant route... period !!!!
 
H

hairtech

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#18
What is your situation hans? What was your pre- transplant situation? And where did you get your transplant?