Not a day goes by that our office doesn’t get a call from a prospective patient saying “I’m interested in the latest hair transplant method called FUE.” This constantly reminds me of how misinformed potential patients are and how they are being misled and misinformed. But in order to understand how patient are being misled today, we must first explain the history of the FUE (Follicular Unit Extraction) of hair transplantation.
This patient had the original type of FUE implants which
gave the “pluggy” look you see on the left photo.
In the 1970s or even earlier, hair restoration was not as simple as today nor did it deliver natural results. Bushes of hair were extracted or punched out (hence the term that today is still used in the FUE method), which included 15-20 hairs. When they were transplanted within a patient’s thinning area, it resulted in a thicker look. However, when the rest of the patient’s native hair also succumbed to Dihydrotestosterone (DHT), it exposed the bushes of hair that were transplanted, thus leaving a very unnatural and pluggy result.
This method continued until the mid 1990s, until doctors started thinking that it might be best to surgically remove a strip of skin with follicle, separate each graft as its own individual unit, thus allowing doctors to transplant the one hair units in the frontal hairline and the multiple hair units in the mid and crown areas, thus giving them the opportunity to mimic mother nature and deliver more natural results. This is when the FUT, Strip, method was born, circa 1995. This method overshadowed the plug method and made a great deal of patients very happy up until today.
Around 2009, the FUE method made a come back due to the improvement of tools and methods. Automated machines were invented that allowed for the harvesting of individual units to be harvested one by one. This new and improved FUE method made a resounding come back and was made to sound as the latest and more up-do-date style of hair restoration.
A couple of private companies have taken full advantage of this and market their units as the best and most modern. They market heavily on the Internet in order to persuade patients to use the FUE method, but also put down the FUT, strip, method as being outdated and unnecessary. And this, ladies and gentlemen, is where the manipulation and persuasion began that exists today more than ever in the hair restoration industry.
Because of a business marketing angle, these companies are promoting the FUE method to each and every patient and downplaying the FUT method. Let’s make something clear, both methods, the FUE and FUT, can be beneficial to patients. However, not every patient is a good candidate for the FUE or the FUT method. It becomes very dangerous and misguiding when a private for-profit company makes an umbrella statement, not considering the effect it may have in those patients that are not good candidates for the FUE method.
We have had numerous young patients that have come into our Fort Myers and Orlando clinics for consultation wanting the FUE method of hair restoration, while displaying a Norwood 5 level of hair loss at a young age of 21. The reason the FUE method is not good for such a young patient with this aggressive pattern of hair loss is because a young patient like this will need numerous, high number of graft procedures. If you produce too many dot scars, next to dot scars in the donor area of an FUE patient, he can suffer from a diffused donor area in the future, thus leaving him with a thinning look in the back…while trying to give him density in the frontal areas???
Instead of helping this patient, you are hurting him long term and guiding him down a path of disappointment. When our hair restoration specialist, Dr. Samuel Botta, sits with a patient in this situation, he expresses to him the reasons why the FUE is not the best method for him. Some patients even buckle and say “well if you don’t perform the FUE method on me, I’ll find another clinic who will.”
At this point we express to the young patient that it isn’t our job to recommend what he wants to hear, but instead what is best for him based on our numerous years of experience. However, he definitely is free to choose for himself.
For an excellent article about the FUT vs. FUE method of hair restoration, please click the following article written by the International Society of Hair Restoration Surgery (ISHRS), http://www.ishrs.org/article/comparison-between-strip-harvesting-and-follicular-unit-extraction-fair-and-balanced-view.
So why do these FUE equipment companies mislead the industry???
It all comes down to the dollar. They know that the more they promote the FUE method on the internet as the best and most advanced method, the more demand there will be for their equipment. Doctor’s offices will call them in order to buy their equipment in order to meet the industry demand created by the equipment companies themselves.
This has also created problem #2 of non-specialist doctors getting involved in the hair restoration industry in order to increase their business volume. The problem here is that these doctors aren’t willing to take the time to learn and specialize in hair restoration. They might take a weekend course to learn the basics, but do not affiliate themselves with the ISHRS or any other hair restoration educational board. This would take too much time and pull them away from their other bread and butter surgeries, such as breast, liposuction and facial plastic surgery.
So what these doctors do is purchase the FUE machines and contract trained technicians to perform full hair restoration procedures, while these doctors keep performing their other plethora of services simultaneously. But the insult doesn’t end there.
These tool companies also sign an agreement with these doctors offices that for every harvest attempt made with their equipment during an FUE procedure, the clinic must pay a royalty of $1.50 back to the tool company. And who pays for this….YOU! So for a 2000 graft procedure, the patient ends up paying $3000 to a manufacturer of a tool!!!!
Sounds like a well-rounded business opportunity for the tool manufacturer…but a very misleading and deceptive, not to mention dangerous, scenario for FUE patients. One thing that we should make clear, not all clinics that perform the FUE method are non specialists. However, the good majority are…and this puts potential patients in a very delicate scenario.
So what is a potential hair restoration patient to do in order to avoid this? He/she must implement a very thorough research campaign in order to week out non specialist, thus increasing their chances of experiencing a great surgery with excellent results…no to mention avoid over paying!
There are 4 steps a potential patient should follow in order to avoid these charlatans:
First, choose a clinic that offers both the FUE and the FUT methods of hair restoration.
Remember that non-specialist do not want to invest time performing hair restoration surgeries. You can’t blame them for investing their time in performing 4 breast surgeries in the time it would take to perform one hair surgery. They make a great deal more money focusing on other types of procedures while their hair technicians develop more “side volume” on their own. Since the FUT, strip, method involves more of an invasive method, it requires a doctor to be more involved, thus confirming they will specialize in hair restoration. This first step does not fully confirm a specialist, but it does weed out those clinics that just purchase an FUE machine and hire technicians only. If you were in the market to buy a new car but hadn’t decided what type of car you’re buying, would you visit a dealership that only sold red Camaros?? If you did, which care do you think they’d try to convince you to buy…while putting other cars down? Instead you should visit a car dealership that offered various models so you can choose the right car to fulfill your particular needs.
Second, after weeding out the non-specialists, you should choose a doctor that is a board-certified surgeon.
After being in the industry for 20 years, I can confirm that a huge difference exists between a family doctor or dermatologist performing a strip surgery than a board certified surgeon. Although a hair specialist’s most important goal is to deliver excellent, natural results, it’s also very important that he/she leaves a very fine line in the donor area. A family doctor, dermatologist, internal medicine doctor and much less a pediatrician know how to do correct closures compared to an actual surgeon. For more information about choosing a board certified surgeon, please read an excellent article by the ISHRS by clicking here (http://www.ishrs.org/content/why-your-hair-restoration-specialist-should-be-physician).
Third, the doctor you’re considering should be a member of the ISHRS or other hair educational board where he/she attends regular conferences in order to keep up to date with methods.
If they are not, you have to ask yourself where they are learning in order to perform this type of procedure.
Fourth, the doctor you are considering should have numerous before and after pictures to showcase the type of results they deliver.
Most clinics that only offer FUE, which depicts them as not being specialist, don’t have many pictures to showcase and even use pictures that the tool company sends them in order to have something to show. For more information about the evolution of hair restoration, click the following article http://www.ishrs.org/articles/hair-restoration-progress.htm.
Finally and most importantly, use your common sense when researching doctors.
Here are a few examples of hair transplant clinics in Orlando that may seem like viable options, but are not the best choices for different reasons:
There is a particular Orlando hair clinic in central Florida that markets themselves as hair specialists. The doctor is an internal medicine doctor that offers a plethora of services. He tries to display himself as an experienced hair doctor by mentioning on his website that “he and his team have a COMBINED 15 years of experience in the hair industry.” Any time a doctor mentions the words combined experience…it means he doesn’t have much experience but adds on the experience of his team to his in order to inflate his actual experience. To boot, he showcases his 85 “5 star” Google reviews in order to convince potential patients of his quality work, but only has before and after pictures of 5 patients on his website, which are not very impressive to begin with. Wouldn’t you expect more pictures and better results from a doctor with a “combined experience of 15 years?” And he only offers the FUE method of hair restoration and shows no membership to any hair restoration board…so where is he learning from??? This particular clinic has caution flags all over it. PATIENT BEWARE!!!
Another clinic located in Orlando gets a great deal of exposure by marketing their services on the radio. Their main doctor is an ophthalmologist who began doing facial work (not a board-certified plastic surgeon) who has numerous negative patient reviews online. He began a hair division in his practice and put a consultant in to head this division. This consultant had his hair restored while working with a national company for many years. He posts his own before and after pictures on their website, which is very misleading considering he had his hair done using the FUT, strip, method when he worked with the national company. They offer the FUE method only, which, again, falls in the line of who really is doing my surgery. They hired a plastic surgeon to head the hair division, stating on their website that he has 15 years of hair restoration experience, which is an absolutely false statement. If you research his name, you will see he has done many years of plastic surgery, but not hair restoration. This doctor has no affiliations to any hair restoration educational board and has not attended any conferences. So you have to ask yourself who really is doing your hair transplant procedure??? You can find out the answer to this question by asking them directly. PATIENT BEWARE!!!
Finally, you will find Orlando Bosley also promoting themselves as an option. They promote themselves as the most experienced hair restoration company, but some of their doctors only have 1-2 years of experience. Therefore, the correct question to ask is how much experience does the doctor have, not the actual brick and mortar company. On average, they charge almost 50% more due to their expensive national television marketing campaign. After all, someone has to pay the bills. But is it necessary to pay 50% more in order to get a great hair transplant? The answer is absolutely not! Again, PATIENT BEWARE!
So if you’re serious about searching for an Orlando Hair MD , make sure you are putting in the time and research to find the right one and avoid the many pitfalls that unfortunately exist in today’s hair restoration industry.