FUE surgery, and indeed like most things in life, has levels and quality change, and this is evident with the same product or service usually given, all things are not equal. This came home to me when I was a student and on a tight budget. I was buying bread for a few pence, it was white, no thrills, thin and basic with plain wrapping, while the artisan bread was £1.60 a go and for sure more appetising to the eye, well labelled and marketed, but less friendly to my pocket. In the building trade the cheap white is great for cleaning smoke damaged walls, (free tip for you if you have a fire), but not for much else. The product is still called ‘bread”, it is edible (just), and often what you put in it makes a huge difference, but you are aware that it will not look, taste, feel, be packaged or give the same outcome as the more costly one!
We are as a society aware that products are not all the same and this is valid from washing up liquid to the latest technology, you get what you pay for and for the most part are aware of that, I am not revealing any great secrets here thus far, this is all obvious up to this point. Enter FUE, an acronym of three letters that for the unlearned is just a technique, FUE with one doctor for many will be the same as with another, a bit like getting a cappuccino, there may be some small variants but nothing to write home about and indeed many market this as the case. The most important aspect is the cost, how much per graft and adhorned with some dubious results from unclear angels and favourable lighting and bingo, many will be happy with the representation. The truth though, is far more complex and for many of these clinics they will avoid to show clear surgery photos and above all the of the patient’s donor. They know that most will not ask to see this and are actually totally oblivious to it and only focus on the so called “result”!, So, the marketing is geared to the lesser educated and about impulse buying. This is a fatal error and one not to be be overlooked.
At BHR Clinic and under the tutelage of Dr.Bisanga, we are big on transparency from the first contact, be it price, the role of the doctor and team, but also on the actual surgery detail, the size and type of punches used, the quality of the equipment, magnification, the cutting tools et al, all need to be without thought of expense but what is in the best interest of the patient. The cheaper you go, the worse the patient will heal, because for cheap deals you cannot expect the best tools or even the best hands on the tools and you certainly cannot expect a thorough protocol for your FUE surgery that takes into account the harvesting and the placing and what is or is not good and ethical practice.
With this in mind we come to what for many is really an unknown and therefore unquestioned element for the masses, i.e donor preservation and the importance of a good extraction pattern with as much as possible with a small punch! Yes, people talk graft amounts and results, but what they tend to over-look is how these grafts are taken and the resulting damage to the donor and more worryingly, the impact of this, both in terms of longterm harvesting and more immediately, how short they can wear their hair!
Although FUE has come on a long way from back in the early 2000s, there is a still, sadly, a real lack of expertise when it comes to the artisan approach, and I will explain what I mean. I see countless FUE cases posted, they get great applaud while the sole focus is on the hair line, often there are no donor photos or they are there but hidden in plain site, because the viewer doesn’t know what to look at nor what to expect . The extractions are often not well spaced at all, but rather become a messy blob of puncture wounds, no thought has been given to the donor, the healing, the damage to surrounding grafts or to the donor zones. The longevity and keeping the donor in good condition for future surgery is not a priority, nor indeed even harvesting from the right areas for the transplanted zones needed. For many, the goal is just to get as many grafts you can and in a the shortest time possible, while remembering every graft is an extra pound, dollar or euro. The hair may grow, albeit at very weird and wonderful angels, but the donor has often been badly compromised and the rich occipital area has been exhausted and wasted on what is really a simple hair line reconstruction.
One can ask why is this a concern? If the growth is good who cares? That not the most important element? Well, firstly, the result will often look pluggy, it will have the wrong calibre and also follicular unit make up on the hair line or temples. Here you have by nature single, finer hairs, so the aesthetic look already will be off and draw attention for the wrong reason. Secondly the donor has been robbed of the rich pickings that should have been kept for a rainy day and for more potential loss. The occipital only approach, aside from not getting the correct grafts that should have been cherry picked for these delicate areas to reconstruct, you have wasted the larger, coarser and more hair-dense areas that should have been in kept in reserve for areas further back that will need them. Once these areas start to thin you will struggle to cover them with with fine, single haired units.
And lastly, the concentration of grafts taken, often with no thought for tomorrow will actually mean you will get less grafts long term. The healing will be worse, the punch can kill surrounding follicles and effectively you strangle and stifle grafts that would have survived had the whole approach been more educated and with thought and scientific and proven protocol. The patient will have obvious hair deprived and over-harvested areas that mean they will need to either wear their hair longer or need SMP or similar to then camouflage the resulting patchy donor.
So, in summary, don’t look just at the growth, ask yourself why do clinics post with no donor photos or if they are posted, do they look as if they really have harvested with any thought in mind and with a clear pattern or is it a case of smash and grab, take as much as you can now approach? Yes, the finer areas are harder to harvest, more time consuming the angles are more acute, more expertise is needed and you wont be able to split them up as much as the richer areas, but for a doctor who appreciates this, it is sacrosanct and against every fibre in their body to do otherwise! Extraction pattern is not just a nice expression to throw about, but something that has real impact, not only own your result but also on your longterm and your styling options, and like that loaf of bread, there are indeed levels!
Thank you for reading, we hope it was educational and please feel free to leave a like and a comment and let us know how we can serve you!