Or FUE vs strip hair transplant (the FUT stands for follicular unit transplantation).
FUE is also known as Follicular Unit Extraction or excision, variously Woods, FIT, DHI etc but so many names are confusing and unhelpful and not entirely accurate in their descriptions. It certainly doesn’t help guide the patient in making an informed choice about their hair transplant.
Hair transplant training at Westminster Clinic courses involve the “tester” and advanced days.
These include meet and greet, small class lectures, videos, one to one dicussions and hands on with our realistic hair transplant heads. Training is for both FUE and FUT (strip) basics and a good grounding for later live patient training.
Dependent on a minimum of five but a maximum of 10 students per weekend course, lunch and refreshments will be provided.
This training is principally aimed at new entrant doctors to the speciality of hair transplantation (or are thinking about it) but may be of use to hair technicians who want to know a greater depth. The course is located at Westminster Clinic in Harley St and nearby offices.
For further information, please email email@example.com or phone 01789 414203
Many artistic and technique related factors come together to make a natural hair transplant.
But firstly, you have to know what a natural hairline actually looks like and it’s a source of frequent surprise to Doctor Rogers, that so few people (both patients and doctors alike) recognise the correct characteristics. In synopsis:
Natural hair line shapes vary a lot, not just stereotypical male and female but also the actual line can have dips and projections, cow licks and widows peak irregularities. Helpful ideas include the snail track design which is a random line weaving in and out of the basic hair line design.
What isn’t natural includes very acute angles, temple lines that curve down in a simian way and the most obvious – just following a straight line without stepping the grafts forward and backwards at all. What Dr Rogers call the Action Man (GI Joe) look.
Along with variation of the actual line, the density needs to change – a natural hair line has fine wispy single hairs grading into stronger hairs and this can be mimicked by using single hair grafts in the first few rows then using2/3 hair grafts behind them.
But even then, the distance between each graft can be varied so that they don’t look like uniform “teeth in a comb” of perfect spacing. Two single hairs could be close together and a deliberate space left to break up the appearance of uniformity.
Natural hairlines are not evenly dense and in particular, the centre is normally thicker looking (due to angulation of the hair further back producing a shingling effect). This means that temples (even without hair loss) tend to be less dense than the centre.
Interestingly, studies have shown that when looking at a face, people look first at the nose, the eyes, flick up to the central forehead and then back down. Temple thinning/recession is barely registered – what matters most is whether someone has hair centrally, not temple receding.
This goes with the cornrow transplant that looks so awful but is so prevalent.
Highest densities can only be achieved by regular patterning that is close together but this can appear unnatural so has to be placed behind the irregular hairline (as above).
Additionally though, the highest density is by interdigitation of the slits (like pushing two combs together), not by two lines spaced apart – corn rows or plowed field furrows.
Dr Rogers has seen a lot of this recently – technically very competent mega sessions completely let down by the corn row spacing of the grafts.
Like many things on the internet, there is a lot of useful information mixed in with a lot of misleading statements and discussions for personal agendas.
Review sites inevitably contain postings from either the site itself, the clinic (or restaurant, hotel etc) and some genuine customers. There’s probably also reviews from rivals too. So all must be taken with a pinch of salt. Having said that, they may help make a choice.
Hair loss forum sites can be information portals, review sites, patient self help groups and paid for advertising companies all rolled into one. This means there are many hidden agendas talking to the innocent or naïve browser of these hair loss forums.
Hair loss forums generally do contain a lot of useful information about the types of hair loss treatments, drug benefits and side effects, types of hair transplant surgery, types of hair loss, male and female pattern, alopecias etc.
They can guide you through what makes a good hair transplant candidate, pre op and post op recovery expectations and of course, reviews of hair transplant surgeons. This, of course, is where things get complicated…
Firstly, there is no good definition of what makes a great hair transplant. Patients vary in terms of hair quality, donor density, amount of hair loss, healing qualities and expectations.
Secondly, it is important to realise these sites are businesses which need to make a profit, paid for by advertising from clinics. So it’s likely there will be biases. Additionally, some of these sites are owned by clinics which will be certainly be biased.
Lastly, many of the posters are sales people masquerading as genuine patients. Especially those who are most ardent about specific doctors or indeed, most dismissive of others.
Turkish hair clinics have been featured in hair forums, in the newspapers and even on the BBC news site. Some of these have been complaints, some more positive. What is the truth?
Many hair transplant patients understandably are looking for a good deal – they have a budget for a hair transplant they feel comfortable with (preferably less!) and are shopping around.
Inevitably, they see the very cheap Turkish hair transplant clinics and think they might take a chance. After all, here in Harley Street, in London or indeed, anywhere in the UK, Europe or USA, they are unlikely to get a hair transplant cost as cheap as in Turkey. It’s just not economically feasible – staff costs, rent, transport, consumables etc, let alone marketing and making a profit above that as well, means that it’s not viable to perform a hair transplantation surgery for less than about £3500. Regardless of the number of grafts, otherwise corners will be cut.
Potential patients we have seen, have been quoted £1500 for 4000 grafts including flights and accommodation in Turkey! How can that be?
Obviously, the cost of rent and staff wages are massively less in Turkey. Also, the unseen costs of providing good quality healthcare – CQC (Care Quality Commission), medical courses, infection control etc are probably not the same in Turkey.
We hear tales of the cheapest overnight accommodation which you really don’t want to be staying in after having had a hair transplant surgery.
But it’s not as simple as that, some facts of which are particularly worrying. We will detail that below, but for the sake of balance, Dr Rogers wishes to state that he has seen personally, some good results from at least one Turkish hair transplant clinic. However, the caveat is that particular patient is a fellow doctor, who already knew the clinic/doctor and paid a comparable amount to a hair transplant clinic in the UK. That is comparing “apples with apples” in terms of results. You don’t get something for nothing.
We are now going to discuss the most worrying issue of so called Turkish “hair mills.”
The Truth about Turkish Hair Clinics
The truth about the Turkish hair mills is simple and this is not about any specific clinic but a way of working which is detrimental to patients.
Typically, the hair transplant surgery will take place in a large room, sub-divided by free standing partition screens, into six areas. Each area will have a patient couch and be attended by two technicians. These technicians will extract the grafts, make incisions and re-implant the hair grafts, according to the plan marked out by the doctor, who will in turn be guided by the salesman who has recommended the number of grafts.
The doctor will simply patrol the six areas, injecting the local anaesthetic as required and leaving the rest to the technicians. All this is not necessarily detrimental to the results – a slick, well trained and skilful team producing consistent results isn’t the problem (see FUE technicians complaint review #1) below.
The following are the problems associated with Turkish hair clinics:
The salesman is incentivised to sell as many grafts as possible – more grafts equals more money. However, more grafts is not necessarily in the patient’s best interests. Everybody has a limited number of grafts that can be safely moved, which differs from person to person. All the salesmen sees is that if he can sell a larger number of grafts, he’ll get more money.
The patient might need 4000 grafts but his safe donor extraction limit might only be 2500. Nevertheless, he will be sold 4000. “Great” says the patients, more grafts for less money than Harley St.
But, the technicians will also be told, “extract 4000 grafts.” They will be paid per graft (piece work) and they WILL extract 4000 grafts, even if that involves going into non safe donor areas, extracting too close, too densely etc. There are many pictures available of “moth eaten” FUE cases available.
It’s the patient that loses out, too late, when they realise their donor has been over harvested. It might have been cheaper at the time but the cost of extra surgeries to try and put things right plus the emotional distress is harder to count.
On the side of balance, it can still happen in any country but Turkey is one of a number of countries which encourages a “perfect storm” of problems. It’s cheap and therefore attractive. But the laws don’t work the same as many Western countries, which is a deterrent in itself. And the rules regarding medical liability are also more difficult to enforce. So the owners of these clinics are fairly well protected against legal action by a disappointed foreign patient.
Traction alopecia is a common problem with Afro hair styling although it can occur with any type of hair. Essentially, traction in braiding, tight pony tails or even overly tight hair curlers cause damage to the hair follicle. It is like slowly plucking out the hair bulb and even just once in this type of hairstyle, can be enough to permanently stop the hair growing.
Lately, there seems to be a fight going on, between those who oppose hair transplant technicians performing the extraction of FUE grafts and those who don’t. Let’s examine the pros and cons of each side, hopefully in a neutral and logical way.
Those who are against FUE hair transplant technicians, suggest that those technicians are inferior to a qualified doctor at performing the task. Many of the same people also suggest that using the FUE robot is acceptable however.
But this seems to be a flawed argument. There is no evidence to suggest that a medical qualification enables you to have better hand/eye coordination than someone not medical. And if so, then the robot must also be banned, since it isn’t qualified either.
Hair transplant goals
The goal is 100% perfectly intact grafts first and foremost. Because they’ll grow.
A second priority is having a very low transection rate i.e. damaging very few hairs that are left in the donor area, so that the remaining donor hair can still be used in the future.
Neither of these requirements depend on a medical degree but needs great skill and technique.
Lastly, over extraction must be avoided (see complaints made about many Turkish “Hair Mills” – later in the Dr Rogers complaints series). But even this can be taught and fundamentally, is down to the overseeing doctor to prevent this from happening. Indeed, if a doctor is happy to see this happening on their patient, he/she would be equally happy to cause it themselves if they are holding the punch. So blaming the technician is like shooting the messenger.
The additional theory is that using an FUE technician “allows” a doctor who is not educated and competent in hair transplantation, to perform hair transplant surgery. The so called “weekend hair transplanter.” But an intelligent, experienced and skilful FUE tech might help make the result better than if the unskilled doctor blunders about doing it themselves, unassisted. Modern hair transplantation is, after all, very much teamwork now.
The robot currently is not as good as a competent human at FUE, medically qualified or not. It doesn’t pass the three tests above but undoubtedly, the technology will improve and will become better than a human. As of now though, it isn’t and yet it still encourages those doctors with little experience or interest in hair transplantation, to add it to “their practice.”
So the logic of those against human FUE technicians but for the FUE robot seems perverse, yet this seems to be the position of the ISHRS even though many members don’t practice what they preach.
Using a competent FUE tech is no different from using an improved FUE robot – a tool to be used by the experienced hair transplant doctor to successfully transplant FUE hair grafts.
These opinions are based on discussions with doctors, hair techs and lay people. Undoubtedly, there are other viewpoints but what matters is a successful hair transplant.
Dr Rogers has started producing short videos to give patients basic information on a variety of subjects. Here is a taster:
“Today I’m going to talk to you about female hair loss
Female hair loss is a more complicated subject than male hair loss, which is generally straightforward genetic male pattern hair loss.
Female hair loss is most commonly genetic but there are quite a number of other conditions in women that can affect the hair quality
Classic genetic female pattern hair loss gives thinning of the hair in an oval pattern, on the front third of the scalp but retaining a strong hairline without recession.
However, some women are susceptible to thinning and receding of the temples, which makes it look like male pattern hair loss. And this is also genetic.
But it’s important to bear in mind that some hormonal conditions will produce a similar appearance too. And to add to confusion, there is some overlap between the causes.
So let’s talk about the other conditions causing female hair loss.
Hormones have powerful effects in the body, so it’s no surprise that they can affect hair quality.
The thyroid hormone, thyroxine, will affect hair quality, whether it’s underactive or overactive. It’s important to keep a steady thyroxine level
Oestrogens and testosterone.
Most people will be aware that women produce oestrogen which is the hormone for female characteristics. A deficiency in oestrogen will lead to poor hair quality which is in part responsible for the change in hair quality after the menopause which results in decreased oestrogen production.
Testosterone is also produced naturally in women in small quantities and that is normal. However, a high natural level in women who have the genetics for male pattern hair loss, will produce male pattern type hair loss – as in receding temples and thinning on the crow.
This overlaps with conditions such as Polycystic Ovary Syndrome where high testosterone levels will give increased body hair, acne and male pattern hair loss.
Women suffer from autoimmune conditions more frequently than men and this includes, alopecia areata, frontal fibrosing alopecia, thyroiditis etc
It’s quite common for women to be careful with their diets either for health reasons, ethical reasons like Veganism or simply to control their weight.
Hair is continuously growing, therefore requires a continuous source of high quality nutrition, particularly iron, B12, folate and fatty acids. All of these are found in the typical Western red meat and vegetables diet but extra care does need to be taken if other diets are followed.
If you are deficient in nutrition, then hair quality (and nails) will soon become poorer – finer, brittle, slower growing hair.
If there are obvious causes, such as iron deficiency, then this first needs treating. And to restore normal levels of iron, it can take 12 months of iron supplements.
Likewise if there are hormonal disturbances, then these need to be treated first but it can take 12 months or more to show improvement in hair quality.
Various medications can help, as well as supplements. But a full range of blood tests should be taken first.
SMP (scalp micropigmentation) can help improve the apparent density of the hair and reduce the “see through” look.
Lastly, women can also have very successful hair transplants.”
Dr Rogers hair transplant complaints blog is where Dr Rogers will be writing his views and reviews about a number of his pet complaints regarding the hair transplant speciality. The complaints that will be under Dr Rogers under investigation will include:
Dr Rogers hair transplant complaints list of blogs to come:
FUE technicians performing the hair extraction process vs doctors – click here
Turkish hair transplant clinic results, including over harvesting – click here
Hair forums and secret salesmen who review their own and rival’s clinics click here
Unnatural hairlines and unnatural corn row hair graft implantation
Results, especially density and naturalness
Respecting that both FUE and FUT (strip) have their place in offering the best hair transplant results to each patient
The commercialisation and corporate mentality taking over the hair transplant speciality instead of the one to one approach favoured by Dr Rogers
All these opinions will be his own and are general, not specific to any one doctor or clinic but are his observations from his 22 years experience. First article coming soon…
Turkey Hair Transplant Clinic on BBC TV and website was something of a promotional advert for Turkish hair transplant clinics but didn’t show the reality of many of the so called “hair mills.”
They focussed on the cost and didn’t explore the fact that many patients have a poor experience there. We have personally seen patients coming back from Turkey with dreadful results and like Greg Williams, would caution those considering travelling abroad for cosmetic treatment. Hair transplant surgery is not to be undertaken lightly (Robbie Williams please note!) and patients should consider more than just cost.
GDPR rules are coming into force in May 2018 – that is General Digital Processing Regulations and these will affect the way businesses intereact with their customers. In short, it covers how we use any data we obtain from you. Full disclaimers and information will be posted elsewhere on this site but essentially:
Our lawful basis for your data is to process your request (and consent) for us to assist providing you with hair loss information and treatment. Our purpose is to use your data to be able to contact you via telephone, post or email communication regarding those services.
Our medical records are paper based and we do not store personal details digitally, except name, address, DOB, payments/invoicing etc to assist administration in contractual applications with you.
We do not supply third parties with your information. You can ask for us to remove your consent to use your details i.e. for direct marketing.
Full version below:
Westminster Clinic Ltd is committed to protecting and respecting your privacy.
Westminster Clinic Ltd understands that your personal data is entrusted to us and appreciate the importance of protecting and respecting your privacy. To this end we comply fully with the data protection law in force in the UK.
For the purpose of Data Protection Laws, the data controller is Westminster Clinic Ltd.
What personal data may we collect from you?
When we refer to personal data in this policy, I mean information that can or has the potential to identify you as an individual.
Accordingly, we may hold and use personal data about you as a customer, for example, when you complete a form, access my services or speak to me.
Personal data we collect from you may include the following:
· information that you give me when you enquire or become a customer including name, address, contact details (including email address and phone number)
· details of referrals, quotes and other contact and correspondence we may have had with you
· other information received from other sources, including from your use of website.
· Where you use any of our websites, we may automatically collect personal data about you including: Technical information, including the Internet protocol (IP) address used to connect your computer to the Internet, browser type and version, time zone setting, browser plug-in types and versions, operating system and platform. For the exhaustive list of cookies we collect see the list of cookies.
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We may use your personal data to:
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We protect all personal data we hold about you by ensuring that we have appropriate organisational and technical security measures in place to prevent unauthorised access or unlawful processing of personal data and to prevent personal data being lost, destroyed or damaged. We conduct assessments to ensure the ongoing security of my information systems.
Any personal data you provide will be held for as long as is necessary having regard to the purpose for which it was collected and in accordance with all applicable UK laws.
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At your request, we may occasionally transfer personal information to you via email, or you may choose to transfer information to us via email. Email is not a secure method of information transmission; if you choose to send or receive such information via email, you do so at your own risk.
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In the usual course of our business, we may disclose your personal data (to the extent necessary) to certain third-party organisations that we use to support the delivery of my services.
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You have the right to ask me not to process your information in this way at any time.
If you no longer wish to receive web based marketing information you can unsubscribe by emailing us. While the precise timings vary we generally ask that you give at least 30 days’ notice.
Accessing and updating your information
The law gives you certain rights in respect of the personal data that we hold about you. In addition to your right to stop marketing, detailed above, below is a short overview of the most commonly-used rights. It is not an exhaustive statement of the law.
With some exceptions designed to protect the rights of others, you have the right to a copy of the personal data that we hold about you
You have the right to have the personal data I hold about you corrected if it is factually inaccurate. If any of your personal data has changed, especially contact information such as: email address, postal address and phone number please get in touch with so we can ensure your personal data is kept up to date
If you want to exercise your rights in respect of your personal data, the best way to do so is to contact us by email or to write to us for the attention of the data protection officer at the address mentioned above.
Prince William haircut news – HRH has clearly accepted his hair loss, detailed in many photos in newspapers in the UK and around the world.
Nothing wrong with that, although he could have been more proactive about 10-15 years and benefitted from drugs such as Propecia or a hair transplantation. All eyes will now be on Prince Harry (or perhaps Meghan Markle) and whether he’ll do anything about his crown thinning…
The Trust me I’m a Doctor BBC TV show, which was on recently, had a 5 minute segment about balding men. Presented by a nearly bald doctor, it very briefly explained some of the choices. Generally it was accurate and helpful, mentioning Finasteride and Minoxidil, hair transplants and alternative medicine. It could easily have been a longer piece and it suggested that Minoxidil worked by blood flow, which is incorrect. However, at least it was fair and neutral and not jokey, unlike many TV shows.
Transgrafts in hair transplant terminology, means performing a high quality, densely packed hairline transplant – either FUE or FUT (strip) Only to the hairline zone. This can be seen more easily in the photo below, showing an initial session.
This then leaves space for a made to measure hairpiece to sit behind the transplants and then the transplanted hair brushed backwards over the hairpiece. The advantage of this is that the transplants hide the edge of the hairpiece, which otherwise can be a giveaway if the hair isn’t styled forward to cover it.
This transgraft technique is best used for patients who are happy with long term hairpieces but desire the ability to have more of a “quiff” hairstyle. eg.
Punchgrafts are the old fashioned method of hair transplants but in essence, very similar to FUE hair transplants.
Essentially the difference is that the punches used (sharp hollow metal tubes) are 4mm across instead of the very small 0.8, 0.9 punches we use now.. They do not give natural results: the difference is clear in the photos
However, it is an important subject, so it’s good that at least it is getting taken seriously.
“For some people it may be the stuff of nightmares, but baldness isn’t just a male problem. Loose Women panellist Nadia Sawalha has posted an emotional video talking about losing her hair at the age of 52. But what is female baldness?
The TV presenter admitted her trademark curls were fake and that she was going through the perimenopause, which is the start of the menopause.
She revealed a doctor told her she had the balding gene.”
The news agency, Reuters, reports a trial from the John Hopkins School of Medicine in Baltimore, whether “hair transplants make men look more attractive” or not?
(Reuters Health) – Balding men who seek to look better or younger by undergoing hair transplants are on the right course, a small new study suggests.
People shown before-and-after pictures of hair transplant recipients rated men with more locks as looking more attractive and younger, researchers found. People also thought the men looked more successful and approachable after the procedure.
“In an attempt to get objective opinions on men’s appearances before and after the procedure, Dr Ishii and her colleagues asked 122 volunteers – 58 men and 64 women – to view 13 pairs of images. Seven pairs showed men before and after having had a hair transplant; the other six pairs were of men who didn’t have a hair transplant or any other significant cosmetic procedures between the two photographs.
The participants were asked to rate each image on age, attractiveness, successfulness and approachability.
The reviewers thought the men who’d had hair transplants looked about four years younger in their “after” photos. They also thought the men looked more attractive, successful and approachable after their procedures.
“It showed there were measurable improvements on measures that are meaningful to the patients,” she said.”
Hair cell jab could restore lost hearing, reports the Daily Mail.
Dr Robert Langer of MIT, explains how this breakthrough successfully regrew crucial inner ear hair cells in the laboratory. A drug combination helped create 60 times the number of hair cells than previously achieved. Although the hair cells are not the same as scalp hair cells, there will be biological similarities which could lead on to the “Holy Grail” of hair multiplication or even cloning.
James Nesbitt relates in a recent BBC interview, how having a hair transplant has really helped him keep working, getting more varied roles that he probably wouldn’t have got otherwise.
The Cold Feet, Murphy’s Law and Lucky Man actor, has gone on record to say how much having a couple of hair transplants has boosted his self confidence and attracting leading roles he may not have been chosen for.