Where do I start? Torsion traction compression is a controversial subject for a number of reasons. There is this idea being floated around that there are three forces (classified as being "detrimental") to a follicular unit when it is harvested via FUE. Those three forces are torsion traction compression. This idea is absolutely correct and I think any doctor that denies these forces exist would be lacking some simple common sense. However, there is another idea about these three forces that I do happen to disagree with and that is that these forces cannot be overcome to the point that allows a graft to grow well. In fact, a few doctors have gone so far as to say that FUE gets, at best 60% to 70% growth because of torsion traction compression and that to expect anything more is wishful thinking (paraphrasing). The idea has been that nothing has changed since FUE was first brought into the hair transplant industry in 2002. This position is flat out wrong.
Dr. Lupanzula, and other doctors, are proving day in and day out that FUE hair restoration, in the right hands, is every bit as good as strip surgery when it comes to overall yield and quality of growth. I used to be one that would criticize the FUE procedure when I worked for Dr. Wong but I started to change my mind about FUE around 2009 or 2010 and I ceased to be so hard on FUE simply because my eyes would not let me continue to critique the procedure as I had in the past. I still to this day stand by my points made so many years ago about the deficiencies of FUE as those points stood at the time but what has changed is reflected in my conversation with Dr. Lupanzula in the video above. The basic methods of FUE may not have changed but the understanding of how those methods are used has. In addition there are new methods to not only preserve follicular units once they've been extracted but also to improve overall yield. HypoThermosol™ storage solutions are a big part of why FUE is seeing healthy growth rates and now liposomal ATP is the newest additive for "energizing" grafts for stronger yields as well. Combined with a delicate touch and a feel for how grafts should be extracted the three forces that act on each follicular unit being extracted during and FUE hair restoration procedure are greatly minimized to the point that they are non-existent barriers to success. If they haven't been overcome then how else can we explain the consistency with excellent results seen by Dr. Lupanzula and other top FUE hair restoration clinics, some of which are Hair Transplant Mentor™ partners?
I think some of this "head in the sand" attitude comes from a lack of exposure to modern FUE and the nuances employed by other clinics to get solid yields. The biggest critics of FUE today are not active in the hair restoration community at large. They do not participate in any ISHRS world conferences nor do they participate in regional meetings that focus on FUE in the form of workshops or general conferences. They've formed their opinions based on their own skillset and what they see coming through their own doors in the form of FUE repair work. This is an understandable position to have as my own exposure to FUE for many years was based on patients seeking repair work from failed FUE procedures. This is a small minded and isolated view of FUE, which is unfortunate. I like FUE a lot and if I have any more work performed myself, it will be an FUE procedure and I will have zero concerns about any issues related to final yield or growth. With the way that Dr. Lupanzula approaches his own FUE procedures, I believe his own patients will feel the same way, as they have for years.