That one I've done, although I don't think it's on film anywhere. It was popular for quite a while in my era, and I'd like to see it come back. The balance on the blade shifts when the head rolls forward, so that's the part that makes it a bit more difficult than the standard sideways lean where your head is partly behind the shoulder of your grasping arm. Rolling your head in front of the shoulder is more difficult for the man also -- your weight is pulling at his arm more then and he has to resist more.
The majority who try to master the FO can't and don't put it into programs, although they may continue to plug away at it in private. A show program is aimed at pleasing the spectators. A competitive program, not so much. That's where you try to stack all the most technically difficult things you can do, hopefully staying on your feet when it counts. Whether that fan sitting up there in row 12, second seat in from the aisle, thinks it looks pretty? I haven't known too many competitors who cared. You try to learn new moves because you're an athlete challenging your own body -- and your mind, if there's fear involved.
I'm light years away from competitions, and rarely do club shows. Not my thing. I only want to challenge myself, to see what I can still do. Age has slowed our reaction times so that my partner and I don't do triples anymore, but we see how many doubles (including the Axel) we can string together in a sequence. We're having a lot of fun trying to do the biggest delayed throw Axel we can manage. His wife has tried to film our attempts just so we can see if it looks like it feels, but so far she hasn't managed to get us both in the frame at the same time. (Which we say proves we're getting close to our goal

.) To be sure, there are many skaters who tailor programs because they're craving attention and approval from others, but they're balanced by those for whom the inner satisfaction of mastering a difficult element is more important.