NeoGraft Hair Transplant: Will this New Device Make FUE More Affordable And Safe?

[SpencerKobren]

The targeted removal of follicular unit grafts, known as Follicular Unit Extraction (FUE), certainly has its place in the field of surgical hair restoration. However, since the procedure has proven to be extremely labor intensive when performed correctly, and limited by the number of grafts that can be safety harvested intact per procedure, many in the field have chosen not to offer this procedure to their patients.

We have also seen some dismal results coming from some of the clinics that have over marketed the procedure without actually learning how to perform it correctly. IAHRS Member, Dr. Alan Feller has repeatedly warned patients about the three detrimental forces that are unique to FUE procedures, these are:

1.Torsion
2.Traction
3.Compression

Will the NeoGraft device help to eliminate these possible detrimental graft destroying forces and allow more hair transplant surgeons to offer FUE to patients who qualify for the procedure?


UPDATED: VIEW IMAGES

[the B spot]

So the device is essentially a 1 step scoring and extraction device? I take it that the grafts are vacuumed out into the receptacle once a certain depth is reached?

A couple of questions:
1. What size is the extraction tool--inner and outer diameter?
2. What potential for damage to the grafts as they are vacuumed out into the receptacle?
3. How does the tool help mimic the graft angle better than a regular hand-held punch?
3a. If this does create an easier extraction method, reducing the above factors laid out by Dr. Feller, is the size of the extraction increased to accommodate a lack of "feel" gained by using a regular punch.

Looks interesting--I would like to see it in action in person.

Take Care,
Jason

[SpencerKobren]

So the device is essentially a 1 step scoring and extraction device? I take it that the grafts are vacuumed out into the receptacle once a certain depth is reached?

A couple of questions:
1. What size is the extraction tool--inner and outer diameter?
2. What potential for damage to the grafts as they are vacuumed out into the receptacle?
3. How does the tool help mimic the graft angle better than a regular hand-held punch?
3a. If this does create an easier extraction method, reducing the above factors laid out by Dr. Feller, is the size of the extraction increased to accommodate a lack of "feel" gained by using a regular punch.

Looks interesting--I would like to see it in action in person.

Take Care,
Jason

Hey Jason,

I’m having Dr. Bauman on the radio program this Sunday 3/15, so feel free to call in with your questions and your FUE insight.

If you don’t have an XM subscription you can watch and listen live here:

http://www.thebaldtruth.com/watch-live/

[the B spot]

Arrrrggg! I will not be able to listen this week!!!! Trust me, I am going to my wife's parent's this weekend----I would much rather listen to your show than listen to them screech at each other for 3-4 hours

I used to wonder why people drank wine at these functions----now I know

Hopefully Dr. Bauman can respond here if/when he finds the time---Technology is so awesome---I know Dr. Shapiro is a real tech nut, so I am bringing this to his attention!

Take Care,
Jason

[SpencerKobren]

No worries Jason,

I’m convinced my future in-laws think I have a drinking problem..I get it! We’ll be archiving the broadcast so you can listen at your leisure.

[HelpROGER]

The video looks impressive. The machine looks like a combination dental drill and water suctioning machine that you see in dentists offices. I assume that there would be less damage done to the follicles since the suction would not be strong enough to rip apart the hairs themselves. Have you ever tried to break a hair, it takes some strength. The skin probably just gives once the cut is made deep enough. I’m no engineer, but this tool looks like it works and if those pictures are the results then they look good.

Spencer, how long has Dr. Bauman been using this thing and on how many patients?

[PayDay]

Wow, this is awesome! It would be fantastic if this could bring down the cost of FUE. How big is the punch?

[tbtadmin]

NeoGraft Photos

We have just received this information from Dr. Bauman, he has been in surgery all day. He says that when he has time he will be more than happy to answer all your questions.

Dr. Bauman wrote:
"Personally, I use an 0.8mm punch when using the Neograft.
These updated photos have a brief description:



In this Neograft hair transplant case, a 0.8mm limited-depth instrument makes a small 'scoring' incision around the follicle. The grafts can then be manually extracted with forceps or extracted with suction from the Neograft machine.



The extracted grafts are examined and sorted by intact follicles per graft. Grafts with transected follicles are counted and tracked for quality-control purposes. This handful of grafts was obtained approximately 1/3 of the way through the Neograft FUE hair transplant procedure. FUE grafts are typically smaller than microscopically-dissected micrografts. Therefore, they require extra care and attention to remain viable for implantation.



FUE with Neograft allows a minimally-invasive approach to hair transplantation with no visible linear scar. This is a 0.8mm limited depth instrument making a scoring incision around the graft. To maximize the harvested yield per procedure, patients are encouraged to allow us to 'buzz' their hair to a 'zero' with an electric clipper. A 'zero' length on a clipper is actually approximately 3mm



This shows the manual extraction of an FUE graft during transplantation. A very specific, gentle approach is used to remove the graft from the skin without trauma to the follicle.



FUE harvesting during a Neograft procedure is a team approach. Tiny incisions are made with the Neograft device around each graft and then they are literally 'plucked' from the skin.



Careful extraction of an FUE graft during an hair transplant procedure. The initial incision was made with a 0.8mm Neograft device.



The major advantage of any FUE procedure is the lack of a linear scar. The tiny 0.8mm harvest sites close 50% in size within 24 hours and can be completely undetectable within a weeks time, depending on the quality of hair in the donor area. Eventually, when the surrounding hair reaches a certain length (approximately 8mm) the area is completely camouflaged.



The recipient area of a hair transplant procedure is the thinning area where the follicles are transplanted to. The Neograft device assists with implantation throught the use of dual mechanical implanters which use suction and positive air pressure to gently place the grafts into the sites the surgeon has created--without the use of forceps. For this patient, we transplanted 1603 grafts into the recipient areas. All grafts were placed into sites that were 1mm in size or less. Hair growth typically begins around 6 weeks, with improvements in coverage occurring from 4 to 6 months, full result in 12 months.



Fast and efficient FUE hair transplant procedures is what Neograft promises. Can the Neograft deliver? FUE is typically tedious and slow. The question is whether Negraft will accelerate the process allowing for more efficient FUE-type harvesting.



This is an updated photo to reflect the status of the recipient area at post-op day #8. Please note that although the transplanted area appears 'full,' it is expected that the transplanted hairs will shed within the next few days and then begin to regrow within 6-12 weeks. Half of the result should be visible at 6 months, full results in 12 months.



This is an updated photo to reflect the status of the donor area at post-op day #8.

[the B spot]

Thank you for your prompt reply Dr. Bauman.

I guess the only thing left is to actually check the machine out. I am encouraged by these type of advancements--It is my hope that fue becomes commonplace and lest costly as a result.

The work you posted looks very clean and the patient should have a great result!

Take Care,
Jason

[bigmac]

I saw this machine in Montreal and got the guys to talk me through it,it looked impressive.

I think the only concern i had was that the storage area for the grafts should not be overfilled if the suction method of extracting the grafts was used.

I seem to remember it was quite expensive too.

It will be good to see one year results from patients who have had this machine used on them.

Thanks for a great informative post.

bm.

[Winston]

That was a great radio show tonight! Dr. Bauman sounds like he's way ahead of the pack. I enjoyed listening very much and Im interested in seeing more pictures of this procedure.

[HelpROGER]

I second that Spencer. The bald truth is the best show on radio today! Your take on life is so right on! Thank you for helping all of us to feel that we’re not crazy to worry about our hair!!!

[the B spot]

Dr. Feller, Dr. Bauman and All--- I love the ingenuity to try and get "better" using the amazing technology at our fingertips. It is a testament to a select few who strive to get better every day, regardless of past success.

With that said,
I think the person doing the extractions must still have the "feel" to mimic the angle of the follicle, regardless of what tool is used. Once Dr. Bauman explained he used this machine with a .8mm punch/extractor, he confirmed my suspicion that his personal skill has a tremendous impact on the success of the NeoGraft's use.

For those who have not seen a .8-.9-1.0mm punch in use, let me tell you it is HARD WORK and exhausting. It is very labor intensive, and is very draining physically and mentally. This is why Dr Feller, Dr. Bauman, and others continue to stress the fact that FUE is not a miracle solution, not everyone is a candidate, and donor management is just as important as ever.

Because I have not seen the machine in use and Dr. Feller already established some concerns I will refrain from any additional technical debate.

However, perhaps if this machine can obtain VIABLE grafts on a majority of FUE candidates, it has the potential to reduce the overall stress of the FUE scoring and extraction process and allow additional clinics to offer FUE. That remains to be seen.

On a potentially negative note, technology such as this is often very cost prohibitive and would likely pressure any clinic to do larger than advisable sessions in an attempt to recoup costs. That could have a very damaging effect long-term on the patient and reputation of the clinic. Dr. Feller's point about unpracticed doctors performing FUE is certainly legitimate when viewed in this light.

Spencer, Dr. Feller, Dr, Bauman-- perhaps we could put together a "meeting of the minds" to observe the viability of the machine and exchange ideas and techniques on FUE in general. Given much of the ignorance and over-selling of FUE, it would be a step in the right direction to have well respected doctors come together to share ideas. Just an idea!

Take Care,
Jason

[TeeJay73]

Brilliantly articulated Dr. Feller! I enjoy reading your posts and listening to you when you call Spencer's show. I like how you couple your engineering background with medicine, providing a unique perspective that not alot of people have or can conjecture on their own.

We engineers are cool, aren't we? :-)

TeeJay

[Jeffrey Epstein, MD]

NeoGraft FUE system

I too greatly welcome the dialogue that goes on between esteemed colleagues and educated lay people. In the 18 plus years of being intimately invoved in the plastic surgery and hair restoration field, I have been witness to an endless number of new technologies- most of which were released with great fanfare, only to be discarded a year or two later as the touted advantages prove to be short-lived. Examples: Dr. Rassman's hair implanter carousel; thread lifts for facial rejuvenation; and Thermage skin tightener. Even the initial laser hair combs and Rogaine, two innovative treatments that now have a potential role in treating hair loss (at least LLLLT hoods such as Revage that seem to be the best system and perhaps the hair combs) got released initially with such incredible accolades that the hype was much more than the reality - all in the name of making money, and perhaps secondarily in helping patients. Maybe when selling cars or perfume, hype and marketing should take precedence over data, but when it comes to medicine- surgery in particular- restraint must take precedence.

I have not seen the NeoGraft system in use, other than a promotional /educational video put out by Dr. Bauman in conjunction with the very company that plans to benefit from such a device- and I cannot think of anyone better than Dr. Bauman to get the message out about this device. What concerns me however, is that there is, quite frankly very little evidence that this device is superior to standard techniques of FUE- in fact, having the delicate hair follicles exposed to suction and air flow, I have similar (but unproven) concerns as Dr. Feller- about the viability of the hairs. Second, in my practice, my FUE grafts after dissection are typically placed into recipient sites 0.5 to 0.6 mm in size, occasionally 0.7 mm- while the automatic planter for the NeoGraft works with recipient sites 0.8 mm and larger, unless I misunderstood. Smaller recipient sites allow for denser packing and more impressive results, and potentially less scarring.
I rely on my carefully trained team of assistants to allow me to harvest (then implant) as many as 1800 FUE grafts in a single 8 hour procedure- equal to apparently the peak number of grafts that the NeoGraft can obtain. Then for planting, these same assistants work with me to place the grafts into recipient sites that I have made with 0.5 to 0.7 mm recipient sites. This is the artistry of hair restoration, and no machine is going to take the place of individual surgeon artistic skills and passion and the skills of talented assistants.

I greatly look forward to seeing some data - reliable US released data by respected peers such as Dr. Bauman- before making any conclusions other than the NeoGraft does seem to allow for the obtaining of FUE grafts with the use of fewer assistants. This is not an advantage for me at this time, but I do hope that the device does improve the results of FUE hair transplants.


Jeffrey Epstein, MD, FACS

https://www.foundhair.com