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  1. #11
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    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.

  2. #12
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    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!!!

  3. #13
    Doctor Representative the B spot's Avatar
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    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
    Patient Advocate/FUE Coordinator for Shapiro Medical Group. My advice and opinions are my own and is not medical advice. I am a Cubs fan.

  4. #14
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    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

  5. #15
    IAHRS Recommended Hair Transplant Surgeon Jeffrey Epstein, MD's Avatar
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    Default 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
    www.foundhair.com
    Jeffrey S. Epstein, MD
    Foundation For Hair Restoration

  6. #16
    Administrator SpencerKobren's Avatar
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    Dr. Feller, Dr. Epstein, Dr. Bauman and all,

    It’s great to see truly passionate experts discussing any possible advancement in the field of surgical hair restoration. Baldtruthtalk.com was created to help better educate and to empower, not only the hair loss consumer, but the hair loss physician as well. Education is an ever evolving process and I’ve learned over the years that while asserting opinions is important for obvious reasons, asserting them in a doctrinaire or dogmatic manner usually creates a less than comfortable environment in which to learn and to share ideas.

    In my view, until it’s proven that the the Neograft machine damages grafts, terms like “detrimental forces”, “torsion” and “desiccation”, are simply words used to make a theoretical point.

    Dr. Feller, your insight holds great significance and is a needed part of this dialogue, but it’s equally important to understand that there might be more than one way to skin a cat. I think Dr. Bauman’s track record speaks for itself, as do the track records of all of your esteem colleagues in the IAHRS.

    As Dr. Epstein so eloquently eludes to, there are very few in the field who have been as effective in promoting state of the art surgical hair restoration to the mainstream consciousness as Dr. Alan Bauman. I see this as just one of Dr. Bauman's considerable contributions to the field.


    I look forward to continuing this dialogue in a professional and mutually respectful manner.
    Spencer Kobren
    Founder, American Hair Loss Association
    Host, The Bald Truth Radio Show

    I am not a physician. My opinions and knowledge concerning hair loss and its treatment are based on extensive research and reporting on the subject as a consumer advocate and hair loss educator. My views and comments on the subject should not be taken as medical advice. Always seek the advice of a medical professional when considering medical and surgical treatment.

  7. #17
    IAHRS Recommended Hair Transplant Surgeon Jeffrey Epstein, MD's Avatar
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    Beautifully put Spencer.
    Loo,king forward to seeing more from Dr. Baumann on this device.
    Jeffrey S. Epstein, MD
    Foundation For Hair Restoration

  8. #18
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    Very well put Spencer. I think this machine looks like it might have real value and I don’t think Dr. Bauaman would risk his reputation on a machine that didn’t work.

  9. #19
    Administrator SpencerKobren's Avatar
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    Thanks for stating your opinion Dr. Feller. Again your insight and your passion for the profession is what makes your online participation so invaluable.

    My question at that start of this thread was:
    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?

    It’s simply a question. At this point until I see more results this entire thread is simply a vehicle to share our thoughts and ask questions about the Neograft machine. I’m hoping we can continue this dialogue without pointing fingers or eluding to the unethical marketing of FUE by well respected members of the field.

    That’s it, no big deal. We’re just having a friendly discussion, and I think it’s fair to state that it should be conducted with professionalism and courtesy. I know this is a foreign concept to our online world, but I think it’s time the we begin setting some higher standards for the profession.
    Spencer Kobren
    Founder, American Hair Loss Association
    Host, The Bald Truth Radio Show

    I am not a physician. My opinions and knowledge concerning hair loss and its treatment are based on extensive research and reporting on the subject as a consumer advocate and hair loss educator. My views and comments on the subject should not be taken as medical advice. Always seek the advice of a medical professional when considering medical and surgical treatment.

  10. #20
    Senior Member gillenator's Avatar
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    Cool

    bspot, I don't know how I missed this before, but I just noticed something classy at your signature. You're a Cubs fan!

    Now, back to the issue. Not that I am any expert on FUE instrumentation, nor a licensed physician, but in the past 29 years, I have seen alot of these come and go. Several years or more ago, there was a big hype about the FUE implanter, remember? Where is it now? Where are the published findings? In the New England Journal Of Medicine? No. In the education arm of the ISHRS? No. Any other society or affiliation, association, not to my knowledge. It's just my opinion but this has that sort of laser comb smell to it.

    And some of you have brought up some of the valid points that Dr. Feller mentioned in another thread and noted below. Yet if you consider the dynamics of torsion, traction, and compression in the extraction process, are they not ultimately controlled by the tooling as well as the surgeon's feel? What is going to replace the feel in the extraction process? What about dermal depth analysis? Oh, I know someone is going to say, "that's what this new machine is supposed to do".

    It's just very difficult for me to imagine that a machine, albeit "cutting edge" technology can make all of the adjustments on every FU targeted for extraction concurrently. And then with the same extraction size for every FU regardless of size. Same size for a single hair FU as a five hair FU extraction? Really? What about extracting MUGs? One size fits all? Really?

    I have a hard time believing that any prudent FUE surgeon who also is considering the lowest degree of invasiveness "per patient" is not going to utitlize a combination of punches and extraction tools. How does the FUE surgeon balance out the level of invasiveness (post-op scarring) with transection? Or is the issue going to be pursued and confined to "speed and efficiency" of the extraction process? Give me a break.

    Who's ever publishing transection rates or let's be positive about this, FUE YIELDS regardless of the methodology? NO ONE, extraction equipment or not. And before anyone speaks up to dare challenge what I am saying, be ready to present your verifiable and substantiated clinical findings.

    Don't get me wrong, I am all for scientific research and technological advancements in this field of surgical hair restoration, and yes there are some docs who always seem to jump on the bandwagon and really push these new devices. Is it really to advance the field or advance one's bank account? And really, I mean no offense to anyone in particular. But ultimately, who is really benefitting from speed and reduced OR staffs? The patient? Really? Really? Or could it just by chance be the clinic or the ones who hold the patent? And why most of the dialogue in the economics and proficiencies of the procedure? What happened to yield?! Every HT patient cares about yield right?

    What happened? Did I miss something? What happened to the patient?
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

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