NeoGraft Hair Transplant Warning - Let The Buyer Beware!

[hudson]

Response to Dr. Epstein

Dr. Epstein, I agree with many of your comments especially the part about having an aesthetic eye, which I think you mean artistic ability, and I also agree about the passion part. These are gifts some people get as a result of how they are wired genetically, and by your sound reputation it sounds as though you have such gifts. I also agree that the NeoGraft is a tool and needs a doctor to work with it. However, this tool helps the doctor to overcome some of the challenges that a manual FUE procedure presents. By using the NeoGraft device, a doctor can greatly reduce the transection rate and the amount of time and technicians required to do a manual FUE procedure. As a result the price of a NeoGraft procedure can be reduced since a NeoGraft procedure tales considerable less time than the same manual procedure. This is important since a manual FUE procedure was out of the financial reach of many patients due to the time factor.

My response to this site was based on my belief that everyone has the right to pursue their goals without others pulling out sirens to dissuade the public from going to them because they are new at something. If those who send out the sirens are facing change in their industry, or new competition in their field of expertise then the motive for those who are sounding the sirens becomes suspect. Given the negative hype, which consisted of false assumptions, misconceptions and false information which was generated on many forums about NeoGraft, I do not want to see this happen to doctors who are buying the NeoGraft device. A general negative warning such as the one given on this site, opens up other issues. For example, the warning does not include that often “experienced doctors” are resistant to make changes in the way they do procedures for their own personal reasons, such as not wanting to retrain themselves in a new, more patient - friendly procedure or invest in a new device when they can earn the same revenue doing an older procedure. This resistance to change will often motivate some doctors to find fault with other doctors who obtain the new device, and issue warnings without taking the full situation about the capability of these doctors into account. What I am referring to is that not only Spencer Kobren issued such a warning, but there have been "experienced" hair restoration doctors and different forum members trying to give the same message.

Furthermore, in this case, if most of the experienced hair restoration doctors are not taking the lead to incorporate the NeoGraft device into their practices, and offer patients the FUE procedure, which is a much more beneficial procedure, or at least offer patients the choice of which procedure they wish to have, then those patients, who want an FUE procedure with the NeoGraft will need to find a doctor who is offering the newer, more beneficial to the patients method on the NeoGraft device. It is also important to remember that the NeoGraft device simplifies the FUE procedure and the learning curve is therefore greatly reduced. An Fue hair transplant with NeoGraft is not as dependent on the skill of the doctor as when a doctor does manual FUE. Furthermore and this is very important is that many of the procedures and techniques that a Strip doctor has to learn for Strip surgery are not part of an FUE procedure. For example, removing an elongated piece of scalp, which is a surgical procedure, that requires sufficient practice so as not to cut nerves or arteries, or dissecting follicles and trimming them, are totally absent in an FUE procedure. By sending out a general warning about new doctors that have NeoGraft, a disservice is done to many of them who are already very competent through training, their own experiences, the simplified NeoGraft procedure, and any talent they may have to do excellent work. What is most unfair is that no light is cast on “experienced” hair restoration doctors who might be less than competent regardless of their experience, or new doctors training in he Strip method.

A blanket warning does not give enough recognition to the complexities involved in who or what makes a good hair restoration doctor or not and so everyone in a targeted group is impacted by these warnings. Experience is only one of the components of a proficient doctor and many experienced doctors never reach the level of proficiency hoped for in a doctor in general. One needs to take into consideration that if a procedure is simplified, as with the NeoGraft device, the experience story changes. Hair restoration doctors do seem to stress the need for experience doing hair lines, however, it is also my impression that, with everyone having a different hairline, (taking into consideration age, face shape, ethnicity etc.) the ultimate result depends more on the doctor’s personal aesthetic sense about what constitutes an excellent hairline. This fact does not negate that doctors can learn to do proficient hair lines in a reasonable amount of time that still satisfies the patient.

There is always someone more talented than someone else. But everyone, short of doing harm, is entitled to do their career and not be subjected to warnings. I need to remind readers that many of the doctors buying the NeoGraft are experienced hair restoration doctors already, many coming from other specialties such as Dermatology and Plastic Surgery and others have done hair restoration in the past and want to resume doing them with the NeoGraft device and this is their right.

I do believe sirens should be sounded once a doctor is identified as being incompetent, and only then. This is more fair reporting than casting doubt on a whole group. Unfortunately,identifying incompetent doctors does not always occur and society does not have a good format for how to make the public informed about incompetent doctors in every field. So in the end we all agree patients must do their own due diligence to find the best doctor they can and if they want a NeoGraft FUE hair restoration procedure they will have to pick from those doctors who offer that procedure, many of which are as I stated already very proficient in hair restoration.


It Being new at something is a relative thing. How much time and training is not considered new? Those doctors who have the of the doctors who have purchased the NeoGraft are not out practicing Of course it is the patients ultimate responsibility to choose a good doctor, and if a not good doctor is identified I believe the public should be warned. But until then it is, in my opinion,
It is our intention, with the NeoGraft device to educate the public that now with NeoGraft, a hair transplant procedure is a more simple non invasive procedure and hopefully, those patients, who may have wanted a hair transplant but were not willing to undergo the surgical procedure of the Slit method, will consider doing so with the NeoGraft device. We have heard many patients express this to us.

And why go after the medical device company? They are doing their job, in fact, most medical device companies go beyond their responsibility to only train on the device, for reasons that too lengthy to enter into here. And since when was it wrong to want to make revenue? It was my impression that one of the major reasons for entering hair restoration for doctors who were all educated in other specialties is because this field can be very lucrative. There may be those doctors impassioned by doing hair restoration and I have met some, but do you think every doctors is impassioned to do hair restoration?
It is wise for patients to seek out the best possible doctors they can. However, I do not agree with posting sensational, incorrect and misleading headlines and posts as many forums have done, because the people posting them, I believe feel they have something to lose, which is patients who may decide that the FUE procedure is for them. Spencer Kobren is not a doctor, but he speaks with a lot of doctors and we have heard this sentiment before about NeoGraft being bought by inexperienced doctors. This is not totally accurate, as many doctors in other specialties who are buying NeoGraft do hair restoration, and some did so in the past and want to start again. But in any case, since everyone was new in hair restoration at one point in time,

[hudson]

Problem with last Post

The post I just sent was to have ended at the paragraph that reads:

I do believe sirens should be sounded once a doctor is identified as being incompetent, and only then. This is more fair reporting than casting doubt on a whole group. Unfortunately,identifying incompetent doctors does not always occur and society does not have a good format for how to make the public informed about incompetent doctors in every field. So in the end we all agree patients must do their own due diligence to find the best doctor they can and if they want a NeoGraft FUE hair restoration procedure they will have to pick from those doctors who offer that procedure, many of which are as I stated already very proficient in hair restoration.

The rest of the post was meant to be another post that I was editing in response to another forum site. I had both posts on the same page and accidentally both posts were cut and pasted to your site. If you can make sense of the other post, since it is in rough and unedited you will see I am
addressing strong opinions on those forums also.

[hudson]

Response to Dr. Epstein re FUE vs. Strip

Dr. Epstein,
With respect to your comment : “I also hugely object to your statement that with the NeoGraft the grafts are more closely matched up to the recipient sites in terms of size than they are with FUG- are you suggesting that my recipient sites that are cut with hand-made blades 0.5 to 0.7, occasionally 0.8 mm in size, do not equal let alone exceed the ability of the NeoGrafts to exactly match up the size of my grafts that are cut with my team of 15 assistants who average 7 plus years of dissecting experience?”

I did not imply in my post that you personally and your team do not do an excellent job of matching up sites and grafts. I was speaking generally. I am sorry if you thought my remark was directed personally to you, it was not. As I mentioned before, your reputation alone would make one certain that when you undertake a procedure it will be done properly. Your standards however do not necessarily cross over to other technicians working with other doctors. What you have confirmed is my point that NeoGraft simplifies the hair transplant procedure, making it possible for doctors to do a hair transplant without having to worry about training many technicians to produce grafts that are of good quality. A Strip procedure is not only dependent on the skills of a surgeon, such as yourself, but also in your case on 15 other individuals who separate the grafts from the piece of scalp that was removed. The method NeoGraft uses automatically extracts grafts the same size, and does not depend on technicians to do so.

I would also like to address your comment: “Now you have lost credibility hudson, making one eroneous statement after another.” Dr. Epstein, I do not wish to lose credibility with you. I would like to have a differing opinion and not lose credibility with you as I respect your work. It is a fact that there is quite a bit of controversy as to whether one procedure is more beneficial than the other. The facts about the two different procedures are often in dispute as well. I want to direct you to post that Dr. Cole wrote, also an ISHRS member titled ‘FUE vs Strip’ on this site at http://www.baldtruthtalk.com/showthread.php?t=1299.
You know where NeoGraft stands on this Topic. Here are Dr. Cole's comments:

Dr. Cole writes:
“I've been advocating the FUE procedure over a strip procedure since 2003. The rationale for this is based on experience. Prior to advocating the FUE procedure, I had performed over 8000 strip procedures and i had seen the negative sequelae of multiple strip procedures over time. The first thing to consider is that a properly performed FUE procedure will yield 2.9 hairs per graft in my hands. This is far more than the 2.0 hairs per graft that a strip procedure will produce in expert hands in an average case.

The next obfuscation you will encounter with strip surgeons is that a larger procedure is better off with a strip procedure. An average donor area has over 16,000 follicular units and there is no reason you cannot remove 25% or more with FUE. An average donor area that yields 4000 grafts averaging 2.9 hairs each is certainly going to yield more hair (and coverage) than the same 4000 grafts averaging 2.0 hairs per graft. The next thing to recognize is that the average strip transplant achieves it's graft count by splitting 3 and 4 hair grafts into 1 and 2 hair grafts. Certainly, you can produce more grafts by fractionating full size follicular units into smaller grafts. (if you read the rest of article which I did not include for brevity, it will explain why Dr. Cole states this about the grafts. It has to do with the technicians.)

The survival of strip and FUE grafts in capable hands is the same. The number of hairs per graft is greater with FUE. The potential for negative scarring is greater with strip surgery. The potential coverage from either procedure is better with FUE based on similar numbers of grafts.
In 2002 FUE was essentially non-existent. In 2006 it was 7.4% of all hair transplant surgeries. In 2008 FUE was 10.4% of all hair transplant surgeries. In due course, it will continue to grow.

if you are confused and uncertain what to do, wait. In time your choices will narrow. Certainly, it is very likely that anyone under 30 will not have a strip as their initial surgery. Of course this is what i have been advocating for over 6 years.”

[Winston]

From everything I have read, including the history of FUE on Dr. Coles website, and on one show when Dr. Bauman called in, it was Spencer Kobren who introduced FUE to North American Hair transplant doctors and called for its practice and acceptance. Dr. Epstein posted that he does three FUE per week and I’ve heard Spencer talk about Dr. Feller's fue machine, and Dr. Harris’s also. So I don’t think Kobren, Dr. Epstein or any good doctor is anti FUE.
I think that that they are anti BS

Hudson, your arguments sound like those of a salesman and you still have not told us who you are. I don't really care, but I do find it odd that you have some much to say but will not divulge your identity.

[Delphi]

Last night Spencer Kobren said on his show that he was going to invite the Neograft people and one or two FUE doctors to talk about the NeoGraft and debate their views on it. I wonder if hudson is going to join in?
Will you be there Dr. Epstein?

[Winston]

It’s unlikely that hudson will be on the show since he still has not identified himself. I do think hearing both sides of the debate is very valuable for anyone who is thinking about having an FUE hair transplant.

[blowmeup]

Any news on the interview? Spencer if you’re reading this can you let us know?

[David Bays]

Absolutely unbelievable. It never ceases to amaze me that whenever a new aesthetic procedure arrives, so too do the critics, almost all of whom have NEVER used or even seen the new technology in question. Introduction: Hello everyone, my name is David Bays, Founder and Managing Partner for Omni Medical, one of the distributors of NeoGraft. I have over 16 years of experience in the medical aesthetics business and have worked for and with some of the most well known companies in the world at the manager and executive level. Let me just jump right in and say that whether I worked with NeoGraft or not, the posts and press releases recently issued...more specifically, the headlines that had the words WARNING and NEOGRAFT broadcasted everywhere were completely over the top, misleading and possibly libelous in my opinion. Its one thing to start a "discussion" on a new technology and how it may or may not improve that particular field and it's quite another to launch what I consider an all out smear campaign. Fact: Plastic & Cosmetic Surgeons would have short lived careers without the technology manufacturers that provide them with the innovative "tools" that "assist" them with their craft and help to ensure the highest levels of safety and quality procedural outcomes are achieved. Fact: ALL surgeons are introduced to new technology ALL the time. I thought it went without saying that NO physician or surgeon is exempt when it comes to learning any new procedure or technique in it's entirety from experienced professionals whether they are veteran physicians, nurse trainers, company representatives or a combination of all of these options. Manufacturers of new technology are obligated to provide options for education and training (both direct and indirect) otherwise that company will not be in business for very long. Physicians, especially new ones who wish to expand their scope of practice (which most have every right to do) are even more obligated to ensure that they are properly trained in any procedure they carry out as they are bound by a "do no harm" code of ethics. They are further incentivised to receive as much training as possible with the threat of malpractice lawsuits and/or license suspension. This is common knowledge or at least I thought it was. Apparently according to some, we need to start including this disclaimer in every single marketing piece. FYI, if a physician "chooses" not to seek out and take advantage of all training available and necessary to competently perform any procedure to the highest standards, then it's safe to say that they won't be a physician for very much longer. I also thought it was common knowledge that it was a patient's obligation and responsibility to research any physician's background and experience before having them treat you. The internet is great these days and gives us access to resources to help us determine if: "I should let this person work on my car," "should I hire this person to be my contractor," and even "should I choose this doctor to perform my hair transplantation procedure." Fact: The new 4th generation, FDA approved NeoGraft is a TOOL that for "some" will offer both them and their patients increased benefits. Just as with any aesthetic device both surgical and non-surgical, these benefits are often subjective. "Do I use IPL, fractional erbium, microdermabration or medical grade skincare to treat my patient's pigmented lesions?" "Do I combine treatments?" "Is this patient even a candidate for this procedure and if not, do I have something else I can offer them?" "Have I been completely trained in all of these possible options?" The bottom line is that if you feel that the new 4th generation NeoGraft isn't a tool that you or your patients will benefit from, then just say no thanks and be done with it. There are and will continue to be plenty more physicians who will actually take the time to see the new NeoGraft in action and decide for themselves that this will indeed be a great addition to their practice. A lot of physicians, some of whom are very well known and respected have already successfully added NeoGraft to their practice. I have no doubt that their patients are happy. In conclusion, I can confirm without hesitation that NeoGraft, Omni Medical and all of the other representatives will continue to encourage physicians to discover the innovation and numerous benefits (both procedural and financial) the new, 4th generation, FDA approved NeoGraft has to offer. We will conduct ourselves with the highest degree of integrity and professionalism…and we are all committed to encouraging the “positive” advancement of the hair restoration industry. Whether NeoGraft was here or not, there will always physicians who will consider expanding their scope of practice to include hair transplantation (strip and FUE.) We will continue to encourage comprehensive and continuous education for all physicians at all skill levels. I look forward to hopefully working together to achieve this common goal.

[Winston]

Thanks for your response Mr. Bays. It sounds a little like political spin to me, but what do I know? You make some interesting points that all lead back to what Spencer Kobren and Dr. Bauman and Dr. Epstein pointed out in the first place. That the Neograft is just a tool as you put it and it’s up to the doctor to get the training to do a good hair transplant. So what’s your gripe?

[Winston]

Mr. Bays, I was curious about NeoGraft’s FDA approval and wondered if you can show me where I can find that approval on the FDA website? I also thought that the FDA only cleared medical devices as a 510k clearance. Can you clarify this for us?
Thanks!

[Don'tDoIt]

Mr. Bays, I think that Winston is asking a reasonable question. What sort of FDA approval does Neograft have? Why haven't you answered Winston's question?