NeoGraft Hair Transplant Warning - Let The Buyer Beware!

[tbtadmin]

Follicular unit extraction (FUE) has come a long way since it was first introduced through The Bald Truth to North America by Australian hair transplant pioneer Dr. Ray Woods. Early adapters of the technique found it to be extremely labor-intensive when performed correctly, and limited by the number of grafts that can be safety [...]

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[Cappy]

So let me get this straight. The Neo Graft is now gaining popularity, more and more surgeons are starting to implement this in there practice, and Dr Bauman now releases a public warning stating that results may range from mediocre to disastrous if the machine is used by the inexperienced?

Isn't there some type of training from the manufacture of this "tool" that can help surgeons achieve the desired results? Perhaps similar to the training a once inexperienced Dr Bauman received?

I don't get it.

[hudson]

Winston
Your comment makes no sense. Do you think that the only training someone gets on the NeoGraft machine is to "punch some holes in a person's head and throw some hair in it?" Do you not think doctors who acquire the NeoGraft device are given training in creating a hairline or angling of grafts if they are new to hair transplantation? Do you think the NeoGraft company wants to allow doctors to use the NeoGraft machine on patients and have them do bad hair transplants? I do not want to burst your bubble but the established hair restoration doctors want patients to believe that it takes years and a lot of experience to learn how to do a hair line or place grafts. The truth is that this is truly not so. These are skills that can be learned quite easily and within a very reasonable amount of time depending on the natural abilities of the doctor. These natural abilities cannot be controlled by NeoGraft. That is why they offer ongoing training for doctors who need more time for learning or practicing.

Furthermore, do you think doctors who acquire NeoGraft are not interested in learning to become proficient hair transplant doctors? Your comment is an insult to both the NeoGraft people and the doctors who are purchasing the NeoGraft device because you are making implications that neither the company nor the doctors care about the patients enough to make certain the doctor gets adequate training. I think you and the rest of the writers on this site should stop using scare tactics on the public in order to dissuade them from going to doctors who have purchased the NeoGraft machine. It is obvious to everyone reading the articles on this site that some of the established hair restoration doctors are fearing the competition from the new doctors buying this device and this is the reason for the misleading warnings given on this site to "BEWARE of new doctors using NeoGraft". Dr. Bauman was once a Newbie himself and I am certain he did not post that on his website! So let other doctors make their way into this field, as is their right, and leave it to their trainers and their own integrity to know when they are sufficiently trained to begin doing transplant surgery, just as Dr. Bauman knew when he was ready to do his own first case.

[Delphi]

I viewed the interview last night and thought it was extremely well done and very balanced. I heard nothing negative about Neograft during the interview that I can recall. To me the focus was on inexperienced doctors doing hair transplants. Whether they use the NeoGraft or if they are just bad at doing regular hair transplants, I think patients need to know. Good idea about the list of doctors who train the new doctors Winston! I wonder if we’ll ever see that list?

[Jeffrey Epstein, MD]

Actually guys, Winston is quite correct- hairline design is not something one learns over a 1 or 2 day course- instead, it takes years and years to develop an ability to convert an aesthetic design into reality and that is assuming the doctor even has an aesthetic design, something of which many doctors do not have much of an understanding.

It has been pretty clear, at least to most of us more experienced and in the "know", that it was the intent of the NeoGraft to be promoted to non-hair transplant specialists to get them to use the device. Otherwise, there would simply not be anywhere near enough surgeons already performing hair transplants to spend the $60,000 or so to purchase the machine. The NeoGraft offers essentially nothing to my practice, other than a potential marketing edge (if I chose to utilize that), as I certainly do not need to use a machine to harvest FUE grafts nor plant them, to do the work that I and my highly experienced team of assistants are already capable of performing to the very highest standards.

The "threat" that the NeoGraft device poses to experienced surgeons is quite minimal in my opinion, as I believe that the majority of prospective patients are wise enough to do their homework and realize that the aesthetics of hair transplantation cannot be duplicated by a machine, nor taught over a day or two course. I would think that spending some time on this site would not question that wisdom.

Jeffrey Epstein, MD, FACS
Miami and NYC

[Jeffrey Epstein, MD]

Training can be sufficient if it is intended to train on the technique on how to use the maching to harvest grafts and then plant them, although I'm sure there is a learning curve.
What cannot be trained in just a week, or even months, is outstanding hairline design. Even with my background in facial plastic surgery aesthetics and 16 years of performing these procedures, I am still developing new appreciations and approaches for hairline design, the single most important element in the hair transplant procedure.

Jeffrey Epstein, MD, FACS
Miami and NYC

[Cappy]

Okay now Im starting to understand this warning. All this time when I would read the word inexperienced I was thinking of a regular HT doc who had simply never used this tool. But now the consensus I'm getting is that the word inexperienced is being geared more towards a surgeon who has never even performed an HT and finds this machine/tool appealing due to its "ease of use.

Thanks for clearing it up guys.

[blowmeup]

It’s not rocket science that the Neograft company is in it for the money, it just looks like the doctors don’t want to buy their expensive machine and they have to sell it to doctors with less understanding of the marketplace. I guess if I was a doctor looking to grow my business and knew nothing about hair transplants and a salesman called my office to explain how much money I can make if I buy his machine, I might bite

[hudson]

NeoGraft Warnings Are Misleading The Public
For more than a year after arriving in North America, the tactic of certain forums and “experienced” doctors was to denounce the capability of the NeoGraft machine through inaccurate conjectures, misleading information, and false conclusions that made it appear NeoGraft was committing follicular homicide. All this negative criticism about NeoGraft occurred without the “experienced” hair restoration doctors or forum members every seeing the NeoGraft machine used in a hair transplant procedure! This was hardly a scientific method for diagnosing a device.
These aggressive tactics, based on totally false facts, had potential to harm the NeoGraft’s image in the public domain, which was an irresponsible act on the part of the forums and the “experienced” doctors. The worst part was that the public was being misled by “experienced” doctors and forum members about the capability of the NeoGraft – not a fair thing to do to your readers, since they look to the “experienced “ doctors and forums to give them researched, honest answers. Generating answers based on false facts, as was done with the NeoGraft device, was a further disservice to the readers, who may believe the false information dispensed by the forum and doctors and limit their choices based on those false facts. Since most of the “experienced” doctors do not offer the FUE procedure for hair transplants, I will leave it to the readers conjecture and speculation as to why the NeoGraft was portrayed so negatively, based on no factual evidence or experience with the NeoGraft machine.
The real facts about the NeoGraft machine is that it has been demonstrated at numerous, live procedures to doctors (about 4-6 demonstrations a month), including the one at the ISHRS in April where over a hundred doctors attended. At these live procedures the NeoGraft machine has consistently shown that it is a highly proficient tool that allows the patient to have the latest, most advanced, and most beneficial type of hair transplant called FUE. (See the discussion on radio http://www.thebaldtruth.com/featured...-a-closer-look ). An FUE hair transplant, compared to a Strip hair transplant is much less invasive surgically as there is no cutting and stitching. With an FUE procedure the hair transplant can be done with greater speed, benefitting the patient and the doctor, there is considerably less down time, much less pain, fewer complications such as cut veins or nerves, a tight scalp feeling, or buried grafts. With FUE there are no elliptical elongated scars as with the Strip method. Some FUE patients, not most, may experience some minor white dots where a follicle was removed, but these become not visible when the hair grows back and hair can be still cut short, unlike with many Strip procedures. Winston, you may not want a “machine made” hair transplant, but it has many advantages over older manual methods.
Now that the “experienced” doctors and the forums are unable to denounce the ability and proficiency of the NeoGraft machine, the latest sensational and misleading forum headlines consist of unjustified warnings to the public to beware of new doctors purchasing the NeoGraft machine. This is just another tactic to try and dissuade patients from using doctors who have acquired the NeoGraft FUE machine, the latest and most advanced way of doing hair restoration . If you look at the roster of doctors who are purchasing the NeoGraft device, you will notice that many of them are the most prestigious, well established, highly regarded leaders in their specialties of Plastic surgery, Dermatology, and Cosmetic surgery. Many of these distinguished doctors have not yet let the public know about their NeoGraft acquisition (as they are busy training). Many of them have done extremely complicated surgeries, compared to hair restoration procedures. The majority of them are trained surgeons, whereas the majority of hair restoration doctors are not. I would bet that all of them feel certain they can achieve the level of expertise required to do hair restoration, beginning with the training they receive with the NeoGraft company’s arrangements. I feel certain that with the reputation most of these doctors have, they will not attempt to begin doing hair restoration on their own, until they feel secure they can do it properly.
With those doctors that have the least experience, the NeoGraft Company has arranged things so that the doctor can take as much additional training as needed. Furthermore, the company recommends that all doctors take outside training at the established organizations and with mentors that offer hair transplant training. So the public, once again, as with the hype about the NeoGraft machine itself, (now it is the doctors) has nothing to worry about. Why go down that road in such a public, meant to harm way to your fellow doctors, with such sensational headlines, unless there is a concern that with more doctors offering hair transplants there will be more competition and one way to eliminate the competition is to warn the public that the doctors may not be trained or experienced? There is a good chance that this kind of reporting pretty much gets registered in the public’s mind that the NeoGraft doctors are not trained, even if they are. I believe this was the intent and this is not fair to the doctors, who already ,like Dr. Bauman are trained or intend to become proficient before working on patients on their own.
Since we are speaking about training, many “experienced” hair restoration doctors were not so well trained themselves, since there are no regulations what constitutes training for hair restoration. There are doctors who open up their hair restoration practices with as little training as a couple of weeks or months, with some up to a year, and they were once upon a time not so experienced also and no one put out warnings. Why not warn the public about the new doctors who are being mentored now to become Strip hair restoration doctors, since Strip surgery is a more serious procedure that FUE and is needs more training time than an FUE procedure with NeoGraft? It is important to understand that the technology NeoGraft uses simplifies the FUE procedure so that doctors can become proficient in using this device in a much shorter amount of time than if the doctor was learning manual FUE or the Strip procedure. This is what technology does. With the NeoGraft machine the procedure is not as dependent on the doctor’s skills as in manual FUE or the Strip procedure. Doctors may not like to hear this but this is a fact.
Winston, you say you found the interview balanced. The interview might have been balanced if the discussion was only about choosing between going to an experienced Strip hair restoration doctor or one that is not experienced. Everyone would agree it is preferable to go to an experienced doctor, hopefully one that also has innate ability to do good work. However, the live discussion between Spencer Kobren and Dr. Bauman about the importance of a doctor’s experience is not the discussion to be had with the NeoGraft device because the NeoGraft device extracts and implants follicles in an entirely different way than what happens with the Strip procedure and even differently than manual FUE procedures. With the Strip method, cutting and stitching of the scalp occurs along with dissection of follicles from the Strip. Follcles are implanted with tweezers which can damage them, when they are pulled or pushed during extraction and implantation. With the NeoGraft FUE method, individual follicles are extracted and implanted with highly engineered tools that use air pressure. No hands or tweezers touch the follicles.
Because of the differences in hair transplant methods between Strip doctors, manual Fue doctors and the NeoGraft method, in the case of NeoGraft, all doctors, whether experienced hair transplant doctors or doctors who have never done hair restoration are “Newbies” when it comes to extracting and implanting with the NeoGraft machine, two of the most important and key procedures of any transplant. Of course there is more to hair transplantation, such as placing of grafts and doing hairlines, but these are skills that can be mastered in a reasonable amount of time with practice. As for the artistry of hairlines, this depends to a great deal upon the innate artistic talents of the doctor, something which training can only teach to a certain point. This is true of all medical procedures doctors learn.
Winston, you state: “ I have a feeling if you thought it was so great Dr. Epstein, that you would buy one and so would the rest of the IAHRS doctors. I mean if it would make your jobs easier and give better results, then why not?” This question has several answers. To my understanding, most hair restoration doctors do the Strip technique. They seem to be resistant to changing over to the more beneficial, less invasive, less painful and less complication prone FUE method, especially now that the NeoGraft simplifies the procedure. Instead of becoming the leaders in FUE transplants and using their experience and skills, in offering patients who are candidates, this more benign, less complication prone procedure, they are issuing warnings to readers to beware of new doctors who have purchased the NeoGraft and who are offering this more advanced method of hair transplantion to their patients.
It is interesting that many of the doctors’ who are purchasing the NeoGraft device, could have become Strip Hair rRestoration surgeons, (some were but gave it up) but chose not to include this procedure into their practice, even though it would have added income to their practice. In fact many of these doctors told the NeoGraft company how many patients they referred to Hair Restoration doctors, losing that income. These doctors now however, understand and see the value of the NeoGraft machine, both to themselves and to their patients and are very excited by the machine. This is why they have decided to add this device to their practice. Many tell us they will designate a doctor to the machine, who can become proficient in doing Hair Transplantation. One can only conjecture that the established Strip method doctors already have their practice established and it seems they feel why should they change the way they are doing things when they are happy with their practice, regardless of the fact that a NeoGraft FUE procedure is more beneficial for the patient who is a candidate for this kind of procedure
On Kobren’s post it was stated: “that there needs to be a more “honest approach [by the NeoGraft company] to the marketing of this device, and that there is a serious potential to cause harm if this machine is irresponsibly sold to entry-level hair transplant practitioners. Furthermore the article continued to say: “The implications of this business model are profound, and should not be taken lightly by anyone considering surgical hair restoration.” These are very sensational, inaccurate and uncalled for statements. It is comments like this that make it difficult Winston, to “take it down a notch!” I do not know what implications of the NeoGraft business model are profound. Do you mean selling machines to doctors who will train to become FUE hair transplant doctors, and over time gain experience and enter into the “experienced category of doctors?” I do not see any profound outcomes with this. This is what all doctors do.
And why is the NeoGraft Company deemed irresponsible if it sells to entry-level doctors if those doctors are going to be trained and become proficient before they begin doing hair restoration? As I have already explained all doctors are entry level when learning to use a new device, whether that device is a heart machine, a laser device, a bone cutting device or any other device and selling them a device that they are going to train on is not irresponsible, it is the norm for how doctors acquire and learn to use devices. The medical regulatory bodies decide who is qualified to use these devices, not the manufacturer or distributor of the devices, so why is the NeoGraft company irresponsible if it attempts to sell the NeoGraft device to doctors that are not skilled on the device (no doctors are as I pointed out) but considered qualified by the medical regulatory bodies to get trained on a device?
And I am not clear about the “honest approach” statement. What do you mean by that? I will say NeoGraft’s approach to selling this device is very open and transparent. We want doctors to see in person what NeoGraft does so we have several live demonstrations every month where doctors observe a live hair transplant. This way doctors can assess for themselves what NeoGraft is capable of doing. I think our business model is very honest, and responsible in its transparency. I do think this type of reporting needs to stop as many comments are inflammatory and not merited or earned. There does not have to be a conflict between a company selling devices and that company having integrity, which NeoGraft has along with the people working with NeoGraft, most of whom are long established in the medical device business with a solid reputaion.
In conclusion, I do agree that each patient has to do his or her research to find the best doctor. The best doctor is not always the most experienced one since a certain amount of talent is involved in everything one does. Sometimes it may be important to find the best technique. The NeoGraft group, along with many doctors, believes that an FUE Hair Transplant with the NeoGraft device is the best, most beneficial procedure for patients today, but was more difficult to master in the past without the NeoGraft machine and so was not routinely offered except by a small number of doctors. I believe every doctor has a right to add devices to their practice, as allowed by the Medical regulatory bodies, and other doctors should not dissuade patients from going to Newbie doctors because they were Newbie doctors themselves at one time. I am not at liberty to give out names of people working with NeoGraft. If you want to know about the NeoGraft training of doctors, you might try speaking with Dr. Bauman who can share hisexperiences with you if he chooses to do so. It looks like his training on the NeoGraft was fine as he is achieving good outcomes, as are the other NeoGraft doctors, some still with assistance and others when ready out on their own.

[hudson]

The last sentence should read:
It looks like his training (Dr. Bauman's) on the NeoGraft was fine as he is achieving good outcomes, as are the other NeoGraft doctors, some still with assistance and others who are already out on their own.

[Jeffrey Epstein, MD]

I welcome hudson's comments, some of which are quite relevant, provided they are in fact true.
As a board certified facial plastic surgeon who spent 5 years in a head and neck surgery residency followed by a full year of facial plastic surgery fellowship where I trained under one of the top hair surgeons of all time, Dr. Shelly Kabaker, I can respect the importance of receiving extensive surgical training as a strong background in this aesthetic field. I also know however that in my 16 years of private practice, performing over 500 procedures a year- of which 150 or more are FUE) there are three critical elements to achieiving truly outstanding results that cannot be taught in a several month period of training: an aesthetic eye, experience in hairline design by accounting for facial structure, and passion; and in fact sometimes these cannot be taught at all. My associate, Dr. Glenn Charles, is an example of this. These three elements, all together, are possessed, to varying degrees, by the doctors that Spencer has assembled in his unique recommended list.
The NeoGraft is a device. It does not assure good surgical outcomes, no more than giving a general surgeon a "bone cutting device" then calling him an orthopedic surgeon, or a vascular surgeon a "heart device" then calling him a cardiac surgeon. Now I understand that a hair transplant is not a cardiac bypass, or for that matter, not even a rhinoplasty (the most challenging of all cosmetic surgery procedures in my opinion), but still, performed unaesthetically (poor angulation of grafts, non-irregular hairline design, inadvertent transection of existing hairs, etc) a hair transplant can have devastating outcomes for the patient, as some of the posts on this site can attest to.
I do believe that most of the relatively "new" hair transplant doctors being trained in the NeoGraft do not aspire to being a world leader in the hair transplant field, but are hoping to achieve consistent, nice results for their patients. I truly feel that, while there is an economic incentive to adding these procedures (and there better be a financial return to justify the cost of the device), they are seeking to provide their patients with aesthetic results. Here it is the responsibility of the patient to do his/her homework and choose the surgeon who will meet his/her expectations.

Jeffrey Epstein, MD, FACS
Miami and NYC

[hudson]

Beware of Hair Restoration Doctors not offering the FUE procedure

After writing my former post, I realized that perhaps the most important warning that the public and potential hair transplant patients need to hear is that the majority of Hair Restorations doctors who do the older Slit procedure, which as I stated is more surgically invasive, painful, prone to more complications, has a much longer and more painful downtime, and produces elongated scars, are not bothering to re-educate themselves and offer the more advanced, patient friendly FUE procedure. Dr. Bauman, himself, and ISHRS member, is puzzled by this as he stated on his live interview with Spencer Kobren. I could understand not offering this procedure prior to there not being a NeoGraft device because the manual FUE procedure had a poor record for high transections and there were other difficulties with a manual FUE procedure. Now with NeoGraft, doctors can do an FUE procedure and experience as good an outcome as with STRIP surgery.

NeoGraft was demonstrated at the Live Surgery Workshop in Orlando last April, and in numerous live demonstrations done for doctors around the country, who were able to see the results doctors can achieve with NeoGraft. It is difficult to understand why the Hair Restoration doctors are not taking the lead and offering their patients this more advanced, less painful FUE procedure. There has been enough experience with the NeoGraft device to show that the outcome of the hair transplant with the NeoGraft is identical to that with the Strip method, because the principles are the same whether you use the Neograft machine or the Strip method. In the end both methods harvest follicles and implant them into recipient sites, with the exception that follicles harvested with the NeoGraft machine are more identical in size, as they are not cut by hand. As a result they "fit" into the recipient sites, which are the same size as the follicles more easily, lessening any damage from different sized follicles that need to be pushed into the sites with tweezers, a device not used by the NeoGraft machine, which uses a no touch, gentle. no squeeze air pressured tool to implant and extract follicles.

The idea of Medical Device companies making money by selling devices has been often used to make these companies appear that they do not have the best interests of patients in mind. Perhaps you could explain how it is in the patient's best interest to not offer the patient the FUE procedure which is more beneficial to the patient? At least the patient should have a choice, after hearing all the correct facts as to which procedures are available. Then if the the patient chooses an FUE procedure, let the Strip doctor recommend an FUE doctor to the patient.

The problem as I see it, is the one I have many times seen with new devices in every specialty. There are always "experienced" doctors who have been trained on an older device who are reluctant to retrain or invest in a new device, regardless if that device improves or advances the procedure and is more beneficial for the patient. We, in the medial device industry, call this group " the old boys club." Why are more experienced doctors often reluctant to accept change? I imagine this happens because they are comfortable with what they do, they will probably earn the same income and when they look at it from their perspective it does not make sense to put in the effort and expense to make any changes.

To be fair to all doctors however, there is always the possibility that some doctors are confused themselves by the negative, false, conjectures and misconceptions often posted on Forums when new devices are introduced as there was about the NeoGraft device. This prevents some of them from changing to the new method. The same has occurred with many new devices, when they were introduced, that are now used routinely by doctors. However, this does not address the best interests of the patient. It has come to our attention that when patients asked some prospective Strip hair restoration doctors about the FUE procedure, they were dissuaded from doing this procedure, based on the false information that had been dispensed by many of the forums, which was not really the doctors fault, if the doctor trusted the forums. As patients become better informed, we feel certain that they will choose an FUE procedure, with NeoGraft a device that greatly improves the outcome of the FUE procedure.

[Winston]

Hudson, with all due respect why not identify yourself to the forum? It’s apparent that you work for NeoGraft and I think it is disingenuous to maintain anonymity if you are working for the company. As patients and posters we depend on having the right to maintain our anonymity, but your arguments might hold more weight if you reveal your identity and credentials.

[Jeffrey Epstein, MD]

Now you have lost credibility hudson, making one eroneous statement after another.
As a surgeon for whom approximately 25% of my work is in FUE (3 or so FUE procedures a week), having performed several hundred of these procedures, I feel I am quite qualified to correct your eroneous statements.
The FUE procedure, whether performed by a motorized device or by hand, has one main advantage- avoidance of a linear donor site scar; and a secondary advantage- ability to harvesting body hair for transplanting into the scalp. The total donor supply available by FUE is reduced from that of strip procedures. The yield of hair growth is less than that of strip, sometimes not a lot but almost universally, due to the removal of the grafts as opposed to them being carefully dissected out under the microscope.
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?
If I was a neophyte hair transplant surgeon looking to build up a practice, without the tremendous investment required to build up a team of excellent assistants (that can take years or many thousands of dollars or both) I too would consider purchasing the NeoGraft, both for its ability to bypass for the most part the need for building up a team as well as the marketing advantages. However, this marketing- which clearly you are doing - needs to be done honestly.

Jeffrey Epstein, MD, FACS
Miami and NYC

[blowmeup]

If the Neograft is a better way to have a hair transplant, then we will eventually all find out about this. I find it distasteful for Hudson to come here and make accusations about the motives of forum readers and doctors to try to throw us off the scent of what is really going on. Hudson is afraid that he will lose business because the pros and cons of the Neograft are being openly discussed by people who are interested in this stuff.
Why is Dr. Epstein’s opinion any less valid then yours Hudson? Like I said, if I was a doctor and wanted to make a lot of money fast, I would buy the neograft and start doing hair transplants. It look easy to learn and people are generally very trusting of doctors so I would assume it would be an easy sell to people who don’t do their research. Maybe this is why you are so frustrated?