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

[SpencerKobren]

Happy Saturday to you too.

I have to assume, given the nature of your business, that when you say:

"You're not on the same page when it comes to patient culpability?"

you mean that it IS up to the patient to do his own research to make a FREE and proper choice; and to live with the benefits OR consequences of that choice.

I hope that is correct.

Being free to make a choice doesn’t ensure the patient has the where-with-all to do his due diligence in the same manner in which you or I would. I think it’s best to move on and focus on the points made by our users.

[tbtadmin]

Provided by IAHRS Member Alan J.Bauman, M.D.

This video demonstration was featured on Rachel Ray's "plastic surgery breakthroughs" show on September 25th 2009.

[the B spot]

If you look at the video, when they are attempting to "shoot" the grafts into the recipient sites, they go in half way, or in slightly, which requires them to be scrapped over into the sites, re-suctioned, and re-inserted. It is my understanding that this machine is supposed to limit the handling of the grafts because they are fragile.

One of the problems here is the claims that this machine is better and faster and Doug claimed (elsewhere) a less than 5% transection rate, for those doctors with no experience doing FUE, including those who are using the machine for the 1st time.

I looked at this thread as an opportunity months ago to see some willingness to actually engage in proper discussion and acknowledge both positive and negative about this machine.

Anyway, nothing personal whatsoever, certainly love the innovation, but the very reason for these forums is disclosure, transparency, discussion, praise and sometimes warning for those of us associated with the HT industry.

Take Care,
Jason

One Caveat: I am 100% in favor of ANY equipment that is shown to clearly benefit the patient over existing, established equipment.

[Jeffrey Epstein, MD]

Wow, I sure missed an interesting discussion on regulation of the hair transplant field.
All of you have some particularly interesting perspectives and ideas, and unfortunately, there is no one correct answer. The problem is, as Dr. Feller stresses, is that who is regulating the regulators. Government employees (and that includes Congressmen) are susceptible to the pressure/advice put on by lobbyists (i.e. those that give money to these employees to help them get reelected or get them tickets to the Dolphins-Jets game tonite (Go JETS)- or maybe there is not graft (no pun intended) or bribery involved, but rather these regulators are susceptible to the advice they get from special interest groups. Has anyone seen what has become of the Obama health care reform- one by one, each component gets torn down by the different interest groups?

It's not a simple- well, everyone has the same incentive- except for those who are practicing bad medicine- and that is, do what is best for the patient. But do you know that different fields of plastic surgeons have for years fought to limit who can perform plastic surgery for largely economic gain? As a board certified facial plastic surgeon, I have nothing to lose by the cosmetic surgery field being regulated such that only board certified plastic or facial plastic surgeons can perform hair transplants along with other plastic surgery. Yes, that would be good- very good- for me economically. However, that would likely remove some of the more experienced and talented hair surgeons from the field- something that would be bad for patients.
And yes, the Florida Bd of Medicine members are vulnerable to the advice of surgeons such as myself, thinking that they have only the best interests of the patients in mind.
On the other hand, there are far too many poor surgeons doing subpar work on unsuspecting patients - see how infomercials and beautiful websites are able to drive business. It is through a site like this- the BTT/IAHRS- that a truly reputable and honest consumer advocate like Spencer is able to try to help the prospective patient who is smart enough and motivated enough to do his/her homework.

That's my two cents on the topic

Dr. E

[hotty_ca]

If I could make a quick suggestion. Why not do what all other industries use to ensure quality, which is oddly enough, follow Quality Assurance practices? You know, measurables. If done properly there is basically no need for government involvement (the need for which has always been a completely nonsensical argument that never got to the heart of bad surgery, and that was stopping bad surgeons). And there's no need to have any grand unanimity amongst ht practitioners. Simply put if you want to make the industry better and put pressure upon the bad doctors to improve or alternately leave you just need to do the following.

First you create an organization of surgeons where the criteria for membership is adherence to certain QA reporting standards. What are these QA standards? Well for starters they are not anything to do with the actual ht work. So surgeons who get involved with this organization won't have to change their practices. We're talking about standards of reporting only.

This means that every patient gets documented the same way. Same picture angles, same camera, same lighting, yadda yadda yadda. At the same schedule (ie. 1 month, 2 months, etc). Obviously you'll need to get patient buy-in to this. That's simple. You ask them for it. All patients who accept are given random id numbers, with any identifying features blacked out.

Next problem. How do you get patients to come in on any regular basis? Well you give them incentive or you don't. Up to the surgeon to give their patients sufficient incentive to follow thru. If the patients don't show up that's just missing data.

The organization I've described does the following. It opens up the database of results to the public. Allow them to slice and search according to every dimension of measurables you can come up with. On the other side of the patient/doctor divide, membership in this organization would require that you meet a minimum standard of reporting or you can't say you're a part of the org. And you'll need to keep providing that evidence or you lose membership. In other words, you'll need to provide X number of patient data a month. Obviously the schedule on something like this is up for debate.

What else does the patient get out of this org? If they have a complaint they can force their case to be included in the dataset. That would be a requirement of membership.

The whole point, basically, is that you provide measurable, standardized data that consumers can pick their surgeons by and provide ratings on. If you're a good surgeon you'll have tons of good examples, certainly more than bad ones. If you're not you'll likely avoid participating. The membership, itself, is the selling point. And it'll give you a constant benchmark of where you stand next to your peers.

This is a simple solution that doesn't require any complex bureaucracy. It's driven by the industry itself and doesn't need gov involvement. It encourages improvement within the industry. And it's transparent. It just shines a light on the information. Those who can hack it will stay and those who can't will go. Problem of bad unethical surgeons more or less solved.

Btw, I've been suggesting this for years. Nobody's done it. I wonder why.

[hudson]

Dr. Feller,
About 18 months ago you wrote:
[QUOTE=Dr. Feller;2544]"Any new FUE device will get my full attention, but I have some serious concerns about this one." You further stated that another "concern" of your is that the NeoGraft machine " utilizes a spinning punch, and while this may facilitate the procedure for the doctor, it also subjects the grafts to TORSIONAL forces which are detrimental to FUE grafts." Next, you were "concerned" about the grafts being "sucked" through the "spinning punch" and finally you were "concerned" about the "transection and trauma" to the follicles, which may look okay but may really be "dead."


This post was written over 18 months ago and all your false, inaccurate, speculations, conjectures, and concerns about the NeoGraft machine have been totally disproved. As a doctor who had never seen the NeoGraft device do a procedure, you based your critical, negative, false concerns on a totally wrong assumption which was that the NeoGraft device is “a spinning punch.” Once you had made this false assumption, and believed it, you then went on to explain how as a “spinning punch” there will be damage consisting of “Torsion, Traction and Compression.” You made it sound as though the NeoGraft device did follicular homicide. However, you were absolutely wrong that the NeoGraft device is a “spinning punch”. The NeoGraft extraction tool spins less than a tool used to extract grafts manually. The NeoGraft device is controlled by the doctor and it spins less than two times before it has extracted the graft. Doctors doing manual FUE have to spin their tool much more often to score the skin. Because of the small rotation NeoGraft technology produces, there is no “Torsion, Traction and Compression” occuring.

As for the graft going through the tube to a receptacle, there is no evidence of any damage to the graft. The NeoGraft machine was used in a live demonstration at the Live Surgery Workshop in Orlando in April of 2010 which was filled to capacity by doctors. These doctors can attest to the excellent quality of grafts extracted by the NeoGraft device. Many of them examined the grafts under the microscope. Furthermore, the NeoGraft machine had the lowest transaction rate of any other manual tool. This means the NeoGraft machine did the least damage to grafts, compared to any other FUE method used. In addition the NeoGraft machine has been demonstrated live 4-5 times every month all over the U.S. with the same results.

As for the grafts drying out, your analogy of wetting your lips and then finding they dry out, does not apply to the NeoGraft technology. With the NeoGraft machine, constant misting of the grafts is possible, so they do not dry out, as was witnessed by the doctors at the ISHRS show who saw grafts that were robust, moist, and of excellent quality. An article such as this, based on false speculation, is very bad reporting, even if it is couched as a “concern”. It opens the door for others to “run” with these false ideas and disseminate them further, turning them into facts, which has happened in the last year and a half. This is unfortunate for the confusion it creates in the reader’s mind, as it may reduce the reader’s choices if he wants an FUE transplant, by scaring the reader.

This negative type of reporting has not hindered other doctors from including the NeoGraft device in their practice, once they saw the NeoGraft device demonstrated (which we do live 4 times a month all over the country) and they realized how beneficial this device will be to their patients. FUE with NeoGraft is beneficial because it eliminates the large elliptical scars that occur so often in many patients with the STRIP procedure. This allows patients to wear their hair short. An FUE procedure with NeoGraft is a much less invasive procedure, without risk of cut nerves or arteries, it is a much less painful procedure, the down time is greatly reduced, allowing patients to get back to work sooner. There are many other benefits to a NeoGraft FUE procedure as well such as less damage to the grafts compared to a manual FUE procedure or from using tweezers in either manual FUE or STRIP surgery to place grafts.

Now that 18 months have passed since this misleading, inaccurate article was written it is possible to dispel another concern which was the concern about the results of a NeoGraft procedure. There are many patients who have undergone the NeoGraft procedure at this point in time. Two of them were Greg Benson, (an actor) and Kevin Nalty, an internet marketing personality. Both of them had a live procedure done on the internet where about 30 thousand viewers watched the procedure. According to Dr. Bauman, who did the procedure, their hair is growing like “gangbusters”, a word Dr. Bauman used on Spencer Kobren’s radio show to describe the results of these transplants with NeoGraft. Dr. Ken Williams has also been on Spencer Kobren’s talk show and he had a NeoGraft hair transplant done himself, and his transplant is grown out and looks excellent. Anyone can watch this video. The doctors who are using the NeoGraft machine have given it excellent testimonials. They claim the NeoGraft machine is “an enormous breakthrough and it is changing the industry” and more importantly they state that many patients do not want “scars, staples” and want to get be able to get back to their activities as quickly as possible. Dr. Bauman says his patients “want this [NeoGraft] and love it.”

[hudson]

Dr. Feller,
Why do you think I wish to have a debate with you? My purpose is to address forums where misleading information was provided so that readers could get the information they need to make a more informed decision for their life about which procedure and which device they should consider. Also, what makes you think I am angry? I am disappointed that a forum like this allows doctors and others to write harsh negative comments based on conjecture and speculation and that there is no standard for what is considered responsible, honest reporting and appropriate, respectful conduct. This is what happened to NeoGraft. There was a great deal of hype and wild conjecture how NeoGraft works and the harm it would do with none of this based on facts, experience or any evidence. This was not scientific reporting.

It has been almost like a form of hysteria with so many posts written in so many forums that were based on this false conjecture and false information about the NeoGraft machine. What a waste of energy. Wildly erroneous statements appeared on many posts as factual truth and much of this false information was couched under concerns and welfare for the patient. Would it not have been more responsible to ask the NeoGraft Company how does the machine extract the grafts? What happens to the grafts when they go into the tube? The NeoGraft Company would have been happy to provide the necessary information asked for in order to help the NeoGraft critics understand the Neograft technology and how it works.

Dr. Feller, you came out with your own tool around the time NeoGraft came on the scene, and never has NeoGraft, nor any of their scientists, their researchers and developers, nor their engineers and other experts who work with NeoGraft and were involved in the design of NeoGraft ever offered an opinion of your device, because these persons had not had any experience with your device. They would never make any critical, false, erroneous and negative statements about your device based purely on conjecture and speculation. Why have doctors done that with the NeoGraft device, including yourself. I do know that the NeoGraft engineers tried oscillation with a tool they were testing but the engineers came out in favour of the NeoGraft system of less than two rotations. However, because these persons are responsible about what they claim, they would never think to offer an opinion based on speculation of how oscillation works with your device, unless they had worked with your device directly. They follow certain ethics and I believe these should be followed on every forum.

I do not really understand your last comment about my needing to “at least make an effort to get your facts straight.” It seems to me that the reason I am addressing your comments is because you did not have the facts straight about the NeoGraft machine. You made the wrong assumption that it is a “spinning device” and once you believed your assumption then you made more wrong assumptions going forward of all the negative harm a “spinning device” could do, implying wrongly that this is the way NeoGraft works. My purpose has been to correct this false assumption of NeoGraft being a “spinning device”, an assumption you made, never having worked with the Neograft machine, and not understanding the NeoGraft technology. As I have explained previously, NeoGraft, under the control of the doctor, rotates less than a manual FUE tool before going under the skin. It is not a “spinning device.” In the last two years NeoGraft has done countless live demonstrations as mentioned in my post above, which have been viewed by numerous doctors, including almost a hundred doctors at the ISHRS Live Surgery Workshop in Orlando in April 2010 . They will attest to the low transaction rate of the follicles, compared to other means of FUE extractions, and that the follicles harvested and implanted by NeoGraft are robust, moist, and of excellent quality.

[SpencerKobren]

[Jkel]

So how come there is no response from Hudson? Spencer calls the Neograft people out and they vanish into thin air???? Hudson is a shill and knows if he goes on Kobren’s show that he’ll have his ass handed to him. I have a question for Spencer. Spencer do you think that Neograft is really so great and is it worth the exorbitant cost to have a Neograft hair transplant ?

[SpencerKobren]

So how come there is no response from Hudson? Spencer calls the Neograft people out and they vanish into thin air???? Hudson is a shill and knows if he goes on Kobren’s show that he’ll have his ass handed to him. I have a question for Spencer. Spencer do you think that Neograft is really so great and is it worth the exorbitant cost to have a Neograft hair transplant ?

Hey Jkel,

To be completely candid, the only advantage that I see with any automated FUE extraction device, is the potential to expedite the extraction of FUE grafts. Being able to “safely” move more grafts in a single session would certainly be of benefit to both the patient and the surgical staff.

In my view, if these devices make the process less demanding for the hair transplant practice, then the cost of an FUE procedure should reflect this evolution. In other words, I would expect the price to eventually be closer to the cost per graft currently charged for traditional harvesting.

I’d like to point out that I personally think that using the NeoGraft for graft placement could prove to be a huge mistake that can potentially leave many NeoGraft hair transplant recipients with a less than aesthetically acceptable result. With that said, in the right hands, the Neograft has proven to be an effective FUE extraction tool.