Michael Vories, MD

This was his pre-op photos. His hair actually needed to be clipped much shorter to perform the extractions.

This is an excellent point. I have always disagreed with the "FUT first" concept. A follicular unit is a follicular unit, whether it was harvested by strip excision or FUE. One of the several advantages of FUE is that we can spread the extractions over the entire donor area, and so minimizing the impact on any one area. Also keep in mind that strip excision changes the scalp architecture, and harvesting grafts (especially below the donor scar) with FUE is made more difficult after strip excision. The only questionable benefit I can see to performing FUE after strip excision is the chance to try to cover up the strip scar with FUE grafts. However, the results of this is variable, and in many cases the strip scar does not have the vascularity to support the grafts. For this reason it is much better to avoid the FUT scar than to plan on covering it with FUE grafts.

The case was evenly split between 3000 grafts in the frontal forelock/hairline, and 3000 grafts in the midscalp and crown. Thanks for the comments!

This 38 year old patient came in for his 6 month follow up today after receiving a 6000 FUE grafts over a two consecutive day period. Very good hair caliber (approx. 85 microns) led to very good coverage, especially in the hard to cover crown area. A 0.85 mm surrounded punch was used to perform the extractions, and grafts were placed with Hans Lion Implanter Pens. All grafts extracted and placed by Dr. Vories.

This patient came in yesterday for his one year follow up after receiving 2000 FUE grafts in a one day session. He is stable on finasteride. Grafts were harvested with a 0.8 mm surrounded punch, and placed with Hans Lion Implanter pens. All grafts harvested and placed by Dr. Vories.

He easily has another 3000 grafts available, but it is not clear he will need it (as long as he continues finasteride). Thanks!

The tuft of hair in the front certainly looks previously grafted, but the procedure with us was his first and only round so far.

This gentleman came in today for his 5 month follow up after receiving 3000 FUE grafts in a one day procedure. His concern was for getting the most coverage he could for his budget. We placed 2000 grafts in his frontal forelock and hairline, and a modest 1000 grafts in his vertex. He is stable on both finasteride and minoxidil. He is happy so far with the results, with the expectation for modest improvement over the next 6 months. All grafts harvested and placed by Dr. Vories.

I believe the technology behind the ARTAS machine is fascinating, but the reason we have not moved forward with obtaining a machine is the punch size. The selling point of FUE is the lack of visible donor scarring, which is only true in our experience with punch sizes of 0.85 mm or less. My understanding is most ARTAS procedures are with punch sizes (internal diameter) of 0.9 or 1.0 mm. These are much more likely to leave punctate donor scarring which takes away from the power of FUE. Making patients pay more money for a procedure that is more likely to produce visible scarring seems counter-intuitive to me.

This patient came in yesterday for a one year follow up after receiving 2000 FUE grafts to restore his hairline and temporal points. He is stable on finasteride. All grafts harvested and placed by the physician.

This patient sent photos yesterday for his 6 month follow up after receiving 2500 FUE grafts into his frontal forelock and hairline. He is stable on finasteride. Most density is expected over the next few months but he seems happy with the results so far. We may want to consider temporal point advancement in a future procedure to enhance the cosmetic effect. All grafts were harvested and placed by Dr. Vories over a one day session.

This gentleman came in to our office yesterday for his six month follow up after receiving 2500 FUE grafts into his frontal forelock and hairline. We restricted grafting to this area to maximize the cosmetic impact of limited donor hair. He is considering further grafting into his vertex and midscalp, but currently is pleased with this early outcome. All grafts harvested and placed by Dr. Vories.

These are all good points. One of things we try to emphasize to all patients is proper expectations. The reality is that 3000 grafts is not that many when considering to reconstitute the area of this patient's hair loss. The patient is very happy with the results, although we did discuss thickening the part line and some of the vertex with a second procedure. We feel much more comfortable doing this with a second procedure, when we the capability of assessing the donor and making sure a second procedure is feasible. Thanks for the comments!

This gentleman came in today for his 12 month follow up after receiving 3000 FUE grafts, with focus on the frontal forelock, midscalp, and vertex. His hairline for the most part was spared with his advanced hair loss. His hair loss has been stable for the past 8 years without finasteride. All grafts were harvested and placed by Dr. Vories.

This interesting case came in today for his 6 month follow up after receiving 1200 FUE grafts into his central frontal forelock and hairline. His scalp biopsy was consistent with male pattern hair loss (AGA), and he was stabilized on finasteride for 6 months before surgery. Targeted grafting was performed in the area of greatest loss in the central forelock and hairline. All grafts harvested and placed by Dr. Vories.

This patient came in today for his six month follow up after receiving 2500 FUE grafts into his frontal forelock in a one day procedure. He is stable on finasteride. All grafts were harvested and placed by Dr. Vories.

This patient came to our office yesterday for a 6 month post-op visit after receiving 3000 FUE grafts in a one day session. 1000 grafts were used in the vertex for a "dusting" of the vertex and midscalp, and 2000 grafts were used to recreate the frontal forelock and hairline. The patient's goal was to keep away from the comb over in his frontal area, and this was achieved with a relatively small number of grafts. His hair loss has been stable for a number of years without finasteride. All grafts were harvested and placed by Dr. Vories.

In our clinic, we have begun taking a high resolution photo of the dishes the grafts are in, separated by groups of 100. We provide this photo to the patient so if they desire, they can count the grafts anytime after the procedure to make sure the count is accurate. Just a thought.

This patient came in today for his one year follow up after receiving 1500 FUE grafts to tighten up his hairline. Microscopic scalp analysis shows 98% graft survival. He is stable on finasteride. All grafts harvested and placed by Dr. Vories.

Here is a hairline photo that I should have included in the initial post. Thanks for the comments!

This gentleman came into today for his 6 month follow up after receiving 4000 FUE grafts over a two consecutive day session. He is stable on finasteride. 2000 grafts were focused on the vertex and midscalp on the first day, and 2000 grafts were placed in the frontal forelock and hairline on the second day. All grafts were harvested and placed by Dr. Vories.

I do not agree with Dr. Feller on many of his posts, but he is absolutely correct here. Extracting previously placed grafts with FUE is difficult because of unpredictable angle changes, with no guarantee of getting all of them intact. The idea of using a slightly larger punch increases the chance of intact extraction, but also increases the chance of scarring. This is a tough situation for both the patient and physician.

This patient came in today for his 6 month follow up. He received 1500 FUE grafts, placed primarily in his bilateral apex areas. His goal was to fill in his apex areas and to flatten out his hairline. He is stable on finasteride. All grafts harvested and placed by Dr. Vories.

Over half of our patients with previous strip excision surgery ask to place grafts into the strip scar. We have had modest success with this, but it is best to test the strip scar with about 100 or so grafts before using more hair (and more money) to concealing a scar that may or may not work. All scars are different, some with excellent blood supply, some with poor blood supply. Best to test it first. Hope this helps!

This patient came in today for his one year follow up after receiving 3000 FUE grafts in a long one day session. His concerns were addressed with limited grafting of 1000 grafts in his vertex, and the remaining 2000 grafts in the frontal forelock/hairline. He is stable on finasteride. All grafts extracted and placed by Dr. Vories. His full face was used with the patient's permission.