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Posts posted by James A. Harris, MD, FACS
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The SAFE System (Surgically Advanced Follicular Extraction) is a blunt punch dissection system that I started to develop in 2002. It has gone through many improvements though the years, including the powered version currently in use. The platform is a blunt (non-sharp) dissection tip that allows physicians to dissect to depths of 4mm, a depth which can’t be duplicated with sharp punch systems (Cole’s devices, SmartGraft, Neograft, Alphagraft, etc.). The importance of this is that a deeper graft dissection depth means a more complete separation of the graft from the skin and therefore less force and trauma are required to remove the graft. There is also the likelihood that there is more tissue around the graft that will protect it against dehydration and implantation/handling effects.
The blunt, non-sharp tip can make contact with the follicles during the procedure but instead of cutting through them, will guide the follicles into the lumen of the punch. Several years ago I noted that the use of a small amount of skin vibration can enhance the dissection process and lower follicle transection rates. This led to the development of a new design call the “Hex” which has a hexagonal cross section which results in skin vibration and improves the dissection process as compared to the standard cylindrical punch design. The Hex and standard cylindrical punch pictures are attached.
My studies examining follicle transection rates indicate that for a .9mm cylindrical SAFE System punch the rate is 5% while the use of the .9mm Hex results in a follicle transection rate of 2.8%. Both studies utilized hundreds of patients. I just held an ISHRS Regional workshop where 8 doctors with a variable amount of FUE experience had a chance to try 5 different FUE devices. The transection rates for the sharp punch systems ranged from 27-32% whereas the SAFE System had a 14% transection rate for these physicians. This illustrates the greater margin of safety for the blunt punch system. These rates would decrease as the physician gains experience.
The actual configuration of the dissecting surface of the punch is a flat surface which is slightly smoothed with electropolishing. This enhances follicle safety when the operator is slightly off angle or direction when performing the dissection.
There are doctors and manufactures starting to copy the flat, blunt punches but this system has been in constant development and improvement since 2002 and have achieved great clinical success in thousands of patients.
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I'm sorry, I don't routinely take photos of the donor and recipient areas immediately post-op unless I need them for teaching purposes.
J Harris
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Thank you! The patient was very pleased with the results in the transplanted area as well as the fact he can wear his hair short with no visible scarring at that length.
J Harris
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A 36 year male patient who had 3 strip procedures with approximately 2000 grafts placed in to the frontal and mid-scalp regions at another clinic. Patient is unhappy with the density of the frontal region and the wide donor area scars making it impossible to wear his hair short.
He had SAFE System FUE with approximately 500 graft placed into the frontal region and 1100 grafts placed into the scar over two procedures.
He is now happy with the density of the frontal region, the camouflage of the scar, and the ability to wear his hair short.
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The patient was late coming back for a follow-up...this was 2 years out.
J Harris
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Thank you...she is very happy!
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Thank you Pete-from-Farjo.
I appreciate everyone's comments.
J Harris
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I am using the ARTAS in selected cases (central forelock or mid-scalp) and only for some of the recipient sites. On the case yesterday I used it for about 800 of the sites. I think the ARTAS has some strengths when it comes to recipient site creation (ability to create sites in between existing hairs) but I also think that at this point the surgeon still has to put the finishing touches on the overall design.
J Harris
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Hi David:
I don't normally take pictures of the donor extraction zone, photos of the implantation, or freshly implanted sites. So today I took photos of my ARTAS patient today who received 1400 grafts in the frontal region and will receive an additional 200 grafts tomorrow in that area as well as an additional 800-1000 grafts to the mid-scalp region.
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Thank you...the patient is very happy!
J Harris
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It's never a good sign if you can't tell the difference between "before" and "after" photos!! Fortunately the patient was very happy when he was seen 10 months after the procedure. The grafts were all in the fronto-temporal triangle areas and the forelock.
I'm attaching before and after photos identified as such. I've also included markings on the areas transplanted.
J Harris
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FUT 3466 grafts by James A. Harris, MD
in Results Posted by Leading Hair Restoration Clinics
Posted
60 year old patient with a Norwood IV chose to have James A. Harris, MD to perform FUT harvest.
Patient received 3466 grafts with outstanding results.
Happy Patient!!