Limmers thoughts on Woods Technique

[Jonny]

This was a post by Dr. Limmer that was posted on the "Dr. Parsley, what was it like performing Hair Transplants in the 70's" thread. It was completely off topic, not sure why Woods even came up. So I thought I would take Pat's que and move it to it's own heading (no deletion is necessary!!). It was a long post, but the entire second half of the post was dedicated to his thoughts of the Woods technique. Seemed like it was getting lost in that thread, so here it is again (notice it says a "brief comment"):

 

_________________________________________________

 

Finally, one brief comment regarding the work of Dr. Woods and Campbell in Australia. I have spoken with Dr. Woods on a number of occasions when he was first starting his "top up" procedure some years ago. I have reservations about it from a scientific standpoint, not the cosmetic standpoint. The technique is basically the punch hair transplant technique first introduced by Okuda in the late 1930's and resurrected by Norman Orentreich in 1958. The difference in Woods technique is that it utilizes a very small punch. The basic claims are 1) that it produces a natural result; 2) it leaves no donor scar. Certainly the first of these would be reasonably accurate since a 1 mm punch would encompass approximately a single follicular unit or a part of a single follicular unit, much of the time only a part of a unit since there is such a high percentage of follicular transection using such a small punch. The second claim that it leaves no donor scar is certainly not correct. Any surgery leaves a scar. What will come of multiple grafts harvested from the donor area with a 1 mm punch will be a very diffuse thinning of the donor area of multiple small, 1 mm or less hypopigmented scars. No surgery can be done without a scar. The universal concern with utilizing multiple small punch donors is that the donor area runs the risk of depletion with a less than optimal survival of grafts placed. What is needed and should certainly be the responsibility of any ethical physician or scientist is survival data on the number of hair removed and the survival of those hair transplanted. This data is available for all other methods in hair transplantation today and should be provided before any method is advertised as an acceptable option in the field. This data has not been available or forthcoming from Drs. Wood or Campbell. From the standpoint of experienced surgeons in the hair transplant field, the concensus is that small punches transect a very substantial percentage of the hair follicles removed by such method. Having done thousands of punch methods utilizing punches from 0.7 to 5 mm in diameter it has been my experience that the smaller the punch gets the higher the percentage of transection of the hair present. The scientific data available shows that transected follicles survive at a lower percentage and produce a smaller hair shaft if they do survive. Every ethical physician on the face of the earth including those in hair restoration surgery are interested in the well being of their patient. Until scientific data is available, none of us would place the well being of our patient at risk. While there is no ethics grading card for hair restoration surgeons, I can honestly say that I have met many highly ethical physicians within the field. This field has evolved from something that was always detectable to something that today is almost uniformly undetectable in the degree of its naturalness. The current ongoing bashing is simply not justified and unfortunately revolves more around the marketing than around the science and the art of the field today. The unfortunate aspect is that the patient is in the least educated and experienced position to pass judgement. My only recommendation would be to do your homework well and to speak with multiple patients who have previously utilized the physician you wish to consider.

[Jonny]

This was a post by Dr. Limmer that was posted on the "Dr. Parsley, what was it like performing Hair Transplants in the 70's" thread. It was completely off topic, not sure why Woods even came up. So I thought I would take Pat's que and move it to it's own heading (no deletion is necessary!!). It was a long post, but the entire second half of the post was dedicated to his thoughts of the Woods technique. Seemed like it was getting lost in that thread, so here it is again (notice it says a "brief comment"):

 

_________________________________________________

 

Finally, one brief comment regarding the work of Dr. Woods and Campbell in Australia. I have spoken with Dr. Woods on a number of occasions when he was first starting his "top up" procedure some years ago. I have reservations about it from a scientific standpoint, not the cosmetic standpoint. The technique is basically the punch hair transplant technique first introduced by Okuda in the late 1930's and resurrected by Norman Orentreich in 1958. The difference in Woods technique is that it utilizes a very small punch. The basic claims are 1) that it produces a natural result; 2) it leaves no donor scar. Certainly the first of these would be reasonably accurate since a 1 mm punch would encompass approximately a single follicular unit or a part of a single follicular unit, much of the time only a part of a unit since there is such a high percentage of follicular transection using such a small punch. The second claim that it leaves no donor scar is certainly not correct. Any surgery leaves a scar. What will come of multiple grafts harvested from the donor area with a 1 mm punch will be a very diffuse thinning of the donor area of multiple small, 1 mm or less hypopigmented scars. No surgery can be done without a scar. The universal concern with utilizing multiple small punch donors is that the donor area runs the risk of depletion with a less than optimal survival of grafts placed. What is needed and should certainly be the responsibility of any ethical physician or scientist is survival data on the number of hair removed and the survival of those hair transplanted. This data is available for all other methods in hair transplantation today and should be provided before any method is advertised as an acceptable option in the field. This data has not been available or forthcoming from Drs. Wood or Campbell. From the standpoint of experienced surgeons in the hair transplant field, the concensus is that small punches transect a very substantial percentage of the hair follicles removed by such method. Having done thousands of punch methods utilizing punches from 0.7 to 5 mm in diameter it has been my experience that the smaller the punch gets the higher the percentage of transection of the hair present. The scientific data available shows that transected follicles survive at a lower percentage and produce a smaller hair shaft if they do survive. Every ethical physician on the face of the earth including those in hair restoration surgery are interested in the well being of their patient. Until scientific data is available, none of us would place the well being of our patient at risk. While there is no ethics grading card for hair restoration surgeons, I can honestly say that I have met many highly ethical physicians within the field. This field has evolved from something that was always detectable to something that today is almost uniformly undetectable in the degree of its naturalness. The current ongoing bashing is simply not justified and unfortunately revolves more around the marketing than around the science and the art of the field today. The unfortunate aspect is that the patient is in the least educated and experienced position to pass judgement. My only recommendation would be to do your homework well and to speak with multiple patients who have previously utilized the physician you wish to consider.

[Guest]

Jonny,

It looks like you are just trying to give Pat a good reason to move your posts, so you can say "see, I told you so".

[arfy]

Dr. Limmer said Woods' technique is "basically the punch hair transplant technique first introduced by Okuda in the late 1930's and resurrected by Norman Orentreich in 1958. The difference in Woods technique is that it utilizes a very small punch."

 

From what I understand, this is not true, Woods does not use a punch. Why do these critics say there are too many "unknowns" about Woods' technique, then turn around and try to explain it to us?

 

I agree with Dr. Limmer when he says "My only recommendation would be to do your homework well and to speak with multiple patients who have previously utilized the physician you wish to consider."

 

Well, that wouldn't be my ONLY recommendation, but it's a start...

[Guest]

I'm still trying to figure out if Dr. Woods does not use a punch, then what does he use? This isn't an argument, I would really like to know.