Michael Vories, MD Office Photo Tour

[Michael Vories, MD]

Submitted is a photo tour of my clinic in Charleston, South Carollna. We perform one FUE surgery per day.

 

First, my staff- which is myself and my surgical technician, Vickie Lesesnse. (I have a second surgical technician- Kathleen Hegarty, in our Charlotte office). Between the two of us we can transplant up to 3000 FUE grafts in one day. Procedures larger than this require two subsequent days. Mike Frame, my clinic manager, took the photos.

 

This case is a 1500 graft FUE case on a 60 year old make with stable hair loss, with grafts weighted towards the vertex. We set up extractions with Vickie on my left side. We use the NeoGraft machine for extractions, for reasons I will supply in a separate thread. I perform all extractions. In this case, since there is a lot of gray hair, we first dye the hair to prevent color bias.

 

Extractions are performed with a 0.9 mm punch. This is a large punch for us, but for salt and pepper hair we get fewer transections than with the 0.8 mm punch we normally use.

 

Grafts are collated by Vickie, and placed in numbered wet petri dishes once they are lined

up for placement.

 

We extract at a typical rate of 600 to 700 grafts per hour, and extraction for this case began at 9 AM, and ended at 11 AM.

 

After a short break, we began placing at 11:30 AM. For placing I move Vickie to my right, since I am right handed. She loads the graft into the Hans implanter, and I use a stick and place motion to place the grafts. We do not use pre-made incision sites, and I place all of my grafts once I have mapped out my grafting area.

 

One of the problems with stick and place is the potential for painting yourself in a corner, so during the placement of the grafts I am constantly assessing where I am and how many grafts I have left.

 

We place about the same speed as we extract, so 300 grafts were placed before a short lunch, and the remaining 1200 grafts were placed between 1 and 3 PM, with the patient discharged at 3 PM. Most cases for us are in the 2000-3000 graft range, so this was a welcome short day.

Edited April 12, 2013 by Vories

[Bill - Seemiller]

Dr. Vories,

 

Thanks for presenting a surgical walkthrough at your clinic. I'm also interested to read your comments about your experience with the NeoGraft and your opinion on the benefits and limitations of the device.

 

If I'm correct, the patient in the above photos received a total of 1500 grafts? Given the large balding area, I'm curious why you and/or he didn't decide on a larger session? Frankly with a scalp this bald (as it appears in the photos anyway), I'd think he'd need 5000 to 6000 plus grafts (most likely over multiple procedures or at least days) to achieve any kind of real fullness on top of his entire scalp. What are your thoughts on this?

 

Thanks,

 

Bill

[Blake Bloxham]

Dr. Vories,

 

Thank you for sharing! Altogether, it looks like you run a dedicated, efficient FUE clinic. I look forward to reading the answers to Bill's (above) questions.

[Michael Vories, MD]

These are good points. This was this patient's second procedure with us, the first being a 1500 graft FUT procedure 5 years ago. He was very pleased with the coverage (I can post before/afters tomorrow when I am back in the office) of his first procedure, and just wanted more coverage in his vertex. As I am sure most on this site already know, salt and pepper hair goes a lot further with coverage, so with a total graft count of 3000 grafts he should be pleased with the outcome.

[Michael Vories, MD]

Here are the before/after photos from the original 1500 graft FUT procedure we performed on this patient in 2007.

Edited April 12, 2013 by Vories