FUE with NeoGraft 12 Days Ago...

[SymbolicHair]

I've researched the HT process for 5+ years when I started thinning and put it off numerous times. I'm not a fan of the 'strip and harvest' method and I like the idea of a precision of the neograft process and tool.

 

I've spoken with 6 of Dr. Fitzpatrick's patients and all raved about the process and 4 of them had used the other method previously and chose to go the Neograft route for a second time.

 

Michael

[Blake Bloxham]

Thank you, Bill, they've been great reads!

 

I'm curious about the Hans Implanter as described in Dr. Vories' link from the Neograft page. Is the Hans Implanter the implanter used on the Neograft in the Neograft video in Mickey85's FUE thread? Does the Neograft video show "Stick and Place" with the Hans Implanter?

 

Nathaniel,

 

The Hans Implanter is a separate device that is not technically related to the NeoGraft. The NeoGraft head features a mechanism for graft placement as well. I believe it's able to suck the extracted grafts back up via a vacuum mechanism, and then release them into pre-made incisions in the donor scalp. However, some who use the NeoGraft don't like this feature, so they chose to use different placement methods - like the Hans Implanter.

 

 

Also, speaking of "Stick and Place," I wonder if you could clarify/expound on what you wrote below at this link: What is the “Stick and Place” Technique in a Hair Transplant | Hair Loss Q & A

 

I believe that the stick and place technique can yield excellent results when performed by well trained and supervised medical technicians. However, I found both the incisions made by the 19 gauge needles and the grafts to be a bit larger than what I typically see at leading hair restoration clinics who have fully implemented ultra refined follicular unit grafting.

 

 

How big is a 19 gauge needle??? And how much bigger are the grafts? And what does "fully implemented ultra refined follicular unit grafting" mean? It sounds like you are describing a technique or method. Is the "Coalition of Independent Hair Restoration Physicians" using a completely different technique - an ascribed method - from Recommended Doctors on the Hair Restoration Network? Or have they just demonstrated a higher level of innate artistry and mastery of skill?

 

Thanks again for this forum!

 

The gauge of the needle has nothing to do with the size of the grafts. The grafts are extracted with manual or motorized punches ranging from (approximately) 0.75 mm to 1.0 mm. Needles, like the ones Bill described above, are used to make the recipient sites (where the grafts are placed).

 

A 19 gauge needle would probably make a (roughly) 1.1 - 1.2 mm site in the recipient scalp. Many think this is too large, even for the 3-4 hair follicular unit grafts - which are normally 1.0 mm in diameter.

 

Ultra refined follicular unit grafting is essentially referring to quality modern hair transplant surgery. It's not really a method or technique in and of itself, but more a way of describing an efficient practice of the current gold standard (Follicular Unit Hair Transplantation). Follicular Unit Hair Transplantation (FUT) can be performed two different ways: via Follicular Unit Strip Surgery (FUSS) - where a strip of hair is removed from the back of the scalp and dissected into follicular units under microscopic dissection before graft placement; and Follicular Unit Extraction (FUE). The Coalition and recommended physicians both perform FUT, and most practice both methods of FUT - FUSS and FUE. Like you said Coalition status demonstrates "a higher level of artistry and skill." However, I still believe that both our recommended and Coalition physicians are excellent, and enthusiastically endorse physicians from both categories!

 

Altogether, I feel like you still have some serious questions. Because of this, I encourage you to keep asking. I personally think it is important to possess a good understanding of the procedure before actually undergoing surgery.

 

Look forward to your reply.

[nathaniel]

Thank you, Blake, for clarification between the Neograft implanting tool and the Hans Implanter used by Dr. Vories. However, I must say, based on what you have written, TygerD's experience, and another link here on the HRN by hair70 I've just found, my confidence in Dr. Vories and/or the Neograft machine is waning fast (which is unfortunate as I live not too far away in Georgia and was considering options within driving distance).

 

You state:

 

A 19 gauge needle would probably make a (roughly) 1.1 - 1.2 mm site in the recipient scalp. Many think this is too large, even for the 3-4 hair follicular unit grafts - which are normally 1.0 mm in diameter.

 

Why would Dr. Vories use a device which makes such large incision sites that many in the medical field consider to be too large? Did you ask him this as part of his "recommended status" vetting process? If so, what was his reasoning?

 

PupDaddy writes in a thread by "Welcome" (http://www.hairrestorationnetwork.com/eve/170349-dr-vs-nurse-placing-grafts-after-extraction-2.html)

 

Make sure that your chosen clinic does not use implanter pens, such as the Hans Implanter Pen or the Choi Implanter Pen. Why? Because if, as your surgeon advised, the tech or nurse is doing the "placement" of the grafts in the recipient sites, and the clinic uses implanter pens for FUE, then the nurse or tech is also necessarily creating the recipient sites -- because that is how these implanter pens work: the recipient hole is made with the implanter pen, which is loaded up with previously extracted grafts, and a graft is placed from the pen simultaneously with the cutting of the recipient hole. You will want to confirm that the clinic does not use implanter pens for FUE and that your surgeon will be creating/making all the recipient sites.

 

I personally think that the transplant physician should at least place all of the frontal hairline grafts (as Dr. Konior and some other top docs do), but as others have said, it is not uncommon or unusual for reputable clinics to have their techs or nurses do all the graft placements.

 

How can a surgeon/tech "select" the appropriate graft for a recipient site if a bunch of grafts are randomly "loaded up" in the pen?!? Now it seems clear to me why the pen makes such large incisions - because it's a "one size fits all" plug (what other reason can there be?).

 

I am particularly bothered that the initial discussion between Dr. Vories and Tyger was locked - I mean, I understand that Bill felt that nothing more could be gained by letting that discussion continue in the open forum, but I quite disagree. The issues here are 1) technique(s) used for harvesting; 2) technique(s) used for implanting; 3) qualifications of the person(s) doing the procedure(s); 4) Full disclosure of all the aforementioned well in advance of the procedure by the supervising physician to the patient. As a potential hair transplant patient, I want to understand why the Neograft procedures undergone by TygerD and hair70 - at two separate clinics at opposite ends of the country - had similarly very poor patient outcomes. And I do mean similarly - weird angles, large graft sizes, large gaps/poor density, a lack of singles in the hair line - and this despite the fact that Dr. Vories is supposed to be a "hair transplant specialist" unlike North Valley Plastic Surgery in Arizona. Specialist or not, it really seems like Neograft is running the whole show and, worse, they aren't in any way qualified to do so. Is this why Dr. Vories is now doing the implanting of hair solely by himself now? Did he realize too late that Neograft was sending him totally unqualified technicians?

 

Many people in TygerD's thread asked questions to which I would like to hear answers - questions about technique, not about "graft survival" (which Dr. Vories keeps focusing on). I mean, I get that sometimes in medical treatments things "don't go right" or "don't go as planned"; however, if the fundamental approach/technique is not appropriately planned from the beginning, how can the outcome be even remotely satisfactory?

 

Ignoring "graft survival" (or lack thereof), let's focus on the initial technique(s) that are most likely to lead to optimal outcomes. Below are questions/comments that were asked/made by more than one person in TygerD's thread regarding density, angles, graft sizes, lack of singles in the hairline, etc.

 

(http://www.hairrestorationnetwork.com/eve/170309-should-i-have-wait-year-receive-my-refund-5.html)

 

Tom Cruise writes:

 

What is going on with that graft placement? It doesn't look right. Doesn't look right at all.

 

GNX1 writes:

 

sorry to hear bro. thats some of the worst FUE work ive seen in quite some time. I wud just define that as early plug work.

 

I would not go back there if THEY were paying me!

 

hairthere writes:

 

What I don't understand is how a good result could have been expected after viewing the patient immediate post-op. The graft placement looks extremely poor in terms of the density, angles, and design. What exact density were those grafts placed at?

 

doesnt even look like there are any singles up front.

 

And as for North Valley Plastic Surgery in Arizona, Spanker states in hair70's thread about hair70's experience with NeoGraft (http://www.hairrestorationnetwork.com/eve/167928-fue-transplant-care-neograft.html):

 

Man, I have seen worse, but that looks pretty bad. Not something you are going to be thrilled about in the end. Low density and it looks like pretty large grafts. Some big gaps.

 

And hair70's pictures, like TygerD's, look AWFUL!!! And hair70's writes how similar his experience was to TygerD's:

 

You are absolutely correct about NEOGRAFT machine and its intended purposes.

 

They are putting these machines in the hands of technicians to perform hair transplant procedures who undergo some sort of training and mentoring program before they are on their own.

 

One could argue the technician has more experience than the plastic surgeon or office doc who wants to provide this service in his practice also.

 

This is still surgery in my opinion and technicians should not be allowed to perform surgery. . .especially unsupervised in my case.

 

During my procedure, even the nurse? took the machine and practiced on me while the solo techician was counting. . .soo unprofessional!

 

When scheduling, they had to call some sort of central dispatcher to find a technician that was available for my surgery date. First it was one person scheduled who I tried to research and then she had family issues last minute soo they sent someone else. . .

 

Doesn't sound promising huh? I was stupid and impatient and should've done more research especially on THIS FORUM.

 

My procedure was over 8 months ago at NVPS in AZ.

 

8 month result attached. . . .less than 100 hairs out of a supposed 1000 FUE implants and most pointing at un natural angles to my hairline. . .it is worst then being bald in recipient area. . .I hoped no more hairs showed up actually!

 

I am sure the transplant gurus will refine extraction techniques in the future whether automated or not but it is going to be almost impossible to teach the artistry of natural hairline creation depending on age, race, facial characteristics, etc, etc. . .

 

Some people are just naturally going to be better than others.

 

For those of you who are looking to get a transplant procedure. . .take it from me after loosing thousands of dollars and even more in sleep, frustration, anxiety, etc, etc. . .don't go to an office that does FUE "on the side" like North Valley Plastic Surgery in AZ who calls a NEOGRAFT dispatch center to send out a "trained" technician to do your transplant.

 

That may work well for getting your car towed when it breaks down but not for your hair surgery!

 

 

 

I also have read your comments, Blake, expressing your own thoughts, opinions, and concerns in these threads - and they are good comments. But I would like to hear more from the doctors who were responsible for performing/supervising these hair transplants. What technique(s)/method(s) did they use and why? And also I would like to hear from Neograft representatives themselves - what is their public response to the concerns expressed repeatedly in various threads on HRN, particularly with regards to charges of "aggressive marketing" and "unqualified techs" performing aspects of hair transplanting for which they are not qualified. I mean, even in the Neograft video when the hairs are being implanted, there seems to be NO CONSIDERATION AT ALL to angle, depth, or graft size while implanting - it literally looks like "shoot and plug" - at least that's what it looks like to me, but admittedly I do not work in the medical field, which is why Neograft needs to explain clearly the technique for implanting hairs demonstrated in that video. Otherwise, man oh man.....based on what I've seen and read, I will not be considering clinics using Neograft for my hair restoration needs!

 

Just to be clear: I do not work in the medical field, for a competing hair clinic, marketing firm or anything to do with hair transplants. I know my post is very long - but I've been reading other members' threads for sometime now, first as an unregistered "guest" and now as a registered member so that I could finally post specific questions about things that remain unclear to me.

 

And I like your comments and posts, Blake, and certainly don't want to seem like I'm coming at you!

 

But you were the last person to respond to my queries, and I was that annoying kid in high school who always asked way too many questions, and now I'm here!

 

As always, thanks for providing this forum!

Edited June 25, 2013 by nathaniel

[Shampoo]

I had a transplant done by Neograft. Perhaps only 40% of over 1100 grafts grew.

Most of my grafts were DOA because they were transected and didn't survive the neograft extraction.

 

Wow!

 

That is pretty pathetic.

[Dr. William Lindsey]

To clarify, I primarily use Feller 0.9-1.1mm hand punches. Occasionally I use the Feller motorized punch. And I have another punch that I use on really curly hairs that is 1.1mm but seems to work in my hands a little better on curly hairs(black and middle easterners with really curly hair that I'm having trouble with my standard punches).

 

Next, I still firmly believe that strip is more reliable, cheaper, way easier on Dr and patient, and results in less(correct less) total scarring that FUE. Unless a person is planning on a crew cut, I strongly recommend strip.

 

Every week nowadays, and yesterday was a fine example, I see a patient who presents for repair of automated FUE. Yesterday's guy was typical of this new breed of patient. He saw a flyer or ad for an automated FUE marketed by a general plastic surgeon or facial plastic surgeon office, went to them thinking that they do hair routinely, and then find that after meeting with the plastic surgeon for a few minutes on the day of surgery, that some "non-employee technicians" (I'm quoting the patient) do their case. Now 10-12 months later they have done some online research on various forums and realize they may have made a mistake. Often times, and I brought yesterdays consulting patient in to the procedure room to meet our patient on whom we were working yesterday(for comparison), the consulting patient has what appears to be 300-500 grafts scattered along the hairline. Surrounding these grafts are lots of miniturized hairs that almost certainly will go soon, and the donor area has what appears to be 1000 or so 1.5mm punch scars.

 

Now I obviously wasn't there for the consulting patient's procedure, and I'm only getting one side of the story...but I hear it every week. Certainly there must be success stories out there, but they don't present for revision...It would be nice if a few posted so forum members could hear their experience.

 

Bottom line: 1. FUE is hard 2. Hair requires planning for the future and avoiding the pitfalls of scarring, too little hair over too much bald head, and errors in hairline placement. 3. Do your research before signing up for surgery. An educated consumer USUALLY makes a better choice. This doesn't guarantee happiness, but does often limit mistakes.

 

I only tune into this thread periodically. There are alot of topics getting thrown around on it. I will check in periodically to see if the original poster would post updates.

 

Dr. Lindsey McLean VA

[nathaniel]

Thank you for your input, Dr. Lindsey!

[nathaniel]

OMG, Dr. Lindsey! That FUE Revision patient on your HRN profile looked horrible before you assisted him!

 

Hair Restoration Social Network - Hair Loss and Transplant Photos

 

At what point does such butchery constitute medical malpractice or legal action?? If I was that guy I'd be suing like He11 the clinic that did that to me!!!

 

I can't understand how a plastic surgery clinic or other doctor would allow such horrific work to be performed in their office!! Are the doctors being duped by these automated FUE companies as much as the patients???

[Blake Bloxham]

Nathaniel,

 

I will address the questions you asked on the previous page later this evening.

[nathaniel]

Thanks, Blake! I look forward to it!

[nathaniel]

Dr. Lindsey, Blake writes about the 19 gauge needle in the Hans Implanter Pen:

 

A 19 gauge needle would probably make a (roughly) 1.1 - 1.2 mm site in the recipient scalp. Many think this is too large, even for the 3-4 hair follicular unit grafts - which are normally 1.0 mm in diameter.

 

This statement is bothersome to me.

 

I'm curious to know what is the size(s) of the needle(s)/blade(s) you use at the recipient site? I'm still a little confused on the "Coalition doctors" who use "smaller blades" at the recipient site - it almost seems like that is a requirement for Coalition status. In your opinion, is it possible to achieve "Coalition" status with a 19 gauge needle? Are there any doctors out there who have achieved "Coalition" status with a 19 gauge needle? And would 1.1 - 1.2 mm cuts along the front of the hairline yield "natural" and unnoticeable results?

 

Thank you, Dr. Lindsey, for your participation in these forums.

[nathaniel]

Every week nowadays, and yesterday was a fine example, I see a patient who presents for repair of automated FUE.

 

For clarification, Dr. Lindsey, there are only two automated FUE machines currently in use in the hair transplant field, Neograft and ARTAS, correct? Are these new breed of patients former Neograft or ARTAS patients? Or a combination of both, and if so, what percentage?

 

Yesterday's guy was typical of this new breed of patient. He saw a flyer or ad for an automated FUE marketed by a general plastic surgeon or facial plastic surgeon office, went to them thinking that they do hair routinely, and then find that after meeting with the plastic surgeon for a few minutes on the day of surgery, that some "non-employee technicians" (I'm quoting the patient) do their case...Often times, and I brought yesterdays consulting patient in to the procedure room to meet our patient on whom we were working yesterday(for comparison), the consulting patient has what appears to be 300-500 grafts scattered along the hairline. Surrounding these grafts are lots of miniturized hairs that almost certainly will go soon, and the donor area has what appears to be 1000 or so 1.5mm punch scars.

 

So you're saying that out of 1000 or so FUE automated punches, only 300-500 survived intact enough to make it into the hairline? Are the miniaturized hairs also implanted hairs, or are they native hairs; and why will the almost certainly go soon?

 

Thank you, Dr. Lindsey!

[greatjob]

I'm curious to know what is the size(s) of the needle(s)/blade(s) you use at the recipient site? I'm still a little confused on the "Coalition doctors" who use "smaller blades" at the recipient site - it almost seems like that is a requirement for Coalition status. In your opinion, is it possible to achieve "Coalition" status with a 19 gauge needle? Are there any doctors out there who have achieved "Coalition" status with a 19 gauge needle? And would 1.1 - 1.2 mm cuts along the front of the hairline yield "natural" and unnoticeable results?

 

 

I'm not Dr. Lindsey but the size of the blades for the recipient site is going to depend on the patients hair characteristics. I could see the potential need for blades of 1.1-1.2 mm for some patients' multi-fu grafts but I really can't see the need for blades that size for one hair grafts at the hairline.

[Blake Bloxham]

Thank you, Blake, for clarification between the Neograft implanting tool and the Hans Implanter used by Dr. Vories. However, I must say, based on what you have written, TygerD's experience, and another link here on the HRN by hair70 I've just found, my confidence in Dr. Vories and/or the Neograft machine is waning fast (which is unfortunate as I live not too far away in Georgia and was considering options within driving distance).

 

You state:

 

A 19 gauge needle would probably make a (roughly) 1.1 - 1.2 mm site in the recipient scalp. Many think this is too large, even for the 3-4 hair follicular unit grafts - which are normally 1.0 mm in diameter.

 

 

Why would Dr. Vories use a device which makes such large incision sites that many in the medical field consider to be too large? Did you ask him this as part of his "recommended status" vetting process? If so, what was his reasoning?

 

Just to clarify, the largest guage on the Choi/Lion is actually 18, not 19 (I apologize for saying this incorrectly before). Additionally, keep in mind that this gauge is used for the largest follicular unit grafts (3-4 hairs) only. The device itself comes with a variety of different guage (size) needles that are customized for different size grafts (i.e. higher gauge/smaller diameter for 1 hair follicular units compared to a 3-4, etc). 1.1 mm holes are not made for each incision/graft placement.

 

And yes, we thoroughly discussed his use of the Lion implanter before being approved for recommendation. Keep in mind that he's not the only recommended physician to use an implanter device (Dr. Lorenzo - the co-inventor of the Lion Implanter - uses a Hans Lion and Dr. Doganay uses a Choi Implanter).

 

PupDaddy writes in a thread by "Welcome" (http://www.hairrestorationnetwork.com/eve/170349-dr-vs-nurse-placing-grafts-after-extraction-2.html)

 

Make sure that your chosen clinic does not use implanter pens, such as the Hans Implanter Pen or the Choi Implanter Pen. Why? Because if, as your surgeon advised, the tech or nurse is doing the "placement" of the grafts in the recipient sites, and the clinic uses implanter pens for FUE, then the nurse or tech is also necessarily creating the recipient sites -- because that is how these implanter pens work: the recipient hole is made with the implanter pen, which is loaded up with previously extracted grafts, and a graft is placed from the pen simultaneously with the cutting of the recipient hole. You will want to confirm that the clinic does not use implanter pens for FUE and that your surgeon will be creating/making all the recipient sites.

 

I personally think that the transplant physician should at least place all of the frontal hairline grafts (as Dr. Konior and some other top docs do), but as others have said, it is not uncommon or unusual for reputable clinics to have their techs or nurses do all the graft placements.

 

 

How can a surgeon/tech "select" the appropriate graft for a recipient site if a bunch of grafts are randomly "loaded up" in the pen?!? Now it seems clear to me why the pen makes such large incisions - because it's a "one size fits all" plug (what other reason can there be?).

 

It is not a "one size fits all" device. It comes with a variety of different sized needles for different sized grafts. What's more, the graft selection process is where the surgeon would select specific grafts based upon needs. He/she would then load one graft at a time into an appropriate sized needle and implant it in the scalp. Small needles with single hair grafts would be used in the hairline; slightly larger needles with 2-3 hair grafts (FUGs) would be used in the frontal/mid scalp; and the large (for lack of a better term) needles with 3-4 hair FUGs would be used where appropriate.

 

I am particularly bothered that the initial discussion between Dr. Vories and Tyger was locked - I mean, I understand that Bill felt that nothing more could be gained by letting that discussion continue in the open forum, but I quite disagree. The issues here are 1) technique(s) used for harvesting; 2) technique(s) used for implanting; 3) qualifications of the person(s) doing the procedure(s); 4) Full disclosure of all the aforementioned well in advance of the procedure by the supervising physician to the patient.

 

I'm sorry the thread closure bothered you. However, all pertinent information is still available in the thread.

 

 

As a potential hair transplant patient, I want to understand why the Neograft procedures undergone by TygerD and hair70 - at two separate clinics at opposite ends of the country - had similarly very poor patient outcomes. And I do mean similarly - weird angles, large graft sizes, large gaps/poor density, a lack of singles in the hair line - and this despite the fact that Dr. Vories is supposed to be a "hair transplant specialist" unlike North Valley Plastic Surgery in Arizona.

 

It's worth nothing that this is one of the dozens of cases Dr. Vories presented, and the implantation methods were likely different between Dr. Vories' case and the Arizona case. While I'm speculating a bit, I assume the graft placement in the AZ case was completed with the NeoGraft machine itself (and not a Lion Implanter - as it was with Dr. Vories).

 

Specialist or not, it really seems like Neograft is running the whole show and, worse, they aren't in any way qualified to do so. Is this why Dr. Vories is now doing the implanting of hair solely by himself now? Did he realize too late that Neograft was sending him totally unqualified technicians?

 

I don't believe Dr. Vories was working with technicians during the case in question. Keep in mind that purchasing and using a NeoGraft machine does not require a physician to use NeoGraft sponsored technicians.

 

What's more, the fact that the NeoGraft is marketed to neophyte surgeons and technicians is one of the biggest sources of controversy surrounding the device.

 

Below are questions/comments that were asked/made by more than one person in TygerD's thread regarding density, angles, graft sizes, lack of singles in the hairline, etc.

 

(http://www.hairrestorationnetwork.com/eve/170309-should-i-have-wait-year-receive-my-refund-5.html)

 

Tom Cruise writes:

 

What is going on with that graft placement? It doesn't look right. Doesn't look right at all. GNX1 writes:

 

 

Quote:

sorry to hear bro. thats some of the worst FUE work ive seen in quite some time. I wud just define that as early plug work.

 

I would not go back there if THEY were paying me!

hairthere writes:

 

 

Quote:

What I don't understand is how a good result could have been expected after viewing the patient immediate post-op. The graft placement looks extremely poor in terms of the density, angles, and design. What exact density were those grafts placed at?

 

doesnt even look like there are any singles up front.

And as for North Valley Plastic Surgery in Arizona, Spanker states in hair70's thread about hair70's experience with NeoGraft (http://www.hairrestorationnetwork.co...eograft.html):

 

 

Quote:

Man, I have seen worse, but that looks pretty bad. Not something you are going to be thrilled about in the end. Low density and it looks like pretty large grafts. Some big gaps.

And hair70's pictures, like TygerD's, look AWFUL!!! And hair70's writes how similar his experience was to TygerD's:

 

 

Quote:

You are absolutely correct about NEOGRAFT machine and its intended purposes.

 

They are putting these machines in the hands of technicians to perform hair transplant procedures who undergo some sort of training and mentoring program before they are on their own.

 

One could argue the technician has more experience than the plastic surgeon or office doc who wants to provide this service in his practice also.

 

This is still surgery in my opinion and technicians should not be allowed to perform surgery. . .especially unsupervised in my case.

 

During my procedure, even the nurse? took the machine and practiced on me while the solo techician was counting. . .soo unprofessional!

 

When scheduling, they had to call some sort of central dispatcher to find a technician that was available for my surgery date. First it was one person scheduled who I tried to research and then she had family issues last minute soo they sent someone else. . .

 

Doesn't sound promising huh? I was stupid and impatient and should've done more research especially on THIS FORUM.

 

My procedure was over 8 months ago at NVPS in AZ.

 

8 month result attached. . . .less than 100 hairs out of a supposed 1000 FUE implants and most pointing at un natural angles to my hairline. . .it is worst then being bald in recipient area. . .I hoped no more hairs showed up actually!

 

I am sure the transplant gurus will refine extraction techniques in the future whether automated or not but it is going to be almost impossible to teach the artistry of natural hairline creation depending on age, race, facial characteristics, etc, etc. . .

 

Some people are just naturally going to be better than others.

 

For those of you who are looking to get a transplant procedure. . .take it from me after loosing thousands of dollars and even more in sleep, frustration, anxiety, etc, etc. . .don't go to an office that does FUE "on the side" like North Valley Plastic Surgery in AZ who calls a NEOGRAFT dispatch center to send out a "trained" technician to do your transplant.

 

That may work well for getting your car towed when it breaks down but not for your hair surgery!

Nathaniel,

To me, it seems as if you are coming to a personal realization about the NeoGraft device. While I truly believe that it is the surgeon - not the tool he/she uses - that determines the outcome of a procedure, others are always welcome to disagree with my opinion. If you think the use of the NeoGraft in anyone's hands leads to subpar results, then it's likely that you should investigate physicians who don't use the device.

However, I do believe Dr. Vories is performing quality FUE.

 

I also have read your comments, Blake, expressing your own thoughts, opinions, and concerns in these threads - and they are good comments. But I would like to hear more from the doctors who were responsible for performing/supervising these hair transplants. What technique(s)/method(s) did they use and why?

 

I think the answers to these questions is dependent on your own personal research. While we do have a plethora of information about our physicians available on our network, if you have any specific questions, the only way to truly receive answers is by asking the doctors themselves.

 

And also I would like to hear from Neograft representatives themselves - what is their public response to the concerns expressed repeatedly in various threads on HRN, particularly with regards to charges of "aggressive marketing" and "unqualified techs" performing aspects of hair transplanting for which they are not qualified. I mean, even in the Neograft video when the hairs are being implanted, there seems to be NO CONSIDERATION AT ALL to angle, depth, or graft size while implanting - it literally looks like "shoot and plug" - at least that's what it looks like to me, but admittedly I do not work in the medical field, which is why Neograft needs to explain clearly the technique for implanting hairs demonstrated in that video. Otherwise, man oh man.....based on what I've seen and read, I will not be considering clinics using Neograft for my hair restoration needs!

 

Again, we have no affiliation with NeoGraft, so this is something you would need to seek out on your own. We (the moderators) can definitely help answer questions, but I can't make any individual come to the forums and reply, nor can I provide inside information about technicians/organizations with which I am unfamiliar.

[Blake Bloxham]

Dr. Lindsey, Blake writes about the 19 gauge needle in the Hans Implanter Pen:

 

A 19 gauge needle would probably make a (roughly) 1.1 - 1.2 mm site in the recipient scalp. Many think this is too large, even for the 3-4 hair follicular unit grafts - which are normally 1.0 mm in diameter.

 

This statement is bothersome to me.

 

Again, just to clarify: the device comes with a variety of needle sizes to fit different grafts. It does not only feature an 18 gauge needle, nor does it only make incision sites that are 1.1+ mm in diameter.

 

I'm curious to know what is the size(s) of the needle(s)/blade(s) you use at the recipient site? I'm still a little confused on the "Coalition doctors" who use "smaller blades" at the recipient site - it almost seems like that is a requirement for Coalition status. In your opinion, is it possible to achieve "Coalition" status with a 19 gauge needle? Are there any doctors out there who have achieved "Coalition" status with a 19 gauge needle? And would 1.1 - 1.2 mm cuts along the front of the hairline yield "natural" and unnoticeable results?

 

Physicians can either use needles or blades to make their recipient sites; I'm fairly certain Dr. Lindsey uses blades.

 

Also, using custom cut blades is not a Coalition status requirement. Coalition physicians use a variety of different techniques and tools. The common denominator is not their tools and methods, it is their consistently excellent results. Click here to read more about Coalition standards.

[Blake Bloxham]

For clarification, Dr. Lindsey, there are only two automated FUE machines currently in use in the hair transplant field, Neograft and ARTAS, correct? Are these new breed of patients former Neograft or ARTAS patients? Or a combination of both, and if so, what percentage?

 

Nathaniel,

 

I wanted to clarify a few things:

 

1. An automated FUE tool refers to a device that has some level of independent functioning. This means the device is able to truly robotically assist the surgeon and offer some level of independent automation. As of now, the only device capable of this is the ARTAS.

 

2. Motorized FUE devices are handheld punches that feature a motorized mechanism. There are a variety of motorized tools, including the NeoGraft, uses today.

 

Here is a summary of some of the devices used today. Please see our FUE section for more information (placing your cursor over the "hair loss treatments" section will allow you to access the information in the different FUE categories as well).

[Bill - Seemiller]

Blake and Nathanial,

 

To clarify, an 18 gauge needle makes a larger incision than a 19 gauge. The below chart is an approximate conversion from gauge to mm. Their extraction device however, is different. Dr. Lorenzo uses the standard Versi handle manual punch and Dr. Vories uses the NeoGraft extraction device.

 

13 - 2.413

14 - 2.108

15 - 1.829

16 - 1.651

17 - 1.473

18 - 1.245

19 - 1.067

20 - 0.889

21 - 0.813

22 - 0.711

23 - 0.635

24 - 0.559

25 - 0.508

26 - 0.457

27 - 0.406

 

That said, both Dr. Lorenzo and Dr. Vories (who are both recommended by our community) use the Hans / Lion implanter with needles no larger than 1.0mm.

 

To learn more about the Lion/Hans Implanter, Choi Implanter and other implantation techniques and devices, visit "FUE Hair Transplant: Implantation Methods and Devices" .

 

I hope that helps to clarify things.

 

Best wishes,

 

Bill

[Bill - Seemiller]

For the record, there is no such thing as a "NeoGraft Hair Transplant Procedure". NeoGraft (the company) did market their device as a distinct procedure when in reality, it's just one of many extraction tools/devices physicians can use during a follicular unit extraction (FUE) procedure. Each tool comes with a unique set of advantages and disadvantages. To learn more about the NeoGraft (the extraction device), visit "NeoGraft Hair Transplant Machine".

 

At the end of the day, the skill and experience of the surgeon and their staff is more relevant than the tool they use.

 

Best wishes,

 

Bill

[Blake Bloxham]

Blake and Nathanial,

 

To clarify, an 18 gauge needle makes a larger incision than a 19 gauge. The below chart is an approximate conversion from gauge to mm. Their extraction device however, is different. Dr. Lorenzo uses the standard Versi handle manual punch and Dr. Vories uses the NeoGraft extraction device.

 

13 - 2.413

14 - 2.108

15 - 1.829

16 - 1.651

17 - 1.473

18 - 1.245

19 - 1.067

20 - 0.889

21 - 0.813

22 - 0.711

23 - 0.635

24 - 0.559

25 - 0.508

26 - 0.457

27 - 0.406

 

 

 

Hi Bill,

 

I agree: generally, the higher the needle "gauge," the smaller the actual diameter (i.e. a 27 gauge needle is actually much thinner than a 20 gauge needle). Additionally, thank you for sharing the actual conversion chart!

[whoknows01]

Just check out this video. **outside link removed by moderator**

 

The doctor is barely there.

Edited June 28, 2013 by Future_HT_Doc

[nathaniel]

It is not a "one size fits all" device. It comes with a variety of different sized needles for different sized grafts. What's more, the graft selection process is where the surgeon would select specific grafts based upon needs. He/she would then load one graft at a time into an appropriate sized needle and implant it in the scalp. Small needles with single hair grafts would be used in the hairline; slightly larger needles with 2-3 hair grafts (FUGs) would be used in the frontal/mid scalp; and the large (for lack of a better term) needles with 3-4 hair FUGs would be used where appropriate.

 

Thank you Blake - and Bill - for clarifying how the Hans Implanter works; Bill, I look forward to reading the new link on implantation devices.

 

But this evening I'm a bit sleepy after a long day out and about in the hot, summer sun; so everyone gets a temporary reprise from my endless questioning!

 

But rest assured, I will return to this thread and after reading through everything more thoroughly, I will no doubt have more questions to pose. Until then, sweet dreams everyone!

[tacolinowest]

that video

[harryforreal]

When was this video made? How does his procedure look now?

[harryforreal]

The original video published on Apr 28, 2011.

 

 

The below video published Feb 14, 2013. Is this really two years post op?

 

 

[harryforreal]

After pics at Hall Plastic Surgery.....a bit thin?

 

**outside link removed by moderator**

Edited June 28, 2013 by Future_HT_Doc

[whoknows01]

Yeah those before and afters can't really be a good selling point. Sean Rima doesn't look very much different for 2k grafts.