Regular Member Michael Vories, MD Posted May 13, 2015 Regular Member Share Posted May 13, 2015 An example of a 3000 graft case performed over a two consecutive day session in our Charleston office. Very good hair caliber gave good coverage of his frontal forelock. Grafting was limited to his midscalp and frontal forelock, with the determination to cover his vertex at a later date. Post-op photos were at the two month and five month period and provided by the patient. Extractions performed with 0.90 mm Vortex punch, and implantation performed with Hans Hair Implanters. All grafts extracted and placed by the physician. Dr. Mike Vories is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
BUSA Posted May 13, 2015 Share Posted May 13, 2015 considering u had a GIANT area to cover it looks pretty good. the last 3 pics don't tell much tho since the lighting is too poor. but chit, this dude was a NW7 before he started so considering that he looks like a new man. Link to comment Share on other sites More sharing options...
Senior Member hairweare Posted May 13, 2015 Senior Member Share Posted May 13, 2015 Dr. Vories, It has been posted here on the forum from a physician with some FUE experience that subcutaneous scarring resulting from the primary FUE procedure will compromise subsequent procedures by making extraction more difficult with a significantly higher transection rate resulting in a lower yield and a graft of poorer quality. In your vast experience performing FUE do you agree with this observation and do you recognize this as a FUE barrier that will need to be addressed by further refinement of the current state of the art techniques? Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 13, 2015 Senior Member Share Posted May 13, 2015 Nice coverage for 3k grafts! Thanks for sharing. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Regular Member Michael Vories, MD Posted May 13, 2015 Author Regular Member Share Posted May 13, 2015 (edited) Dr. Vories, It has been posted here on the forum from a physician with some FUE experience that subcutaneous scarring resulting from the primary FUE procedure will compromise subsequent procedures by making extraction more difficult with a significantly higher transection rate resulting in a lower yield and a graft of poorer quality. In your vast experience performing FUE do you agree with this observation and do you recognize this as a FUE barrier that will need to be addressed by further refinement of the current state of the art techniques? I have seen this stated before, but I do not agree with it. We have done many surgeries on previous FUE patients, and we measure all transection rates. We have seen no difference in transection rates in subsequent FUE procedures. What we do see, however, is increased transection in what we would expect in patients whom have had prior FUT procedures- especially below the FUT scar, where exit angles get distorted due the tension in closing the FUT wound. Edited May 15, 2015 by David - Moderator Responding to quote Dr. Mike Vories is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 13, 2015 Senior Member Share Posted May 13, 2015 Dr Vories, Interesting. I've personally noticed a difference attempting to extract from 2nd round FUE patients. Do you notice any difference in the texture of the donor region during the second and third passes? Does it feel harder or more fibrotic to you? Also, you guys are seeing similar transection rates, but what about scored attempts to failed extractions? Or overall growth yield? I've heard similar things about distorted graft angles around strip closures, but I don't notice this when inspecting the actual grafts from underneath during a second strip removal. I read an interesting post from Joe Tillman where he said the distortion from strip closures is rare as well. In the end, a lot of it probably comes down to patient physiology and the way different people heal! Guess that's what makes hair transplant surgery challenging and interesting! Thanks for your replies. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member hairweare Posted May 13, 2015 Senior Member Share Posted May 13, 2015 I suspected that FUE surgeons with extensive case load experience would not elect to stage procedures by intent if that issue prevailed. Thanks for your input. It will be interesting to hear the details of the new technique that Blake will be soon presenting. Hopefully it will be a real breakthrough that truly improves FUE rather than just another marketing strategy. Link to comment Share on other sites More sharing options...
Regular Member Michael Vories, MD Posted May 13, 2015 Author Regular Member Share Posted May 13, 2015 We really do not notice a change, but that may have to do with the very sharp Vortex serrated punches we use. As for previous strip surgeries causing angle distortion, there is no question that inferior to the scar there is often marked changes to exit angle- sometimes to the point that we abandon harvesting inferior to the scar because of unacceptable transection. Dr. Mike Vories is recommended on the Hair Transplant Network Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 13, 2015 Senior Member Share Posted May 13, 2015 Dr Vories, Thanks for taking the time to answer. Interesting information about the punch. I haven't heard much about the Vortex serrated punch before. I know you are now doing all the graft delivery manually with forceps, but are you still using the NeoGraft -- with this new punch -- for scoring? Or did you move to manual with the serrated punch? Hairweare, I definitely understand the marketing strategy "fatigue." We often hear about new "breakthroughs" that result in nothing or expose themselves as a marketing ploy. I don't think this is the case with our new technique. I can say this: it's a totally new approach to FUE. It's not just a new tool or small tweak on something else. It's something Dr Feller first thought up to try on a patient with subcutaneous scarring from multiple -- strip and FUE -- hair transplant surgeries. The gentleman wanted more FUE, but there was too much scarring and he wasn't sure he could extract the grafts, yet alone extract quality grafts. Necessity bred invention and it continued evolving from there. We've done really well with it and seen big improvements in yield and hair characteristics/quality. Look forward to sharing more! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
Senior Member hairweare Posted May 13, 2015 Senior Member Share Posted May 13, 2015 Blake, rest assured that I will look at it both critically and objectively. We are all on the same team here. Link to comment Share on other sites More sharing options...
Senior Member ontop Posted May 14, 2015 Senior Member Share Posted May 14, 2015 When is this breaking news going to happen blake? Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 14, 2015 Senior Member Share Posted May 14, 2015 Weare, Absolutely! Look forward to your input both as a physician and patient. Ontop, The goal is to make a "teaser announcement" about the technique next week. I'll share a few generic details and some images. Dr Feller and I are then going to work on a professional video that explains the whole process and really showcases how this new FUE is performed. This will be out in the Summer. I'll be happy to answer all questions as well -- though I may have to stay a bit mum on some details ; ) "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
BUSA Posted May 14, 2015 Share Posted May 14, 2015 inquiring mind wud like to know Blake.... Weare, Absolutely! Look forward to your input both as a physician and patient. Ontop, The goal is to make a "teaser announcement" about the technique next week. I'll share a few generic details and some images. Dr Feller and I are then going to work on a professional video that explains the whole process and really showcases how this new FUE is performed. This will be out in the Summer. I'll be happy to answer all questions as well -- though I may have to stay a bit mum on some details ; ) Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 14, 2015 Senior Member Share Posted May 14, 2015 Next week, next week! Hahaha. I'm feeling obligated to share more than I initially planned though. I feel like I may have unintentionally hyped it a bit and should actually explain more than I originally intended to! "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
BUSA Posted May 14, 2015 Share Posted May 14, 2015 Next week, next week! Hahaha. I'm feeling obligated to share more than I initially planned though. I feel like I may have unintentionally hyped it a bit and should actually explain more than I originally intended to!well u won't hurt my feelings if u share a little more.... please tell me its not something I'm gonna have to wait 15 years for like FUE back in 2000 lol. cause I'm still on the fence about who I'm going to have perform my HT. Link to comment Share on other sites More sharing options...
Senior Member Blake Bloxham Posted May 14, 2015 Senior Member Share Posted May 14, 2015 Busa, Haha. Sounds fair. Nope, it's ready to go now! I'm not sure of the exact number, but I think together -- Feller and Lindsey practices -- it's been performed on around 30 patients. "Doc" Blake Bloxham - formerly "Future_HT_Doc" Forum Co-Moderator and Editorial Assistant for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum All opinions are my own and my advice does not constitute as medical advice. All medical questions and concerns should be addressed by a personal physician. Link to comment Share on other sites More sharing options...
BUSA Posted May 14, 2015 Share Posted May 14, 2015 ok Blake I will wait patiently then..... thanx Link to comment Share on other sites More sharing options...
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