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Foreceps vs. Implanter


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  • Regular Member

So I see many places are using both, does anyone have any knowledge on the pro's/con's of both? I've been doing my own research with Dr. opinions but its a lot of he said she said stuff and often times is contradicting each other, was hoping to get some patient feedback, thanks!

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Looking forward to the responses on this thread, my guess is you need to judge the surgery on the end results and not the procedure. All the doctors have their own supporting arguments to implanter versus forceps. I’m considering using Dr Vila as she has now departed from Dr Lorenzo and could be a hidden gem at  @€2.5 per graph. 

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  • Senior Member

I've asked this same question before on the forum and didn't get much of a conversation...

In my opinion an implanter pen makes more sense and while I have no data to back it up, it seem's like there would be less stress on the grafts, providing better growth. Forceps, you tend to see the grafts pinched and who knows how the grafts react to that sort of trauma.

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  • Senior Member

Grafts are loaded into the implanter with a foreceps, so grafts are handled by foreceps in all cases. But it may be less traumatic using a foreceps to load grafts hair-first into an implanter pen than follicle-first into recipient sites for FUE-excised grafts that have less tissue around the bulbs.

Some clinics use implanter pens for stick and place, making the recipient site and planting the graft at the same time. Other clinics make the site incisions first and then plant them with foreceps or pens. Some use one approach for delicate work (in eyebrows for example) and use another approach for filling in larger areas.

 

 

 

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Based in Madrid, website - ximenavila.com although it’s under construction but you’ll get contact details. I’ve been communicating with her but most of her work is on Lorenzo’s website which she can’t showcase on her website. If you believe what you read she did Lorenzo’s hair transplant.

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  • Senior Member

We should make a distinction between (a) implanter tools that both cut the recipient site and implant the graft into that site, versus (b) implanter tools for inserting grafts into recipient sites that have already been made using a custom cut blade or needle.

The critical distinction is that Category A tools are used by the surgeon (or technician at some clinics) to simultaneously make a recipient incision and plunge a graft into it, whereas Category B tools are used by technicians only to seat grants into recipient sites that the surgeon has already made.

Category A tools include Choi and Lions type pens, as used by Lorenzo, Vories, and others.

Category B tools include Erdogan's KEEP tool and Yaman's implantation tool.

Category B tools essentially hold the walls of the pre-made recipient site open and form a channel for grafts to be fed through. Forceps are used in conjunction with the KEEP tool (a Category B tool), but only after the graft has been loaded through the side of the tool’s hollow tube using a sort of swiping-rotational movement off the back of the hand and only to then finish seating the graft into the recipient site. Yaman's implantation tool, also a Category B tool, is similar. It looks like a Category A implanter pen but the point of the hollow needle is blunted and isn’t used to cut a recipient site. Instead of using forceps to guide the graft the remaining way down the hollow metal tube into the recipient site, the technician uses the tool’s plunger to perform this task. Both these tools purport to reduce trauma to grafts that can result from gripping them at the "meat" between forceps and "cramming" them into tiny recipient sites--trauma that can be exacerbated by fatigue and by recipient sites starting to close up after some time.

Some ht docs have employed a combination of Category A and B tools for FUE transplants, favoring blade or needle-made recipient sites for hairline work that are then filled using Category B tools (e.g. KEEP, Yaman) and using Category A tools to both make recipient sites and seat grafts behind the hairline zone.

MY SUBJECTIVE, PERSONAL VIEW: I strongly favor ht surgeons and their teams using Category B type tools to reduce graft trauma during the implantation process. I am solidly against the use of Category A type tools for hairline and temple work. Based on viewing hundreds if not thousands of photos and videos, I don't see the consistent cosmetic refinement of hairline work and frontal temple work performed by the top surgeons using Category A type implanter pens (yes, I include Dr. Lorenzo and his spawn) that is achieved by top surgeons who make recipient sites using custom blades or needles.

I personally think that graft survival and growth rates of FUE will be significantly enhanced, as will their consistency, by the widespread adoption of Category B implantation tools in the hands of well-trained technicians, everything else being equal.

Excellent topic, Squidward! I hope you'll forgive my pontification.

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  • Senior Member

Gasthoerer,

I dont' contend that one type of Category A tool is superior to another type of Category A tool (I wouldn't know), or that Category B tools are "superior" to Category A tools or vice versa. Category A tools and Category B tools have different purposes--apples and oranges. I'm only saying that I favor the use of Category B tools for insertion of grafts into premade recipient sites over forceps-only insertion of grafts into premade recipient sites. 

If Dr. De Frietas uses true implanter pens for his hairline work that could help explain why he isn't on my personal "tops" list of hairline docs, although I admit I haven't studied a lot of his recent work.

Timely and interesting topic.

 

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4 hours ago, TrixGlendevon said:

Yes - that's why I am interested. Have you asked her directly if she did it or not? I had seen that site but it was, as you say, under construction. 2.5 euros is a bargain!

I’m waiting for some links from her that showcase her work & availability for surgery etc. I’ve found her very responsive & honest in her replys. 

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54 minutes ago, Gasthoerer said:

Freitas also used type A? His hairlines are great IMO. I think at the moment, there is no tool which is significantly superior than another in general. 

Agree, focus on the end result and don’t get distracted by their individual methods. 

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  • Senior Member
On 10/22/2018 at 1:22 PM, Raker said:

Based in Madrid, website - ximenavila.com although it’s under construction but you’ll get contact details. I’ve been communicating with her but most of her work is on Lorenzo’s website which she can’t showcase on her website. If you believe what you read she did Lorenzo’s hair transplant.

I asked her directly. She did both of them, along with the clinic's team of course. I confirmed the price too. It is just over 2.50 with the IVA included. Her waiting list for a consultation is too long though and I think I want FUT. Shame!

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  • Regular Member

I just had mine done with Dr. Nadimi Thursday.  I honestly don't know what process they used to implant, but this was crazy easy.  It's 48 hours now since it was done and I have no scabbing.  I started a thread in the FUE forum.  Whatever it was that she uses, it is the right thing because I was walking around Chicago and didn't get any second looks, stares or anything.  I'm 6'4" too so not many could look down on it, but it was as clean of a procedure as I could imagine man.  I'd highly recommend her.

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  • Regular Member

It seems like nobodly wants to really speak up about the method of inserting the grafts into the recipient site for the Western Dr's here, I'm going to message them each individually, but I'm pretty sure they mostly use foreceps, though I am surprised with how active some of these members are who have had procedures, and as many views as this post has had that people are reluctanct to comment, however, A few e-mails will clarify. If results are being produced consistently, I dont think the method really matters.

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