New Hair Transplant Instrument by Dr. Harris Revolutionizes FUE

[Bill - Seemiller]

From "Revolutionary New Hair Transplant Tool Makes FUE Surgery Faster and Easier" below:

 

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Dr. James Harris has been recommended on the Hair Transplant Network for several years and has consistently gotten very good patient reviews. Impressive examples of his results can be found in the "Results Posted by Leading Hair Transplant Clinics" forum and hisrecommendation profile.

 

Dr. Harris is also world renowned and recognized among his medical colleagues as an innovator in refining and teaching follicular unit extraction (FUE). His two step FUE process, which he refers to as the "SAFE System", improves on traditional FUE by virtually eliminating follicle damage during the extraction process.

 

Follicular unit extraction (FUE) has become an increasingly popular procedure over the years due to its elimination of a linear scar and increased recovery time for patients.

 

Recently, Dr. Harris presented the "Powered SAFE Scribe", a new and revolutionary surgical FUE tool to his colleagues at this year's 2009 ISHRS (International Society of Hair Restoration Surgery) scientific meeting in Amsterdam. Research and testing have proven that this new powered instrument is even more effective than its manual, non-powered predecessor. The Powered SAFE Scribe is safe and effective in the hands of a skilled hair restoration physician and can reduce the time it takes to perform the procedure by half. Extraction rates of 500-700 per hour have been reported using the new powered version of the Scribe as opposed to approximately 200-300 with the manual one.

 

Surgeons who have used the powered SAFE scribe have reported the following benefits

 

* Reduction in pain

* Minimal scarring

* Almost all patients can become candidates for the FUE procedure

* Minimal follicle transection and damage

* Decreased time to perform the procedure (potentially leading to lower costs)

 

Let's give kudos to Dr. Harris for working to revolutionize and improve the follicular unit extraction procedure and making it a more viable solution to prospective hair transplant patients.

 

Bill

[swim]

Interesting.

 

However, not clear to me. You first say

virtually eliminating follicle damage during the extraction process.

After that you say

Minimal follicle transection and damage

 

Which one is it? Or, are those two statements, in your opinion, the same?

Also, not clear to me, but would like to know, after the follicle is extracted via FUE,is it examined? Is it checked for damage during extraction?... or not.

If not ,is it placed/planted regardless?

 

If yes. Who examines that? The surgeon or the tech?

[Bill - Seemiller]

Swim,

 

"Virtually eliminating" means that it comes very close to eliminating it altogether, but not completely. Thus, this phrase is equal to "minimal". Get it?

 

The procedures on how follicular units are inspected after extraction varies from clinic to clinic. Before implantation, follicular units are checked often with magnification by technicians before placement. Some clinics may even further trim the follicular unit of excess tissue in order to further refine it for a snug and perfect fit into the recipient site. Damaged follicular units would not be placed during the procedure.

 

I hope this helps.

 

Bill

[thanatopsis_awry]

Interesting. Any idea how this instrument compares to the one Dr. Feller recently revealed, in terms of similarities and differences in the tool's goal, design, etc. Also, I wonder if Dr. Harris has been using this tool on his FUE cases for some time with grown out results, or if it's an extremely recent innovation; and, what average session size range does Dr. Harris feel comfortable doing(?)

[bostankles]

Any pics of donor areas as this promises to achieve even less scarring?

[Dr. Jean Devroye]

For 6 months, I have been using my own prototype for FUE surgeries.

It has the advantage of turning alternatively with a very low angular motion, and the regulation of the speed is made using a foot treadle, allowing a work as refined as done by hand. However, the work is easier because the hand has only to maintain the punch on the right angle and it is no longer moving. Thanks to it, I increased a bit the speed of the extraction (but I did not reach 700 grafts per hour!) and nowadays I can reach 1500 grafts per day, instead of 1200. You can see a video of the work on YouTube:

 

 

You will also see the results of the harvest, the first day, almost FU3 and FU4 only with a very low transection rate.

Concerning the transection rate, I do not think that the engine brings an improvement. It is more the experience of the surgeon and the size of the punches that influence the risk of transection.

As far as the size of the punches is concerned, I am not a small 0.7 mm punches believer. For several reasons, I use 1 mm punches rather. I was able to observe that, by using small punches, the transection rate is surely going to increase. Also, we are obliged not to take the most beautiful grafts as too big for the punch size. Finally we get little and poor grafts which are not, in my opinion, going to grow very well.

The scars obtained with 1 mm punches are frankly small and when the hair is cut very short I have not seen any difference of aspect on areas where a 0.7 or 1 mm were used.

If the patient says he wants to shave his head completely, I recommend him just to avoid any kind of hair transplant because both scars, made with 0.7 or 1mm punches, are still slightly visible.

 

I am working actively on another prototype; it should be ready in a few weeks. Some sophistication will be added but I will talk about them later on...

 

Dr Jean Devroye MD

 

www.hairtransplantsurgery.com

www.hair-transplant-pictures.com

[HairHope]

There is more than one way to skin a cat - so to speak! I think the manual one or similar was used during my FUE.

[Jon Jones]

Does anybody know if any docs in the Texas area are using this technology?

[Bill - Seemiller]

Dr. Devroye,

 

Thanks for sharing information on innovations you've crafted to continue to improve FUE surgery as well. If you would like to send me information on this privately, I'll be happy to publish the content on our highly popular Hair Loss Q&A Blog as well.

 

This goes for any of our doctors working hard to improve and revolutionize hair transplant procedures.

 

Best wishes,

 

Bill

[Bill - Seemiller]

Interesting. Any idea how this instrument compares to the one Dr. Feller recently revealed, in terms of similarities and differences in the tool's goal, design, etc. Also, I wonder if Dr. Harris has been using this tool on his FUE cases for some time with grown out results, or if it's an extremely recent innovation; and, what average session size range does Dr. Harris feel comfortable doing(?)

 

Thana,

 

I couldn't tell you how it compares with Dr. Feller's new tool in terms of speed and effectiveness however, Dr. Harris was previously using another tool he called the "SAFE scribe", but it was manual rather than powered. Regarding grown out results, I think we ought to leave the additional details up to Dr. Harris who is welcome anytime to post on our forum.

 

Best wishes,

 

Bill

[thanatopsis_awry]

Sounds good, Bill. Hopefully, Dr. Harris can find some time to get into increased detail on the forum -- 700 extractions, or grafts, per hour, like Dr. Devroye alluded to, is extremely impressive.

 

I also look forward to Dr. Devroye revealing more information on his prototype as it progresses; with such esteemed Dr's getting more and more involved in FUE it really gives hope that a new, truly progressive era of FUE is here to stay.

[prezident]

Hey Bill,

Isnt it true that follicle extraction during FUT yields the least damage to follicles and, therefore,greatly increases the transplanted follicles chances of survival in the recipient site? Please respond. I sent you an email about a week ago and have not gotten a response. Thanks in advance,

Prezident

[prezident]

Thana,

Please Take a look at the question that I forwarded to Bill and let me know what your thoughts are. It would be greatly appreciated. I have viewed your previous postings on this site and I greatly appreciate your very candid responses. Unfortunately, in this day and age, it is very difficult to find people who are willing to dispense with the (edited for profanity) and cut to the chase! Thanks in advance.

Prezident.

[Bill - Seemiller]

Prezident,

 

I apologize if you've emailed me and I haven't responded. However, since I'm caught up on all my email, maybe you sent it to the wrong address? Where did you send it?

 

To answer your questions, most hair restoration surgeons would agree that overall, FUT via microscopic dissection produces higher yield than FUE consistently. This is due to the extra forced placed on the hair follicles during the extraction process. Below I've presented a few articles written by leading hair transplant surgeons on FUE, its benefits, limitations, and potential problems.

 

"What are the benefits, limitations, and potential problems with FUE/FIT?" (by Coalition member Dr. Alan Feller)

 

"The Evolution, Advantages and Disadvantages of Follicular Unit Extraction (FUE) Hair Transplant Surgery" (by Coalition member Dr. Ron Shapiro).

 

In my opinion however, follicular unit extraction has come a long way and in many patients, FUE can produce hair growth yield equal to that of strip. Though most hair restoration physicians would still argue that only a select audience are actual candidates for FUE, the group of candidates continues to broaden with recent advancements in revolutionary tools designed by those surgeons dedicated to improving the FUE procedure.

 

In my opinon, FUE will never fully replace strip. But as time moves forward, I suspect it will become a more viable option for a larger audience of prospective hair transplant patients.

 

I hope this helps.

 

Bill

 

P.S. Please eliminate the use of profanity in your posts as it's a violation of the terms of service you agreed to when you signed up.

[thanatopsis_awry]

Prez, I'd agree with Bill, as well,, and the two links he posted are among the best threads around on FUE.

 

If I can make one subjective thought on FUE, which I've found myself thinking more and more of late. First, a statement, followed by some metaphor, and then wrap everything together: FUE has been maligned so horribly by so many (Armani being the figurehead, but certainly not a lone wolf) that it has warped perception and has created conflict when we go to talk about FUE and its yield, and how it compares to strip. We are caught balancing theory with practicality. In theory, FUE's yield should be able to rival strip every step of the way; in practicality, there is a sliding scale that varies surgeon to surgeon on when practicality begins to breaks down theory (i.e. when the limitations of FUE overwhelm the surgeon's capabilities on a given patient).

 

The x-factor is the evolution of hair transplantation, and how these two babies born have developed, and matured. Strip has been taken and it's principles cemented at a truly, ultra-refined level; so much so, that I would say with regard to extraction, harvesting, and yield it's reached a certain 'ne plus ultra', and simply can't reach much higher than that you can currently find with the absolute best. FUE not so, and when there isn't a *gold standard* cemented in its efficacy and so there will be more variability in results, and more confusion from a patient's perspective when evaluating clinics, even amongst the elite.

 

Strip is a mature adult, and you know what he will look like day to day, week to week, month to month, thus knowing what to expect. FUE, however, is a pubescent, fickle child, in a dynamic state of development and maturation. And this boy's adolescence was hijacked by the wrong crowd; resulting in to-be-expected distrust, skepticism, and criticism by what has marked him to date. Yet, this belies the character lurking beneath the surface, character that if nurtured can shine through -- and the true character of FUE has indeed begun to shine through.

 

I would say that FUE's yield will approximate Strip when it is performed by an elite surgeon. In part, this is because the elite surgeon will not fly too close to the sun and allow the fickleness of this pubescent child to catch him off guard and veer him into blindness. I suppose first and foremost I am advocating that you take it upon yourself to do exhaustive research -- research into the links posted above, research into individual clinics -- and determine who these elite FUE practitioners are. This site is certainly an excellent place to go about this process. Remember, FUE is a fickle child still in a state of dynamic change and evolution -- there is marked variability even amongst the best, which makes individualized research paramount, and generalized statements less useful.

[prezident]

Thanks Bill and Thana,

your collective insights were very helpfull. For your info I underwent a 3500 FUE procedure in September 2007. Over the following year the transplanted follicles grew out beautifully and my hairline was completely restored. However, around 14 months post-op the transplanted hair began to fall out and continues to this day. The procedure was limited to zone 1. Recent bloodwork yielded perfect results. The problem is not me. It is emotionally devastating to experience the loss of my hair for a second time. What are your thoughts on what is happening in my situation. Your comments and thoughts are greatly appreciated. Thanks in advance!

Prezident.

[Severn]

prez, how long have the grafts been falling out? Are you sure they just aren't going through a telogen phase?

[Bill - Seemiller]

Prezident,

 

At first, I was going to post that it seems like there's been an epidemic of patients reporting transplanted hair loss however, after reading your last post, I remember receiving your email and replying. I'm not sure why you didn't receive it...but I recently transformed it into a blog article because I thought the topic of transplanted hair loss was highly important.

 

You can read my response to your inquiry by visiting "Losing Transplanted Hair One Year After a Hair Restoration Procedure.

 

Best wishes,

 

Bill

[prezident]

Severn,

The transplanted hair has been falling out since November 2008 and is not regrowing. The telogen phase only lasts 3 months. I initially thought the same thing but too much time has passed for the hair to still be in the telogen phase. I consulted with both a dermatologist and an internest and both do not have an explanation for the loss. I do not have any medical conditions, i do not take 'any' medication and to my knowledge the hair was not harvested from outside of the safe zone.

Prezident

[Severn]

Well that just doesn't make any sense then. Bill's post seems to indicate there are others posting similiar occurances but I don't remember reading any.

 

I wonder if this odd phenomenon has been restricted to FUE? Have you consulted with your surgeon over the matter? It sure seems like they are either going to grow or not grow. To grow out healthy then inexplicably die is very strange.

[prezident]

Severn,

I agree with your assessment. It simply does not make any sense. Because of the lack of feed back that i have gotten from my surgeon and others on this issue, I am only left to assume that the hair transplant industry, as a whole, does not want to admit that hair transplant surgery is a complete and utter failure in a certain percent of the population. If you think about it, how many people would second guess an expensive and painfull hair transplant if they knew that there was a certain percentage of the population that experienced a complete and utter failure of a HT procedure. I have learned, from my own research, that there are countless others like me who are left with absolutely no explanation as to why their HT was a total failure even though there was absolutely no medical explanation for it. Think about it! If I told you i wanted to charge you 30 or 40 thousand dollars for a HT procedure and then told you that it simply does not work on a certain percentage of the population, How many people do you think would decide to roll the dice with that kind of money? In my estimation, not many! Go figure!

Prezident

[Bill - Seemiller]

Prezident,

 

I actually agree that there is a certain population (though minimal) where hair transplantation simply just doesn't work. I've seen a few cases like these and the reasons are unknown.

 

However, your case is different. Your hair GREW and then started to fall out. The question is why?

 

I did respond to you with a few possibilities, but you didn't reply.

 

Anyway, I do hope you and your doctor can get to the bottom of it.

 

Best wishes,

 

Bill

[prezident]

Bill,

I did reply by thanking you and Thana for your very helpful and collective insights. I have forwarded my pics to Dr. Feller and hope to consult with him soon. Dr. Feller did not perform my 3500 FUE procedure. My procedure was performed by another surgeon whose clinic has advised me that they do not know why my transplanted hair is falling out. Hopefully Dr. Feller will find the answer to this mystery. I do find it interesting that the doubles have held better than the singles. This may simply be coincidence or it may be that the doubles are holding better because they contain more DHT resistent DNA! I obviously have not performed an exhaustive count to confirm this.

Prezident

[Franklin]

Sorry to here about your results. One thing I will say as I said before. "NOT ALL FUE IS THE SAME" There are some doctors that have been performing this technique for a long time that will have different opinions on how they go about extractions. And results will vary between clinics. In my opinion Fue should not be rushed. Here is a post from an employee on how his doc goes about it.

[Franklin]

"" Dr. Bisanga has adapted and improved his FUE punch technique over the years, one obvious example is the size of punch he uses has dropped in diameter to minimise traumatic impact on the scalp and surrounding follicular units. Another aspect is the technical ability and objective technique, the ability to feel the follicular unit and surrounding tissue when entering the scalp and gauging the depth and angles of each FU.

 

During my FUE sessions I was always aware of the changing positions Dr. Bisanga used to make, moving himself and adapting to changes in the angles and directions of the FU. Now watching FUE punching from the other side I have seen more.

 

FUE has and will always be technically a very difficult technique, the fact that each FU has to be removed individually and the average op is 1000 grafts plus obviously multiplies the room for error as each extraction can be different in some cases. Dependent on the area of the scalp,the angle the FU exits the scalp changes, dependent on the area it can be easier to extract the FU as the lay of the FU can be more consistent and also the position of the head when resting on the operating chair allows for easier extraction.

 

For example the back of the head, around the occipital area is much easier to punch. It is important the doc can understand his position needs to change otherwise there will be a greater scarring impact and potentially increased transection. The constant need to change position is not something that can be avoided regardless of tool size or the type of tool, this is about the technique itself.

 

Pressure control is also important to achieving minimum transaction and the least potential trauma to the surrounding FU. A largely forgotten aspect to FUE is the effects on the surrounding FU that are left in the donor. A FUE donor maybe be spread over the entire donor safe zone and if used well can leave minimal to almost no signs hair has been removed, but incorrect punch and extraction can greatly reduce the potential for future FUE and the graft numbers and even hinder Strip extraction.

 

The greater the friction created when the punch enters the skin the harder to balance the direction of the hair with any potential changes as there becomes less sensitivity between the fingers and the tip of the punch. The tension can be micro but Dr. Bisanga has found through changing his technique that even manually the tension can be reduced and this improves graft survival and collateral damage. The finger to punch pressure helps gauge the skin characteristics and even possible to feel the FU with practice. With this technique of punching Dr. Bisanga has minimised transaction to as little as 1-2% in most cases and even on demanding cases rarely increases to above 5%; this is only made possible by the touch sense gained through minimal transference of distance and resistance between his fingers and the punch.

 

The next aspect that is over looked much of the time is miniaturisation existing in the donor and the potential to create miniaturisation. Dr. Bisanga feels that anything near 20% miniaturisation in the donor can rule you out from surgery, certainly having FUE. Miniaturisation does not affect the density of the donor hair as such because that is just the calculation of FU per cm2 but it will affect the number of FU that can be removed. We have seen miniaturisation spread all over the donor and also just in isolated areas, either way it will reduce the numbers that can be extracted. By definition the miniaturised hair cannot be used so they must remain in the donor, this creates the problem of how close to the miniaturised FU can the extraction take place. Too close and the thickness of coverage will drop and could potentially traumatise the miniaturised hair and cause it to fall out.

 

So, the extraction pattern has to become wider thus less FU per cm2 are removed to retain the integrity of the donor, especially for the future. Miniaturisation can also be caused with the extraction, going back to the tension or resistance in the punch movement, this can create a ripple effect, like a 'skin quake', the punch hole being the epicentre and the vibrations moving out from the central point. As above Dr. Bisanga has minimised aspects of this by his punch motion technique, he has certainly found less resistance was caused creating obviously less contortion of the wound and the surrounding Follicular Units. This is very important, we have seen miniaturisation created post FUE surgery that has possibly rendered the areas non- harvestable due sometimes to over harvesting but also peripheral damage creating miniaturisation.

 

Dr. Bisanga's feeling on these problems is to lessen the motion when making the punch action, the least friction or motion allows for greater sensitivity and feel between punch and fingers and this in turn has reduced transection, decreased peripheral damage either to the skin or surrounding FU with changing directions as well as miniaturisation. With the many documented FUE cases he has to his name as well as the many more he has performed and internally documented he feels confident to say that in respect of physical technique he has reduced these negative factors a great deal but then research is obviously ongoing."

Posts: 199 | Location: New York | Registered: October 17, 2002