Manual punch vs Micromoter FUE

[MrZennie]

Maybe when Diep says manual, he means non-Artas?  

[Gasthoerer]

Update the list:

Clinics I am aware using WAW now are:

- Devroye (obviously)

- Feriduni

- PHC

- Konior (at least sometimes)

- Hasson & Wong

[LonelyGraft]

4 hours ago, Gasthoerer said:

Update the list:

Clinics I am aware using WAW now are:

- Devroye (obviously)

- Feriduni

- PHC

- Konior (at least sometimes)

- Hasson & Wong

Who is phc? Pro hair clinic?

[Gasthoerer]

On ‎8‎/‎22‎/‎2019 at 3:05 AM, jj51702 said:

Who is phc? Pro hair clinic?

Yes!

It is quite an interesting list with different type of clinics. 

[LonelyGraft]

12 minutes ago, Gasthoerer said:

Yes!

It is quite an interesting list with different type of clinics. 

Haven’t heard much about them lately. I remember maybe 10 years back they were the talk of the town on various forums.

[Gasthoerer]

They somehow share(d) the facilities with Dr. de Reys. There are a lot of cases in the german forum (alopezie.de). Reasonable priced for Europe, but IMO slightly below top clinics density wise etc. 

[a.j.]

On 8/12/2019 at 4:52 AM, MrZennie said:

Maybe when Diep says manual, he means non-Artas?  

By "manual," Dr. Diep means handheld. As in, non-robotic. He uses a motorized punch device with foot pedal control similar to a dentist's drill or Devroye's WAW. I think he rigged it up himself or had someone build it for him.

[bruce90]

Which method do you guys think results in less damage to the donor area like less scaring and lower transection rates? I think this is the most import aspect of this for me and remember someone saying manual fue was better in this regard. What's the consensus on this? 

Edited August 25, 2019 by bruce90

[a.j.]

Whether the extraction tool is motorized or not isn't really the question. What determines the nature and extent of FUE scarring and donor damage are the punch sizes used, the extraction pattern and spacing within the donor, and the extractor's skill. 

[stephcurry30]

On 2/11/2019 at 9:15 AM, Dr. Raymond Konior said:

What is my opinion on clinics that utilize technicians for extracting grafts?  Hmm…

Answer these three questions:

1)      Would you allow a tech to remove a brain aneurysm on your mother?

2)      Would you allow a tech to perform coronary artery bypass on your father?

3)      Would you allow a tech to remove a testicular cancer on you?

If the answer is “yes” to any of these questions, you should do nicely in a tech-driven hair restoration facility.  If, on the other hand, you answered “no” to all questions, then ask yourself why you would allow a technician to perform a surgical procedure on your scalp.  Also, if you answered “no” to all questions, and you decide to use a facility that uses technicians for graft extraction – without direct supervision by the operating doctor – ask your doctor why he or she is not performing the procedure, but rather uses the service of a technician to perform what I deem to be a surgical procedure.  Questions I would direct to the physician if he or she uses technicians for graft extraction without direct doctor supervision:

1)      Do you use a technician because you have poor eyesight?

2)      Do you use a technician because you have a tremor?

3)      Do you use a technician because you will be in another room maximizing your profit for the day?

4)      Do you use a technician because you don’t believe patient care and supervision is important?

5)      Do you use a technician because you are lazy and prefer to surf the web or check your stock portfolio?

6)      Do you use a technician because you lack surgical skills and believe the technician is capable of delivering a better quality graft than you would be capable of delivering?

7)      Do you believe harvesting grafts is a “simple” component of the surgical procedure or that harvesting grafts is “no big deal” such that it can readily be delegated to a technician?

The bottom line is that I believe hair restoration is a surgical procedure that should be performed by a doctor.  It is not a mundane and simplistic task that is capable of being delegated to the technician level.  Face it, most technicians have little to no formal education, i.e. they receive “on the job” training.  Who is training them and who is supervising them?  We in this practice respect the doctor-patient relationship and feel that the patient is entitled to the doctor’s presence in the operating room from beginning to end. 

 

wow. What a great answer. 

[Gasthoerer]

On 12/23/2022 at 3:27 AM, stephcurry30 said:

wow. What a great answer. 

While it is an intersting answer, I do not think it is a great answer, as it is a simplification. And with all due respect it is also partly advertising - similiar to the "manual FUE is the best" comments from some clinics.

The truth is: Even in heart surgery, large part of the surgery are done by the team inlcuding opening and closing of the "chest" etc. Now, is it debatable, which part of the surgery can or should be outsourced? Yes, of course. Does the experience of the techs play a mojor role, and should we know their experience better? Yes, of course. But especially for larger surgeries a doc only approach IMO also has limitations.