Importance of Harvest - Incisions - Implants

[Zizou88]

As most people I have been looking for many years for a Dr. I will feel comfortable doing a FUE procedure.
Based on previous reviews I contacted Hasson & Wong clinic to learn more about the procedure and what would be the involvement of Dr. Jerry Wong if I decide to move forward with them. They mentioned, that "FUE technician will harvest the follicular units - Dr Wong will make all incision sites - surgical technicians will implant the follicular units into the slits Dr. Wong has created". 

Does that means that the premium price you pay for one of the most recognized doctors in the industry are mainly for his incisions? Is this the most important part of a FUE procedure?
Is this the same case will all top level doctors? The mainly focus on the incisions and shape and technicians do the harvest + implants?

Thank for the help.  

[pkipling]

As a general rule, you want the surgeon to be doing the extractions and making the recipient sites. I'm not sure of the law in Canada, but in the US, it's illegal for anyone except the surgeon to do the extractions. It's possible that by harvesting, they simply mean the technician lifts the grafts once they've been extracted and begins the process of separating, cleaning, and counting them. If that's the case, this is standard procedure. Chances are that's what they're talking about, as I can't imagine a reputable surgeon having technicians extracting grafts. 

[chris345]

All the extractions at H&W are done by their techs. All the amazing before & after FUE photos from that clinic were extractions/ implants done by the techs. Likewise with Rahal clinic.

[Gasthoerer]

On 3/13/2020 at 6:48 AM, pkipling said:

….as I can't imagine a reputable surgeon having technicians extracting grafts. 

Almost all top clinics have techs extracting the grafts. The top clinics who have the doc doing the entire procedure are countable on 1-2 hands.

It has been discussed here 1000 times and the clinics are mentioned even more than that. 

[Zizou88]

Thanks for the responses and help. I understand the good results the clinic has followed the same process. 
I think I might be more comfortable with another top clinic where the doc is more hands on. Recently reached out to Bernstein Medical - they mentioned "All surgical aspects of the procedure are done by Dr. Bernstein or Dr. Shaver. Technicians check grafts, sort them, and place them into the scalp". Personally will be more comfortable with this type of involvement. 

[LonelyGraft]

6 hours ago, Zizou88 said:

Thanks for the responses and help. I understand the good results the clinic has followed the same process. 
I think I might be more comfortable with another top clinic where the doc is more hands on. Recently reached out to Bernstein Medical - they mentioned "All surgical aspects of the procedure are done by Dr. Bernstein or Dr. Shaver. Technicians check grafts, sort them, and place them into the scalp". Personally will be more comfortable with this type of involvement. 

Doesn’t Bernstein only perform fue using artas? I haven’t seen many impressive fue results from them compared to h&w tbh

[pkipling]

On 3/15/2020 at 12:16 AM, Gasthoerer said:

Almost all top clinics have techs extracting the grafts. The top clinics who have the doc doing the entire procedure are countable on 1-2 hands.

It has been discussed here 1000 times and the clinics are mentioned even more than that. 

It seems like the confusion here is what exactly is meant by "extracting" the grafts, which I suppose is technically a two part process. 1) The surgeon incises/scores the graft, which is when the device is used to physically cut through the skin and dislodge the graft from the tissue. 2) The technicians then come in and lift those grafts that the surgeon scored and begin to separate and clean them. 

What I was referring to - and what I am under the impression most patients think of when they think of "extracting" - is the incision aspect of using the punch to dislodge the graft. This is the part that is extremely crucial and I believe every top surgeon does this. In fact, (and I may be mistaken and can't confirm right this second), I believe it's illegal for anyone other than the surgeon to do this aspect of the surgery in North America. 

[gillenator]

On 3/13/2020 at 1:48 AM, pkipling said:

As a general rule, you want the surgeon to be doing the extractions and making the recipient sites. I'm not sure of the law in Canada, but in the US, it's illegal for anyone except the surgeon to do the extractions. It's possible that by harvesting, they simply mean the technician lifts the grafts once they've been extracted and begins the process of separating, cleaning, and counting them. If that's the case, this is standard procedure. Chances are that's what they're talking about, as I can't imagine a reputable surgeon having technicians extracting grafts. 

You are spot on regarding the laws of who can and who cannot legally make incisions...and BTW,  yes in most clinics it's the techs who are performing the entire extraction process, not the surgeons!...obviously I cannot name anyone specifically but this is something to get clarified up front.

The industry is totally unregulated and I imagine why there is nothing being done about it!....😠

Edited March 24, 2020 by gillenator

[pkipling]

1 minute ago, gillenator said:

You are spot on regarding the laws of who can and who cannot legally make incisions...and BTW, yes in most clinics it's the techs who are performing the entire extraction process, not the surgeon!

The industry is totally unregulated and I imagine why there is nothing being done about it!....😠

Hey Gillenator! So you're saying that even in the US/Canada, there are surgeons who allow the technicians to score the actual grafts - even though it's illegal? 

[gillenator]

YES...that is exactly what I am saying!

[pkipling]

38 minutes ago, gillenator said:

YES...that is exactly what I am saying!

Damn. I think it's safe to say that at the very least, the top North American surgeons recommended on this site aren't the ones doing that... At least as far as I know. 

[gillenator]

I think a large factor is the amount of time required during the extraction process....and if the surgeons were doing it themselves, the cost of the procedure would undoubtedly increase dramatically.