ISHRS

[Pat - Community Publisher]

Reporting from Vancouver Canada - impressions regarding the annual scientific meeting sponsored by the International Society of Hair Restoration Surgery (ISHRS).

 

After five days of lectures, workshops, meetings and presentations I've finally found the time to sit down and share some highlights and observations from this years meeting.

 

I'm impressed with the genuine passion and intensity that most attending physicians share for evolving and mastering their procedures and techniques. While there has always been debate as to the relative advantages and benefits of various techniques and procedures, my sense is that the profession of hair restoration surgery has come a long way from the first meeting I attended over 5 years ago in Washington, D.C.

 

Every one, including the big national groups, seem to be making real improvements in their over all quality and value. Surgical hair restoration is producing more consistent and dependable quality results overall. The early days, just a few years ago, when truly natural results were the exception rather than the rule seems to be moving rapidly into the rear view mirror.

 

Hard fought for innovations such as microscopically prepared follicular unit grafting are now widely accepted and practiced. So how fitting that the physician who pushed, pulled and fought most tirelessly for the wide adoption of Follicular Unit Hair Transplantation was chosen as this years recipient of the "Golden Follicle Award". Those who know the history of Follicular Unit Transplantation will have no trouble guessing his name ??“ Dr. Bill Rassman (see photos below).

 

Myself and all other patients who today benefit from natural follicular unit hair transplantation owe a debt of gratitude to Dr. Rassman, directly or indirectly, for fighting the good fight to overcome inertia and resistance until this procedure became the acknowledged "Gold Standard in Hair Transplantation". So how fitting that he now win the Golden Follicle Award.

 

Dr. Rassman has always been willing to point out when the emperor had no clothes even when it made him unpopular with his colleagues. He was willing to put himself in the line of fire for what he believed in as a major in Vietnam and he was awarded the Silver Star. As a hair restoration physician he once again stood up under fire and has finally been awarded the Golden Follicle Award. Congratulations Dr. Bill Rassman.

 

"Those who say it can't be done should not stand in the way of those who are doing it every day."

- Dr. Bill Rassman

 

Upon accepting his award Dr. Rassman commented on how pleased he was that the hair restoration profession had evolved so much that he had little left to criticize. As one of his profession's toughest critics, this was a high compliment.

 

While follicular unit grafting has brought a high level of refinement to the hair transplant procedure, it is not without limitation. Given the limited donor hair available in all patients, follicular units spread over a wide area still only create the illusion of fullness at best. This was clearly evidenced during the live patient showing.

 

Over 50 patients from various physicians attended this event and each was seated under a bright spot light. Those of us who have known hair loss know that this is the most unforgiving lighting possible.

 

Under this bright light follicular unit grafting, especially the sub follicular unit grafting that some clinics practice, has a relatively thin, dispersed and semi transparent appearance.

 

It is this obvious limitation that has convinced some physicians to advocate for the judicious use of small microscopically prepared "follicular groupings" in combination with follicular units to create the ultimate combination of naturalness and the illusion of density.

 

This new hybrid combination grafting procedure is not a return to mini/micrografting. Rather it is a hybrid technique that uses small refined grafts and tiny minimal depth incisions with the advantage of moving more hairs with fewer grafts and incisions.

 

By creating small grafts from neighboring follicular units that are very closely grouped together, a surgeon can continue to use tiny grafts and incisions, while moving more hair per graft. This enables surgeons to combine these multi haired grouped follicular unit grafts with standard follicular unit grafts to create densely packed arrangements of grafts that produce the ultimate illusion of density compared to evenly dispersed grafts composed of follicular units that contain very few hairs.

 

Several respected physicians presented supporting information about this technique and I believe this multi unit grafting (MUG) provides patients with the best value, appearance of fullness and naturalness. In many ways multi unit grafting takes the best of all techniques and concepts and combines them.

 

This years' prestigious "Platinum Follicle Award" was presented to Dr. Melvin Mayer of Medical Hair Restoration (MHR). He is considered to be one of the best surgeons working for MHR and has contributed along with Dr. Matt Leavitt (recipient of the Golden Follicle award 2002) to the popular annual live surgery workshop in Orlando Florida. Congratulations to Dr. Mayer.

 

I also had the opportunity to view a patient of Dr. Matt Leavitt during the live patient showing. I found that the quality of this particular case was high. I hope that this work will become the standard for all work being done in all MHR clinics.

 

Dr. James Arnold was presented with the Manfred Lucas award for his life long dedication to hair restoration and his many contributions to improving the aesthetics of the procedure. Dr. Arnold is retired and living in California.

 

Kudos also to Dr. Paul Rose for organizing and implementing the ISHRS's new probono program "Operation Restore Hope", which provides free hair restoration to people suffering hair loss due to accident or illness. Many members of the ISHRS having been doing such free work for years but this program will make it more systematic and broad based.

 

Dr. Tony Mangubat is the first physician to volunteer his services. Dr. Mangubat introduced his patient ??“ a young boy who was disfigured due to burns and hair loss - to physicians attending the general session. The boy's mother then made a touching heartfelt speech about how life changing this operation would be in her families' life.

 

Many physicians attending this years meeting stated that they thought it was the best ISHRS meeting they ever attended. In many ways I agree.

[Pat - Community Publisher]

Reporting from Vancouver Canada - impressions regarding the annual scientific meeting sponsored by the International Society of Hair Restoration Surgery (ISHRS).

 

After five days of lectures, workshops, meetings and presentations I've finally found the time to sit down and share some highlights and observations from this years meeting.

 

I'm impressed with the genuine passion and intensity that most attending physicians share for evolving and mastering their procedures and techniques. While there has always been debate as to the relative advantages and benefits of various techniques and procedures, my sense is that the profession of hair restoration surgery has come a long way from the first meeting I attended over 5 years ago in Washington, D.C.

 

Every one, including the big national groups, seem to be making real improvements in their over all quality and value. Surgical hair restoration is producing more consistent and dependable quality results overall. The early days, just a few years ago, when truly natural results were the exception rather than the rule seems to be moving rapidly into the rear view mirror.

 

Hard fought for innovations such as microscopically prepared follicular unit grafting are now widely accepted and practiced. So how fitting that the physician who pushed, pulled and fought most tirelessly for the wide adoption of Follicular Unit Hair Transplantation was chosen as this years recipient of the "Golden Follicle Award". Those who know the history of Follicular Unit Transplantation will have no trouble guessing his name ??“ Dr. Bill Rassman (see photos below).

 

Myself and all other patients who today benefit from natural follicular unit hair transplantation owe a debt of gratitude to Dr. Rassman, directly or indirectly, for fighting the good fight to overcome inertia and resistance until this procedure became the acknowledged "Gold Standard in Hair Transplantation". So how fitting that he now win the Golden Follicle Award.

 

Dr. Rassman has always been willing to point out when the emperor had no clothes even when it made him unpopular with his colleagues. He was willing to put himself in the line of fire for what he believed in as a major in Vietnam and he was awarded the Silver Star. As a hair restoration physician he once again stood up under fire and has finally been awarded the Golden Follicle Award. Congratulations Dr. Bill Rassman.

 

"Those who say it can't be done should not stand in the way of those who are doing it every day."

- Dr. Bill Rassman

 

Upon accepting his award Dr. Rassman commented on how pleased he was that the hair restoration profession had evolved so much that he had little left to criticize. As one of his profession's toughest critics, this was a high compliment.

 

While follicular unit grafting has brought a high level of refinement to the hair transplant procedure, it is not without limitation. Given the limited donor hair available in all patients, follicular units spread over a wide area still only create the illusion of fullness at best. This was clearly evidenced during the live patient showing.

 

Over 50 patients from various physicians attended this event and each was seated under a bright spot light. Those of us who have known hair loss know that this is the most unforgiving lighting possible.

 

Under this bright light follicular unit grafting, especially the sub follicular unit grafting that some clinics practice, has a relatively thin, dispersed and semi transparent appearance.

 

It is this obvious limitation that has convinced some physicians to advocate for the judicious use of small microscopically prepared "follicular groupings" in combination with follicular units to create the ultimate combination of naturalness and the illusion of density.

 

This new hybrid combination grafting procedure is not a return to mini/micrografting. Rather it is a hybrid technique that uses small refined grafts and tiny minimal depth incisions with the advantage of moving more hairs with fewer grafts and incisions.

 

By creating small grafts from neighboring follicular units that are very closely grouped together, a surgeon can continue to use tiny grafts and incisions, while moving more hair per graft. This enables surgeons to combine these multi haired grouped follicular unit grafts with standard follicular unit grafts to create densely packed arrangements of grafts that produce the ultimate illusion of density compared to evenly dispersed grafts composed of follicular units that contain very few hairs.

 

Several respected physicians presented supporting information about this technique and I believe this multi unit grafting (MUG) provides patients with the best value, appearance of fullness and naturalness. In many ways multi unit grafting takes the best of all techniques and concepts and combines them.

 

This years' prestigious "Platinum Follicle Award" was presented to Dr. Melvin Mayer of Medical Hair Restoration (MHR). He is considered to be one of the best surgeons working for MHR and has contributed along with Dr. Matt Leavitt (recipient of the Golden Follicle award 2002) to the popular annual live surgery workshop in Orlando Florida. Congratulations to Dr. Mayer.

 

I also had the opportunity to view a patient of Dr. Matt Leavitt during the live patient showing. I found that the quality of this particular case was high. I hope that this work will become the standard for all work being done in all MHR clinics.

 

Dr. James Arnold was presented with the Manfred Lucas award for his life long dedication to hair restoration and his many contributions to improving the aesthetics of the procedure. Dr. Arnold is retired and living in California.

 

Kudos also to Dr. Paul Rose for organizing and implementing the ISHRS's new probono program "Operation Restore Hope", which provides free hair restoration to people suffering hair loss due to accident or illness. Many members of the ISHRS having been doing such free work for years but this program will make it more systematic and broad based.

 

Dr. Tony Mangubat is the first physician to volunteer his services. Dr. Mangubat introduced his patient ??“ a young boy who was disfigured due to burns and hair loss - to physicians attending the general session. The boy's mother then made a touching heartfelt speech about how life changing this operation would be in her families' life.

 

Many physicians attending this years meeting stated that they thought it was the best ISHRS meeting they ever attended. In many ways I agree.

[Pat - Community Publisher]

Dr. Melvin Mayer of Medical Hair Restoration receiving the "Platinum Follicle Award".

[Pat - Community Publisher]

Dr. James Arnold receiving the "Manfred Lucas" award.

[Pat - Community Publisher]

Note - This topic is for those who would like to discuss the ISHRS meeting in Vancouver. Those who want to indulge in politics and infighting need to visit another forum.

[Brando]

My question got deleted so I'll ask again. You mentioned the MUG, which is awesome, but besides that was there any talk about any future techniques such as hair multiplication, a substitute to Propecia, etc..? Was Dr. Gho or Bazaan's name mentioned at the convention? Was there any talk of Bazaan's so called September release of hair multiplication?

[lorenzo]

Good!!! I was wondering if anyone could tell me which doctors came and from which countries. Also why didn't Dr. Zondos , Dr. Fellar or Dr. C*le show up??

[Pat - Community Publisher]

I was only able to attend some of the meetings. However, Dr. Rose told me that he would be willing to provide a more in-depth report on events in BC for this forum.

 

I was not at the hair multiplication talks. However, I did spend time speaking with the lead people for a firm called Intercytex out of England. This group along with the Aderans Research Institute, which is owned by the Bosley Medical Group, is working hard to make hair multiplication commercially viable. I suspect with their resources they are out ahead of the small single phycisian operators.

 

They envision using the hairs initially more as filler hair to create density as these replicated hair follicles cells will be hard to control hair growth direction at least initially.

 

The use of hair multiplication, even as a supplement to regular hair transplantation is at least 5 years off using even the most optimistic estimates.

 

However, within ten years this process may over come the need to rely on a limited donor supply. So theoretically some day it may be possible for a class 6 to look like James Dean or Elvis.

 

Perhaps Dr. Rose and others can provide more insight on these questions.

 

Pat

[Pat - Community Publisher]

Lorenzo,

 

This years meeting was fairly well attended. However, I know there was disappointment among the ranks that the FUE physicians did not really show up present. This same situation occured last year.

 

Pat

[HairBeThere]

I think I'm ok to post this...

 

Here is a great article on upcoming cloning, and describes as Pat stated about filler for density.

 

It's RealPlayer or Windows Media Player format.

http://abcnews.healthology.com/webcast_redirect.asp?f=hairloss&c=hairloss_cloningtech&webcasttype=ms&speed=56&webcast=hairloss_cloningtech&clipOn=

[gillenator]

Pat,

 

While you probably already know that FUG is not a new concept, I think what I am hearing you say is that more HT doctors are actually putting this concept into practice? Please correct me if I misunderstood you. Moving hair in follicular unit groupings/families I believe is probably more practical with strip harvest than FUE/FIT extractions. Most FUE/FIT surgeons utilize a 1mm punch and may not have the diameter necessary to safely extact f/u groupings/families. In addition the angulation of the neighboring f/u may be slightly different from the primary f/u so more potential for transection may occur. And even if they were to use a larger punch, the extraction would be more invasive would it not? Well I am not a doctor so I stand to be corrected if necessary. It is food for thought. I also know that it takes an extremely skilled tech to cut the MU grafts under scope (strip harvest), to make them as lean as possible so I certaily would not want a tech in training cutting my MUs. The bottom line as you said, will save us patients money without compromising the aesthetic result. It sounds like there were alot of HT patients at the meeting. Did MHR have just the one patient you saw or did they have lots to showcase from? Thanks for the feedback on the meeting.

[Brando]

Thanks for the feedback Pat. Wow...a class 6 looking like James Dean or Elvis. Hopefully THAT is 10 years away. I know Dr. Cooley was at the meeting, did he speak?

HairBeThere: Excellent link, man!

[EastCoast]

I also read Dr. Shapiro had a patient with mixed grafts. This sounds like couple fu's which I had that did not look natural.

 

Pat. This site is very conflicting, both with recommended Dr.s and techniques:

In conclusion, it is possible to achieve the appearance of naturalness and density on a consistent basis with natural follicular groupings called "follicular units". This method requires greater numbers of grafts and technical skill in order to achieve cosmetic density. But once the technical skill to perform this technique is achieved the look is invariably natural. The question is: Is the increased degree and consistency of naturalness produced with follicular units worth the effort and risk necessary to achieve the appearance of density, especially in the central area were grafts are less scrutinized.

 

Mini grafting in the central area using 3-5 hair grafts "cut to size" offers the practitioner and patient a faster, slightly more economical way to achieve coverage, and if performed skillfully can achieve nearly the same degree of naturalness as single follicular groupings. However, the caveats are several, and when not observed, the results are a step down from the Mercedes Benz of grafts, the follicular unit.

 

Other methods of transplantation group the naturally occurring follicular units into unnatural-appearing aggregations (clumps, tufts, plugs), always resulting in an unnatural tufted visibility of the final product, which requires multiple additional sessions to hide the unnatural appearance. Such restoration procedures include standard round or square plugs and all forms of minigrafts (round, square, triangular, oval slots, linear slits, strip grafts).

 

Please define MUG !!!

[Bushy (fka jontew)]

Hey, what happened to the 85 posts that were here earlier today? Why were they removed?

[Pat - Community Publisher]

EastCoast,

 

Using small microscopically prepared follicular family grafting or MUG (multi unit grafts) is NOT at all like going back to mini grafting. Otherwise I would have simply stated that physicians were reverting back to mini micro grafting. Nor is it coupled follicular units.

 

I wish I had Dr. Arthur Tykocinski's of Brazil's power point presentation and his excellent photos showing the vast difference between carefully trimmed 3, 4 and some times 5 hair follicular unit family grafts versus standard 3 - 5 hair mini grafts.

 

The basic idea is that some follicular units are so close together that they can be trimmed and kept together as one small graft, while containing enough hair so that when they are postioned strategically and in combination with 1, 2, and 3 hair follicular units they can create the optimal illusion of density that can't be achieved soley with pure follicular units.

 

The physicians behind this and advocating for it were also generaly the inovators and early adopters of the follicular unit procedure.

 

I hope to gather up images to illustrate the many advantages (and not just in terms of cost) of using follicular families with standard follicular units.

 

Pat

[EastCoast]

Fair enough.

 

Thanks

[Gregg]

Dr. Arnold performed one of my transplants. While he did an good job on my frontal hairline, I was left with a 1" wide inch donor scar. It has taken me two scar revisions to lessen this.

[MoHair4Me]

Dr. Arnold performed one of my transplants. While he did an good job on my frontal hairline, I was left with a 1" wide inch donor scar. It has taken me two scar revisions to lessen this.

 

ONE INCH WIDE donor scar?! Horrible. Gald you were able to get it reduced somewhat.

[arfy]

Last year Pat didn't report on the meeting, so I'm glad he wrote something about it this year.<BLOCKQUOTE class="ip-ubbcode-quote"><font size="-1">quote:</font><HR>Upon accepting his award Dr. Rassman commented on how pleased he was that the hair restoration profession had evolved so much that he had little left to criticize. As one of his profession's toughest critics, this was a high compliment.

If Dr. Rassman now feels complacent about the state of the industry, which is still loaded with serious problems, then that is a big disappointment.

 

Also, WHY OH WHY is there still talk of grafting artificial fibers, at a hair transplant meeting? This is a meeting about HAIR grafting, no? There is no hair grafting involved, when artificial fibers are used. Why not spend time talking about hair pieces? Hair pieces are closer to artificial fibers than hair transplantation is.

 

I also noticed that Dr. Carlos Puig was on a panel discussion on "Managing the Unhappy Patient". Since Dr. Puig probably has several decades of experience in "managing" unhappy patients, he'd be able to contribute a vast personal insight to the subject.

[shaulema]

To Pat - Publisher of this Community

I send you this mail because i want to know if you know Dr. Arthur Tykocinski's of Brazil's and his work.

Thanke you.

 

 

EastCoast,

 

Using small microscopically prepared follicular family grafting or MUG (multi unit grafts) is NOT at all like going back to mini grafting. Otherwise I would have simply stated that physicians were reverting back to mini micro grafting. Nor is it coupled follicular units.

 

I wish I had Dr. Arthur Tykocinski's of Brazil's power point presentation and his excellent photos showing the vast difference between carefully trimmed 3, 4 and some times 5 hair follicular unit family grafts versus standard 3 - 5 hair mini grafts.

 

The basic idea is that some follicular units are so close together that they can be trimmed and kept together as one small graft, while containing enough hair so that when they are postioned strategically and in combination with 1, 2, and 3 hair follicular units they can create the optimal illusion of density that can't be achieved soley with pure follicular units.

 

The physicians behind this and advocating for it were also generaly the inovators and early adopters of the follicular unit procedure.

 

I hope to gather up images to illustrate the many advantages (and not just in terms of cost) of using follicular families with standard follicular units.

 

Pat