Category: FUE

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Hair Loss InformationFUE Without Shaving the Donor Area? – Hair Loss Information – Balding Blog

Dr. Rassman,

Thanks for the good work of educating us on hairloss on this website. You may not recall but I came to your clinic in December last year. One of the main questions I asked was whether it was possible to do FUE without shaving the donor area. You showed me a picture of a patient with “stripped shaves” as a way of hiding the surgery.

Recently, I came across Dr.Cole’s website. The website talks of a technique in which FUEs can be harvested without shaving your hair. I find this an interesting prospect as I would not want to have evidence of my transplant when I go to work.

Is this something that you may consider doing at NHI?

Here is the link: Forhair.com

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I must be missing something. I read the link you suggested, but it sounds like what we’ve been doing for years… which is to clip a small area of the donor to extract the grafts. It allows those having FUE to maintain their same hair style, as the hair just above the donor area will cover the clipped part. The link you sent seems to just talk about how Dr. Cole’s patients now don’t have to shave their entire head.

At NHI, we do not completely shave the head to do FUE, as shown in the photos here.

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Hair Loss InformationAny NeoGraft and Artas® Robot Alternatives? – Hair Loss Information – Balding Blog

What other “automated” or similar hair restoration systems are available besides Neograft and Restoration Robotics?

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The follicular unit extraction (FUE) technique is a simple and elegant technique conceptually, but it is highly variable or difficult in practice. Since I published my FUE article in 2002, hundreds of doctors have adapted their own automation and instrumentation. I encourage this, as one superior technique or machine may emerge. But as of 2011 it has not.

There are handful of doctors who have invented their own technique in some form or another. NeoGraft and the Artas® robots are just commercial adaptations. Both Dr. Cole and Dr. Harris have developed instruments which are diametrically opposed as to how they work. There is also Dr. Boudjema in France (one of the brightest and most creative people in the hair business) who first invented an FUE automation machine back in the mid-1990’s called the Calvitron (which is similar to NeoGraft). He always has a new approach and just recently talked with me about his most recent innovation (brilliant as always).

Real inventing requires ‘out-of-the-box’ thinking, but most of what is out there are just minor variations of each other. There are powered punches that vibrate, twist one way and then the other way, that are slow in RPMs, that are fast in RPMs, that claim sharper punches or duller punches as the key to best results, etc.. The Artus system uses sharp followed by dull punches and the Neograft uses very sharp punches. Each doctor will likely say ‘his’ instrument is the best.

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Hair Loss InformationPimples in the Donor Area 7 Weeks Post-Op – Hair Loss Information – Balding Blog

I will ask the question again. I am a NW3. I had a hair transplant of 3650 grafts, about 8500 hairs into an area about 50cm2 in the frontal area. This was a FUE procedure. I am having small bumps, nodules, pimples? in the DONOR, NOT recipient area. I am exactly 7 weeks post op. What are these bumps and what caused them? thanks

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When FUE transection occurs, remnants of hair are left in the donor scalp and they become a foreign body causing pimples and abscesses. You should see the doctor who did this and get his expertise in treating it. If you do not get the infections under control, they may just get worse and worse.

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Hair Loss InformationWhat is FOX Negative? – Hair Loss Information – Balding Blog

What does FOX negative mean?

Thanks.

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We coined the term “FOX” at New Hair Institute back in 2002 for FOllicular unit eXtraction. We thought FOX sounded better than FUE. We also published a paper on follicular unit extraction, describing how some patients are good FOX/FUE candidates and some are not.

I realize FUE is performed at many clinics without any pre-testing on all patients who want to have the surgery, however at NHI we pre-qualify potential patients with a FOX/FUE test to see if they are good candidates. A very small percentage of patients will have high transection rates with FUE and these are the FOX negative patients we are talking about.

We generally do not recommend FOX/FUE surgery if the transection rate is approaching 20% or more. If the patient is FOX negative, it is an inherent problem to the patient (not the doctor or clinic or machine). As we wrote about our experience with NeoGraft a week ago, the machine could not successfully harvest a known FOX negative patient.

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Hair Loss InformationHave You Tried NeoGraft Yet? – Hair Loss Information – Balding Blog

Hi Dr. Rassman,

I read where your colleague, Dr. Bernstein, recently decided to add the NeoGraft Unit to his office’s hair restoration offering – see his blog for more information. I was wondering if you have had an opportunity to try the NeoGraft and whether or not they have managed to overcome trauma to the grafts from “drying” and mechanical effects (during extraction and implanting)? I have read your blog concerning your (and Dr. Pak) device (hydro) and was really hoping that they might take a page from your book on this technique.

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I did try NeoGraft on one of our known FOX negative patients and the results were not good, but comparable to what we would have gotten using our own techniques in such a patient. A quick aside, the FOX test means that we ran a small FUE test to see if they are candidates for a full FUE procedure… and FOX negative means we do not recommend the FUE procedure for them.

The NeoGraft system did what we would have expected it to do. I believe (without direct experience) that the ARTAS robot would have also produced damage with this FOX negative patient, but as most patients are not FOX negative, the test of the NeoGraft on this patient was not a fair representation of what it should do.

I have asked for a loan of a NeoGraft system to help me find a place in my practice for it. I know that Dr. Bernstein is getting an ARTAS system and I am sure that when he has a FOX negative patient, I will find out what his experience is with such a patient.

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Hair Loss InformationDo Doctors Track Transection Rates in Hair Transplant Surgery? – Hair Loss Information – Balding Blog

I was curious if you know if any doctors track the survivability of the grafts? I know that there is quite a bit of information on transection rates for different surgeons but was wondering if anyone monitors this metric? If they do – how might the survivability be determined outside of just counting the grafts in the recipient area a few weeks/months after the surgery? Thanks

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This is a great question. We track transection rates when we perform FUE surgeries. The transection can vary from 5% to 50%. I believe 5 to 10% is an acceptable number. If there is a high transection rate then we will abort or never recommend surgery. This is the reason why at NHI we always pre-test all potential FUE patients, but I realize other clinics and doctors may not do this.

The data for other clinics and doctors is not available or well published in studies. I believe mainly it is directly linked to business. No one would publish poor results or high transection rates, as it is not good for business. As unfortunate as it may be, the consumers and patients are left to do their own due diligence and trust their doctor, probably by contacting patients who had it done by that doctor. One way around this would be for patients to ask about seeing actual patients in person or seeing their own surgical records of how the grafts were tracked (if it is done at all). In theory, the transection rate should be documented on the day of surgery, but I realize not all doctors will keep this record (as it is not mandatory) and some may refuse to show it to their patients. I can say this because I have heard these issues come up in consultations with some patients that have had procedures done elsewhere previously.

I know of one doctor who promotes and reports 96% good FUE grafts (4% or less transection), yet I have see many of his patients and found a high degree of failures in those of his patients who came to me for a second opinion. This is a buyer beware business. Sometimes you can expose poor practices through reports by the chamber of commerce or the courts in the areas where the doctors practice. I’ve also been asked to post the names of doctors to be weary of, but if I were to speak up and identify those who may not be honest in their representation, I would become a target for slander. I have better things to do than take up residence in the court system.

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Hair Loss InformationShaving the FUE Donor Area – Hair Loss Information – Balding Blog

I would like to know if you have to necessarily shave a part of the donor area to perform FUE ? Can it be done if you keep your hair at normal length ?

If you have to shave it how long do you have to keep the rest of the hair in the donor area to camouflage the part that’s shaved ? Is it noticeable ?

Thanks

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It depends on the number of grafts you need through follicular unit extraction (FUE). A large number of grafts will require an area to be shaved. When we see you and give you a quote, we can tell you the answer to that question.

Take a look at the patient example on our FUE page. We kept his hair long and clipped small areas that were easy to cover with his existing hair. We can often get 500 or so grafts from such an area.

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Hair Loss InformationWhat Happened to FUE2? – Hair Loss Information – Balding Blog

Dr Rassman,

What ever happened to FUE2? When it first came out it was marketed like the next big thing in hairloss but know never gets a mention.

Was it a failure? Or are you still working on it?

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We still use FUE2 in selected patients. The system in not automated, so it is more difficult to do it by hand, but we do use it. When I finally get it automated, I suspect that I will use it all of the time.

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Transplanting Beard Hair to the Scalp? – Hair Loss Information – Balding Blog

Hello doctor

What do you think about transplanting beard hair to the scalp ?

a ) Does it worth the cost ? Is it a measure of last resort or a reasonable addition to achieve better coverage and thickness ?
b ) How many hair can you get from a beard to transplant ?
c )Is there a significant risk of little dot scars to the face ?
d ) Is it true that although beard grafts are mostly single haired , those hairs are 3 – 4 times thicker than scalp hair ?

Appreciate your time

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At NHI, we do not perform beard hair transplants to the scalp unless the donor supply is depleted. We therefore do not endorse this treatment. Another way to put it is, we do not recommend surgery that we would not want done on ourselves. I realize there are other doctors and clinics that advertise and transplant beard hair to the scalp, but results we have seen have been mixed (some good, some bad).

You must remember beard hair texture and growth is completely different than scalp hair, so there is a potential for mismatch. There is also a chance of some sort of scarring to the face. ALL surgery or cut on the skin will produce some form of a scar. Even the best FUE will produce a scar if you look close enough. Most people will never see the FUE scars, because they’re in the back of the scalp, but FUE to the face and beard area will stand out if you shave.

The cost of the surgery and its benefits are something only you can assess based on your expectations. The number of hairs and the quality of beard hair is dependent on your beard hair characteristics. Everyone is different and there is no universal answer.

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Bumps in Donor Area After FUE – Hair Loss Information – Balding Blog

I had a FUE operation of 3650 grafts exactly six weeks ago to my frontal hairline NW2. I recently, last 5 days, have about ten bumps like pimples in the DONOR area? what is going on?

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Norwood 2If you were really only with a Norwood Class 2 pattern balding, why would you have 3650 grafts transplanted? This just does not make any sense to me.

Two things come to mind that could explain the bumps you’re seeing — 1) When transected hairs in a graft are placed, they can act as a foreign body. 2) There may also be folliculitis at the recipient sites.

If there is a folliculitis, the treatment should be incision and drainage of the bumps, a culture of what comes out of the wound and the use of antibiotics. Once the culture has grown out, the organisms will be identified and tested against the medication that the doctor will give you. That will tell him if his guess is the correct diagnosis.

For transected hairs, there may be a different course. As much as I would like to help you, I think that you will be best served to go back to your doctor.