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What Is The Difference Between The ARTAS and NeoGraft?

There are so many different options for hair transplants nowadays. What are the difference in Artas and Neograft? Why are they so popular?

Think of the ARTAS as using an electric wrench held by a robot to tighten a loose nut. The Neograft is like using an electric wrench held by a human to tighten a loose nut. A human (doctor) can just as easily tighten the loose nut with a hand held socket wrench. The results are same. It is just more expensive to own a robot.

Despite what you may think, hair transplant surgery is basically taking hair out and relocating to another area.
The skill and expertise required to carry out this task is what sets doctors apart.

There are two general methods in taking out (harvesting) the grafts: (1) FUE and (2) FUT – strip.
The ARTAS and Neograft are just tools that harvest the grafts using the FUE method.

The “options” you mention are pertaining to the TOOLS that doctors use to carry out surgery. The ARTAS system is just a tool that a doctor may use to harvest the hair grafts. The results from ARTAS should be the same as any other type of surgery in the same capable hands.

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How Can You Ridicule the LaserComb But Support Rogaine?

Hello Dr Rassman.

I have a slight bone to pick with you, regarding some interesting comments made about the Lasercomb. In one of your articles you mentioned the line “I still go by my gut feeling, an application three times a day by a comb going through the hair just does not sit right with me and my intellectual judgment (which dictates a great deal about why I think that way)”. I would like to point out the ridiculous parallels of this comment to a certain other product called Rogaine. Firstly no one actually knows how Rogaine works (the company readily admits this on there website) Secondly I dont think its any more absurd or outrageous to think a comb with lazers is any less effective than putting an alcohol like solution called “Roagine” which no one really knows ingredients of and how and why it really works on your head everyday. Or for that matter Propecia. They all take an element of FAITH! But at least the lasers have a basic theory of stimulation of the hair follicle. How the hell does alcohol going to do any better?

To answer to your question, I need to explain a bit about medical research, which could be found behind almost any new treatment modality in medicine. Any new drug needs to go through different phases of testing before becoming approved for use in humans. The LaserComb did not go through such testing, but rather got FDA approval because other such devices were approved in the past (predicate device).

New treatment modality first needs to go through preclinical testing, which involves using new treatments in the lab, including cell cultures followed by its use in animals for its efficacy and safety evaluation. If it proves safe and effective in animals, a clinical trial follows.

Clinical trial is the direct application of a new drug on humans and has four phases:

  1. Phase one is the first stage of testing drug in a small group of volunteers. This phase is done to prove safety and tolerability of drug.
  2. Phase two is performed on larger groups of patients to assess the efficacy of the new treatment and its possible side effects. This phase usually last a few years.
  3. Phase three is a randomized controlled trial on larger groups of patients (a few hundreds to thousands of subjects). It is done to define the value of a new treatment in comparison with other available treatment options. If medication passes this phase it could be offered for its general use.
  4. Phase four is performed on a longer period of time, and involves post-launch safety evaluations, long term adverse effects and technical support of a drug.

Minoxidil is a medication that was initially used for the treatment of high blood pressure. This medication was first studied for one of its side effects, “increase of hair growth” in the early 80s. After its effectiveness for treatment of androgenetic alopecia was confirmed by initial studies, it was studied on cell cultures, animals, and humans in different concentrations. Several research centers and universities studied the effectiveness of this medication and its comparison with other modalities. Since the experiments in the early 80s, minoxidil was first suggested for its use for treatment of androgenetic alopecia. It has been studied for different groups, sexes, ages, and races. Numerous research projects directly evaluated the effectiveness of minoxidil since early 80s. The result of these studies is over 100 articles that are published in major peer reviewed medical journals.

Although the application of laser for treatment of baldness sounds glorious, so far there is no reliable research papers in peer reviewed journals to prove its effectiveness for hair loss treatment. A physician, unlike a sales person, needs to see solid based research published in peer reviewed medical journals before being able to use or recommend a new treatment modality. For the LaserComb, none is available at this time.


2007-03-09 15:37:56How Can You Ridicule the LaserComb But Support Rogaine?

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What is the timeline for balding?

Well to my dismay I am now a member of this community at 23. The idea of balding hadn’t even entered my mind until my mom mentioned my hairline receding a few weeks ago. Now i see it. Her dad was bald at like 30 so i guess it makes sense. Now i go around staring at dudes’ hairlines and guessing what their NW levels are.

My question is: what kind of timelines have people experienced? Does this ever start and then stop for a decade or is it all downhill from here? Do some people only recede a little or is everyone who experiences any MPB destined to become larry david? Id like to keep my hair at least thru my 20s so do i just need to get on finasteride immediately? Or wait and see a few months?

Balding is progressive in men as shown in this link: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/.


2019-05-19 10:33:08What is the timeline for balding?

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How Do I Know I Really Got All the Grafts I Paid For?

Hello doctor,
I am 22 year old and i had a hair transplant yesterday. I was told by my surgeon that 2560 grafts have been implanted. My question is how do i know if 2560 have been planted or not? Thanks

As the doctor’s staff are preparing the grafts, there should be accounting sheets that allow the technicians to count and sort the grafts by the number of hairs in each graft. Ask your doctor to show you the sheet and the doctor should be easily willing to do this.

While you do have to have some level of trust in the surgeon and his staff, these accounting sheets will show that the number of grafts, once counted and sorted, have been reviewed and prepared by a large staff of people.

It’s rather sad that a day after your surgery you are having trust issues with your doctor.


2013-12-06 07:25:49How Do I Know I Really Got All the Grafts I Paid For?

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What Percentage of Middle Age Men Experience Each Norwood Class?

Hi,

I just wanted to know if there were any solid statistics on what percentage of men are norwood II, III etc. in middle age?

Thanks

There are two studies that I know of that were published on the subject. Drs. O’Tar Norwood and James Hamilton both did studies and each came up with different numbers.

Although there’s no general agreement on the statistics for the frequency of balding, it’s believed that advanced balding (defined as a Norwood Class 5, 6, or 7 pattern) occurs in about 35% of balding men. Balding itself is present in approximately half of all men over the age of 45. For those that fall into the 35% of Class 5, 6, or 7 pattern balding, this doesn’t mean that there’s a complete absence of hair in the balding area, as some hair may remain. Norwood Class 2 and 3 patterns appear in about 42% of middle aged men, however, I do not look at Class 2 patterns as much more than men with a mature male hairline.

Update: I removed the statistical breakdown from Dr. Hamilton’s study that I initially posted, because they’re unclear and they are widely different than other published statistics.


2008-05-09 19:29:54What Percentage of Middle Age Men Experience Each Norwood Class?

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How Do You Get Dissecting Cellulitis of the Scalp?

well we finally got a name for my son’s hair loss problems! he is a white male 19 yrs old. first developed a “cyst” in 2005. it was drained, and a bald spot developed.hair finally started to grow back.about 6months ago started having more. it would start with a bump,break open with nasty yellow drainage and hair loss around the area.after seeing several doctors, last month,we were told it was dissecting cellulitis of the scalp.he is taking solodyn 90 mg 1 x a day. a few hairs have started to grow in that spot. but now he has several more started, and several more bald spots. what can we do to help his hair not come out? and to stop these bumps? how did he develop this in the first place? is it an imbalance of something? could this turn out to be serious health problems?? he’s very embarrassed about all the bald spots. please share anything you know about this. thanks!

Dissecting cellulitis is a very virulent infection wherever it is found. This type of infection can be life threatening as the bacteria eats away on the tissues of the impacted area. In the days before penicillin, Streptococcus was the main cause of battlefield deaths through dissecting cellulitis, which invaded every organ of the body and eventually led to multi-organ failure. I saw a number of such cases in Vietnam, but with modern drugs, most of these cases were controlled. Usually a recurrent cellulitis has a history of how your body keeps it under control. I would hope that you and your son’s doctor have a good line of communication open. I would assume that you have already received a second opinion from an infectious disease specialist.

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What you need to know about shampoos

Web MD wrote a detailed article about shampoos, their ingredients, and how these ingredients help or harm your hair. I summarized today’s article as relevant to my readership and added some comments that I thought may shed more insights into the content. The most important takeaway here is to be careful about claims as to what any particular shampoo will do for you. If you look at the ingredients on the shampoo label, you will see the items discussed below. Educate yourself, especially if you have particular hair problems. Everyone reading this should know that the hair grown from the head is not alive once it appears from the scalp; it is dead tissue like your fingernails. We want to do things for hair to make it look and feel better, fuller, and more vibrant, but we certainly can’t give it life.

  1. Carrying agents: Shampoos contain water, which dissolves ingredients within the shampoo. Water, when used in a commercial shampoo product, should be safe.
    • Some manufacturers add alcohol, propanol, ethanol, isopropyl, and propyl alcohol, all of which can make your hair dry or brittle
  2. Thickeners are chemicals like glycol distearate that drive water into the substance of the hair shafts. The additional water absorbed within the shaft causes the hair shafts to increase their diameter or thickness. When you want a thickening agent, look at the ingredients listed below, and then you will know you are buying the right product. Common hair thickeners include Stearic acid, Gelatin, Xanthan gum, Carnauba wax, Stearyl alcohol, and Cetyl alcohol, which usually seals the water in the hair shafts.
    • People with thinning hair: I am always asked what I can do about this problem as surgery is rarely a solution for men and women with diffuse thinning, regardless of cause. The answer is here, in the use thickening agents described in this section. The commercial manufacturers have known about this for years and have produced products that address thickening the hair shafts using appropriate additives as discussed here.
  3. Surfactants are ingredients that make shampoos act like detergents. They increase suds production, and the better the surfactant, the better it cleans the hair, dirt, wax and debris from your hair. It can also address the wax buildup, which many people call clogged pores. The lather tends to make your hair dry because it washes off the protective oils that the body produces to protect your hair.
  4. Surfactants to look for include Ammonium lauryl sulfate, Sodium laureth sulfate, Ammonium laureth sulfate, Sodium trideceth sulfate
  5. Emollients balance the effects of surfactants, helping keep moisture in your hair and protecting it against brittleness. These lubricants make your hair silky and are necessary to counterbalance the surfactants discussed above. Emollients include aloe vera, vegetable oils, mineral oils, and silicone. They allow your hair to hold onto the water it acquires when you shampoo your hair. Because they are lubricants, they make your hair shiny. Dimethicone is the most common emollient.
  6. Preservatives stop mold from growing in your shampoo. The most common preservatives are sodium benzoate and potassium sorbate.
    • Another group of preservatives are called Parabens, which include Methylparaben, Isopropylparaben, Ethylparaben, Isobutylparaben, Butylparaben, Propylparaben
    • This second group has been associated with claims that they can produce cancer.
  7. Some people want only natural ingredients. These shampoos include essential oils like peppermint, lemon, and lavender, certified-organic ingredients like aloe, Coconut oil, Organic hemp, Organic honey, Chamomile, Olive, and Plant oils like geranium or jojoba oil. These products have many of the characteristics outlined above.
  8. WebMD suggested that people avoid the following ingredients for the risks outlined:
    1. Sulfates: they increase skin sensitivity and strip hair of their natural oils, causing dryness
    2. Parabens: they increase the risk of skin cancer
    3. Phthalates: they are dangerous to the environment and cause hormonal disruptions
    4. Formaldehyde: is carcinogenic and easily absorbed by the skin
    5. Dimethicone: it prevents moisture from entering the hair and clogs pores over time
    6. Retinyl palmitate: causes itching, scaling, and peeling
    7. Alcohol: makes your hair dry and brittle
    8. Toluene: can hamper the immune system and cause congenital problems
    9. Imidazolidinyl: irritates the skin and eyes

[If you have any questions, you can reach me at williamrassman33@gmail.com]

 

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When Does Finasteride Thicken Up Hair Shafts?

Does finasteride thicken up hair shafts DURING the growth phase, or (with good results of course) does it thicken up only when a new cycle begins?

I do not have a definite answer to your question, but I can venture a guess. As the usual hair cycle is over 2 years in most men and we see benefits from Propecia in 8-12 months, I would guess that as the hair shaft emerges from its source, the shaft thickens. Of course, as the hair growth above the skin grows at about 1/2 inch per month, I would expect that the thickening of the hair shaft starts quickly and increases over time.

All miniaturized hairs are not equal. Let’s say that the shafts that have lost 90% of their bulk will be slower to benefit (if they benefit at all) than those miniaturized hairs which have lost 20% of their bulk. The impact on new hair should be better if these new hairs are healthy ‘terminal’ hairs that have considerable life left in them. When I see patients for follow-up examinations and comparison studies, I see that there are less miniaturized hairs and more of thicker shaft hairs, and as we use the bulk analysis instrument on more patients, the answer to your questions will be much more clear.

I think you have a great question from a scientific perspective. I wish there was a time lapse photo of a hair shaft under the influence of Propecia (or even Rogaine).

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How important is Propecia post-FUT?

I am 44 years old so this is an important question for me, “How important is Propecia post-FUT?”

Finasteride is less important because shock loss is less of a problem following hair transplants in a 40+ individual; however, the value of finasteride also includes slowing progression of the hair loss process. Your call. Many times, I go forward with a hair transplant on a 40+ man without finasteride on board.


2021-01-17 07:27:01How important is Propecia post-FUT?