NeoGraft, a New FUE Instrument
Can you tell me about the Neograft technology. Is it better that what is out there?
Automation of the hair transplant process has been a goal of doctors from the earliest part of their career because of the tedious manual processes used today. In particular, with the large sessions, fatigue becomes a problem and the skill sets required of the staff take years to acquire proficiency.
I have been a pioneer of many of these devices, receiving patents on some of them. Included was the Carousel, and a series of follicular unit extraction (FUE) techniques devised for faster extraction. The NeoGraft machine is just one of the newer devices, but unfortunately it has its problems.
NeoGraft uses a vacuum system to assist in the removal of grafts that are first partially dissected with a sharp punch. The grafts that are “sucked†out of the scalp are collected in a chamber. The grafts are then removed from the chamber and drawn up, again by suction, into a needle and then injected into pre-made recipient sites using air pressure. The NeoGraft seems to eliminate some of the risks of mechanical injury to grafts in traditional FUE by not requiring forceps to remove grafts from the donor site or insert the grafts into the recipient area and, in theory, may save time by eliminating the need to extract grafts manually. A concern expressed by those who have seen the system in action is that the suction removal has a tendency to strip the surrounding tissue from the lower portion of the grafts or pull out just the upper part of the graft. Because the grafts are exposed to a great deal of air movement, the continuous flow of the vacuum adds to the risk of graft drying, a problem well known to be a major cause of poor graft survival. To our knowledge no independent studies have been performed to show that grafts are not harmed by this vacuum technique and it is our concern that the drying action of the air on the exposed grafts may limit their growth. As many of the grafts are stripped from their fat, the risks to the grafts are theoretically significant.
Restoration Robotics (RR) has a better way to do this with a robot, but it is not yet on the market and it will most probably be very expensive. RR have been successful at doing FUE, although slowly, but they have yet to demonstrate an ability to place grafts mechanically.
There is no substitute to learning and mastering the manual skills that are used in the best hair transplant clinics around the world. So without a good automation instrument, many of the doctors who use an unproven method for hair transplantation just makes the risks to the hair transplant procedure greater and the work by the doctors who use them possibly second class. Would you buy grafts from a second class surgical team and pay the consequences of poor growth?
Dr. Rassman,
I am affiliated with NeoGraft and I want to let you know you have been given wrong information about the NeoGraft device. You wrote in one of your posts on your site that:
“A concern expressed by those who have seen the system in action is that the suction removal has a tendency to strip the surrounding tissue from the lower portion of the grafts or pull out just the upper part of the graft. Because the grafts are exposed to a great deal of air movement, the continuous flow of the vacuum adds to the risk of graft drying, a problem well known to be a major cause of poor graft survival.”
We are aware of the identity of those persons who wrote these negative statements about NeoGraft and the truth is that they had never seen the NeoGraft device perform a hair transplant when they made those comments! They were simply speculating how NeoGraft works because they had no knowledge of how the NeoGraft device is able to harvest excellent grafts.
Last week there was a live surgery workshop in Florida. A live hair transplant demonstration was done using NeoGraft which was witnessed by over 100 doctors. About 350 grafts were harvested by the NeoGraft device with all the doctors watching. The doctors were able to witness that the grafts were not dried out, but were very moist, they were not stripped, but very plump and surrounded by just the right amount of tissue. In addition and most important there was an extremely low transection rate, one which would be extremely difficult to achieve by a manual FUE regardless of how much training a doctor has had. Most of the doctors at the Live Surgery Workshop examined the grafts harvested by NeoGraft under the microscope. It might be best to ask the opinion of the doctors who were at the Live Surgery Workshop about the NeoGraft procedure they viewed rather than write about NeoGraft based on the opinion of those who had never seen NeoGraft perform a procedure.
It may be difficult to accept, but the NeoGraft device, improves the doctors chances of harvesting excellent grafts due to the technology used by NeoGraft. Most doctors can become proficient NeoGraft FUE harvesters after we have trained them. Learning to do FUE with our NeoGraft device simplifies the FUE process for the doctor making it possible for the doctor to have good success with harvesting and implanting. NeoGraft also speeds up the process which helps to reduce the cost. How long it takes a doctor to become proficient using NeoGraft depends on the doctor but it is not a long protracted learning curve. That may upset the doctors but that is what technology does. I suggest you attend one of our live demonstrations in order to see NeoGraft for yourself and then you form your own opinion of NeoGraft. We do about four live procedures a month all over the U.S. You can contact NeoGraft for the dates and locations of our next demonstrations.
Dr. Rassman,
I wanted to add some extra comments to the post above. I forgot to mention how NeoGraft technology keeps the grafts moist. With NeoGraft, the doctor is able to consistently draw saline solution into the tube and receptacle, keeping the grafts moist. The doctor is also taught to empty the receptacle very often and place the grafts in a solution. At the Live Surgery Workshop doctors, as I stated, were able to see that the grafts remained moist and robust.
Another point I wanted to make is that a split exists in the medical community between doctors who do the STRIP technique and those that do FUE hair transplants. Those doctors who do the STRIP technique claim that there is not enough protective tissue around the graft when the FUE procedure is used. Doctors doing STRIP are the ones who are writing about the amount of tissue around the graft, trying to make this a problem when it is not. Those doctors who do FUE, many of whom were STRIP surgeons before they switched to FUE are not the ones claiming that this is a problem. In fact, it seems to me that once a doctor switches to doing FUE, he seldom reverts back to the STRIP technique unless the patient has a small donor area.
FUE has been practiced for many years by quite a few doctors in the U.S. and in Europe and there is not one bit of evidence to prove that FUE transplants do not produce the same quality of hair transplants as the STRIP method. In one believes the before and after pictures on doctors web sites, one only needs to look up sites of doctors that do FUE procedures to see that successful transplants are possible. I myself personally have seen patients who had FUE procedures done many years ago and they have had excellent outcomes. If doctors who do FUE did not get good before and after results why would they continue to offer this procedure? When done manually, it is more time consuming, tedious and more difficult than the STRIP procedure. Why would they endure these problems unless they believed in the FUE procedure?
Another fact is that if a doctor was willing to measure the uneven grafts cut by technicians from a strip of scalp and then measure those harvested by the FUE method, my guess is that many of the uneven grafts from the strip of scalp would be the same size, with a similar amount of tissue as those grafts harvested by the FUE method. And if these grafts which came from the excised scalp survive then there is no reason that FUE grafts will not survive just as well, and they do.