The before and after photos are of a 58 Year old male from Hawaii. The patient came to Dr. Yazdan’s Orange County CA office. He had multiple hair transplant procedures prior, that left him with major scarring on his scalp from another physician. He had no donor zone hair left on the sides and back of his scalp. The after photo (right) is 1 year after he underwent 1 FUE procedure by Dr. Yazdan utilizing Beard & Chest hair to transplant 1884 FUE hair grafts to the scalp. The chest hairs were used in the hairline to mask the previous “plug” grafts giving a softer appearance and the beard hair was mixed in for better density.
The first hair transplant patient was a 31 year old male with blonde hair. He was losing hair for the past 5 years and was very self conscious about his thinning hair. He used the hair camouflage powder called Toppik to try and conceal his hair loss. Dr. Yazdan (with offices in Orange County and Las Vegas) performed 1,568 FUE hair grafts to fill in his frontal forelock. After results were photographed 9 months post op.
Before and After FUE Hair Transplant – 1568 grafts in one procedure.
The next patient – age 44 – had more extensive hair loss (Norwood Class V) and had been noticeably losing his hair for the past 7 years. He had used Rogaine but had little success. Dr. Yazdan performed 1,922 grafts in one session with the FUE technique in the hairline to the crown. Post op results after 1 year.
There has been a lot of conversation online and in advertising about FUE being a scarless hair transplant procedure. The answer is both Yes and No. Part of the reason for our answer is that it depends on the execution and experience of the surgeon. Recently Dr. Yazdan consulted with a patient in his Las Vegas hair transplant office who said he had 2000 FUE grafts at a local office that performed an FUE procedure with the NeoGraft Automated Hair Transplant System. He decided on NeoGraft because was told the procedure would be scarless. He also assumed that the Doctor would be performing the procedure. In both cases he was unfortunately wrong. The day of the procedure he discovered that medical technicians performed the procedure and he quickly learned that the donor area had significant scarring.
The issue of technicians performing hair transplant procedures has be addressed by the International Society of Hair Restoration Surgeons (ISHRS.org) in their highly publicized consumer alert.
The reason for his scarring was because of poor technique. In this patient’s case the donor area was too small for 2000 grafts (although it appeared that less than 2000 grafts were performed.) so that the incisions were run together and were too deep. In addition the circular scalpel that extracted the grafts was too large – 1mm or larger. By running the incisions together the patient experienced both scarring and poor hair growth because many of the hair grafts were transected. The donor area was also high on the back of is head and could potentially be exposed if he continued to experience hair loss over time.
In order to improve the naturalness and density in the transplanted area Dr. Yazdan personally performed 1250 additional FUE grafts using his custom instrumentation and a .7mm diameter scalpel. The photo below shows the previous NeoGraft harvested donor area (Top) and the FUE grafts harvested by Dr. Yazdan (Below – day of surgery) which will appear virtually scarless because or the tiny incisions and proper spacing technique. Poor NeoGraft donor technique above. Proper follicular unit extraction below by Dr. Amir Yazdan.
Below is the donor area of a FUE patient 30 days post-op. Donor area 30 days post FUE Hair Transplant by Dr. Yazdan.
If you are pursuing a hair replacement surgery, you’ve likely considered a FUE or FUT hair transplant. But how do you know which is right for you?
Dr. Amir Yazdan discusses who is a better candidate for follicular unit extraction (FUE) vs strip (FUT) hair transplant harvesting when performing hair transplant surgery. Both procedures can be very effective but there are issues that determine if a patient is better for one procedure versus another.
With FUE hair transplantation the follicular units of 1-4 hairs are excised one at a time using a very small (.7-.9mm), precise circular scalpel. The incision is so tiny that when the wound heals there is virtually no visible scar. This is particularly popular for patients who have less hair loss and want to keep their hair very short.
Patient’s with more hair loss and desire more hair transplanted in a single session may prefer the FUT strip excision method. With a narrow strip a large amount of hair can be extracted at one time and with microscopic graft dissection the hair grafts are prepared by size. With modern tricophytic donor closure the scar is very fine and easily covered by the existing donor hair.
FOLLICULAR UNIT EXTRACTION (FUE) HAIR TRANSPLANT DEVICES
There has been a great deal of conversation online about the most effective procedure for performing a hair transplant procedure. In our Orange County & Las Vegas hair transplant offices we have had many patients come in for consultation that are confused by FUE, AlphaGraft, NeoGraft, Artas and other FUE hair transplant devices. That is correct, these are devices and not a surgical procedure.
In many cases patients believe that a NeoGraft hair transplant is a surgical technique when it is only a mechanized devices for performing FUE hair transplants. Simply put, follicular unit extraction involves removing tiny follicular bundles from the back of the scalp with a tiny .7-1mm circular punch. The incision is typically so small that there is no visible scar after the wound heals.
WHAT IS THE NEOGRAFT HAIR TRANSPLANT SYSTEM?
According to the company – NeoGraft is the first and only FDA cleared follicular unit harvesting and implantation system. The NeoGraft system delivers automation of the FUE technique. The above statement is true. the device, originally developed in Europe is combination electrical hand engine the powers a hollow circular punch and then sucks the hair graft into a container where the grafts are gathered and then implanted. Although the company has developed a device to also insert that grafts it is rarely used. The concern of many experienced hair surgeons including Dr. Yazdan is that the suction tears the tiny graft from the connecting fat tissue at the bottom and can tear or transact the graft which can significantly impact graft hair growth. There have also been concerns that in some cases the procedure with these devices is actually performed by unlicensed technicians for surgeons with little or no hair restoration experience. (Read more)
ARTAS ROBOTIC HAIR TRANSPLANT SYSTEM
Artas was launched in 2011 as the first robotic hair transplant system. The system is sophisticated, utilizing computer assistance to harvest hair follicles during the actual process of hair replacement. ARTAS incorporates a number of elements in its operation, including an image-guided robotic arm and special imaging technologies that co-ordinate together for the purpose of implementing the “follicular unit extraction (FUE)” technique upon the recipient of the system. The system is very expensive – approximately $200,000, cost more for physicians to use and to date has shown no superiority in hair graft quality from those of experienced hair surgeons using hand operated mechanized FUE devices. In FDA trials ARTAS showed no superiority to hand held follicular unit extraction by an experienced hair transplant surgeon.
IN OUR PRACTICE
Dr. Yazdan has developed his own instrumentation to assure the most precise results possible. He will modify his instrumentation to adapt to a specific patients hair type and angle of hair growth. The important issue for patients to understand is that follicular unit extraction (FUE) is a procedure and that everything else is a reference to a device that helps the physician extract the follicular units. Many surgeons use different devices to perform excellent FUE results and the important part is the surgical expertise and care of the grafts once harvested that assures optimal results for the patient.
Below is a video of Dr. Yazdan performing the procedure.
Many patients are confused by the various hair transplant techniques and who is a good candidate for which procedure.
Orange County hair transplant surgeon Dr. Amir Yazdan explains who is the best candidate for FUE vs FUT. Although there are many specific reasons a patient will have one procedure versus another the decision is typically based on two criteria.
A patient who is best qualified for follicular unit extraction (FUE) #1 wants to keep their hair very short in the back and doesn’t want even a very thin scar to be visible and #2 needs usually 2000 grafts or less.
A patient that typically has strip FUT hair transplantation #1 does not keep his/her hair short in the back and #2 needs more than 2000 hair grafts in a single session.
In Dr. Yazdan’s Orange County and Las Vegas offices he will review all options including medical treatments during your consultation and together you will make a decision based on multiple factors prior to hair transplant surgery.
Before and After FUE Hair Transplant – 1568 grafts in one procedure.
