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Will I Need Multiple FUE Hair Transplants Over Time?

March 18th, 2013

Q: I’ve noticed from the chatter on blogs, that it is not uncommon for men to go through multiple FUE procedures over 10+ year time-frame. It seems to be that after the initial FUE procedure to address moderate hair loss, the patient continues their natural balding to where they must undergo another FUE procedure in order to get back to their desired look. I’m almost 33 and while I take Propecia, my hair loss has been very gradual since I was about 26. I still have what many would consider a full head of hair, although very thin and with noticeable loss at my temples and crown. I’d always thought that a hair transplant would be a “1 and done” procedure, and now I’m concerned that if I do an FUE procedure now to replace what’s been already lost, I’ll just have to revisit a subsequent FUE down the line. Are ongoing FUEs simply part of the hair maintenance that a patient needs to accept about hair restoration process?

A: Your concerns are correct and would apply to any hair transplant procedure; FUT or FUE. That is why it is best not to begin hair restoration surgery too early.

Rating: 1 Star

Topic: Follicular Unit Extraction

Tags: Early Hair Transplant, FUE, Hair Transplant Long-term Results, Multiple Hair Transplant Procedures, Multiple Hair Transplant Sessions, Propecia (Finasteride)

Posted by Robert M. Bernstein M.D. on March 18th, 2013 at 3:30 pm

Dr. Bernstein Proposes Improvements to FUE Hair Transplant Procedures

August 21st, 2012

Robotic FUE has improved Follicular Unit Extraction by automating what has been a labor intensive and often inexact manual procedure. It is the latest in a long line of improvements made to hair restoration procedures that lead to better results for hair transplant patients. Dr. Bernstein’s recent publication in Hair Transplant Forum International improves the FUE procedure even further, whether performing follicular unit extraction with the FUE robot or by hand.

In his article, Dr. Bernstein suggests two techniques to enhance the FUE procedure. First, he recommends that surgeons create recipient sites prior to extraction, in order to decrease the time grafts are in their holding solution outside the body. Second, he suggests adding time between site creation and graft harvesting and placement, to allow recipient site healing to progress.

Pre-Making Recipient Sites

As is discussed in the full article (which is available for viewing and download in our Medical Publications section), by making recipient sites first, the time grafts are out of the body will be reduced.FUE procedures lend themselves to easily reversing the normal hair transplant sequence of graft (strip) harvesting followed by dissection and site creation.

These “pre-made” recipient sites will also exhibit less bleeding than newly created sites and will exhibit the stickiness that makes older sites easier to place grafts into with less popping (a common source of graft injury). Besides allowing the placing step to proceed more quickly, pre-making sites will reduce the risk of mechanical injury inherent in repositioning elevated grafts.

After Site Creation, Add Delay between Graft Harvesting and Placement

While Dr. Bernstein acknowledges the expediency for the hair restoration physician, as well as the comfort of the patient in a single-day session, he suggests that, to facilitate growth after a transplant, multiple-day procedures should be considered in large hair transplant sessions that involve the placement of thousands of grafts.

In conclusion, these two modifications -— pre-making recipient sites and adding a delay before graft placement -— to the FUE procedure can potentially contribute to better growth due to easier, less traumatic graft insertion, a shortened time “out of body,” and the creation of a more fertile bed for the implanted grafts.

View the full article to read details about these and other potential advantages of pre-making recipient sites

Rating: 1 Star

5.00 stars from 1 vote(s)

Topic: Follicular Unit Extraction

Tags: After Your Hair Restoration, Follicular Unit Harvesting, FUE, Graft Holding Solution, Graft Injury, Graft Popping, Hair Transplant Forum International, Hair Transplant Growth, Hair Transplant Pioneer, Hair Transplant Procedure Length, How Large Should Hair Transplant Sessions Be, Megasessions, Multiple Hair Transplant Sessions, Placing Grafts into Recipient Sites, Pre-Making Recipient Sites, Recipient Site Healing, Recipient Sites, Robotics in FUE, Scalp Crusting After Hair Transplant, Scalp Healing, Steps in FUE Procedure

Posted by Robert M. Bernstein M.D. on August 21st, 2012 at 2:26 pm

What is the Latest in Hair Transplant Robotics?

April 11th, 2011

Q: I have read your page on robotics in hair restoration and am interested in learning more. Are there any updates in the development of the system you mentioned? — W.T., London, UK

A: Restoration Robotics, Inc. — based in Mountain View, CA — has spent the last few years developing and testing a robotic hair transplant device for follicular unit extraction (FUE). The ARTAS^™ robot system has recently received 510(k) approval from the Food and Drug Administration, meaning that the company may now begin marketing the system for use in hair restoration clinics.

The FDA classifies the device as a “computer assisted hair harvesting system” and describes it as being used to identify and extract follicular units and to help the surgeon do the same during hair transplantation.

The ARTAS^™ robot consists of a computer assisted station with needle mechanism, force sensor, robotic arm, and video imaging system. The software that runs the instrument helps the surgeon target follicular units for extraction and also uses stereoscopic video images to guide the needle mechanism and robotic arm.

We will update you as more information becomes available about the ARTAS^™ system and Restoration Robotics.

See a photo of the ARTAS robot and stay on top of developments by visiting our Robotic Hair Transplantation page

Rating: 1 Star

4.33 stars from 3 vote(s)

Topic: Follicular Unit Extraction

Tags: ARTAS Robot for FUE, Follicular Unit, Follicular Unit Extraction, Food and Drug Administration (FDA), Hair Restoration, Hair Transplant, Image-guided Robotic System, Restoration Robotics, Robotics in FUE

Posted by Robert M. Bernstein M.D. on April 11th, 2011 at 5:46 pm

On Rachel Ray Show Dr. Youn Implies Neograft FUE Machine Is Painless and Non-Surgical

July 14th, 2010

Q: I recently saw an episode of the Rachel Ray Show where her guest, Dr. Anthony Youn, said that the Neograft machine for Follicular Unit Extraction is painless and uses a vacuum rather than surgery to remove the grafts. Can this be true?

A: Follicular Unit Extraction (FUE) using the Neograft machine is not painless and, while it does not produce a linear scar, it is surgery and there is significant scarring in the form of thousands of tiny holes that heal with round white marks.

In the video, Dr. Anthony Youn asks: “Do you wanna take a feel? It’s just a vacuum.” Rachel Ray states: “You don’t feel a thing.” Youn replies: “No [you don't].”

This is very deceptive on the part of the doctor, since the instrument is basically a cutting instrument with the suction being used to remove and insert the grafts. Although the suction part would not be painful, the cutting part certainly is and requires the same anesthesia as a traditional hair transplant.

Our main concern is that the machine produces grafts that are sub-optimal with respect to quality and potential growth, as the Neograft’s suction apparatus tends to strip follicles away from their surrounding protective tissue and tends to dry the grafts out.

For in-depth information on this topic, read our pages on Follicular Unit Extraction (FUE) and the Neograft Machine for FUE.

Rating: 1 Star

2.67 stars from 6 vote(s)

Topic: Follicular Unit Extraction

Tags: Dr. Anthony Youn, Follicular Unit, Follicular Unit Extraction, Follicular Unit Grafts, FUE Pain, FUE Scarring, Neograft FUE Machine, Rachel Ray Show, Scarring

Posted by Robert M. Bernstein M.D. on July 14th, 2010 at 1:25 pm

After Follicular Unit Extraction at the Hairline, Will Bumps Go Away?

September 1st, 2009

Q: I have had a hair transplant done in the hairline of 1,000 or so FUE grafts. However, as the hair sheds, under natural light the recipient skin seems bumpy with incisions and holes that are noticeable. Do these tend to go away with time once they have healed?

A: If a follicular unit transplant is performed properly (using either extraction or a strip) there should be no bumps or surface irregularities. When the hair restoration is totally healed, the recipient area should be appear as normal looking skin.

With FUE it is important to sort out the grafts under a microscope, to make sure that all of the grafts placed at the hairline are 1-hair grafts and that the larger grafts are place behind the hairline. They should not be planted without first being sorted under a microscope.

Rating: 1 Star