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Have you heard of the Ahi technique based on FUE. Is this truly original or simply a marketing spin on the FUE method of hair transplant. The company in question is http://www.ailesburyhairclinic.com/

Their site says that it’s just follicular unit extraction (FUE) but the difference is, “the AHI variation of this method is that we use a specially designed implantation pen to place hair follicles…”

Many clinics use FUE extraction tools and the implantation instrument they’re likely using is called the Choi Implanter. The Choi implanter has had variable results in its use — many complete failures and some excellent results with those who have mastered it. The Choi is probably the most universally used instrument for implantation, but few use it in the US, where there is more accountability to failures of the transplant.

Dr. Richard Shiell recently reported: “I think the original device was invented by a non-doctor who was doing eyebrow grafts at a Leper hospital in Korea some 30 years ago.” There are many innovative people in this world who, when challenged, rise to the situation and create new technology.

This post isn’t responding to a submitted question, but an observation we’ve been seeing more and more lately…

Donor area depletion is now becoming apparent in many patients who have had many FUEs done in the donor area. Just like strip surgeries, once hair is removed from the donor area, the donor area become thinner with each subsequent Follicular Unit Extraction (FUE) procedure. Those individuals who have had between 3000-6000 grafts extracted with FUE are now showing problems in the donor area where coverage of the back and side of the head is becoming a problem. Somehow doctors and patients thought that FUE was a free ride — no significant donor scar without a downside. But alas, there is no free ride. One does not get something for nothing.

I believe that many doctors do not understand what I wrote above, but they will be caught with their pants down when the patient finds that he has a donor area coverage problem that he never expected. With this assessment, I am referring to the doctors who do FUE right (with minimal transection damage), but I suspect that the number of good doctors who have mastered the technique and get transections in the 5% or less range are a minority of those offering the procedure.

Over and over again I say, “Let the Buyer Beware” and that still remains the Rassman dictum.

Hello Ive noticed that after looking at dozens of FUE donor scars that Beard FUE scars have significantly less hypopigmentations that scalp FUE scars?

Is there a reason for this? Thanks

That’s a good question. Unfortunately, I don’t know the answer for sure.

On the scalp, I have seen patients with great (practically unnoticeable) FUE scars, as well as some not-so-great FUE scars. Of the few patients I’ve seen that had follicular unit extraction using beard hair, I’d agree that the FUE scars have been less detectable by way of discoloration when the graft is removed from the beard. I think the degree of scarring is based on the individual and their healing potential.

I believe Dr. Rassman I can shed some light on a recent post. You have answered the question many times in regards to BHT and short cut hair. I agree that it does seem somewhat pointless to shave ones head after recieving a hair transpant however I do understand the logic behind it. With a short cropped haircut (even a #1 clipper shave) you can still see a visible hair line that defines the face much like the tattooing service you are now offering. With a completely shaved head it is not visible.

Many people such as myself would prefer real hair on their head rather than ink although I must admit that the results do look pretty good. None the less body hair is different than scalp but cut short can offer a more realistic illusion of stubble that in this day and age appears acceptable if not attractive. Counter argument it is very expensive for just stubble. Agree?

Why would you bother with body hair transplants (BHT) when you can use your scalp hair? Body hair tends to be texturally different. If you truly want a stubble look with real hair, using Scalp MicroPigmentation (SMP) with scalp hair extracted with FUE is a good way to accomplish this. On the flip side, patients who’ve had a hair transplant and want the closely cropped look would already have stubble, so SMP is a great option to add the appearance of fullness.

Here’s an FUE patient who had very little restoration work done — under 600 grafts to the front corners — and later decided to shave his head. On the top of his head, the hair is miniaturized so it appears thin and lighter in the picture. The following result shown is immediately after the first SMP session. This will fade slightly as the color sets and the client will return in 3 to 4 days for a touch-up. (Note that because the photo was taken immediately after the SMP session, you can still see some initial redness.)

Before SMP on left; After SMP on right. Click photos to enlarge:

Hello,
After consulting with a doctor, I need 2500 units for my hair transplant. It can be by FUE, because I have a good donor area. Considering the two-day visit of a clinic in Turkey. I’m worried that so many units is called a megasession. Can it be done in a one-day procedure, or two day procedure, or would you recommend to do the first year approx. 1500 units and the following year 1000 for density?

By this letters you are one of the most experienced, so I appeal to you,because in Europe and my country is not many information about FUE procedure. thanks for the reply, with respect

FUE can be done over two days. For the larger sessions, some doctors do it this way. I’d follow-up with your surgeon about his/her recommendations.

Hi Dr.Rassman. If you were to incorporate one of those fue robots in your practice would it lower the cost of an fue session? I know time limit would be lessened. Which method of the fue session is most labor intensive, the extraction process or the implanting one? I heard you have an interest in the success of these robotic systems. Please educate the public docter.

I am told the robot will cost about $250,000. I think that this has to be paid down and the result should be a more expensive hair transplant. At least initially. I am just speculating, though, as we don’t have the robot in our practice.

This may be an issue of quality, not cost alone. Don’t focus on costs. A poorly done FUE procedure will cause permanent loss of your donor hair (not uncommon) and that costs you much of your future hair supply. How does one put a price on quality?

Note: The robot at the right is not going to be doing the FUE procedure, though it would be kind of neat to see.

Snippet from the article:

The FDA has approved a machine called the Artas System for use, according to manufacturers Restoration Robotics, Inc. The company describes Artas as “an interactive, computer assisted system utilizing image-guided robotics to enhance the quality of hair follicle harvesting” by combining “several features including an interactive, image-guided robotic arm, special imaging technologies, small dermal punches and a computer interface.” Artas can be used on patients with straight brown or black hair; blondes or redheads still have to face male pattern baldness without robotic assistance, at this stage.

Read the full text at Time.com — Now, Robots Can Save You from Baldness… As Long As You’re Not Blond

We posted about the FDA clearance of Restoration Robotics’ Artas System a couple weeks ago, but with all the emails I’ve gotten about it and more articles showing up in my Google Alerts daily emails, I figured at least some of you might like to see a press photo of the instrument (see below):

The FUE harvesting that this robot can do is just one step in the process for hair restoration. Some doctor must design the hairline and decide what has to be harvested. Plus, the management of the grafts is a strict science, and the placement of the grafts into the recipient area requires a team of specialized personnel. This is a good addition for instrumentation, but it is not the automation of the entire process.

While I mentioned before that we licensed the core optical technology for the robotic FUE technique and have a vested interest in seeing this instrument be successful, I realize how surreal this might seem. So with that said, feel free to post your cyborg/robot jokes in the comments section.

Hello Doctor

Do you believe that with the advent of scalp micro-pigmentation, it is now feasible for transplants in younger patients / more aggressive transplants in general?

A patient could have a transplant to frame the face with a NW2 or so look, and if they cannot keep up with hair loss via meds + additional transplants, they may have the SMP procedure, (with the option of some hair transplanted to the regions), in order to obtain the close-cut stubble look.

Additionally, has there been any attempts to fill in the “white dot” scarring from FUE procedures?

The answer is yes on all accounts. Scalp MicroPigmentation (SMP) works wonderfully in filling in the white dots from FUE harvesting. Combining SMP and transplants must be made individually by a person skilled in the art.

Snippet from the article:

Medical device company Restoration Robotics Inc. said Thursday the Food & Drug Administration approved its system for treating hair loss.

Mountain View-based Restoration Robotics, which is privately held, said the system harvests hair follicles from the scalp in men diagnosed with male pattern hair loss with black or brown straight hair.

Read the full story — FDA approves Restoration Robotics system for treating hair loss

This product has limited use, as it only performs the FUE (follicular unit extraction) harvesting, not the implantation of the grafts, which is by far the most challenging technical aspect of the hair transplant process. The learning curve for manual FUE takes a few months, but the learning curve for placing the grafts easily approaches one year. For the novice surgeon who never learned the manual FUE technique, it allows that person (with minimal training) to produce a high quality FUE process.

In our original article which introduced FUE to the hair transplant community a decade ago, we categorized patients in 5 categories to determine which were the best and the worst patients for FUE (Fox class 1 was the best and Fox class 5 was the worst). In that article, we reported the worst Fox class 5 patients reflected about 20% of the population. It remains to be seen whether the robot can produce the high quality grafts with minimal damage in the Fox class 5 patient. Today, I believe that only about 10% of patients would be classed by me as a Fox class 5.

The cost of the robot, I believe, will be very high (significantly more than $100,000)… so the market will be small. There are many alternative approaches to the FUE technology, as there must be more than a dozen extraction devices produced. Some work, but many do not. Despite the automation of the extraction process, I doubt that this robot will become today’s ‘Standard of Care’. There is no doubt that the FUE technique has been well defined and proven today with the various techniques, but there are still a number of doctors who perform the technique very poorly. I have unfortunately seen too many of their failures in my office. At least with the robot, I would expect that the patient will be confident that what he is paying for and what he is going to get is what he expects he will get, and that alone should help the patient make a decision about their surgeon (if there are any doubts as to their chosen surgeon’s competency).

I must reveal here that we have a vested interest in the success of this particular robot, as we licensed the core optical technology for the robotic FUE technique many years ago. Seeing that the product finally has come to the market is very satisfying to us. We have also developed comparable hardware technology for placing grafts and obtained US patents in this arena, so when and if Restoration Robotics moves into graft placing, we can finally say that the automation process is complete.

Im a 58 year male who is seriously considering transplant surgery to restore my frontal hairline area. Im interested in the FUE procedure. My question is if Im not satisfied with the results can I still undergo strip harvesting in the future

I realize your question is very limited and I don’t know anything about your hair loss, but based on what you are asking I think you are going about this completely wrong. First, you need a Master Plan for your hair loss.

Follicular unit extraction (FUE) is a great surgery, but it has limitations. One of the main reasons you should have an FUE procedure is because you want to cut your hair short in the back without seeing a linear scar. If you don’t mind the linear scar (which I assume to be the case if you’re considering the strip procedure), I’m not sure why you’d want to go with FUE to start with. There’s a list you might find to be an interesting read — The Pros and Cons for FUE / Strip Harvesting.

So while the short answer to your question is “yes”, I think you should seek a good hair transplant surgeon to discuss your overall goals and expectations.