FUE Instrumentation

By Sara Wasserbauer, M.D.

One of the important aspects of modern FUE techniques is the instrumentation that has evolved to help the surgeon remove grafts efficiently and intact.  NeoGraft is an example of one of these machines that a doctor can use to help remove individual Follicular Units (FUs) from the scalp.  Using a rotating punch (a tiny little metal tube) that the surgeon holds at a right-angle to the head, grafts are extracted with a combination of suction and traction and are then collected in a tiny vial on the machine.

The holes left behind once the grafts are extracted are tiny. – hence the main attraction of this technique for patients considering a hair transplant.  Scars from any FUE procedure are diffuse and miniscule, whether done with the NeoGraft or by hand or with any other instrumentation.  The main benefit of the NeoGraft include the ergonomic right-angle orientation of the hand piece which some surgeons prefer, and the suction and collection feature which decreases the need for an additional staff member to handle the grafts and take them out.  Detractors state that the suction and traction used to remove the grafts has the potential to cause damage to the grafts themselves.  Proponents point out that the grafts are handled more when they are removed by hand.  Both camps have points worth considering.  A head-to-head growth study comparing the different mechanical means for graft removal has not been done for the NeoGraft, so this remains an open question.

What is clear is that a surgeon who is trained in modern hair transplant and placement techniques (remember, the grafts still have to be placed in the head in an aesthetic and natural pattern!) is the only person who has the judgment and expertise to be using a NeoGraft.  Several well-trained surgeons have them and use them to good effect, and their patients have been very pleased with their results.  Any machine, when used well and for the right patient, can be a benefit.  So if you are considering FUE, choose the surgeon first for their expertise and track record and consider the instrumentation as an extension of the surgeon.