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    The state of hair restoration

    When he describes the state of hair restoration today, Atlanta-area plastic surgeon Dr. Keith Jeffords doesn't just talk about the wonders of modern follicle transplants. He has another message too: Your scalp won't have to pay the price.

    "There's new technology, new devices, new ways to do this that are less painful and less invasive but still satisfactory," says Jeffords, M.D., D.D.S. "No one goes to get their gallbladder out with a 12-inch scar like they used to. That's what we should be doing: We shouldn't leave a 12-inch scar on the back of somebody's head."

    Dr. Jeffords, who's in private practice in Smyrna, Ga., spoke about adding hair restoration to plastic surgery practices at Plastic Surgery The Meeting 2016, the annual gathering of the American Society of Plastic Surgeons. In a conversation with Cosmetic Surgery Times, he talked about technological advances, competitive advantages for plastic surgeons and the market for reconstructive hair restoration. 

    Restoration Technology Changes the Game

    Years ago, Dr. Jeffords refused to get a hair transplant himself because he didn't want to be sidelined from working. Why? Because he wouldn't be able to perform surgery for several weeks in order to prevent the hair-grafting scar from widening, which would happen by moving his head during procedures. 

    Technological advances have since allowed Dr. Jeffords to undergo two hair transplants. "Follicular unit extraction doesn't create a scar," he says. "Instead, you remove a follicle at a time to reconstruct the hair line." 

    Now, new automated follicle removal devices allow physicians to harvest 600 to 1,000 grafts per hour, he says. "I just did a 3,000-graft case, and finished harvesting in 2.5 hours," he says. "It's much quicker, much safer, with no scars."

    The new grafting technology can even allow scar revision procedures, Dr. Jeffords says, such as graft hairs into scars. It's even possible to use the grafting devices to improve the appearance of scars without adding hair. "If you have a white scar that shows through dark hair, you can make holes in that scar so it will revascularize, turning a white scar into a flesh-colored scar." 

    NEXT: Plastic Surgeons Can Stand Apart

    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.

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    • DRDAVID@------.COM
      I read Dr. Jiffords, congrats for the article and I have several comments too. First of all, I want to congratulate to Dr. Bill Parsley for his comments. Hair Transplant surgery involved six steps and each of them is critical and important for a successful surgery outcome and natural results. Donor harevesting is ONLY one step of the hair surgery, we have two techniques for harvesting the hair grafts: the donor strip and the punch technique (FUE). Both techniques have pros. Cons, side effects and complications. And it doesn't exist a scarless surgery with the punch technique (neograft, robotic, manual or motorized devices). Also, the hair transection is variable from 5-15% percentage with punch technique vs 0% transection of the microscope dissection of the donor strip. So, donor harvesting is a critical step for excellent good hair growth and survival in the recipient area. I want to point out that the scars with the punch technique could be worse than the strip technique and many times tha donor area is over harvested With the punch technique that will show thinning and scarring overtime. Both donor harvesting techniques are excellent options for the hair surgeon with experience and training.
    • parsleyw@------.net
      I just read Dr. Jeffords article and would like to make some comments. 1. That FUE leaves no scars. The truth is that each and every punch graft site in the donor region leaves a scar. Some are barely noticeable but others leave a small hypo pigmented scar. They are sometimes visible through the hair, especially with 2 or more passes. Also the scars are spread over a zone 8-10 times as large as a strip harvested zone.There is no free lunch in hair harvesting. 2. That he couldn't work for several weeks if he had a strip procedure (which is followed by microscopic dissection) to avoid a widened scar. No one is the International Society of Hair Restoration Surgery, which is the largest hair restoration society in the world, would recommend that someone take off several weeks. We generally allow a surgeon to return to work in 2 days. Using conservative techniques the "12" inch scar is usually very hard to find even by the hair stylist. The alternative with FUE is shaving the back of the scalp and having an odd looking haircut for several weeks. One may not remove a gall bladder with a 12 inch scar but neither would one remove it with a shotgun. 3. Neograft makes an automated machine for extracting small plugs. It is a reworking of the old Calvitron machine in which larger round grafts were extracted and is a relatively good tool in the proper hands. The issue most hair surgeons have is the practice model used, in which they will fly in techs (most unlicensed by any type of medical or nursing board) to perform most, and sometimes all, of the procedure. 4. This is not an easy field for any doctor including dermatologist and plastic surgeons to enter. Knowledge of hair disorders, androgenetic alopecia, holding solutions, harvesting techniques, placing techniques, medications, etc. are required. Both Follicular Unit Extraction (punch removal) and Strip Harvesting with stereomicroscopic dissection are good techniques but each can have complications. We all want to give our patients the the best and most current treatment available. It requires dedication and experience.
    • DRDAVID@------.COM
      Dear Bill, Congrats for your comments, I totally agree, you mentioned and pointed out critical issues about the hair transplant surgery that each surgeon should know before entering to the hair restoration field. Any manual or motorized device for donor harvesting (punch technique) requires training and experience of the hair surgeon.

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