Experience of Your Surgeon is *Much* More Important Than Any Method or Machine Used.
NeoGraft was introduced about 5 years ago, and is simply a machine that a physician (or, more likely, a technician) uses to perform the follicular unit extraction (FUE) procedure. It is more or less a motorized, hand-held circular punch, attached to suction. I attended a physician's office in Florida in 2009 for a demonstration of the NeoGraft device. I've been performing FUE procedures since 2003, and I was very interested to see this device. While at this meeting, hosted by the NeoGraft corporation, it was interesting to note that I was the only dedicated hair restoration surgeon in attendance. The others there to see and perhaps purchase the machine were spa owners, obstetricians, several family practice doctors, and a few business managers for doctors who dabbled in cosmetic surgery in general. I was pretty surprised. The graft placement feature of the NeoGraft device with positive pressure is a gimmick, as I asked the head trainer for the NeoGraft corporation to place a graft using this. We were observing an live procedure, and we watched as he tried several times, but was not able to place a single graft with the machine.
NeoGraft has done a tremendous amount of marketing, and I see physicians who have never done a hair transplant around the country acquire this machine, piggyback on the marketing done by NeoGraft, and start to offer this complicated, and permanent procedure to the public. In much of the country, the doctor will simply hire a technician (the going rate for a NeoGraft tech in Atlanta is $70/hour) to perform the procedure. It should be noted at this point that hair restoration technicians have the same exact medical training requirements as grass cutters: absolutely none. The physician only need sign the papers and be on the premises. No joke. So, whether using the NeoGraft, or the much more advanced ARTAS robotic hair restoration system, or any other device, including a 50 cent 1mm biopsy punch, it is the experience and dedication of the surgeon and his team that will determine the outcome.
Hair Restoration is it's own specialty now. There's a global society (the International Society of Hair Restoration Surgery) and a Board. Choosing a surgeon 100% dedicated to hair restoration is paramount. If "NeoGraft" suddenly appears on a long list of other procedures a physician offers, I would be wary, as it is unlikely that the physician has a full-time, highly-trained team of hair restoration technicians, and is just hiring one of many "hired gun" technicians that will arrive at the office, and do the procedure for $70 an hour. There are hundreds of subtleties and nuances in hair restoration, and assuming that because a physician now offers NeoGraft, in addition to all the other procedures offered, will be competent and excel at hair restoration surgery is simply foolish. Look at the experience and dedication of the surgeon who will be performing the surgery, and make sure technicians are not actually the ones who will be performing the surgery. Also make sure the physician you choose is actually a trained surgeon. The majority of hair restoration "surgeons" are, in fact, not trained in surgery at all, and hold no board certificates in any surgical specialty whatsoever, so examine your physician's credentials carefully. You should feel perfectly comfortable asking for a copy of the surgeon's resume to review. Look for many years of dedication exclusively to hair restoration, not just cosmetic surgery in general.
This problem is so rampant and common that the International Society of Hair Restoration Surgery, the global community of physicians practicing hair restoration, issued a consumer alert about this issue. I see patients every month who had a hair restoration performed by a technician with the NeoGraft device presenting to our office asking for help; asking me to repair the unnatural looking hair transplant results. This is often very difficult, and occasionally impossible. Because as we say in this specialty, "the good thing about hair restoration is that it's permanent. The bad thing about hair restoration is that it's permanent." Consult with more than one surgeon, make sure he or she is actually a trained surgeon, and get a feel for who you think will be the best for you. A machine absolutely does NOT guarantee good, or even acceptable results.
Having placed over 500,000 grafts with the device, automated FUE has proven to be a superior alternative to decreasing the morbidity associated with strip surgery. You must consider the experience of the physician using the device. It has a steep learning curve and in the right hands, much like many other procedures, offers a safe alternative to the conventional strip method.
NeoGraft Device for Hair Transplant
I am disappointed to see as many inaccurate statements in the above comments, and unfortunately they only serve to further confuse the public. NeoGraft is a device that removes follicular unit grafts one at a time- a well-used technique called FUE. Just because the NeoGraft device is used does not mean that this is the only way to do the FUE technique, nor is this a guarantee of a high rate of regrowth. It is only a tool, that does not assure an aesthetic result.
Note that since I first answered this question two years ago, I have started to use Neograft as one of the devices for FUE procedures, along with our own E-Fue System. The role of the surgeon in any hair transplant procedure is invaluable for assuring a natural-appearing result, for it is the surgeon who makes the recipient sites and does the hairline design and makes other key treatment decisions.
I have had over 13 years of experience in hair transplantation, and I feel the NeoGraft FUE device is a great way of harvesting FUEs without leaving a visible linear scar on the harvest area (back of the scalp). Realize that some surgeons do the FUE with a manual skin punch and others use the new robotic hair transplantation system by Artas. Each of these have their place in hair restoration. I feel the NeoGraft is a great tool is harvesting large number of grafts (<2000) in the quickest time. However, it is dependent on the skill of the person using it. The Artas system uses a robotic system that is more consistent in graft quality results. I would not do NeoGraft if the case needed over 2000 hairs, since the surgeon might get fatigued and the later grafts might not be as good as the earlier grafts. Over 2000, I recommend the robotic system for consistent graft quality and results.
Is neograft the best?
Don't believe everything you see in the news or on TV. It's best to meet with an experienced hair transplant surgeon to discuss the different methods with you. In my practice I do not use a Neograft because I do not like the larger punch size, the fact that you have to punch deep, and the additional stress/trauma placed on the hair follicles via the suction mechanism.
I prefer to use small punches (so patients heal better and I extract only hair follicles) and extract my grafts manually and place them in chilled hypothermosol solution.
I think Dr. Ken Anderson's response to this question is one of the best I have seen. Very few "Experienced" Hair Restoration Surgeon's use a Neograft, and most of the ones that did stopped using it shortly after they started seeing the negative aspects of the device.
NeoGrafts verses Other Hair Transplant Instruments and Technologies
The Neograft device is a hand-held, powered Follicular Unit
Extraction (FUE) tool that uses sharp edge dissection. Because Neograft relies
on manual control and suction, it risks damage to hair follicles during
harvesting from both the shearing of grafts from the suction and transection of
follicles due to human operator error.
Instruments that address these shortcomings include the
manual SAFE System which uses a two-step sharp-blunt dissection technique and
doesn’t rely on suction and the ARTAS Robot which has these advantages and also
use a robotic image-guided system to minimize human error.
Best Hair Transplant Method
NeoGraft is a device used for FUE (Follicular Unit Extraction). Our office has been using NeoGraft exclusively for the past four years. With this technique we avoid the linear scar and reduce damage to the hair follicules extracted for our office. NeoGraft results are superior to traditional strip method.
FUE Hair Transplant with Neograft
Neograft is essentially FUE harvest with a dental drill combined with suction extraction. Very few hair transplant specialists use the pneumatic device to implant and as such this aspect is more of a gimic. Other power assisted devices exist which are are also modified dental drills or dermabraders. The key feature is to avoid transection of the grafts which is best accomplished by using the sharped punches and careful handeling on removal. This can be accomplished just as well manually if not better than with the use of the suction device. The future may be with Robotics however robotics does not eliminate the potential for transection as there is no tactile feel with a robotic device. Additionally, robotic surgery only helps with the extraction phase not implantation. I do not see real advantages to robotics at this time.
Neograft works on males and females with any hair type. The biggest advantage of Neograft as opposed to more common "strip" methods is that the patient avoids the linear scar across the back portion of the head. There are no scalpels or stitches involved. The advancement of Neograft technology allows the technicians to harvest and transplant hairs more efficiently than the manual FUE technique. A maximum of 3000 grafts can be transplanted at one time. Most patients can return to work in 3 days.
The Transparent FUE Answer
Neograft is just one of several options an experienced hair transplant surgeon can use to perform a Follicular Unit Extraction (FUE) procedure. Our office uses a motorized unit that is very light and comfortable, which allows me to perform excellent quality extractions. That being said, it is important to note for the benefit of the public that there's a great deal of marketing being done by 2 FUE equipment companies, promoting the FUE procedures to EVERYONE, which is a great disappointment. Not everyone is a candidate for the FUE method, just like some patients aren't candidates at all for hair restoration for that matter. I usually recommend the FUE method to patients with slight hair loss...not showing an advanced pattern of balding. The reason is that a patient who might need several surgeries to reach their goal, might run into a problem using the FUE method, which can results in having too many dot scars next to each other, which can cause a diffused thinning look in their donor (doesn't make sense to cause a problem in the donor while trying to fill other balding areas). For these patients, I recommend the FUT, Strip, method, which allows for a better handling of the donor (leaves a linear scar that hides well under the hair and everything above and under that line is as thick as when the patient was born).
What I find interesting is that no other hair specialist who has answered this questions has also brought up the fact that these 2 FUE companies that sell their equipment to hair transplant clinics, a good number of them not being specialists at all, also require that a $1/graft royalty be paid back to the equipment manufacturers. This is also another reason why I chose another option of FUE tool...one that is not tide to any royalty program, which I find to be very tacky and borderline unethical, since this answers the question of why these 2 companies market their equipment and FUE method to EVERYONE (knowing they will make money when they sell the units to doctors, but also make with royalties on the back end).
By using a comfortable, motorized FUE unit, I am able to deliver quality grafts, which equals great results AND save my patients $2-3k by avoiding the royalties paid to these other 2 FUE manufacturers.