Would a team of Neograft technicians have an advantage over an individual doctor in harvesting the grafts? (Photos)

Dear aquanda,
Thank you for posting this question. The short answer is that in most states, including California, a Neograft technician harvesting grafts is straight-up illegal, and the doctor who allows this to happen in his or her clinic could very well be putting their medical license in peril. Technicians are not permitted to pierce skin with any instrument, and skin is most definitely pierced in the course of an FUE procedure.
Physicians must undergo rigorous medical training, which I think is obvious to most people. Just how much training may not be evident. After college and after medical school (4 years), doctors must choose specialty training. I spent 7 additional years after medical school receiving sub-specialty training in ear, nose and throat surgery and facial plastic surgery. There are many aspects to a surgical procedure, not merely the harvesting of follicles with an instrument. Hair restoration surgery is surgery, with all the attendant risks of any office-based surgical procedure, and that’s why only doctors may perform surgery. Not technicians.
Hair restoration technicians, including the Neograft ones, have the exact same medical training requirements for their job as the guy who cuts the grass outside my office: absolutely none. Quite literally anyone who wants to be a hair restoration technician may call themselves one at any time. Finding work is not hard as most doctors who offer hair restoration do not have a full time staff of technicians, but rather rely on independent contractors, like the Neograft technicians. Problem here is how do you know how much experience a technician has? How good are they? Impossible to know if you have new ones showing up every other week, as the results of a hair restoration procedure take a full year to manifest, and often the techs are long gone.
In looking for a surgeon, it’s a good idea to make sure your surgeon practices only hair restoration surgery, and hasn’t recently added hair restoration to a long list of cosmetic procedures they already offer. Look for a long track record of success in the field. Also, make sure the before and after photographs are from your surgeon, not provided to him by companies like Neograft. That happens all the time. Finally, it’s important that your surgeon offer both FUE and the linear FUT procedure. If only one or the other is offered, that’s a HUGE red flag for any hair restoration practice. If only FUT is offered, the practice is well behind the times. If only FUE is offered, they are likely very new to the field, and it’s possible that the surgeon recently acquired a Neograft machine and wants to get a return on his investment for the device, and so will start to offer hair restoration surgery despite never having performed an FUT procedure, which remains the gold standard in hair restoration today. It’s not only my opinion that FUT remains the gold standard in this industry, it’s the opinion of the International Society of Hair Restoration Surgery (ISHRS). The FUE method is a specialized method for those who want the option of wearing shorter hairstyles in the future, but due companies like Neograft selling these expensive instruments to doctors who previously did not offer nor perform hair restoration surgery, many doctors are pushing this method of hair restoration surgery. It’s just the economics of what’s happening in the field of hair restoration surgery today. I hope this information is helpful to you.
Kind Regards,
Ken Anderson, MD, FISHRS

I would politely disagree with one of the previous surgeons who suggested that Neograft is inferior to an individual surgeon.  In our office, I meet with every patient, draw in their hairline, inject local, map out the donor site but then let the highly skilled NeoGraft technicians remove the individual follicles and transplant them.  Keep in mind that these people perform these procedures on a daily basis and know how to not only extract but also transplant hair and have done this for years.  In reality, they are probably more skilled than even the surgeon at transplanting the hairs.  If you don't believe me, I encourage you to check out before/after results and go from there. I hope this helps and wish you the very best!Warmest regards,Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

Thank you for your question. I suggest that you move forward and consult with a board certified facial plastic surgeon. It is important that you work with a trained specialist with experience performing the procedure.
Best wishes,

Hello, The model of Neograft is to have technicians come to your office and do the case for surgeons who don’t specialize in hair.  This can lead to poor results as hair restoration is not just up having technicians extract and throw hair follicles on your head.  It should be a carefully planned procedure with physician guidance including hairline design, use of regenerative techniques, hair angle design, and ensuring the graft quality is ideal.  The traveling team of technicians model does not seem to be ideal.
Best,
 Dr. Anil Shah

Team of Neograft techs performing surgery is generally considered illegal in many states. Having a medical license does not make you a skilled doctor either but why would someone trust technician who has no medical training to perform surgery on your body?

Making the comparison to physicians as a group is difficult. There are many experienced hair restoration physicians as well. The blanket claim of the superiority of one over the other suffers from the same weakness as any generalization.Neograft technicians are among the most experienced in the field. Many have had extensive experience in hair restoration prior to joining Neograft. One of the major benefits of the Neograft team approach is the additive experience of all those involved. Each member brings his/her unique experiences to the table and will impart something unique to the treatment plan.Additionally, the extra man-power allows for greater efficiency when all of the components to an FUE procedure are taken into consideration: prepping the donor site, infiltration of local anesthesia, harvest, counting/separating grafts, preparing recipient sites and finally grafting.With regards to your specific question, all of the above stated options are safe and reasonable approaches to hair restoration, each with unique benefits. I have found the Neograft team approach to be the most safe and efficient option in my practice.As always, discuss your concerns with a board certified plastic surgeon (ABPS) with experience in hair restoration.

Hair transplant surgery is a surgical procedure.  It is illegal and reportable to the respective state medical board for unlicensed technicians to perform the procedure.  Search for a physician who actually performs the procedure, and has documented before and after photos to back up his/her work.

The technicians can help with implantation which is mainly a laborious process but design, extraction and numbing should all be done by a surgeon without exception. I'm sure many technicians could perform these tasks and do them well but that does not make it appropriate. The bottom line is this procedure can easily be done by a Neograft technician and the truth is ghe physical act of pulling out the grafts they are probably better than most surgeons because of shear practice. The issue is that they don't follow up before or afters or have as much of a vested interest in obtaining the best results. It truly isn't a safety issue but simply that the current regulations don't allow it. 

There is an inherent problem with the use of Neograft technicians to harvest grafts, make recipient sites, and place grafts.  Technicians are not physicians.  Some technicians may be highly skilled and well trained, however many neograft technicians are not highly skilled, nor highly trained.  More importantly, most neograft technicians have no formal medical training and no neograft technicians are licensed physicians.  None of these technicians are licensed to perform surgery and none of these technicians have medical malpractice insurance.  
The International Society of Hair Restoration Surgery issued a statement that cutting grafts and making recipient sites is performing surgery.  Performing surgery should be done by licensed physicians only.  I know that my surgery technicians are highly skilled and personally trained by me.  I would not allow anyone them to perform a hair transplant surgery on any of my patients, however.  You will find that experienced hair transplant surgeons do not allow technicians to perform hair transplant surgery.  Personally, I would not allow any physician, who delegates a surgical procedure to a technician to be involved in my care.  
If you examine your question well, the answer is easily answered by yourself.  

The machine used to harvest is not that important. The person on the other end of the machine is what is most important. The benefit of the Neograft and Artas is that they can be handled by technicians. Manual FUE machines are handled by Doctors that demonstrate expertise at harvesting thousands of hairs per procedure.