What is Neograft?
Neograft is a device used for follicular unit extractions (FUE). These grafts are extracted for transplantation from the donor area of the scalp. The donor area is the area of the scalp that is not susceptible to either male pattern or female pattern hair loss. The donor area generally consists of the back (occipital) and sides of the scalp (parietal). Using the Neograft technology, follicular units are individually removed from the donor area, avoiding a linear scar in these areas. Follicular units are the natural groupings of hairs as they exit the scalp. Everyone’s hair exits the scalp in units consisting of either one, two, three, four and less frequently five hairs. You can think of these units like a plant in a pot. The “pot” with all the roots of the plant is the follicular unit and the “stems” being the hairs emanating from the roots. Continuing with this analogy, Neograft allows for the hairs to be removed from the roots, contained with their individual “pots.” The Neograft device simultaneously extracts and suctions the follicular units removing them in their entirety. The follicular units can then be quickly and efficiently removed and transplanted in the recipient areas for transplantation.
Why choose Dr. Bared for your Neograft procedure?
The important distinction that needs to be understood about Neograft is that it is a device for follicular unit extraction. Once the follicular units are extracted with Neograft device they are then transplanted into the recipient area by a hair restoration surgeon—the most critical step in hair restoration. The outcome of a hair restoration is mostly dependent on the creation of all the recipient sites where the follicular units are transplanted. Through the creation of the recipient sites, Dr. Bared determines the angle and direction of hair growth which is critical to the natural appearance and the density of the transplanted hairs. Dr. Bared determines the exact placement of each follicular unit in the recipient area: where each one, two, and three hair grafts are placed, ensuring the most natural results.
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Considering Hair Transplantation?
Dr. Bared is a double board certified facial plastic surgeon who specializes in hair transplantation. Dr. Bared’s qualifications as a facial plastic surgeon place him in a unique class amongst hair restoration surgeons, as there are very few double board certified facial plastic surgeons in the nation who specialize in hair restoration. As a facial plastic surgeon, Dr. Bared brings with him a critical and keen artistic eye to his hair transplantation procedures in addition his technical expertise. Hair transplantation makes up approximately half of all the procedures Dr. Bared performs, making him a true specialist in the field of hair restoration. Dr. Bared treats each case on an individual basis from the consultation through the procedure itself. As a hair restoration specialist, Dr. Bared will examine and help you determine the best possible course for your hair loss by either surgical or non-surgical means.
Dr. Bared is an invited speaker at national and international plastic surgery meetings, speaking on the subject of hair restoration. Given Dr. Bared’s qualifications and experience, he has been selected as a recommended surgeon by the International Alliance of Hair Restoration Surgeons and The American Hair Loss Association, recommendations only achieved by 5 other physicians in the entire state of Florida. Dr. Bared received his hair restoration training from Dr. Jeffrey S. Epstein at the Foundation for Hair Restoration and Plastic Surgery. Dr. Epstein is a world-renown leader in the field of hair restoration. At the Foundation for Hair Restoration and Plastic Surgery, Dr. Bared works alongside a highly experienced team of hair transplantation technicians with more than 20 years of experience in hair restoration. The staff working alongside Dr. Bared is a full-time hair restoration staff, a rare feature amongst surgeons using the Neograft technology for follicular unit extractions. After many years of performing follicular unit extractions for donor hair removal, the Foundation has implemented the Neograft device for its efficiency and quality of FUE extractions.
FUE versus FUG “strip”
FUE and FUG or “strip” procedures are the two methods utilized for donor hair removal (harvesting). They each have their potential indications. In the traditional FUG or “strip” procedure, donor hair is removed via an incision from the back and sides of the scalp. The length of the incision is determined by the quality of the donor hair as well as the total number of grafts to be transplanted. The FUG “strip” procedure, unlike many of the FUE procedures, does not necessitate the need for the shaving of the back and sides of the hair at the time of the procedure. In cases, where a longer hair styles are worn (typically greater than one inch) FUG can be a good option for patients. The incision from an FUG/ “strip” procedure can be well concealed with hairstyles longer than one inch. However, for patients wanting to avoid an incision and wear shorter hairstyles, an FUE procedure such as Neograft is the option for them. In an FUE procedure, in most cases, the back and sides of the scalp need to be shaved for the procedure itself. In some cases where a smaller number of graft extractions are needed the back and sides of the scalp do not need to be shaved. Every case varies depending on the length and quality of the donor area but, on average, around 500-800 grafts can be extracted in men and around 1,100 grafts can be extracted in women without the need to completely shave the entire back and sides of the head. This, of course, varies with the density of the hair, the hair texture, and the length of the hair. However, in most cases, the back and sides of the hair need to be shaved for the harvesting of sufficient grafts for transplantation in FUE cases. Dr. Bared will discuss with each patient and present the options for donor hair harvesting. Dr. Bared will review with you the potential benefits of each during your consultation so that you can make the most informed decision possible for your procedure.
Who is a candidate for Neograft?
Men or women in generally good health seeking hair transplantation and wanting to avoid a linear scar are the best candidates for Neograft. Patients who have never had a previous procedure and who do not mind the need to shave the back and sides of the hair for the extraction of grafts are great candidates for the Neograft. The procedure is also a great option for patients of African descent who wear their hair styled short. In those patients who have had a previous “strip” procedure, they may be best served with a secondary strip procedure and not an FUE procedure. It is not to say that having had a previous “strip” procedure prevents the possibility of Neograft, it is just that the shaving of the back and sides of the hair for the extractions may expose the previous linear scar. For this reason, Dr. Bared would recommend either a secondary “strip” procedure or a ‘hybrid’ procedure. In a ‘hybrid’ procedure for secondary “strip” cases, the incision is limited to the back of the head and not extended to the sides of the head. Instead Neograft extractions can be taken from the sides of the head to increase the total number of grafts extracted, while maintaining the hair long throughout the scalp. In these cases ‘tunnels’ of shaved hair are made within the hair along the sides of the head where the Neograft extractions are performed. The surrounding hair is not shaved. Dr. Bared may utilize this approach in patients who have had previous “strip” procedure and want to avoid a longer incision. As a hair restoration specialist, Dr. Bared is able to offer these various options to his patients.
Donor site preparation for a female patient undergoing FUE procedure of 1,100 grafts. Shown is the patient wearing her hair down covering the donor site.
Your consultation with Dr. Bared for Neograft
During your consultation with Dr. Bared for Neograft he will review your history as well as perform an examination of your hair. Dr. Bared will be able to better assess your candidacy for the procedure and understand your goals and expectations from the procedure. Dr. Bared will listen to your goals and communicate with you what to expect from a procedure. As a hair restoration specialist, Dr. Bared sees and evaluates patients for hair loss of the scalp as well as eyebrow, beard, and body hair transplantation. Depending on your goals, Dr. Bared will design a plan to meet them. Many patients travel in from out of town for their procedures with Dr. Bared. Out of town patients will send in their photos for Dr. Bared to evaluate.
Out of town patients will then either have a telephone consultation or a consultation over webcam. The main goal of the consultation is for Dr. Bared to listen to your concerns, perform a physical examination of your hair loss and determine your candidacy for a Neograft procedure.
What to expect on the day of your Neograft procedure with Dr. Bared
On the day of your Neograft procedure with Dr. Bared, you will meet in the morning with the doctor and the areas to be transplanted (the recipient areas) will be marked out for you in front of a mirror. Dr. Bared will perform these markings, ensuring the most natural results. You will have an opportunity to ask any further questions you may have as well as review the post-operative instructions. Dr. Bared will explain in detail the plan for the day and what to expect. After the markings have been made by Dr. Bared, the donor area along the back and sides of the hair are trimmed with a trimmer. This is performed to a ‘level 1′ trim. This trimming is needed for the Neograft extractions. In some cases, as mentioned above, the entire back and sides does not need to be entirely trimmed as Dr. Bared will explain to you. However, this is limited to cases with generally smaller number of grafts and patients with longer existing hair. You will then be given the option of taking an oral sedative medication before the commencement of your procedure. During the first part of the procedure, you will be lying face down in a comfortable table with a hole for the face similar to a massage table. This position is needed for the Neograft extractions to be performed along the back and sides of the scalp. On average, this takes around 2 hours depending on each patient’s donor hair density, the ease of follicular unit graft extraction, and the total number of grafts. Prior to making the extractions the area is anesthetized with local anesthesia. The local anesthesia is delivered with a wand device which limits the discomfort of the injection. Once the donor hair grafts are removed from the back and sides, you will then be turned over to be lying on your back in a reclined position. At this point, the recipient area is anesthetized with the same wand device and each recipient site is tested to exactly fit the size of the follicular units. The recipient sites are tenths of a millimeter in size and each is made to exactly fit the grafts to be transplanted. Hair transplantation is a very meticulous procedure. Each graft that is extracted is evaluated under a microscope for its quality and each graft is counted. The recipient sites are made in such a manner to give the most natural-appearing results with the greatest achievable density. As each follicular unit may contain from one to five hairs, these are arranged and transplanted by Dr. Bared and his team to give the most natural results.
Recovery after your Neograft procedure with Dr. Bared
The donor area after a Neograft procedure will heal in around 3-5 days following the procedure. During this time you will apply antibiotic ointment to the donor area. It is best to sleep with your head elevated for the first week after the procedure. Maintaining head elevation helps to decrease any swelling after the surgery. Patients also relay that they benefit from using a travel pillow around their neck when they sleep as this helps to relieve some pressure from the back of the head in the area of the donor site. The recipient area (where the grafts were placed) will heal in around 5 days. During which time you will have crusts covering the recipient sites. Depending on the recipient site (i.e. scalp, eyebrow, beard, etc.) the crusts may persist for longer periods of time. After several weeks the grafts fall out. The grafts will then become dormant and the transplanted hairs do not grow for several months. After around four to six months, the transplanted hairs will start to re-grow. Final results are often not seen for one year to fourteen months after the procedure.
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