- I have written a post on my blog Orlando Hair Restoration concerning a question that was raised by a well known Hair Transplant Surgeon, the question was "You still know patients that want a linear scar" ? So it got me thinking about Neograft and FUE.
- If the cost of Neograft was equal to that of strip for the same amount of grafts, would every hair transplant patient choose Neograft ? I'm guessing that the answer would be yes. I'm also assuming that the makers of Neograft would tell you that it is a premium service and hair loss patients should pay more for no linear scar. Even though Neograft states that it brings down the cost of FUE. I have some solutions to bring down the cost, making Neograft affordable for every hair loss patient that chooses hair transplantation.
- I have a method to complete a Neograft procedure of 1500 follicular units in 3 hours, this would allow surgeons to perform 3 cases in 1 day. Instead of 1 1500 graft procedure per day, even though your fee would be less, the volume would go up along with revenue. This would also allow Neograft to sell more devices, because every hair transplant surgeon would want to offer this. Even though Neograft is an improvement over manual FUE, it still takes too long for the existing hair transplant surgeon to justify the cost. It is also too expensive for the average hair loss patient to afford. By bringing the cost down for the patient, the demand will skyrocket, and existing strip surgeons would gladly purchase a device. If you own a Neograft and are interested in cutting your existing procedure time in half, contact me at 386-216-5429
Minde recipient site blades are the sharpest and most durable blades, you can use 1 blade for thousands of sites, SP brand of blades will get dull after 500+ sites, when a blade gets dull it causes more trauma to the skin. SP blades also dialate the site which makes for easier placement, but the Minde creates a cleaner site, it is a thinner blade which allows the hair transplant surgeon to place sites closer together. Don't let the lower cost of the SP influence your decision when purchasing recipient site blades, once you give Mindes a try you and your staff will stay with them forever, plus the patients heal faster and the final result is better.
The ISHRS has put out a statement regarding non-physicians excising follicles, they are against it in any form. So the companies that are selling Automated FUE devices, and telling doctors that it is ok to hair transplant technicians to do the extractions during FUE are not giving accurate information. Check with your state laws before buying any of these devices thinking that the techs can do the the procedure. They also did a comparison between FUE and Strip donor removal, you can find both of these articles on the ISHRS home page towards the bottom of the page. It explains why the majority of hair transplant surgeons have not integrated FUE into their practices, and why hair loss patients also choose strip over FUE.
Should you enter into contracts when hiring Hair Transplant Technicians for staffing or training of your nurses or medical assistants ?
There are 2 or 3 staffing companies, you can read their contracts on the websites. If you read carefully you can see that the contract is very one sided, they take no responsibilty for the outcome of the hair transplant procedure even though hair transplant technicians perform 80% of the work.
When you are spending the amount of money that they request, they should at least have a policy that if there is poor growth, and the patient is not happy, they should agree to come back at their expense to make your patients happy.
You also do not want to tie yourself to a staffing company until you see for yourself how they perform, and do they fit in with the image of your practice, in a cosmetic practice you need people that represent your practice to the same standards that you require of your full-time employees.
Another big problem with some staffing companies is you don't know who they will send, you could get a different team every time you perform a hair transplant procedure.
You should demand that you get to pick the techs, prior to scheduling ask for names and experience level of all the hair transplant technicians that will have access to your clinic, they might try to tell you that they can't provide this information, if they do find another team.
Get in writing the experience level and names of the technicians, on the day of surgery if you are greeted with a team that isn't what you paid for, you should get a discount.
On some of these contracts they punish you if you have to cancel, but what happens if they cancel on you ? There is no penalty that they pay you if they cancel or don't show up (one-sided contract), most of the technicians out there are good people, but it is not uncommon for them to cancel on you if they get a better offer, this is why it is very important that you get at least 15-20 references from hair transplant surgeons that they have worked with.
You should also not pay per graft, it is too easy for the techs to cut a few hundred grafts raising the fee. You can pay for the day, or per case but don't pay by the graft, I also recommend this when you charge your patients, like all other cosmetic procedures you should just charge a set fee.
This is what I recommend, I have been offering Hair Transplant Staffing and Training since 1993.
- Do not sign a contract which commits you to anything beyond the day of surgery, you can have a written agreement for each day, and what each party is responsible for.
- Do not pay per graft.
- Get at least 15 references from experienced hair transplant surgeons who have worked with the techs that are being sent. Not references about the lead tech or owner of the staffing company, but on each tech that is coming.
- I would not pay any portion of the fee upfront, you can pay for their flights, that is the same as a deposit. Your dealing with people you have never met, I would not give them my credit card information.
- You should get in writing, that if the result is unacceptable, and your patient is unhappy, the team will come back at their expense to make your patient happy. If they tell you that they have never had a less than incredible result it is not true, even the most experienced and well known hair transplant surgeons have some unhappy patients, or patients with poor growth, this is more likely to happen during FUE procedures because you have less "safe" donor hair available. Dr. Ron Shapiro states this on his website, and he is one of the best in the world.
- Be careful what you allow the technicians to do during the procedure, the techs should cut the grafts, place the grafts, and assist you during the procedure. I would be careful allowing them to perform extractions and making recipient sites, you can get their advice concerning what size Minde's to use during the recipient site phase. As far as Extracting the grafts during FUE, this is definetly the surgeon's area of responsibility, you might be told that it is ok for techs to do, but check with your attorney, if your patient gets a poor result and all they remember is that the hair transplant technician was performing the extractions, you might regret your decision to allow the tech to do the extraction. With new FUE devices to speed up the extractions you can do it yourself in a very short amount of time, plus your patient's will reward you for taking the extra time by refering you to their friends, the word will spread that you are doing the extractions.
- Bottom line do your research, their are a number of experienced, quality hair transplant technicians available. You can call me I have friends in most states that are very experienced, we don't require contracts, we stand behind our work, we don't charge by the graft, and we have not missed a scheduled assignment. We also will train your staff for free, when we come in for staffing we will teach your staff for no additional fees. We don't require a deposit upfront, and we don't penalize you for a cancellation, we understand that patient's do change their minds, and you shouldn't be penalized for something you can't control.
- You can call me at 386-216-5429, or email rkirk@hairtechs.com
The key to getting perfect follicular units starts with the hair transplant surgeon choosing the best available donor, and then removing a strip while visualizing the follicles, this is just one area where strip F.U. is superior to FUE. Once the strip is given to the hair transplant technicians, they will break it down into 1-2mm wide slices, these slices are then divided into follicular units by the hair transplant technicians, all of this is done with the use of lightboxes and microscopes. The hair transplant technicians are able to see the follicles, during the FUE procedure, you don't see the follicles until after the cutting has occured.
What do the experts, the leaders in the field of Hair Transplant Surgery say about FUE. FUE or Follicular Unit Extraction is a technique to perform hair transplantation. In the last few years there have been some devices that automate and help the surgeon perform the extraction faster, increasing graft survival and the end result. Dr. Ron Shapiro states on his website that there can be as much as 50% less hair available when performing FUE compared to traditional strip FUT, he goes on further to state that because of this you may have to harvest donor hair from outside the "safe zone", this hair may be of poor quality or non-permanent. This is evident when you search in google images for FUE, automated FUE, or by the specific names of the devices on the market that automate the FUE procedure. Healing pictures of FUE donor areas are shown, you can see very clearly that some of the grafts were taken from outside the "safe zone". Regardless of the procedure FUE or FUT, and regardless of the devices used to assist the surgeon, you can't change the physiology of the follicles. In every text book written for hair transplant surgeons, the "safe zone" is not disputed, that and position of a hair line are long standing rules that should not be broken. Now as a surgeon performing FUE it is your responsibility to tell the patients if you will be extracting follicles that could fall out in the future. In the last year there has been a pretty large increase in the number of doctors performing FUE, this is due to some new devices that have made the procedure easier, and the role of hair transplant technicians. If you are a surgeon looking to add hair transplantation to your practice, take the time to do the research, don't be enticed by the financial reward. You can get Facts from the ISHRS website about actual types of procedures performed, this will help you evaluate the true demand. As many doctors have learned, you can't create a demand, you can end up spending a lot of money advertising only to perform 2-3 procedures a month. Also do not limit yourself to one type of procedure, this will greatly decrease the number of available patients, there is only 1 full-time FUE surgeon in the U.S. There are about a dozen new doctors that perform FUE, but they are not performing 15 cases a month like the average hair transplant surgeon that performs strip FUT. The members of the ISHRS, will share with you the truth about starting up a hair transplant practice, not to discourage you, but let you know that it is not easy, and it takes knowledge. A lot of these surgeons will let you come to their offices and learn, you can also attend meetings and workshops held every few months. Like any business, research the market, educate yourself to the supplies and staff that you will need to perform hair transplant procedures, and move forward.
I have been working as a surgical assistant in the field of hair restoration since 1993, after serving in the U.S. Navy as a Hospital Corpsman. I have seen the incredible advancements in the field and have been teaching at ISHRS meetings and workshops since 1995, it is a great group to be a part of, and if you show a real desire to help hair loss patient's the doctors in the ISHRS will help you. If you would like to come visit my clinic in Orlando, Fl. just give me a call, we welcome doctors and their staff to come see first hand how smooth a procedure can be if you have an experienced team of techs and surgeons. If you want advice on FUE or strip FUT, I will give you an honest opinion and the resources to help you. I will also put you in contact with the physician experts in both procedures that reside in your area. Since I have been in the field for so long, I have a large network of experienced technicians that I know, they love what they do assisting doctors, and they don't play games with restrictive contracts, or outrageous fees. You can reach me at 386-216-5429, or email at rkirk@hairtechs.com , you can also meet with me at the upcoming ISHRS annual meeting in Boston.
NEOGRAFT NEWS
Dr. Bauman, the first doctor in the U.S. to publicly support NEOGRAFT has issued a warning on the internet concerning the use of the device by doctors with no hair transplant experience. Remember NEOGRAFT is just a tool, that speeds up the extraction of follicles. It does not produce a better hair transplant by itself. It will in the hands of experienced hair transplant doctors and tecnicians help them remove hair follicles faster. In Florida there are 2 doctors with many years of experience who use Neograft. Dr. Bauman in Boca Raton and Dr. Hirsh in Jacksonville, Sarasota, and Orlando. FUE has limitations, just as FU surgery has. It is up to the doctor to educate a prospective patient on the methods that can benefit him, and let the patient decide. Hair Transplant Techniques explained.
Recommended services for the start-up hair transplant doctor:
Hair Transplant Staffing: You found it.
Hair Transplant forceps to place follicular units into the smallest recipient sites from 0.6mm to 1.3mm are hard to find. Each technician has his or her preference, a lot of clinics and techs are not aware of some of the more advanced follicular unit forceps. The best forceps that I have found to place the smallest of grafts are the Leavitt Bonn and Miltex 18-836 and 18-837 forceps. I started using them years ago and every tech that borrowed mine were hooked and either bought a pair or had their doctor by them at an annual ISHRS meeting. These forceps will increase the speed at which you can place grafts, and increasing productivity is a good thing in this economy. These forceps are more expensive than others, but if you treat them well they will last for years, I have a few pair that I have used for 10 years.
Contact Florida based at 386-216-5429.
Finding a technically qualified hair transplant technician who can perform follicular unit hair transplants is not an easy task. Over the years hair transplant surgeons have had to utilize on the job training to achieve this, this type of training takes years to complete and is loosely structured without a curriculum to follow. We have changed that, since 1993 we have been developing hair transplant techs in the U.S. and in 2005 we introduced our hair transplant techniques at the ISHRS meeting in Sidney, Australia.
Training in follicular unit dissection and placement is offered to pre-screened R.N.'s, LPNs, Surgical technicians, and other clinically experienced medical personnel. We will not train non-medical staff in hair transplantation, as some hair transplant surgeons are doing. The students will be taught follicular unit dissection using
Mantis microscopes or High Definition Video dissection, which is above the industry standard in hair transplants. This training can be done in your office, saving you additional expenses sending out your staff to an off-site location.
Staffing is provided to hair tranplant surgeons who have had training in hair transplantation through the ISHRS or the AACS. Our
experienced hair transplant techs have over 20 years in this field and only perform the "gold" standard in follicular unit dissection and placement.
New study by Dr. Beehner confirms that follicular units with a small amount of surrounding tissue to protect the grafts provides for better growth than grafts that have been trimmed excessively. This confirms previous studies dating back to 1998. Excessive trimming of follicular units is a result of trying to achieve recipient site densities of greater than 50/cm2, and sometimes reaching 100/cm2. It takes time to see the results of new techniques in hair transplantation, 12-18 months, so go slow when implementing new technology and techniques that you learn at ISHRS meetings and workshops.
The 16th annual Live Surgery Workshop was held in Orlando, Fl. this week, the highlight of the meeting was the demonstration of the Neograft FUE device. This could have been the first time that the device was demonstrated at an ISHRS workshop. The device performed as I expected it to, it's rotary punch scored the skin around the follicular unit and the suction device, sucked it up into the canister. It appeared to me that if more tumescence was used, the extraction process would be faster, but I am not an expert on FUE. I should have asked Larry Leonard, what technique is fastest, as he is the best FUE technician in the country. Dr. Bauman form Boca Raton, Fl. was the doctor in charge of the Neograft FUE procedure. Dr. Bauman is the leading physician expert on the Neograft FUE device, and Al Tariq is the leading tech. Dr. Bauman was extracting grafts at a rate of 1 every 6 seconds, I don't think this was an accurate representation of the capabilities of Dr. Bauman or the Neograft FUE device. Dr. Bauman was performing the procedure with a room full of doctors and he was answering questions. After extracting a few hundred grafts, he turned the handpiece over to Al Tariq, Al Tariq was extracting grafts at a much higher rate, 1 every 2 seconds by my watch. For doctors wanting to learn Neograft FUE, I would tell them to go to Dr. Bauman, if technician services are needed for Neograft FUE you should contact Al Tariq, for all other types of FUE contact Larry Leonard. My thoughts about the Neograft device have not changed, it's true genius is the extraction process, if Neograft could seperate that part of the device and sell it for about 10,000 dollars it would be a tremendous success. The pneumatic insertion device is not needed, a good hair transplant tech with the best forceps can place grafts alot faster than the handpiece. Neograft in my opinion is an expensive piece of equipment, there is a need to automate aspects of the FUE procedure, so Neograft is trying to fill that need, but the demand for FUE is not that great yet. I believe a basic principle in marketing is to create a product that there is a demand for not to try and create demand for a new product. Time will tell if the demand for FUE can exceed 10% of hair transplant procedures.
Training Outline