The Truth About The Neograft

There has been a lot of advertising recently about the 'revolutionary Neograft procedure.' Unfortunately, some of the advertising is rather misleading. The Neograft actually refers to a device which automates the process of follicular unit extraction. But what is follicular unit extraction and is it beneficial?

Follicular Unit Extraction vs. Strip Harvesting

The current state of the art in hair transplant surgery is a process called follicular unit grafting (FUG). In follicular unit grafting individual hairs or small groups of hair follicles are transplanted into bald areas. While FUG refers to how the grafts are placed, there are two ways to harvest donor hairs - strip harvest or follicular unit extraction. In either method, the hair is harvested from the back and lower sides of the scalp in areas that are not going to fall out because of androgenic alopecia.

The strip harvest is the time honored method which removes a 'strip' of hair from the back of the head. The biggest down side is that there will be a linear scar left behind. With good closure techniques, this scar is usually not visible under the hair, even with a short hair cut. There is the possibility of a widened scar but a simple scar revision procedure can be undertaken to improve the scar. The advantage to the strip harvest procedure is that a large number of hairs can be harvested at one time with minimal transection rates. Additional risks do include damage to nerves and blood vessels producing numbness on the back of the scalp as well as infection, bleeding, and hair loss around the harvest site.

The follicular unit extraction technique relies on individual punches of hair being removed. The technique was first described in the medical literature in 2002. Recently the technique has been marketed heavily after the introduction of an automated harvesting machine known at the Neograft. While a reasonable technique, some of the advertising related to the device can be misleading. Unlike the strip harvest, follicular unit extraction leaves small white scars on the scalp. Unfortunately, anytime the skin is cut, a scar is left behind. The biggest drawback to follicular unit extraction, even with the Neograft device, is the risk of transection of the follicles producing follicle which can not be used for the transplant. The transection rate with follicular unit extraction is greater than the transection rate with strip harvest techniques.

Follicular unit grafting works well for smaller transplant sessions, patients who have undergone multiple sessions, or patients with thin hair in the donor area for some reason.

An additional evaluation of follicular unit extraction versus strip harvesting can be found on the International Society of Hair Restoration Surgeon's website at

http://www.ishrs.org/article/follicular-unit-extraction-fue-manual-and-powered-device-assisted.html

and

http://www.ishrs.org/articles/strip-harvesting-vs-fue.htm