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Greetings,

Here is a patient of mine who underwent an FUE hair transplant. He explains the entire process from his prospective.

It is an enjoyable and educational video.

All the best,

Marc Dauer, M.D.

Greetings,

Here is a video documenting a patient of mine’s FUE (follicular unit extraction) hair transplant harvest. The grafts were placed into the patient’s previous strip scar (which was created by another doctor), and the frontal scalp and hairline. The results are dramatic and are shown 7 months after the patient’s procedure. I hope you enjoy watching.

All the best,

Marc Dauer, M.D.

Greetings,

The patient in this video had a wide donor strip scar performed by another physician. The physician tried to resect the scar multiple times with no improvement. The patient also had scalp micro pigmentation which only provided slight improvement. I harvested approximately 500 beard grafts via FUE and placed them into the scar. The result show 2 weeks after the procedure shows significantly visible improvement and it will get even better when the hairs grow longer. In addition there is no visible scarring in the heard area from where the grafts were taken.

I hope you enjoy watching and I will provide a follow up video in 6 months.

All the best,

Marc Dauer, M.D.

Greetings,

Today I want to highlight a new article I just saw on CNN discussing how various organs were engineered in the lab to create new organs for individuals that were missing these specific organs.

This is a huge step forward for organ cloning as the closer we get to being able to clone tissue, the closer we get to being able to clone hair. Once we can clone hair we will no longer need to harvest donor hair from the scalp and every person will have unlimited supply for whatever demand they have for scalp hair. I am not trying to say that we are a few years away from being able to clone hair in practical terms, but I know think that we may see hair cloning in the real world in 10-20 years.

I can’t wait for that day!

I have attached a link to the article below.

All the best,

Marc Dauer, M.D.

http://www.cnn.com/2014/04/10/health/tissue-engineering-success/index.html?hpt=hp_t2

Greetings,

Here is a new hair transplant patient testimonial of one of my recent patients. This particular patient is a well known actor and he describes his experience undergoing the procedure both the day of and the subsequent healing period. I also describe my surgical approach to this particular patient.

I hope you enjoy watching.

All the best,

Marc Dauer, M.D.

Greetings,

Today I want to discuss the tool I use in performing Follicular Unit Extraction otherwise known as FUE. Every person’s scalp is different and therefore it is important that we do not approach what we do as Hair Transplant surgeons as a one size fits all approach. Along those lines, I recently started using a sharp tip punch with serrated edges as an option for my FUE cases. Prior this the only punch I had found that produced good results was a blunt tip punch. I will still continue to use the blunt tip as an option in some cases that do not respond well to a sharp tip punch, but I can truly say that these special sharp tip punches with serrated edges allowed me to harvest FUE grafts that are completely on par with strip harvested and dissected grafts, which continue to be the gold standard by which all hair transplant grafts are measured by. In the photo below you can see the perfectly intact FUE grafts and the large hair grouping that are present in these grafts harvested with a 1mm sharp serrated punch. In one side you can see the single hair grafts that were dissected out of the larger grafts in order to restore the patient’s hairline. In the other corner you can see the total of transected grafts which amounted to under 50 grafts. Based on this case of 1656 grafts harvested total the transection rate was approximately 3% which is incredibly low for any sort of FUE case, manual or automated. If you look closely at the grafts you can also see the amazing consistency of the grafts which you do not see with FUE grafts obtained with automated machines. I have showed this photo to a number of highly respected hair transplant surgeons and they have stated that these FUE grafts look just like dissected strip grafts which is the biggest compliment one can give to an FUE graft.

In summary, every individuals scalp and anatomy are different and it is imperative that we as Hair Transplant surgeons have many useful tools at our disposal in order to give each and every patient the best result possible.

All the best,

Marc Dauer, MD

These are FUE grafts harvested with a serrated sharp tip. The natural intact groupings are seen in the bottom right and top left corners, the single hair grafts in the top right corner, and the transected grafts in the bottom left corner.

These are FUE grafts harvested with a serrated sharp tip. The natural intact groupings are seen in the bottom right and top left corners, the single hair grafts in the top right corner, and the transected grafts in the bottom left corner.

Greetings,

Today I will discuss the effect of the old hair Transplant “plug” method on the donor region. The old hair transplant plugs have been gone for a number of years, but I still see a number of individuals who had this procedure performed years ago and need corrective work to repair their results. The purpose of this blog entry is to discuss the effect of this procedure on the donor region. The old hair transplant plugs involved taking a punch graft from the donor region and punching the same graft into the area of balding on the scalp. These plugs were harvested using punches ranging in size from 2.0mm-5.0mm. The plugs consisted of between 4-20 hairs per plug. This was in essence the same technique we use today for FUE, however with FUE today most physicians use punches ranging from .8mm-1.1mm. These much smaller size FUE punches allow us to harvest the natural follicular unit, which ranges from 1-5 hairs per follicle. As you can see from the photo, the old plugs cause a tremendous amount of scarring in the donor region and deplete the amount of donor hair that is available for future procedures. In these cases the best course of action to harvest additional donor supply is to find the least harvested region in the permanent donor zone, and perform a strip harvest procedure. In this way, we can remove some of the plug scarring and yet still obtain good donor hair. Below I have included donor photos of the patient who had large plugs and another photo of a patient 7 days after 1600 grafts were harvested via FUE utilizing a .9mm punch tool. The difference is dramatic.

All the best,

Marc Dauer, MD

Donor Site Of Old Technology Punch Plug Extraction

7 Days After 1600 Grafts Harvested via FUE

Greetings,

Today I will discuss the custom cut recipient blade sizes in hair transplant procedures  that I use to create the recipient sites for my hair transplant grafts. I have a machine which allows me to cut custom sized blades. Typically my blades range in size from .5mm-1.1mm and I have blade sizes in every size in between in .05mm increments. This allows me to use the smallest possible blade for the patients natural follicular units. The hair type and caliber are defining characteristics that determine which size blade to use. Typically I try to find the smallest possible blade which still allows for easy placement. An extra .1mm opening may not seem like much, but when multiplied by 1500-3000, which is the number of recipient sites I create in a typical hair transplant procedure, an extra .1mm can add up to significantly more injury to the scalp and circulation, which in most cases is not necessary. I also custom cut my blades with a 45 degree angle at the end and I angle the deepest portion of the blade so that it is at the superior aspect of the incision. This means that the blade also causes less injury to the scalp circulation and positions the graft at a more acute angle which gives a better final result. Minimizing damage to the scalp and the vascular bed minimizes scar tissue in the scalp and thus minimizes the potential of “shock loss” (which I will address in another blog entry).

I hope this blog entry clarifies why the blade size is very important in Hair Transplant Procedures.

All the best,

Marc Dauer, MD

Greetings,

Sometimes when I meet a patient for the first time in consultation, they come to me with their mind made up as to which harvest procedure for the hair transplant they wish to undergo. Other times they come to me with no idea as to which harvest method for the hair transplant that they prefer. The Internet has been an amazing tool to educate patients regarding all aspects of hair transplant procedures, however there is a huge amount of misinformation in the Internet as well. Often it is difficult for the average consumer to differentiate between the truth and the fiction. To further complicate things, some Hair Transplant surgeons have their own agendas as well. These physicians may only be proficient in either FUT or FUE, and may then try to steer patients towards the procedure that they are more comfortable with. In other instances, the physician may have purchased an expensive piece of equipment that he needs to pay for, and then will steer patients towards the procedure which helps to pay off the equipment.

When I meet with patients the first thing I do is pay close attention to the hairstyle they wear when they come into my office. How short their hair is, how it is combed, product in the hair, hair color, etc. These are all clues that help me to understand the patient as an individual. In addition, between the family history of hair loss and the patients physical exam, I do my best to estimate how severe the patient’s hair loss will progress over time. I explain in depth the pros and cons of FUT hair transplant versus FUE hair transplant and tell the patient that I have no vested interest in which procedure the patient decides to have. I truly enjoy performing both FUT and FUE. My only interest is that the patient undergoes the procedure that suits them best. Not just in the short term but in the long term as well. That is part of my duty to my patients. I encourage my patients to take their time in deciding which procedure suits them best, so that they make the right decision. Not a quick decision that could prove to be wrong in the long term.

All the best,

Marc Dauer, MD

Greetings,

Today I will discuss microscopic dissection in Hair Transplant procedures. Since the advent of Follicular Unit Hair Transplantation there are many different ways that physicians employ their staff to dissect the donor strip into individual follicular units in the process of hair transplant procedures, that is the groupings of hair that naturally occur on the scalp that we seek to move to the areas of thinning. There are many different types of microscopes that people use to dissect grafts and many different levels of magnification. Some physicians only have their staff use magnifying glasses on light boxes. I personally have my staff dissecting our grafts using brand new state of the art microscopes with 10x magnification and LED lighting. These microscopes are much more expensive than the typical microscopes but I believe they perform a superior job in dissecting the grafts. The 10x magnification is necessary to visualize the follicle in it’s entirety and allow for optimal dissection and the LED lighting provides excellent visualization while generating almost no heat (which typical lighting generates and can cause the grafts to dry out thus diminishing their chances of survival). Lessor magnification can result in the loss of intact follicles that cannot be visualized under lower magnification. This is turn can lead a lower survival of grafts in the hair transplant procedure.

In summary, state of the art high powered LED lit microscopes are more expensive, but superior in creating healthy follicular units for use in hair transplant procedures.

All the best,

Marc Dauer, MD