NeoGraft, ARTAS, SmartGraft, Which Method Is Best?

Whether you are a physician interested in offering hair transplant surgery or a patient considering it, if you're asking which turnkey hair transplant method/device is best, you’re not ready to enter the field or undergo surgery. Spencer Kobren and IAHRS accepted member, Miami hair transplant surgeon, Paul Rose, M.D., discuss the “one size fits all” model of the new device driven hair transplant industry and how detrimental it can be to patients who are not fully informed about what any FUE “method" device can and cannot do.

Paul Rose, MD:  It's very disappointing. We need multi-center studies, but the problem always becomes: Who's going to pay for it? Who's going to pay to do these studies? Are you gonna get proper documentation and proper registration for the study to be done? Do you need an IRB? That's where a lot of the hesitancy comes in, but we do need a multi-center study looking at a lot of these questions; otherwise, we're just really flying by the seat of our pants. 

It brings to issue another that you raise, which is who's beginning to do this stuff, or who has been doing it? And many times, it's people who don't have a background in hair, in dermatology, in skin diseases and scalp diseases. So, the impedes for a lot of these people is simply to add on to their practices without taking the time to really understand the nuances and the finesse involved in hair restoration diagnosis and hair restoration treatment, whether it be surgical or medical. 

And I think that's what's so disappointing with some of these companies, that they're putting machines out there, whether they're robotic or non-robotic, or whether they're hand held devices, and giving them to physicians and even non-physicians. Having non-physicians sometimes even do some of the surgery, which could be illegal in some states without thinking about the damage that could be done to patients and to the field, honestly.

Spencer Kobren: Look, I was on this panel and some guys were asking questions, and they had a very limited scope in understanding of surgical hair restoration, and their question was: What's better, the neo graft or the smart graft, and that was one of the more basic questions. It's not like, what's better for the patient. They've been sold, and what this one technician actually said, and I included it as part of my talk, the physicians and the consumers are being sold a lie. They're being sold a dream. They're not being told the entire truth. 

So, new guys you don't understand the nuances of surgical hair restoration really believe that all of these devices are what's state of the art about hair transplantation today, as opposed to these devices are just tools, they're user dependent. You can screw up somebody with a neo graft just as badly as you could screw up somebody with a hand punch or an artist. Or you can do a great job with all three. And it's very disappointing.

Paul Rose, MD: Yes, I think I've told you this, there's no perfect system.

Spencer Kobren: Right.

Paul Rose, MD: And there's no patient who's perfect for every one of the systems. Each one of the has pluses and minuses. I think the neo graft machine is a nice machine, but again as you note, it's operator dependent. 

Spencer Kobren: Right.

Paul Rose, MD: The sharp graft, nice machine. Operator dependent.

Spencer Kobren: Right.

Paul Rose, MD: The artist system. Operator dependent too, to a large degree. I mean, you can go outside the safe zone, whether you're using a robotic procedure, or you're using hand held FUE, unless you understand the rationale for trying to say within the safe zone depending on the patients age and various other factors, then you're missing the bode about what hair restoration is about.


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The International Alliance of Hair Restoration Surgeons is a consumer organization that selectively screens skilled and ethical hair transplant surgeons. The IAHRS does not offer an open membership policy to doctors practicing hair transplatation, and is the only group that recognizes that all surgeons are not equal in their skill and technique. Its elite membership seeks to represent the best in the discipline, the true leaders in the field of surgical hair restoration.