# Hair Transplants > Hair Transplant: Start Your Own Topic >  NeoGraft Hair Transplant: Will this New Device Make FUE More Affordable And Safe?

## SpencerKobren

The targeted removal of follicular unit grafts, known as Follicular Unit Extraction (FUE), certainly has its place in the field of surgical hair restoration. However, since the procedure has proven to be extremely labor intensive when performed correctly, and limited by the number of grafts that can be safety harvested intact per procedure, many in the field have chosen not to offer this procedure to their patients.

We have also seen some dismal results coming from some of the clinics that have over marketed the procedure without actually learning how to perform it correctly. IAHRS Member, Dr. Alan Feller has repeatedly warned patients about the three detrimental forces that are unique to FUE procedures, these are: 

1.Torsion
2.Traction 
3.Compression

Will the NeoGraft device help to eliminate these possible detrimental graft destroying forces and allow more hair transplant surgeons to offer FUE to patients who qualify for the procedure? 


UPDATED: VIEW IMAGES

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## the B spot

So the device is essentially a 1 step scoring and extraction device? I take it that the grafts are vacuumed out into the receptacle once a certain depth is reached? 

A couple of questions: 
1. What size is the extraction tool--inner and outer diameter? 
2. What potential for damage to the grafts as they are vacuumed out into the receptacle? 
3. How does the tool help mimic the graft angle better than a regular hand-held punch? 
3a. If this does create an easier extraction method, reducing the above factors laid out by Dr. Feller, is the size of the extraction increased to accommodate a lack of "feel" gained by using a regular punch. 

Looks interesting--I would like to see it in action in person.

Take Care,
Jason

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## SpencerKobren

> So the device is essentially a 1 step scoring and extraction device? I take it that the grafts are vacuumed out into the receptacle once a certain depth is reached? 
> 
> A couple of questions: 
> 1. What size is the extraction tool--inner and outer diameter? 
> 2. What potential for damage to the grafts as they are vacuumed out into the receptacle? 
> 3. How does the tool help mimic the graft angle better than a regular hand-held punch? 
> 3a. If this does create an easier extraction method, reducing the above factors laid out by Dr. Feller, is the size of the extraction increased to accommodate a lack of "feel" gained by using a regular punch. 
> 
> Looks interesting--I would like to see it in action in person.
> ...


 Hey Jason,

I’m having Dr. Bauman on the radio program this Sunday 3/15,  so feel free to call in with your questions and your FUE insight. 

If you don’t have an XM subscription you can watch and listen live here:

http://www.thebaldtruth.com/watch-live/

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## the B spot

Arrrrggg! I will not be able to listen this week!!!! Trust me, I am going to my wife's parent's this weekend----I would much rather listen to your show than listen to them screech at each other for 3-4 hours  :Mad: 

I used to wonder why people drank wine at these functions----now I know  :Big Grin: 

Hopefully Dr. Bauman can respond here if/when he finds the time---Technology is so awesome---I know Dr. Shapiro is a real tech nut, so I am bringing this to his attention!

Take Care,
Jason

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## SpencerKobren

No worries Jason,

Im convinced my future in-laws think I have a drinking problem..I get it! :Smile:   Well be archiving the broadcast so you can listen at your leisure.

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## HelpROGER

The video looks impressive. The machine looks like a combination dental drill and water suctioning machine that you see in dentists offices. I assume that there would be less damage done to the follicles since the suction would not  be strong enough to rip apart the hairs themselves.  Have you ever tried to break a hair, it takes some strength. The skin probably just gives once the cut is made deep enough. Im no engineer, but this tool looks like it works and if those pictures are the results then they look good.

Spencer, how long has Dr. Bauman been using this thing and on how many patients?

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## PayDay

Wow, this is awesome! It would be fantastic if this could bring down the cost of FUE. How big is the punch?

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## tbtadmin

We have just received this information from Dr. Bauman, he has been in surgery all day. He says that when he has time he will be more than happy to answer all your questions. 

_Dr. Bauman wrote:_
*"Personally, I use an 0.8mm punch when using the Neograft.
These updated photos have a brief description:*



In this Neograft hair transplant case, a 0.8mm limited-depth instrument makes a small 'scoring' incision around the follicle. The grafts can then be manually extracted with forceps or extracted with suction from the Neograft machine.



The extracted grafts are examined and sorted by intact follicles per graft. Grafts with transected follicles are counted and tracked for quality-control purposes. This handful of grafts was obtained approximately 1/3 of the way through the Neograft FUE hair transplant procedure. FUE grafts are typically smaller than microscopically-dissected micrografts. Therefore, they require extra care and attention to remain viable for implantation.



FUE with Neograft allows a minimally-invasive approach to hair transplantation with no visible linear scar. This is a 0.8mm limited depth instrument making a scoring incision around the graft. To maximize the harvested yield per procedure, patients are encouraged to allow us to 'buzz' their hair to a 'zero' with an electric clipper. A 'zero' length on a clipper is actually approximately 3mm



This shows the manual extraction of an FUE graft during transplantation. A very specific, gentle approach is used to remove the graft from the skin without trauma to the follicle.



FUE harvesting during a Neograft procedure is a team approach. Tiny incisions are made with the Neograft device around each graft and then they are literally 'plucked' from the skin.



Careful extraction of an FUE graft during an hair transplant procedure. The initial incision was made with a 0.8mm Neograft device.



The major advantage of any FUE procedure is the lack of a linear scar. The tiny 0.8mm harvest sites close 50% in size within 24 hours and can be completely undetectable within a weeks time, depending on the quality of hair in the donor area. Eventually, when the surrounding hair reaches a certain length (approximately 8mm) the area is completely camouflaged.



The recipient area of a hair transplant procedure is the thinning area where the follicles are transplanted to. The Neograft device assists with implantation throught the use of dual mechanical implanters which use suction and positive air pressure to gently place the grafts into the sites the surgeon has created--without the use of forceps. For this patient, we transplanted 1603 grafts into the recipient areas. All grafts were placed into sites that were 1mm in size or less. Hair growth typically begins around 6 weeks, with improvements in coverage occurring from 4 to 6 months, full result in 12 months.



Fast and efficient FUE hair transplant procedures is what Neograft promises. Can the Neograft deliver? FUE is typically tedious and slow. The question is whether Negraft will accelerate the process allowing for more efficient FUE-type harvesting.



This is an updated photo to reflect the status of the recipient area at post-op day #8. Please note that although the transplanted area appears 'full,' it is expected that the transplanted hairs will shed within the next few days and then begin to regrow within 6-12 weeks. Half of the result should be visible at 6 months, full results in 12 months.



This is an updated photo to reflect the status of the donor area at post-op day #8.

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## the B spot

Thank you for your prompt reply Dr. Bauman. 

I guess the only thing left is to actually check the machine out. I am encouraged by these type of advancements--It is my hope that fue becomes commonplace and lest costly as a result. 

The work you posted looks very clean and the patient should have a great result!

Take Care,
Jason

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## bigmac

I saw this machine in Montreal and got the guys to talk me through it,it looked impressive.

I think the only concern i had was that the storage area for the grafts should not be overfilled if the suction method of extracting the grafts was used.

I seem to remember it was quite expensive too.

It will be good to see one year results from patients who have had this machine used on them.

Thanks for a great informative post.

bm.

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## Winston

That was a great radio show tonight! Dr. Bauman sounds like he's way ahead of the pack. I enjoyed listening very much and Im interested in seeing more pictures of this procedure.

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## HelpROGER

I second that Spencer. The bald truth is the best show on radio today!  Your take on life is so right on! Thank you for helping all of us to feel that were not crazy to worry about our hair!!!

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## the B spot

Dr. Feller, Dr. Bauman and All--- I love the ingenuity to try and get "better" using the amazing technology at our fingertips. It is a testament to a select few who strive to get better every day, regardless of past success.

With that said,
I think the person doing the extractions must still have the "feel" to mimic the angle of the follicle, regardless of what tool is used. Once Dr. Bauman explained he used this machine with a .8mm punch/extractor, he confirmed my suspicion that his personal skill has a tremendous impact on the success of the NeoGraft's use. 

For those who have not seen a .8-.9-1.0mm punch in use, let me tell you it is HARD WORK and exhausting. It is very labor intensive, and is very draining physically and mentally. This is why Dr Feller, Dr. Bauman, and others continue to stress the fact that FUE is not a miracle solution, not everyone is a candidate, and donor management is just as important as ever.

Because I have not seen the machine in use and Dr. Feller already established some concerns I will refrain from any additional technical debate.

However, perhaps if this machine can obtain VIABLE grafts on a majority of FUE candidates, it has the potential to reduce the overall stress of the FUE scoring and extraction process and allow additional clinics to offer FUE. That remains to be seen. 

On a potentially negative note, technology such as this is often very cost prohibitive and would likely pressure any clinic to do larger than advisable sessions in an attempt to recoup costs. That could have a very damaging effect long-term on the patient and reputation of the clinic. Dr. Feller's point about unpracticed doctors performing FUE is certainly legitimate when viewed in this light. 

Spencer, Dr. Feller, Dr, Bauman-- perhaps we could put together a "meeting of the minds" to observe the viability of the machine and exchange ideas and techniques on FUE in general. Given much of the ignorance and over-selling of FUE, it would be a step in the right direction to have well respected doctors come together to share ideas. Just an idea!

Take Care,
Jason

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## TeeJay73

Brilliantly articulated Dr. Feller!  I enjoy reading your posts and listening to you when you call Spencer's show.  I like how you couple your engineering background with medicine, providing a unique perspective that not alot of people have or can conjecture on their own.  

We engineers are cool, aren't we? :-)

TeeJay

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## Jeffrey Epstein, MD

I too greatly welcome the dialogue that goes on between esteemed colleagues and educated lay people.  In the 18 plus years of being intimately invoved in the plastic surgery and hair restoration field, I have been witness to an endless number of new technologies-  most of which were released with great fanfare, only to be discarded a year or two later as the touted advantages prove to be short-lived.  Examples:   Dr. Rassman's hair implanter carousel; thread lifts for facial rejuvenation;  and Thermage skin tightener.  Even the initial laser hair combs and Rogaine, two innovative treatments that now have a potential role in treating hair loss (at least LLLLT hoods such as Revage that seem to be the best system and perhaps the hair combs) got released initially with such incredible accolades that the hype was much more than the reality -  all in the name of making money, and perhaps secondarily in helping patients.  Maybe when selling cars or perfume, hype and marketing should take precedence over data, but when it comes to medicine-  surgery in particular-  restraint must take precedence.

I have not seen the NeoGraft system in use, other than a promotional /educational video put out by Dr. Bauman in conjunction with the very company that plans to benefit from such a device-  and I cannot think of anyone better than Dr. Bauman to get the message out about this device.  What concerns me however, is that there is, quite frankly very little evidence that this device is superior to standard techniques of FUE-  in fact, having the delicate hair follicles exposed to suction and air flow, I have similar (but unproven) concerns as Dr. Feller-  about the viability of the hairs.  Second, in my practice, my FUE grafts after dissection are typically placed into recipient sites 0.5 to 0.6 mm in size, occasionally 0.7 mm-  while the automatic planter for the NeoGraft works with recipient sites 0.8 mm and larger, unless I misunderstood.  Smaller recipient sites allow for denser packing and more impressive results, and potentially less scarring.  
I rely on my carefully trained team of assistants to allow me to harvest (then implant) as many as 1800 FUE grafts in a single 8 hour procedure-  equal to apparently the peak number of grafts that the NeoGraft can obtain.  Then for planting, these same assistants work with me to place the grafts into recipient sites that I have made with 0.5 to 0.7 mm recipient sites.  This is the artistry of hair restoration, and no machine is going to take the place of individual surgeon artistic skills and passion and the skills of talented assistants.

I greatly look forward to seeing some data -  reliable US released data by respected peers such as Dr. Bauman-  before making any conclusions other than the NeoGraft does seem to allow for the obtaining of FUE grafts with the use of fewer assistants.  This is not an advantage for me at this time, but I do hope that the device does improve the results of FUE hair transplants.


Jeffrey Epstein, MD, FACS
www.foundhair.com

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## SpencerKobren

Dr. Feller, Dr. Epstein, Dr. Bauman and all,

It’s great to see truly passionate experts discussing any possible advancement in the field of surgical hair restoration. Baldtruthtalk.com  was created to help better educate and to empower, not only the hair loss consumer, but the hair loss physician as well. Education is an ever evolving process and I’ve learned over the years that while asserting opinions is important for obvious reasons, asserting them in a doctrinaire or  dogmatic manner usually creates a less than comfortable environment in which to learn and to share ideas. 

In my view, until it’s proven that the the Neograft machine damages grafts, terms like “detrimental forces”,  “torsion” and “desiccation”, are simply  words used to make a theoretical point.

Dr. Feller, your insight holds great significance and is a needed part of this dialogue, but  it’s equally important to understand that there might be more than one way to skin a cat. I think Dr. Bauman’s track record speaks for itself, as do the track records of all of your esteem colleagues in the IAHRS. 

As Dr. Epstein so eloquently  eludes to, there are very few in the field who have been as effective in promoting  state of the art  surgical hair restoration  to the mainstream consciousness as Dr. Alan Bauman.  I see this as just one of Dr. Bauman's  considerable contributions to the field.


I look forward to continuing this dialogue in a professional and mutually respectful manner.

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## Jeffrey Epstein, MD

Beautifully put Spencer.
Loo,king forward to seeing more from Dr. Baumann on this device.

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## Jkel

Very well put Spencer. I think this machine looks like it might have real value and I dont think Dr. Bauaman would risk his reputation on a machine that didnt work.

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## SpencerKobren

Thanks for stating your opinion Dr. Feller. Again your insight and your passion for the profession is what makes your online participation so invaluable.

My question at that start of this thread was:
_Will the NeoGraft device help to eliminate these possible detrimental graft destroying forces and allow more hair transplant surgeons to offer FUE to patients who qualify for the procedur_e? 

Its simply a question. At this point until I see more results this entire thread is simply a vehicle to share our thoughts and ask questions about the Neograft machine. Im hoping we can continue this dialogue without pointing fingers or eluding to the unethical marketing of FUE by well respected members of the field.

Thats it, no big deal. Were just having a friendly discussion, and I think its fair to state that it should be conducted with professionalism and courtesy. I know this is a foreign concept to our online world, but I think its time the we begin setting some higher standards for the profession.

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## gillenator

bspot, I don't know how I missed this before, but I just noticed something classy at your signature.  You're a Cubs fan!  :Wink: 

Now, back to the issue.  Not that I am any expert on FUE instrumentation, nor a licensed physician, but in the past 29 years, I have seen alot of these come and go.  Several years or more ago, there was a big hype about the FUE implanter, remember?  Where is it now?  Where are the published findings?  In the New England Journal Of Medicine? No.  In the education arm of the ISHRS? No.  Any other society or affiliation, association, not to my knowledge.  It's just my opinion but this has that sort of laser comb smell to it.

And some of you have brought up some of the valid points that Dr. Feller mentioned in another thread and noted below.  Yet if you consider the dynamics of torsion, traction, and compression in the extraction process, are they not ultimately controlled by the tooling as well as the surgeon's feel?  What is going to replace the feel in the extraction process?  What about dermal depth analysis?  Oh, I know someone is going to say, "that's what this new machine is supposed to do".

It's just very difficult for me to imagine that a machine, albeit "cutting edge" technology can make all of the adjustments on every FU targeted for extraction concurrently.  And then with the same extraction size for every FU regardless of size.  Same size for a single hair FU as a five hair FU extraction?  Really?  What about extracting MUGs?  One size fits all?  Really? 

I have a hard time believing that any prudent FUE surgeon who also is considering the lowest degree of invasiveness "per patient" is not going to utitlize a combination of punches and extraction tools.   How does the FUE surgeon balance out the level of invasiveness (post-op scarring) with transection?  Or is the issue going to be pursued and confined to "speed and efficiency" of the extraction process?  Give me a break.  

Who's ever publishing transection rates or let's be positive about this, FUE YIELDS regardless of the methodology?  NO ONE, extraction equipment or not.  And before anyone speaks up to dare challenge what I am saying, be ready to present your verifiable and substantiated clinical findings.  

Don't get me wrong, I am all for scientific research and technological advancements in this field of surgical hair restoration, and yes there are some docs who always seem to jump on the bandwagon and really push these new devices.  Is it really to advance the field or advance one's bank account?  And really, I mean no offense to anyone in particular.  But ultimately, who is really benefitting from speed and reduced OR staffs?  The patient?  Really?  Really?  Or could it just by chance be the clinic or the ones who hold the patent?  And why most of the dialogue in the economics and proficiencies of the procedure?  What happened to yield?!  Every HT patient cares about yield right?

What happened?  Did I miss something?  What happened to the patient?

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## SpencerKobren

We’ll be continuing the NeoGraft discussion tonight on the live broadcast. If you don't subscribe to XM Satellite Radio, you can watch tonight’s program here:
The Bald Truth Live! 

Feel free to call in to join the discussion. The toll free number is 1-877-885-0007. The program airs at 5pmPST/8pmEST.

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## PayDay

Great show last night guys. You guys sounded like you were having a blast. Vey informative as usual too! How come TeeJay got to do the show with you guys. I want in. :Smile: 

Paul

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## Winston

The show was very entertaining , I enjoyed listening very much. Hairloss stuff can be so dry when I read about it, but its cool to listen to the people in the know talking about it.

I still dont know however if the Neograft is a good thing or a bad thing. Spencer seems to be on the fence about it and Dr. Law said it had some value, but Dr. Feller makes it out like its worthless. Whats the answer?

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## TeeJay73

I'll throw in my 2-cents as a pure layman and as a happy hair transplant patient (strip method).  I even had a chance to say this on the show last nite.  (Thanks Spencer, you're THE MAN!).

If I am going to undergo cosmetic surgery (and I have), then I am going to do as much research and due diligence beforehand as possible.  When I put all of the information that I have learned regarding the strip method next to all of the information that I have learned regarding FUE (regardless of how the FUE is performed, machine, or no machine), I conclude that the strip method has a substantially greater knowledge base attached to it and is significantly more time-tested, trusted, and "doctor approved".  I also conclude that the strip method produces consistently, very well-known high yield rates (meaning that the % of transplated grafts that grow in their new area is 90% or more).  The FUE method, on the other hand, and again based on what I have read and learned, seems to produce very sporadic yield rates, sometimes as low as 50%.

The mere fact that "yield" is a focus point in HTs means that when a patient undergoes an HT, he/she is actually reducing the total # of hairs on his head.  He/she is simply creating the illusion of a fuller head of hair thru the cosmetic redistribution of hairs across the head.  If I am going to pay my money to reduce the total # of hairs on my head, then I am going to go with the method that offers the best possible guarantee of the minimization of this reduction, and the strip method seems to be the clear winner.  I'm too conservative and I'd be too nervous to undergo FUE of any type, not knowing what % of my precious grafts were going to survive the surgery.  And I'd be on "pins & needles" for the 6 months or so that are needed to get some idea of the HT results.  So, as a pure layman, FUE isn't something I'd even consider, irrespective of how the grafts are extracted (machine, or no machine).

I say this, and at the same time have complete and total admiration for Dr. Bauman.  If I lived in Florida, there is not a doubt in my mind that I'd choose him to be my physician.  His results are incredible and I love the fact that he is so leading-edge in his practice, using the latest tools and technologies in an effort to make patients happy and advance the surgical HT field.  I like to be leading-edge in my own work, too, using the latest tools and technologies, even if they aren't time-tested yet, or accepted entirely by my peers and colleagues.  

I guess the dividing line here is this: as a doctor, charging ahead with new tools and technologies, as well as challenging them, ultimately benefits HT patients, even if it may not seem so at the immediate moment, and it certainly endears me (and probably other patients) to the doctors that use and/or challenge these new tools and technologies.  But as a patient that is altering his physical appearance (quite expensively, too!) and undergoing the risks of surgery, I am just not interested in the additional risk that FUE seems to come with, no matter how it is performed, even if that means the strip method is slightly more invasive and produces a linear scar, both of which in my opinion (as a veteran HT patient) are no big deal.

TeeJay

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## gillenator

> Gil,
> In the end, as you've already eloquently noted, it's all about RESULTS. 
> 
> The device is described as making extraction FASTER, but not a word was said about extracting grafts SAFER. 
> 
> I do not see where this mega-machine improves graft safty by lowering graft trauma. In fact, I see the opposite with respect to that spinning punch and the gauntlet of suction tubing the graft must travel through. 
> 
> This is why I am so adament about articulating and describing the forces working against us: Torsion, Traction, Compression. Any proposed FUE advance must address either one or ALL of these forces to be of any use.


 I could not agree more Dr. Feller.  I just shuddered when I read about the dynamics of how it works and the additional trauma the grafts would sustain.  I mean I don't know how it could be avoided considering the mechanics.

Where is the scientific evidence regarding lowered transection and improved yields?  Because without that, I am trying to figure out what benefit it has for patients.

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## gillenator

Great post TJ and I agree with alot of what you stated.  The only thing though is your statement about being time-tested or not.  Something like this piece of equipment must be time-tested or clinically substantiated with scientific proof.  And for the reasons you stated, donor limitations and yield.  All of my work was done by strip but now I am out of laxity.  If I ever do have any touch-up work, it may have to be done by FUE because I don't think I can regain enough laxity after four strip procedures.

But if I do ever have FUE, you can bet it won't be by Neograft.

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## HelpROGER

Saw you on the show TJ, your hair transplant looks very natural. You were quite good on the show too, were you nervous to be at the radio station and to talk on the radio?You sounded quite relaxed.

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## amadeus

If there was evidence that the hair grafts really got cooked how can this machine be sold and used for hair transplantation? How can you tell if the grafts were heated to the point of being destroyed and don't you think it would be  counter intuitive for a company  to sell a hair transplant machine that results in inferior hair transplants?

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## TeeJay73

> Saw you on the show TJ, your hair transplant looks very natural. You were quite good on the show too, were you nervous to be at the radio station and to talk on the radio?You sounded quite relaxed.


 Hey HelpROGER,

Appreciate the hair transplant and radio compliment.   It's been an interesting hair journey, man, but I am very lucky.  One botched up surgery with a non-IAHRS clinic (800 grafts), and then a great surgery with Doc McAndrews of the IAHRS (1600 grafts).  Doc McAndrews really fixed me up good.

Being on the radio was friggin' sweet.  Spencer is one of the coolest guys ever, seriously -- laid-back, easy-going, and fun.  Turns out I wasn't feeling nervous; I just gave into the experience entirely, which was an awesome one and I have Spencer to thank.  I did knock down a thing or 2 in the studio, and spilled some water all over the place, but I think that may have been the little bit of scotch I downed, as opposed to nerves :Smile:  

TeeJay

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## PayDay

Why don't they add some kind of a cooling sheath, something that does not conduct heat,  to the inside of the punches used? This will solve the heating problem.

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## amadeus

Thanks Dr. Feller. What you say makes sense, but I'm the type of person who needs to see proof for either side. :Smile:

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## bigmac

With this Neograft machine,were any hair transplant doctors involved in its development?

The Neograft website is pretty vague to say the least.

They claim its been in use for 3 years now so i would assume there should be ample examples of patients who`ve had a HT with this machine.

I`m not saying its a good or bad thing,just would like to see some documented results.

bm.

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## Thomas Law, MD

Gentle readers, let me remind you that doctors are required to give full disclosure when they have a financial interest in a product that they are discussing and promoting. This is important whether we are talking about a ten dollar disposable punch or an $85,000 machine. There is always a conflict of interest whenever anyone profits from selling or promoting anything, but in medicine doctors are held to a higher ethical standard by their medical licensing board, in order to protect the unwitting patients life and limb (scalp and hair). It would be proper to have full disclosure here. 

And, dont forget that prototypes of powered punching, sucking, and graft insertion machines have been available since at least 1996 (ref: Hair Replacement Surgical and Medical; Stough and Haber; pub, Mosby 1996 chapter 11, section D, pages 370-374 Automated Hair Transplant Systems: the Boudjema Technique). One of the latest versions has been renamed the Neograft machine. There have always been problems with this technology that continue to plague those brave enough to use it today. There are still many unanswered questions and a paucity of available documented results. Hmm?
Also, gentle readers, we should all be reminded that whatever experience one has had in the past practicing FUE with hand tools, motorized technology is powerful and represents a potential paradigm shift in FUE. It is not clear that this possibly faster, and possibly easier (due to decreased user stress fatigue) method can produce equal or better results than manual FUE (much less strip surgery ).  When one newly incorporates a specific machine into their practice, one with which they have only recently received training, one must be careful not to include older manual FUE before and after results in the discussion of Neograft powered surgery. That would be confusing and misleading. As always, pictures should be accurately labeled, in this case at least as to whether a hand punch or motorized punch was used (and even clarify motorized as to whether rotary, oscillating, etc). These small details are relevant and people are looking.  Do the pictures represent suction extraction or manual extraction, pneumatic insertion or manual insertion? 

By the way, there also many issues taken state by state, as to what unlicensed individuals (technicians) participating in FUE surgery are legally allowed to do. Can they man the punching device and essentially drill a patients scalp one to 1500 or 1600 hundred times? I think patients may be alarmed to find out that the procedure is easier for the doctor performing FUE surgery (and to whom they gave their hard earned cash) because he is not even scoring the skin, much less extracting the tissue (grafts).  This may be one reason some doctors have kept their FUE practices shrouded in secrecy. This is only legal according to Neograft, Inc. (and by extension any doctor acting as their contracted representative). In fact, this is reminiscent of the LIMA scandal in New York in the early 1990s where two enterprising technicians set up shop after hours and performed half price plug transplants in the doctors own office. When supplies diminished without explanation, the doctor set up a camera. Boo-yah! Two technicians were prosecuted and one did hard time in jail at Rykers Island!  How quickly we forget! In the LIMA case the doctor was being taken advantage of. But what about the doctor who is complicit in allowing illegal undertakings to go on in his office? Im not naming names here, but will he lose his medical license or end up in Rykers Island all so the patient can have his hair replaced one at a time and have a perfect donor area as well.  Jail time orarghh!

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## the B spot

Interesting Dr. Law---I remember the Lima scandal----the legal system worked very quickly to put the techs out of commission.

Unfortunately, we are unable to say the same for the many others committing the same crimes using the exact techniques who just happened to have M.D. after their name. 

Again, your 100% right about disclosure--- it will be interesting to see if this machine goes the way of the dodo, like so many that come before. 

Thanks Again, 
Jason

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## gillenator

It's not very often that you see a physician speak up and direct to the true issues of this new technology.  I personally don't know of any state that allows anyone that is not a licensed physician to make any type of laceration in flesh tissue.  You would think that every medical board in this country would be jumping on that one, but for some reason, it goes on unregulated.  

And like Dr. Law pointed out, we are not talking about a few cuts here.  We are talking about thousands of extractions being done, and who knows if some of them are making the recipient sites as well.  I mean even if that doctor's state he is practicing in is indifferent to this obvious malpractice, how can that physician in good conscience allow this to go on.  And what really gets me is that an extremely high percent of these techs making these cuts and incisions have aboslutely no to very little medical schooling or formal training or certification or even state licensing.  They don't even have a nurse's aide certificate.  They know nothing about taking or reading vitals, nothing about emergency medicine.  Just how can any state or even the federal government allow this to go on?!?

There were and still are a few new FUE clinics that simply pay any licensed physcician who is willing to hang his shingle in their clinic.  Then the tech states that he/she is working directly under the supervision of the licensed doctor.  What a crock.  One clinic had two docs who practiced in an entirely different field of medicine.

My understanding is that only a PA is allowed to makes these incisions under the direct supervision of the OR surgeon.  It is clearly not an issue of having shingles nailed to the wall to be in compliance with the law.

Thank goodness there are some independent clinics and HT practitioners who do not allow these things to go on, and have a sense of responsibility in the oath they took and are genuine in looking out for what is in the patient's best interest and care.

Part of the challenge in this industry is that HT techs learn the trade and skills "inside" because it is a non-regulated industry.  And there are many, many experienced, reputable, competent, skilled, techs that are worth every penny they are compensated.  And I personally feel many of them should be recognized for their service to patients and the hairloss community as a whole.

Possibly some of the trade organizations can make this a regular event at their annual conferences and each doctor/clinic can submit their candidates for recognition.  Heck, send these hard working dedicated techs on a cruise or something!

IT'S WHY THIS ENTIRE INDUSTRY NEEDS TO BE REGULATED HOLDING ALL PRACTIONERS FULLY ACCOUNTABLE.

And absolutely true and obvious that PROPER DISCLOSURE should be made whenever there are financial interests in the products being promoted.  And when proper disclosure is not made, IT SPEAKS VERY LOUDLY ABOUT THAT INDIVIDUAL'S ETHICS AND CHARACTER.  We tend to pay attention to the things that people do, but you sure can learn just as much about them in what "they don't or fail to do".

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## Jkel

Thats an interesting point Jason. I bet some assistants are better than some doctors.

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## the B spot

Dr. Feller-- I agree to a certain extent---I would like to see more emphasis given to extended training programs and inspection of actual surgical procedures. 

For those of us who support only the best doctors, it is rather easy to say there is no issue. However, for those who prey on the uneducated and uninformed with falsities and half-promises, there is very little recourse--even in our legal system. 

I have looked at just about every HT case that is publicly available in the last 20 years--in almost every case, the doctor prevailed through summary judgment/ruling. Admittedly, some doctors are unfairly targeted for legal action, but the same is absolutely true for the patients who are permanently disfigured and did not achieve success, if only because there is no "actual standard" 

For all the organizations that HT doctors belong to there is no actual medically recognized standard---ie-- You MUST microscopically dissect grafts, You must use the smallest possible incision making instruments customized to the patient, You must have an adequate staff to perform X amount of grafts, You must disclose the process for unsatisfied patients, etc... 

I know I am preaching to the choir--but a regulatory board made up of actual HT doctors and learned lay-people-- that could at least enforce the minimum standard would be better than what we have now. 

Much like Attorney's and the Bar Association--- public censure is a very powerful tool, just as 30-90 day suspensions and stripping of license. 

I believe a separate license (above and beyond state license) to practice Hair Transplantation is necessary, coupled with requiring an extended training
program and yearly/bi-yearly training (ie going to the ISHRS and attending lectures) ----it can't hurt and it can only help. 

I do not pretend to have all the answers, but if all the cards are on the table and myself, Dr. Feller, Gillenator, Spencer and a couple others visited every clinic doing HT's--- even with a minimal standard, many would still fall very short. 

Take Care,
Jason

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## gillenator

Dr. Feller,

Let me tell you something straight.  A good man has nothing to fear including regulation.  And whenever business starts complaining about regulation, it's about money.  Now let's be honest here and not start insulting the intelligence and competence of individuals like bspot or myself.  Not that I took anything personal or am suggesting you offended me because you did not.  And listen my friend, I know firsthand that you care about your patients.  You are not that far away from me or should I say some of your patients are not far.  If you go back though and read your last post to bspot you'll see how you conveniently attribute the uninformed patient who gets whacked as being "his fault".  That the patient was irresponsible?  He should have first methodically completed his online research right?  And because he did not, you can't hold the industy responsible right?  I am sorry, and in all respect sir, you are dead wrong.

Let me explain.  You all took an oathe right?  Go back and read it again sir because you will find that there are no disqualifiers for the uninformed patient.  That's the whole idea behind the oath to begin with, primarily there to govern the ethical conscience of the practitioner.  To practice medicine in the best interest of the patient.  In other words, soviety recognizes the threat AND abuse of the crooks in this industry.  

Your comments in my opinion are centered around the fact that regulation is bad for business and there are nothing but incompetents in Washington.  I could not agree more with you!  And please please don't take this wrong because I don't mean anything personal.  But you know darn well that you and any other any licensed physician are out to make money.  You don't pay all of the dues and six figure tuition because you are all mercenaries.  And no don't think I am nuts and believe there is something wrong with making money.  I love America and the free enterprise system if you want to call it that.  But that's idealism, not reality and history just proved it again when the regulations on Wall Street were lifted and what happens every darn time?!  Abuse and corruption.  Give me a break please.

And listen Dr. Feller, you all in the ISHRS know doggone well of the abuse AND CRIMINAL ACTIVITY that takes place in this industry.  Listen to me for a moment.  I mean really listen.  The difference between you and me is that I have seen and listened to COUNTLESS cases of abuse in the past 29 years.  I get the worst of the worst.  You cannot possibly understand the psyche of the hairloss sufferer to make those convenient generalized comments.  Many of these patients go off the deep end are emotionally driven in their decisions right or wrong.  If I have learned anything in three decades of helping patients, I have learned that everyone responds differently to hairloss. I really need to write a book about it.  It is so misunderstood.  Oh I know you see some pretty botched cases from time to time, but trust me, nothing like I have.  This is not about business, IT"S ABOUT PATIENT SAFETY!  

And let's get real for a moment.  All of the HT docs could have instituted the standards and protocol bspot referred to including some defined required standard to meet, both on the physician and technician side.  You all could have established a fair unbiased board because it would include educated experienced lay people like myself, and even people outside of this specialization, but from another area of elective surgery that has no direct relation to the HT industry.  A board that would act punitively to all offenders.  Like bspot said, the other professions have them, but not HT doctors.  That's because it's bad for business.   I don't care what you say Dr. Feller or how much you want to defend our capital system and the so-called good guys in the white hats, YOUR PROFESSION AND FIELD OF SPECIALIZATION HAS DONE NOTHING ABOUT IT SIR, period.  

And since the HT industry refuses to self regulate in the interest of PATIENT SAFETY, the government has to!  

I am going to give you one example of why we need safety regulation.   There is a HT doctor not far from me who uses target ads in the local paper, on the radio, presented as the are's top HT doctor!  And IMHO, does some of the worst strip work I have ever seen.  Whenever I get one of his whacked patients referred to me, I ask them how they heard of him.  They always say, he's on the radio, tv, sports page, etc, etc.  I ask them if they did any research on the internet and they say they don't spend time on computers.  They hunt, they fish, they play softball, they lift weights.  Get the idea?  Things are changing for the better but not everyone is into computer research and it's not their fault anyway you want to call it.  

Again that's why the physicians oathe to be licensed and practice medcine acknowledges that patients cannot be held responsible when a corrupt physician takes advantage of them and their distressed emotional state.  The oathe recognizes that there will be abuse.  There would not be a need for people like Spencer and myself and a few others if not for the corruption.

No offense but please don't insult us with that philosophical rhetoric about govt regulation never works.  Partient safety comes first and foremost right Dr. Feller?  Thank you sir.

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## SpencerKobren

I had to swipe willworkforhair’s .gif for this post...Well done Gillenator, there’s always a place for respectful, healthy debate. Next time tell us how you really feel? :Wink:  


More than a decade ago, I was personally moved to initiate the consumer advocacy movement that has helped to evolve this field, so I can certainly see Giilnator’s point. 

Last week we received a request for membership in the IAHRS from a hair transplant surgeon who promotes himself as a pioneer in the field. He's worked for a large chain hair transplant clinic and is known by many in the industry. During our initial investigation we were informed that this applicant had lost his NY Medical license in 2003, and was denied a license in OH based on having been convicted in a U.S. District Court of 19 felony counts of misapplying money and funds belonging to a gaming establishment operated by an American Indian tribe. 

Apparently this “physician” still has a medical license in the state in which he practices, and I’m sure he’ll be performing surgery on some unsuspecting schnook on Monday morning.  Can we really blame the patient for not having the where-with-all to do his Due Diligence to the extent that you our I would? I’m just not comfortable with that notion.

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## SpencerKobren

Hey Dr. Feller,

Happy Saturday!

I was actually applauding Gillinator's welcomed efforts to help prospective hair transplant patients avoid becoming just another of the walking wounded. I agree with your assessment of government intervention, however we’re not on the same page when it comes to patient culpability. 

My views on the free market system are no different than yours, and I appreciate the freedom that this country has offered me.

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## SpencerKobren

> Happy Saturday to you too. 
> 
> I have to assume, given the nature of your business, that when you say:
> 
> "You're not on the same page when it comes to patient culpability?" 
> 
> you mean that it IS up to the patient to do his own research to make a FREE and proper choice; and to live with the benefits OR consequences of that choice.
> 
> I hope that is correct.


 Being free to make a choice doesnt ensure the patient has the where-with-all to do his due diligence in the same manner in which you or I would.  I think its best to  move on and focus on the points made by our users.

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## tbtadmin

Provided by IAHRS Member Alan J.Bauman, M.D.

This video demonstration was featured on Rachel Ray's "plastic surgery breakthroughs" show on September 25th 2009.

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## the B spot

If you look at the video, when they are attempting to "shoot" the grafts into the recipient sites, they go in half way, or in slightly, which requires them to be scrapped over into the sites, re-suctioned, and re-inserted. It is my understanding that this machine is supposed to limit the handling of the grafts because they are fragile. 

One of the problems here is the claims that this machine is better and faster and Doug claimed (elsewhere) a less than 5% transection rate, for those doctors with no experience doing FUE, including those who are using the machine for the 1st time. 

I looked at this thread as an opportunity months ago to see some willingness to actually engage in proper discussion and acknowledge both positive and negative about this machine. 

Anyway, nothing personal whatsoever, certainly love the innovation, but the very reason for these forums is disclosure, transparency, discussion, praise and sometimes warning for those of us associated with the HT industry. 

Take Care,
Jason

One Caveat: I am 100% in favor of ANY equipment that is shown to clearly benefit the patient over existing, established equipment.

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## Jeffrey Epstein, MD

Wow, I sure missed an interesting discussion on regulation of the hair transplant field.
All of you have some particularly interesting perspectives and ideas, and unfortunately, there is no one correct answer.  The problem is, as Dr. Feller stresses, is that who is regulating the regulators.  Government employees (and that includes Congressmen) are susceptible to the pressure/advice put on by lobbyists (i.e. those that give money to these employees to help them get reelected or get them tickets to the Dolphins-Jets game tonite (Go JETS)-  or maybe there is not graft (no pun intended) or bribery involved, but rather these regulators are susceptible to the advice they get from special interest groups.  Has anyone seen what has become of the Obama health care reform-  one by one, each component gets torn down by the different interest groups?

It's not a simple-  well, everyone has the same incentive-  except for those who are practicing bad medicine-  and that is, do what is best for the patient.  But do you know that different fields of plastic surgeons have for years fought to limit who can perform plastic surgery for largely economic gain?  As a board certified facial plastic surgeon, I have nothing to lose by the cosmetic surgery field being regulated such that only board certified plastic or facial plastic surgeons can perform hair transplants along with other plastic surgery.  Yes, that would be good-  very good- for me economically.  However, that would likely remove some of the more experienced and talented hair surgeons from the field-  something that would be bad for patients.
And yes, the Florida Bd of Medicine members are vulnerable to the advice of surgeons such as myself, thinking that they have only the best interests of the patients in mind.  
On the other hand, there are far too many poor surgeons doing subpar work on unsuspecting patients  -  see how infomercials and beautiful websites are able to drive business.  It is through a site like this-  the BTT/IAHRS-  that a truly reputable and honest consumer advocate like Spencer is able to try to help the prospective patient who is smart enough and motivated enough to do his/her homework.  

That's my two cents on the topic

Dr. E

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## hotty_ca

If I could make a quick suggestion.  Why not do what all other industries use to ensure quality, which is oddly enough, follow Quality Assurance practices?  You know, measurables.  If done properly there is basically no need for government involvement (the need for which has always been a completely nonsensical argument that never got to the heart of bad surgery, and that was stopping bad surgeons).  And there's no need to have any grand unanimity amongst ht practitioners.  Simply put if you want to make the industry better and put pressure upon the bad doctors to improve or alternately leave you just need to do the following.

First you create an organization of surgeons where the criteria for membership is adherence to certain QA reporting standards.  What are these QA standards?  Well for starters they are not anything to do with the actual ht work.  So surgeons who get involved with this organization won't have to change their practices.  We're talking about standards of reporting only.

This means that every patient gets documented the same way.  Same picture angles, same camera, same lighting, yadda yadda yadda.  At the same schedule (ie. 1 month, 2 months, etc).  Obviously you'll need to get patient buy-in to this.   That's simple.  You ask them for it.  All patients who accept are given random id numbers, with any identifying features blacked out.  

Next problem. How do you get patients to come in on any regular basis?  Well you give them incentive or you don't.  Up to the surgeon to give their patients sufficient incentive to follow thru.  If the patients don't show up that's just missing data.  

The organization I've described does the following.  It opens up the database of results to the public.  Allow them to slice and search according to every dimension of measurables you can come up with.  On the other side of the patient/doctor divide, membership in this organization would require that you meet a minimum standard of reporting or you can't say you're a part of the org.  And you'll need to keep providing that evidence or you lose membership.  In other words, you'll need to provide X number of patient data a month.  Obviously the schedule on something like this is up for debate.

What else does the patient get out of this org?  If they have a complaint they can force their case to be included in the dataset.  That would be a requirement of membership.

The whole point, basically, is that you provide measurable, standardized data that consumers can pick their surgeons by and provide ratings on.  If you're a good surgeon you'll have tons of good examples, certainly more than bad ones.  If you're not you'll likely avoid participating.  The membership, itself, is the selling point.  And it'll give you a constant benchmark of where you stand next to your peers.   

This is a simple solution that doesn't require any complex bureaucracy.  It's driven by the industry itself and doesn't need gov involvement.  It encourages improvement within the industry.  And it's transparent.  It just shines a light on the information.  Those who can hack it will stay and those who can't will go.  Problem of bad unethical surgeons more or less solved.

Btw, I've been suggesting this for years.  Nobody's done it.  I wonder why.

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## hudson

Dr. Feller, 
About 18 months ago you wrote:
[QUOTE=Dr. Feller;2544]"Any new FUE device will get my full attention, but I have some serious concerns about this one."  You further stated that another "concern" of your is that the NeoGraft machine " utilizes a spinning punch, and while this may facilitate the procedure for the doctor, it also subjects the grafts to TORSIONAL forces which are detrimental to FUE grafts." Next, you were "concerned" about the grafts being "sucked" through the "spinning punch" and finally you were "concerned" about the "transection and trauma" to the follicles, which may look okay but may really be "dead."  


This post was written over 18 months ago and all your false, inaccurate, speculations, conjectures, and concerns about the NeoGraft machine have been totally disproved.  As a doctor who had never seen the NeoGraft device do a procedure, you based your critical, negative, false concerns on a totally wrong assumption which was that the NeoGraft device is a spinning punch. Once you had made this false assumption, and believed it, you then went on to explain how as a spinning punch  there will be damage consisting of Torsion, Traction and Compression.  You made it sound as though the NeoGraft device did follicular homicide. However, you were absolutely wrong that the NeoGraft device is a spinning punch.  The NeoGraft extraction tool spins less than a tool used to extract grafts manually.  The NeoGraft device is controlled by the doctor and it spins less than two times before it has extracted the graft. Doctors doing manual FUE have to spin their tool much more often to score the skin. Because of the small rotation NeoGraft technology produces, there is no Torsion, Traction and Compression occuring. 

As for the graft going through the tube to a receptacle, there is no evidence of any damage to the graft.  The NeoGraft machine was used in a live demonstration at the Live Surgery Workshop in Orlando in April of 2010 which was filled to capacity by doctors.  These doctors can attest to the excellent quality of grafts extracted by the NeoGraft device.  Many of them examined the grafts under the microscope. Furthermore, the NeoGraft machine had the lowest transaction rate of any other manual tool.  This means the NeoGraft machine did the least damage to grafts, compared to any other FUE method used. In addition the NeoGraft machine has been demonstrated live 4-5 times every month all over the U.S. with the same results.

As for the grafts drying out, your analogy of wetting your lips and then finding they dry out, does not apply to the NeoGraft technology.  With the NeoGraft machine, constant misting of the grafts is possible, so they do not dry out, as was witnessed by the doctors at the ISHRS show who saw grafts that were robust, moist, and of excellent quality.  An article such as this, based on false speculation, is very bad reporting, even if it is couched as a concern.  It opens the door for others to run with these false ideas and disseminate them further, turning them into facts, which has happened in the last year and a half.  This is unfortunate for the confusion it creates in the readers mind, as it may reduce the readers choices if he wants an FUE  transplant, by scaring the reader.

This negative type of reporting has not hindered other doctors from including the NeoGraft device in their practice, once they saw the NeoGraft device demonstrated (which we do live 4 times a month all over the country) and they realized how beneficial this device will be to their patients. FUE with NeoGraft is beneficial because it eliminates the large elliptical scars that occur so often in many patients with the STRIP procedure.  This allows patients to wear their hair short.  An FUE procedure with NeoGraft is a much less invasive procedure, without risk of cut nerves or arteries, it is a much less painful procedure, the down time is greatly reduced, allowing patients to get back to work sooner. There are many other benefits to a NeoGraft FUE procedure as well such as less damage to the grafts compared to a manual FUE procedure or from using tweezers in either manual FUE or STRIP surgery to place grafts.  

Now that 18 months have passed since this misleading, inaccurate article was written it is possible to dispel another concern which was the concern about the results of a NeoGraft procedure.  There are many patients who have undergone the NeoGraft procedure at this point in time.  Two of them were Greg Benson, (an actor) and Kevin Nalty, an internet marketing personality.  Both of them had a live procedure done on the internet where about 30 thousand viewers watched the procedure. According to Dr. Bauman, who did the procedure, their hair is growing like gangbusters, a word Dr. Bauman used on Spencer Kobrens radio show to describe the results of these transplants with NeoGraft.  Dr. Ken Williams has also been on Spencer Kobrens talk show and he had a NeoGraft hair transplant done himself, and his transplant is grown out and looks excellent.  Anyone can watch this video. The doctors who are using the NeoGraft machine have given it excellent testimonials.  They claim the NeoGraft  machine is an enormous breakthrough and it is changing the industry and more importantly they state that many  patients do not want scars, staples and want to get be able to get back to their activities as quickly as possible.  Dr. Bauman says his patients want this [NeoGraft] and love it.

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## hudson

Dr. Feller,
Why do you think I wish to have a debate with you?  My purpose is to address forums where misleading information was provided so that readers could get the information they need to make a more informed decision for their life about which procedure and which device they should consider.  Also, what makes you think I am angry?  I am disappointed that a forum like this allows doctors and others to write harsh negative comments based on conjecture and speculation and that there is no standard for what is considered responsible, honest reporting and appropriate, respectful conduct.  This is what happened to NeoGraft. There was a great deal of  hype and wild conjecture how NeoGraft works and the harm it would do with none of this based on facts, experience or any evidence. This was not scientific reporting.

It has been almost like a form of hysteria with so many posts written in so many forums that were based on this false conjecture and false information about the NeoGraft machine. What a waste of energy.  Wildly erroneous statements  appeared on many posts as factual truth and much of this false information was couched under concerns and welfare for the patient.    Would it not have been more responsible to ask the NeoGraft Company how does the machine extract the grafts?  What happens to the grafts when they go into the tube? The NeoGraft Company would have been happy to provide the necessary information asked for in order to help the NeoGraft critics understand the Neograft technology and how it works. 

 Dr. Feller, you came out with your own tool around the time NeoGraft came on the scene, and never has NeoGraft, nor any of their scientists, their researchers and developers, nor their engineers and other experts who work with NeoGraft and were involved in the design of NeoGraft ever offered an opinion of your device, because these persons had not had any experience with your device. They would never make any critical, false, erroneous and negative statements about your device based purely on conjecture and speculation. Why have doctors done that with the NeoGraft device, including yourself.   I do know that the NeoGraft engineers tried oscillation with a tool they were testing but the engineers came out in favour of the NeoGraft system of less than two rotations.  However, because these persons are responsible about what they claim, they would never think to offer an opinion based on speculation of how oscillation works with your device, unless they had worked with your device directly.  They follow certain ethics and I believe these should be followed on every forum. 

I do not really understand your last comment about my needing to “at least make an effort to get your facts straight.” It seems to me that the reason I am addressing your comments is because you did not have the facts straight about the NeoGraft machine.  You made the wrong assumption that it is a “spinning device” and once you believed your assumption then you made more wrong assumptions going forward of all the negative harm a “spinning device” could do, implying wrongly that this is the way NeoGraft works.  My purpose has been to correct this false assumption of NeoGraft being a “spinning device”, an assumption you made, never having worked with the Neograft machine, and not understanding the NeoGraft technology.  As I have explained previously, NeoGraft, under the control of the doctor, rotates less than a manual FUE tool before going under the skin.  It is not a “spinning device.”   In the last two years NeoGraft has done countless live demonstrations as mentioned in my post above, which have been viewed by numerous doctors, including almost a hundred doctors at the ISHRS Live Surgery Workshop in Orlando in April 2010 .  They will attest to the low transaction rate of the follicles, compared to other means of FUE extractions, and that the follicles harvested and implanted by NeoGraft are robust, moist, and of excellent quality.

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## SpencerKobren



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## Jkel

So how come there is no response from Hudson? Spencer calls the Neograft people out and they vanish into thin air???? Hudson is a shill and knows if he goes on Kobrens show that hell have his ass handed to him.  I have a question for Spencer. Spencer do you think that Neograft is really so great and  is it worth the exorbitant cost to have a Neograft hair transplant ?

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## SpencerKobren

> So how come there is no response from Hudson? Spencer calls the Neograft people out and they vanish into thin air???? Hudson is a shill and knows if he goes on Kobren’s show that he’ll have his ass handed to him.  I have a question for Spencer. Spencer do you think that Neograft is really so great and  is it worth the exorbitant cost to have a Neograft hair transplant ?


 Hey Jkel,

To be completely candid, the only advantage that I see with any automated FUE extraction device, is the potential to expedite the extraction of FUE grafts.  Being able to “safely” move more grafts in a single session would  certainly be of benefit to both the patient and the surgical staff.

In my view, if these devices make the process less demanding for the hair transplant practice, then the cost of an FUE procedure should reflect this evolution. In other words, I would expect the price to eventually be closer to the cost per graft currently charged for traditional harvesting.

I’d like to point out that I personally think that using the NeoGraft for graft placement could prove to be a huge mistake that can potentially leave many NeoGraft hair transplant recipients with a less than aesthetically acceptable result.  With that said, in the right hands, the Neograft has proven to be an effective FUE extraction tool.

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## Dr. Glenn Charles

If the Neograft device is really making the FUE procedure that much easier and saving so much time then the prices should reflect this. We would get a better idea if this was true if the physicians who are using/promoting this device would share with everyone what they are charging their patients per FUE graft.

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## hudson

> 


 
Mr. Kobren, Hudson is an amalgam of ideas from different individuals that represent, are affiliated with or work with the NeoGraft Company. Our group includes those in management , investors, techs, doctors who have purchased the NeoGraft device, and patients.  We came together to address the many false, misleading assumptions, conjectures and incorrect statements, that were posted about the NeoGraft device.

 Here is our position. We do not ascribe to the notion that because someone is visible, or makes their identity public, that this means that person is more honest, credible, accountable and responsible than someone who is not visible. Facts are not any more true or false, when stated by someone who is visible or anonymous.  The facts speak for themselves. It was never our intention to post on any forums.  However, we were very disturbed about the wrong, misleading information being disseminated about the NeoGraft device and felt the public had a right to know the real facts about the NeoGraft Company, the real facts of the NeoGraft technology, and the benefits to the patients that can be achieved with the use of the NeoGraft device.  This is what motivated us to address forums discussing NeoGraft. 

As for Dr. Feller, We do not find it reasonable to have more interaction with him than we already have, given his antagonistic position to us.  We are not looking for him to give us the benefit of being acknowledged, nor are we looking to debate our position, two things he mentions in his post. We are simply looking to clarify false assumptions and misleading information stated about the NeoGraft device. It is our belief that falsely maligning the NeoGraft device, as Dr. Feller has done, without evidence or experience on the machine is not reasonable behaviour.  Dr. Feller would have the reader believe that he had seen and used the NeoGraft machine before he began maligning it.  

It is obvious that Dr. Feller had never worked with the NeoGraft device before he began maligning the NeoGraft machine since his posts referred to the NeoGraft device as a motorized spinning punch.  Dr. Feller then attributed to NeoGraft all the negative effects of a motorized spinning punch, including the killing of grafts.  Since the NeoGraft is not a motorized spinning punch his negative remarks about NeoGraft were therefore based on pure conjecture and speculation, not on any technical knowledge of the NeoGraft device.  The NeoGraft device is not a motorized spinning punch. NeoGraft only does about two rotations before going under the skin.  In fact, the NeoGraft does less rotations than a manual FUE punch. 

Dr. Fellers false negative posts were written as though his speculations and conjectures about the NeoGraft were absolute facts, but they were really his conjectures. You addressed this issue Mr. Kobren, when you stated in one of your posts that until there is evidence to the contrary some of the [ false, misleading] words used to describe the technology of NeoGraft  are just theorizing. However we feel you did not go far enough in addressing this problem and Dr. Feller has continued maligning the NeoGraft machine, as though his maligning statements are facts.

 Even after several very lengthy posts by us pointing out Dr. Fellers false misleading conjectures and assumptions, Dr. Feller has not only stuck by his erroneous statements, but escalated the maligning of NeoGraft in his latest post.  In his latest post Dr. Feller wants the reader to believe that his latest round of maligning the NeoGraft is based on his knowledge of physics. Dr. Feller writes in his post: They [his ideas about NeoGraft] are not subjective viewpoints, they are facts based on physics.  Maybe these facts are true of  motorized spinning punches but NeoGrafts technology is different. 

As I have stated previously in response to Dr. Fellers conjectures about NeoGraft, our research and development team, and our engineers, do not understand the physics Dr. Feller is referring to when he is describing the NeoGraft.  It might be interesting to know that we are working with a major University that is known for their plastic surgery program in order to develop an accredited training program for NeoGraft.  The University has seen the NeoGraft device perform in their facilities and based on their knowledge of physics and assessment of the NeoGraft machine they want to work with us and accredit this program. Obviously the University disagrees with your assessment of the NeoGraft device. We will release more information as soon as the details have been finalized.

Dr. Feller launched his hand held device about the same time we did the NeoGraft.  Might this have influenced his negative posts about the NeoGraft device?  I will leave it to reader to speculate about this.  As I pointed out in other posts and this is very important Mr. Kobren and not to be taken lightly, we have never maligned or stated false, negative comments about any doctors device if we had not had experience with that device. We would not do so because we are accountable and ethical and if we have never used a device we would not make wrong destructive comments, like grafts dying, about any doctors device, as Dr. Feller did with the NeoGraft.  

In his latest post Dr. Feller, again speaks negatively of the NeoGraft.  He does not give up.  Dr. Feller states:  The presence of a few results posted [on the web] by the company itself is not "proof" of efficacy in my view.  I need to remind you Dr. Feller, that our focus is the doctors. We do not deal with the patients. Doctors will not purchase a device from pictures on the web, so we only have a few cases shown on the web. Perhaps you do not remember that in my prior posts I wrote that the NeoGraft company made the decision to be very transparent and interactive with the doctors who were interested in acquiring the NeoGraft device and we decided to do live demonstrations around the country several times a month so that doctors could visually see and experience firsthand the efficacy of the NeoGraft device. Many doctors come to more than one demonstration to satisfy themselves of the efficacy of the NeoGraft.  Because of our live hair transplant demonstrations we only posted a few examples of NeoGraft cases on the web, mostly for the readers that come on our site. 

 Our proof of efficacy comes from the substantial number of NeoGraft machines that are now doing FUE procedures in doctors offices, not only in the United States, but in other countries as well where we are actively promoting the NeoGraft device.  These NeoGraft machines are collectively harvesting many, many thousands of grafts every day and through our contact with our doctors we hear they are very happy with the performance of the NeoGraft device.  Based on the growing reputation of the NeoGrafts efficacy which is being established by the doctors using the NeoGraft device we now have a backlog of orders, not only in the U.S. but with our International distributors as well.  Since we do not do surgical procedures, we mostly leave it to the doctors to post their own pictures, and as their cases build up they will be posting more pictures. 

The doctors who have acquired the NeoGraft device feel that this device offers many important benefits to their patients such as a no cut, no stitch procedure compared to the STRIP invasive surgical procedure.  NeoGraft FUE is less painful that a STRIP procedure, requires less down time than a STRIP procedure, and offers the patient the ability to have short hair because large elliptical scarring is not a problem as it can be with the STRIP method.  The NeoGraft device also greatly reduces the transections of grafts of a manual FUE procedure and shortens the time of the manual FUE procedure.  All evidence, Dr. Feller, shows you are alone in your inaccurate misleading assessment of the NeoGraft device at this late stage of the game. 

We think your program Mr. Kobren, does a very good job in general educating readers and bringing out important issues.  For some reason your good formula has had mixed results for NeoGraft as many issues discussed about NeoGraft have not been honestly or fairly presented.  At first your program appropriately questioned the ability and value of the NeoGraft device and had a wait and see respectful attitude.  That was a fair position to take.  Yes, you did work with Dr. Bauman and the NeoGraft device to have the Greg Benson live demonstration on the internet.  We were very appreciative and thankful (see Neografters where we thank you) of your efforts to let the viewers know about NeoGraft.  We were not looking for an automatic stamp of approval of the NeoGraft machine.  We believed NeoGraft would be judged on its good results, and good performance and this is what happened with the doctors buying the NeoGraft device.  But, strangely this did not happen on this forum.

 Instead, somewhere along the way, on your forum, the atmosphere towards NeoGraft shifted.  In addition to Doctors like Feller who are hosted on this forum writing wrong misleading, not evidence based information about NeoGraft, you invited  doctor Dr. Bauman, who came on your show with ridiculous, hyped up headlines, like NeoGraft Warning.  The Bauman interview was a false portrayal of Dr. Bauman as a NeoGraft Guru, which he is not, who was self appointed to warn patients to stay away from doctors buying the NeoGraft because some of them were not experienced in hair restoration. This warning was very misleading and greatly self serving for Dr. Bauman.

As I pointed out in another post, all doctors training on the NeoGraft start out inexperienced, whether they were hair restoration doctors or not because this device is different from other devices and all doctors need to be trained on the NeoGraft.  In that sense Dr. Bauman was inexperienced too when he began less than two years ago, and no one was posting on Forums to stay away from him.  It is rude to do so now to other doctors who have trained on the NeoGraft already, like him or are presently training.  These doctors have a right to train on medical devices like NeoGraft, just like Dr. Bauman did.  Dr. Bauman is playing double standard, as he was a Newbie not so long ago with NeoGraft, and he is stepping outside of ethical boundaries warning patients to stay away from doctors who are doing the same as he did when he trained on his medical devices.  We hear the doctors he has warned against are very agitated by his behaviour and most of them are more highly accredited surgeons than Dr. Bauman is and entitled to train on new devices as he is.  

Dr. Bauman may make the case that he has more experience than some of the doctors buying the NeoGraft device who have never done hair restoration.  Okay, we could accept that, in the area of hairlines (because the rest is all newly learned NeoGraft procedure) and argue that hairlines can be learned in a reasonable amount of time, in spite of the fact that certain doctors want the public to think it is difficult to learn. But what we cannot understand is how after Dr. Bauman came on the Bald Truth Talk show and warned about how important it is for Neograft to be in experienced hands, (for hairlines) Dr. Williams was invited on the same show with Spencer Kobren to also warn patients to stay away from inexperienced doctors when Dr. Ken Williams, had never had any experience in hair restoration of any kind including hairlines before purchasing the NeoGraft device??!! 

We thought Dr. Williams would have been thought of as the kind of totally inexperienced doctor that Dr. Bauman was warning the readers about.  In fact, we thought Dr. Williams should have been a Poster Boy for the NeoGraft procedure and the right candidate to refute the claims of Dr. Bauman that so much experience is needed to become proficient on the NeoGraft in order to do hair restoration procedures.  First, if one looks at Dr. Williamss hair transplant done with the NeoGraft, (go to the web) one can see the excellent results of Dr. Williams FUE NeoGraft hair transplant including his hair line.   He is a great candidate for showing how successful a NeoGraft procedure is.  Next, if one looks at Dr. Williams hair transplant cases, one can see that, even an inexperienced family doctor can learn to become proficient at doing NeoGraft FUE hair transplants in a reasonable amount of time, including doing hairlines. This makes Dr. Williams a good candidate for refuting the notion that one needs so much experience to become a NeoGraft hair restoration doctor, including learning how to do hairlines.  Dr. Williams, as far as we are concerned, proves that all those hyped up Warningsabout NeoGraft getting into inexperienced hands are totally unsubstantiated, as Dr. Williams was totally inexperienced when he acquired the NeoGraft device less than two years ago. This is an example of technology speeding up the learning curve. 

Some of the doctors Dr. Williams Warned against, may also not have had hair restoration experience like himself when they acquired the NeoGraft, but the majority of them are highly skilled board certified surgeons whereas Dr. Williams is a family practitioner who has never had any formal surgical training.  What makes Dr. Williams superior to this group that he is the one Warning about these doctors.??!!  The whole show did not make sense to us.  We also do not understand Dr. Williams lack of loyalty and gratitude for the good work done by the NeoGraft company in helping him become trained as a NeoGraft hair restoration doctor, condsidered qualified enough to go on Spencer Kobren's show.  Dr. Williams has not won any friends amongst the doctors he warned against, as for the NeoGraft company, we will not comment although we will continue to support him in every way we can.  

 Also what moral right did Dr. Williams have to accuse other doctors of having improper motivation for buying the NeoGraft, stating that those doctors were only buying it to earn money, while at the same time trying to make the public believe Dr. Williams and Dr. Bauman have a different kind of moral character and a higher motive than making money for doing hair transplants and other procedures?  Dr. Williams wanted us to believe he is doing hair transplants for the passion not the money. But then how come Dr. Williams began doing liposuction and fillers before hair transplants? Was aspirating fat also about passion and not a money motive? 

As for Dr. Williams comment on the interview that a doctor mentioned he does not have to be at the hair transplant procedure, this has nothing to do with the performance of the NeoGraft device or the integrity of the NeoGraft company. How doctors choose to follow the rules of their profession and the doctors ethics has nothing to do with our selling the device to doctors.  There will always be doctors and individuals in other professions , who try to beat the system or take advantage of it. We are not a doctor police force. A doctor being present or not at a procedure is an issue for a medical regulatory body, not for a company selling devices.  Why was this even a comment for a video presentation on any forum?  Do you not think we could bring out a whole laundry list of rules that are not followed by certain doctors. What has that to do with anything, except that you seem to reach for any straw, to cast dispersions on the NeoGraft company and doctors buying the NeoGraft device. 

We would never have imagined that a medical device company trying to sell medical devices by following the rules, is faulted for selling these medical devices to doctors qualified by the medical profession to buy them and then accused of selling to the wrong doctors, when we are not even obligated to sell to doctors, but go out of our way to make sure a doctor is involved in the sale,  while at the same time being accused of being dishonest, irresponsible, disingenuous, and only selling devices to make money!  WOW. If you do not like to whom medical devices are sold to please blast the regulatory bodies that make the rules for sales. Why target the NeoGraft Company?  Furthermore, YES, we agree we are in the business to make money, just like Spencer Kobren and just as all the doctors we sell to and do not believe anything to the contrary.  However, it is possible to want to make money and still be an honourable, caring, honest, respectful rule following and responsible company, which the NeoGraft Company is. 

Here is a final example of why we came to the forums.  On the audio tape the question was asked  Is it reasonable to sell this device [NeoGraft] to a medispa that has no physician on the premises.   The no doctor on the premises part was emphasized in the audio post.  Then we were asked  How is this reasonable and responsible? The way the question was stated is misleading implying that a medispa has a NeoGraft device and there is NO doctor on the premises EVER to operate this device. The next false conclusion is that the NeoGraft company is unreasonable and irresponsible.  We think it is unreasonable and irresponsible to make denigrating statements without any basis about the NeoGraft company.  First of all it is not true that any medispa that the NeoGraft Company has sold a NeoGraft machine to does not have a doctor working with them who operates that machine.  But even if this were true we would still be acting reasonably and responsibly according to the rules and regulations of the medical device industry.  

Medical device companies are not obligated to sell medical devices to doctors.  I would guess most medical devices are not owned by doctors.  Hospitals, clinics, medispas, private investors and medical office management companies often own medical devices and even doctors practices. The owners of the device are responsible for having a qualified doctor use the device. When a medical device is not used properly this is not the problem of the medical device company. Once we sell a device we have no control over it and how it will be used in the future.   As I stated we are not a police force for the medical profession.  

 I am certain you know also Mr. Kobren that doctors have many different business arrangements for the use of machines and for being able to work in different offices.  Doctors sometimes have more than one office, often in another state or even another country.  They can work part time in medispas, they can contract with franchises to work part time for them, such as Bosley or Hair Club for Men.  There are many situations when the doctor is not on the premises.  This does not mean he is not on the premises when he/she has a patient.  Why is this even a topic of conversation?  You know this is how the cosmetic and the hair transplant industry works so why make misleading innuendos implying a medispa has a NeoGraft but no doctor to do the procedure.  Furthermore you ask on the audio tape if a doctor flies in to do the transplant at the medspa as though this is a novel and not to be desired action!! Yet you know this happens very often where doctors fly in to do a procedure, especially when they work part time for large franchises or have another office.  In many remote regions this is how the population gets to see any kind of a doctor  they fly in.  

We were baffled by this line of questioning and wondered why you were trying to give your readers the impression that there was only a nurse or a dentist on the premises of the medispa when, you must know a doctor can fly (drive) to the premises and this is a medical industry standard.  Basically, it is not important who owns the machine or where it is parked, assuming the place is properly equipped as a surgical place, it is only important that a qualified doctor operates the machine, whether he is on the premises or comes to the premises to do his procedure.  Why make a public issue about doctors on premises and vilify the NeoGraft company when this is how the medical industry works. The particular medspa you speak of has very qualified doctors come and do procedures offered by the medspa.  If you have problems with the rules of the medical profession that allow for this, you need to talk to those in power to change the system and not attack the NeoGraft company that is following the rules.  

To conclude this lengthy post, we are not hiding in the shadows as you claim.  Nor do we need help with our case by becoming public.  We do not have a case, simply the need to refute false, incorrect information and we do not feel that refuting false, damaging information is a good and sound reason for us to go public.   As for credibility, we are letting the NeoGraft device give us our credibility.  As you stated, the truth is the truth and we believe this also. But truth can be distorted and get lost amidst false, inaccurate, conflicting information.   This is why we answer some of the posts. We are not looking for agreement with our beliefs about FUE being the way of the future, even if Dr. Harris has stated so. We could happily debate that. 

We are open to criticism given in the right spirit based on experience with NeoGraft and accurate facts. It is this kind of criticism and sharing of information of well meaning doctors in the last few years that has spurred our engineers and developers to make the modifications that brought about this more advanced fourth generation of NeoGraft that we have introduced.  It is this kind of good will and spirit we are looking for, both in posts and public interviews to promote good, honest, informative discussions that lay the fertile ground for new learning.  There would have to be this kind of benefit for us to come on your program, meaning feelings of good will, or the sense there will be a fair and intelligent discussion.  With the present climate surrounding NeoGraft and the Company we do not think we will receive these benefits. 

Your latest poster wrote: Hudson is a shill and knows if he goes on Kobrens show that hell have his ass handed to him. These are the type of comments and sentiments that are unacceptable to us as they do not create the kind atmosphere that we would like for an interview. These comments are rude, hostile, and not in the spirit of sharing and learning.   Statements you have made in recent and past posts such as your being  concerned the way it[NeoGraft] is being marketed and to whom and that Representatives of the [NeoGraft] company are being disengenous to public and press and that the NeoGraft company is irresponsible and dishonest are themselves disingeneous and inflammatory statements.   We cannot see how a fair honest discussion could ensue, given some of the false, negative positions taken about the NeoGraft device and the NeoGraft Company.

Let us make a conjecture about why there is this kind of tension where the NeoGraft is concerned. You are an intelligent man Mr. Kobren, and you come across as very affable on the net, and as we said we have found your other topics fairly balanced.  Why is this not occurring with NeoGraft?  We believe that the NeoGraft device is challenging the STRIP hair restoration doctors to make changes and incorporate the FUE procedure into their practice, in order to allow their patients a choice.  We have found when patients are given a choice, and understand the benefits of FUE they will choose FUE. We have found the traditional STRIP doctors reluctant to come on board.  They mostly have their STRIP method that works for them, earns them their income and it is our belief that they are not happy about having to make the necessary changes to become proficient as FUE doctors. 

 History shows doctors do not accept change easily. There was the same uproar with laparoscopy with some doctors saying this procedure will kill people.  Other groups of doctors like the Plastic surgeons, Cosmetic surgeons and Dermatologists are very strongly embracing the NeoGraft.  Most of these doctors were not interested in doing STRIP surgery, and so did not get entrenched by the Strip routine.  The new doctors can there for accept change more easily as they do not need to dismantle the STRIP routine. They see the value of the NeoGraft and are acquiring the NeoGraft .  This must be causing concern for the STRIP doctors, who may be worried about losing patients to FUE hair transplants.  We believe that you know and feel for these doctors and we wonder whether your compassionate feelings are influencing you to not see things as clearly or as fairly as you usually seem to do. 

On the other hand, Mr. Kobren, you are in a unique position to influence people and their beliefs and cause harm to the reputation of certain individuals like doctors and entities like NeoGraft which we believe puts you in a position of serious responsibility which calls for fair and honest reporting in order to do no harm.  For example, honest and fair reporting about the medispa would have had you enquire about who uses the NeoGraft device, instead of attacking and assuming that no doctor comes to the premises and dispensing that information to the public as though the NeoGraft company is the villain.  Even if there should happen to be no doctor, the responsible thing would have been not to attack the NeoGraft company but apprise yourself  with the knowledge that medical device companies often sell devices to non doctors and the onus to get the doctor is on the owner of the machine. Did you ever consider that maybe there is a possibility that the NeoGraft Company which does require that a doctor be attached to a machine they sell, (even though that is not necessary in our business) could also have been deceived about a doctor attached to the NeoGraft device? Our knowledge as I said is that any medspa that has bought a machine has a doctor using it. And why the innuendoes that there is something wrong about a doctor flying in to do a procedure when this is a commonplace practice? We hope you review your actions  and see our point of view.  

At this time we do not want to be caught up in an interview that gives any extra importance or credibility to some of the statements made by those that believe it is okay to make irresponsible, hostile and unaccountable statements both about our device and our company.  Mr. Kobren, in answer to your audio video, the NeoGraft company and its many representatives, called Hudson, has decided to not do a live interview at this time.  This does not mean we would not do one in the future. But first we would like you to understand that the kind of reporting both about the NeoGraft Device and the Company would need to change before we consider sending a representative to do an audio or video broadcast.

----------


## hudson

[QUOTE=Dr. Feller;14761]

Dr. Feller,
You do not give up.  You repeatedly state the same erroneous points over and over regardless of how often it has been explained to you that you made incorrect assumptions and have the facts wrong about how the technology of the NeoGraft device works.  You appear to need to hang on to and disseminate incorrect information about the NeoGraft device.
I will address your comments in this latest post once again, directly after your quote. 

Dr. Feller Quote: but I'm also glad you [spencer kobren] understand where I'm coming from when insisting that he identify himself before I give him the benefit of being acknowledged. Hey, I'm not anonymous, why should he be? 

Hudsons Answer:  I not think a voice or being visible conveys more than the written word. Being anonymous is a choice just as you chose to be highly visible.   Being anonymous does not affect what is written. I have stated facts and these facts stand on their own and can be checked out whether I am anonymous or not.  I do not seek "acknowledgement", nor do I have a need to be acknowledged by you Dr. Feller or anyone else. Accountability comes not from knowing who a person is, or what he looks like but from checking out the facts.  You, Dr. Feller, are not anonymous, but quite visible, yet you continue to post incorrect and inaccurate information on this site about NeoGraft.  How accountable and responsible is that?  The bottom line is the facts. If the facts can be acknowledged then accountability is there.  Only the facts need acknowledging and this is done through research and fact finding.  Having said this, we are very willing to let you know that Hudson is not any one person but a group of people who represent NeoGraft, or work with NeoGraft or have bought NeoGraft devices.  The posts written by Hudson are a collaborative effort reflecting the sentiments of people affiliated with NeoGraft, including sales representatives, doctors, technicians, hair tech trainers and even patients.  Here are more quotes taken from your last article and Hudsons answers.

Dr. Feller Quote:   he [Hudson] has made materially false statements about me in prior posts that he should stand accountable for. Throwing out accusations and criticism is easy when you're anonymous, but people tend to be more civil and responsible when their identity is known to all.

Hudsons Answer: Dr. Feller, we have not made any false statements about you. In all our posts we quoted your inaccurate and misleading statements that you made about the NeoGraft machine and then we corrected these incorrect statements with our knowledge of how the NeoGraft device works.  In spite of your visibility you are not, as I said being accountable or responsible when you make inaccurate statements and continue to do so even when the NeoGraft Personnel have many times written to point out your incorrect statements.  I will quote these inaccurate statements of yours again here.   In March of 2009, before you had ever seen the NeoGraft device do a procedure you stated: 

Dr. Feller Quote:  Any new FUE device will get my full attention..it  [NeoGraft] utilizes a spinning punch  it also subjects the grafts to TORSIONAL forces which are detrimental to FUE grafts..the largest concern I have, is the chance for transection and trauma as the splayed out follicles come in contact with the spinning punch as it gets sucked down the entire length of the punch. If this device, as described, scores down to a certain point with the spinning punch and then relies on suction to pull the graft free from the bottom, then any part of a splayed graft is going to get cut off or at least nicked pretty significantly by the spinning punch. And even though the graft may not APPEAR to be damaged, it may well be dead.

Hudsons Answer:  Your statement that the NeoGraft device is a SPINNING PUNCH is a totally incorrect description of the technology NeoGraft uses to extract follicles. You mention four times in that last quote that NeoGraft is a SPINNING PUNCH.  NeoGraft is not a SPINNING PUNCH.  Because it is not a SPINNING PUNCH there are no high speed motorized rotations which is how you have described spinning punches. Since NeoGraft is not a spinning punch, therefore no DAMAGING heat, torsion or traction occur.   Countless doctors have attended our live demonstrations and there is no evidence of damage as you describe to the follicles. They are robust, moist, and in excellent condition. These live demonstrations also show a low transection rate of the follicles.  You obviously do not understand how NeoGraft is engineered and it is obvious you did not do research on how the NeoGraft works before  incorrectly ascribing the damaging effects of a motorized SPINNING PUNCH to the NeoGraft device which has a totally different mechanism for harvesting grafts.  I have explained the mechanism NeoGraft uses on other posts and will not repeat these here. It will suffice to say that the NeoGraft device rotates less than a device used for manual FUE procedures.

The point, which you choose to ignore Dr. Feller, for what reason I do not know, is that the doctors buying the NeoGraft machine are as intelligent as you are, and many of them have good technical knowledge as well. Since they are an intelligent group, they do their due diligence. The majority of the doctors who purchased NeoGraft for their practice came to multiple live NeoGraft demonstrations to assure themselves that any one procedure they saw performed by the NeoGraft device was not just a fluke, something you allude to about the NeoGraft. So far most doctors  have taken anywhere from eight months to one and  a half years investigating NeoGraft before they purchase a NeoGraft device from when they are first exposed to the NeoGraft device. In spite of posts like yours denouncing the NeoGraft device,  the majority of the doctors who have come multiple times to see the NeoGraft  machine purchase the NeoGraft, telling us that each time they come they are more impressed with the machine. During their visits to demonstrations, they get to see the grafts, look at them under a microscope. Many doctors get to see a grown out NeoGraft FUE hair transplants with patients who are having a second transplant.  Most of the time if a doctor does not purchase the machine, it had to do with being unable to get financing.  Here is another incorrect, wildly off track quote written in March of 2009: 

Dr. Feller Quote:   suction means air-flow and thats deadly to a graft. It doesnt matter if the air-flow is toward or away from a graft, flow in any direction WILL desiccate the graft. No ands, ifs, or buts. It will do it every time. I personally believe graft desiccation is the number one cause of poor growth in hair transplants of any kind. Again, once such grafts are rehydrated they may LOOK alive, but are long dead. 

Hudsons Answer:  We have repeatedly explained that there is constant misting and moisture in the tube and receptacle of the NeoGraft. Therefore there is no desiccation. The suction is very minimal and more gentle to the grafts than pulling out the grafts with tweezers which both STRIP and manual FUE procedures do.  Perhaps you should let the readers know that when a doctor does STRIP surgery, the piece of excised scalp is cut up into many sections, and handled by many technicians (2-5 or more).  The sections of scalp are then further sliced up under hot microscopes. There is always a chance of the follicles drying out and dying unless misted by a technician. Misting the follicles is important in both procedures and the NeoGraft device has a mechanism for misting the follicles.  There is not one ounce of truth to your speculations about desiccation and dead grafts, with NeoGraft.  We could write the same thing about a STRIP procedure if we wanted to mislead the public.   

Again, the doctors coming to our live demonstrations which are done 4-5 times a month, would not be buying machines that are killing grafts.  You must think your fellow physicians as a group are really quite unintelligent.  By sticking with your inaccurate comments you make it appear you are the only one who has these insights about the NeoGraft device and the doctors who are doing their homework and checking out the NeoGraft carefully are an ignorant lot buying a device that makes grafts dead.  We have loaned many doctors the NeoGraft machine for up to three months and of the large group we allowed use of the machine there were only two that did not purchase the machine and the reasons had nothing to do with NeoGrafts performance but other kinds of issues which will remain confidential. 

In another post in March 2009, before you had ever seen the NeoGraft do a procedure you wrote again:
Dr. Feller Quote:  If the three main detrimental forces of FUE are:
1. Torsion
2. Traction
3. Compression
Which of these forces does this machine [NeoGraft] address? 
Definitely not numbers one and two. Perhaps number three since there is less compression required due of the use of suction, but this gain is more than outweighed by new losses due to desiccation and the grafts gauntlet ride as its sucked down the tubing.

Hudsons Answer:  Once again you attribute Torsion, Traction and desiccation to NeoGraft. But all the evidence from our live procedures, as I mentioned before, viewed by many doctors shows that NeoGraft technology produces very robust, moist, intact grafts which are extracted with a very small transaction rate.  The evidence and facts do not back up your claims and yet you persist in continuing to hold on to your false position. Why is that Dr. Feller? Even Spencer Kobren tried to have you understand that your comments needed clarification.  On March 17, 2009 Spencer Kobren wrote:  
Kobren Quote:   until  its proven that the the Neograft machine damages grafts, terms like detrimental forces, torsion and desiccation, are simply words used to make a theoretical point.  

Hudsons Answer:  I could not agree more. All your false claims were assumptions and conjectures not based on any evidence or experience with NeoGraft,  in other words they were theories which were  based on a lack of knowledge of NeoGraft technology.  But instead of recognizing that you are theorizing you turned your theories into facts. In spite of Spencer  Kobrens comment you continued with your inaccurate charges against NeoGraft.  In March 22 2009, before you had seen the NeoGraft perform a procedure you answered Gil in a post and wrote:

Dr. Feller Quote:  
Gil, in the end, as you've already eloquently noted, it's all about RESULTS. 
The device [NeoGraft] is described as making extraction FASTER, but not a word was said about extracting grafts SAFER. I do not see where this mega-machine improves graft safety by lowering graft trauma. In fact, I see the opposite with respect to that spinning punch and the gauntlet of suction tubing the graft must travel through. This is why I am so adament about articulating and describing the forces working against us: Torsion, Traction, Compression. Any proposed FUE advance must address either one or ALL of these forces to be of any use.

Hudsons Answer:  Dr. Feller, you claim that in the end it is all about RESULTS.  Yet, when numerous results of NeoGraft procedures have been demonstrated for almost two years, and  recently at the live surgery workshop in April, 2010 where there was a packed room full of doctors, and the results were EXCELLENT, you choose to ignore these results and you continue to stick with your inaccurate facts as shown by your latest post. Amazingly, while the NeoGraft company was continuing to travel around the country demonstrating that the NeoGraft machine was harvesting very good quality grafts, the next day of the prior quote, on the March 23, 2009 you raised the bar even more with even stronger inaccurate speculations and posted:

Dr. Feller Quote:   Do you want to know why the FUE results from motorized spinning FUE punches are poor to moderate? It's not just the destruction secondary to the three detrimental FUE forces, but simply because such devices COOK the grafts.
During use, the inside wall of a standard punch rubs right up against the graft. This close approximation often results in a significant cohesion force that causes the graft to dangerously twist within the punch as it spins. 
As the punch continuously rubs against the graft at high speed, a huge amount of heat is produced secondary to friction-the result is similar to an indian "rub-burn" which will not only cook the graft, but dry it out as well.  To get around this problem I designed and patented the first Feller Punch manufactured specifically to reduce friction between the inside wall of the punch and the graft. Decreased contact with the graft means less twisting force, less trauma, less heating, and less desiccation. 
This is just one reason why motorized spinning punches for FUE are non-starters and shouldn't be used IMO.

Hudsons Answer:  By accusing the NeoGraft machine of cooking grafts, extracting dead grafts, and dessicating grafts, because it is a motorized spinning device, you show us that you frankly do not know anything about the NeoGraft device and how it works. As I stated you are also dismissing the good intelligence of your peers, who see the value of the NeoGraft device and are purchasing this device. You have not acted in good will by making false claims about how the NeoGraft works, especially since when you made those comments you had never performed any procedure with the NeoGraft device.  We have evidence of this.  As I explained in an earlier post the NeoGraft group, including our engineers, scientists and developers, have never once made any comment about your device, nor would we ever attempt to, because we had never used your device.  We have a strong sense of ethics and are accountable about what we say about other peoples devices. We do not want to cause anyone harm or attempt to damage their reputation with wild conjectures.  Now that you have sold your device, you continue with your campaign against NeoGraft. Your latest post continues to affirm your false hostile stand.   You state:

Dr. Feller Quote:  As for my views on the Neograft machine, I stand by them firmly. They are not subjective viewpoints, they are facts based on physicis and 8 years of actually studying and performing FUE in my practice. I have also seen and used the Neograft machine in person, contrary to false reporting by "Hudson". This experience only confirmed and supported my position to stay away from it.I state again that no matter the method used, all FUE surgery suffer from the following detrimental forces:
1. Torsion
2. Traction
3. Compression
And Neograft is no exception. In fact, to my mind and observation, Neograft introduces even more detrimental forces in addition to those just listed. It's just a plain fact of the physics of the mechanism they chose to utilize.

Hudsons Answer:  Standing firmly by false inaccurate information is your choice Dr. Feller.  I do not know where you got your physics training, but our engineers, scientists, and developers, do not agree with any of your conclusions. The results produced by NeoGraft at our live demonstration, which have been many all over the country, with numerous doctors attending, have time and time again proven you to be wrong in your facts. The doctors see very excellent quality grafts harvested and implanted.  As for your having seen and used the NeoGraft machine, that may be so , but we have it on record, that your mistaken, false, comments were made before you had ever seen the machine do a procedure.  Your comments were therefore based on speculation and conjecture which ended up feeding the public false facts.  

Now that you claim you have used the machine, I cannot understand why you need to stick to your false position.  The doctors who use NeoGraft , once trained sufficiently, are able to get very good results.  There is no reason why, assuming someone gave you proper training that you would not get the same excellent results our other doctors get.  We agree that even though the NeoGraft simplifies the FUE procedure, it is still a tool in the doctors hands.  Since the doctors we train become proficient and harvest and implant very good quality grafts, I think you need to check out and adjust what you are doing in order to be able to achieve the quality of harvesting other doctors are able to achieve. You wrote in your latest post:

Dr. Feller Quote:   NeoGraft introduces even more detrimental forces in addition to those just listed

Hudsons Answer:  This comment is an example of your need to continue to bash the NeoGraft.  You are not convincing anyone.  More and more doctors are contacting us every day wanting to see the NeoGraft in a live demonstration based on the good reports from other doctors who are using it. We are starting to see more and more referrals with doctors now contacting us whereas when we started we were contacting the doctors.  And we are working with a University to accredit a course for the NeoGraft device and FUE training. They have worked with the machine and are excited by it and going to accredit our course. Your next point about a machine not having a reputation is something I do not agree with.  You state:

Dr. Feller Quote:  Another issue that Spencer Kobren brings up is a good one. In essence, it seems that the company is attempting to sell the reputation of the machine, and in doing so is trying to put the emphasis on the tool instead of the human practitioner.  You continue But a machine can't have a reputation. Nobody speaks of the reputation of Andre Agasey's tennis racket, Reggie Jackson's baseball bat, or Paul Jr.s tool kit in making a new custom chopper. It's the PERSON that builds and earns the reputation, not the tool. Ever.

Hudsons Answer:   A machine can have a reputation. This means that some machines have abilities other machines do not, just like doctors who get a reputation. We now have airplanes that fly automatically and those that do not (flying visually). Computers (calculators) can do calculations in a second that would take humans hours to calculate. The calculator has the reputation for this ability not the human.  There are so many automated devices that have taken over from humans such as bank money dispensing machines, bottling plants, and other robotic machines. Some machines or devices have reputations for doing things better than other devices in their category.  Apple, I phone and other devices have won those reputations.  Even cars have reputations for performance and features other cars do not. These machines have the reputation for what they do, not the humans. 

These machines are a collaborative effort of many humans, but the machine does the work.  Those machines have earned their reputations.  Sometimes the machine does everything, sometimes there is a partnership as between a human and a machine as with NeoGraft and the doctor.  But like it or not, technology simplifies many procedures and makes them less reliant on the skill of the operator. This is what NeoGraft does. It is not our job to sell the doctor and let people know how great one or another doctor is. Our job is to sell a good quality, efficient machine and let others know that the machine makes it easier to do FUE than if done manually.  In that sense a machine can have a reputation.  Finally you state:

Dr. Feller Quote:  So if Mr. Kobren is issuing a warning about the way the machine has been marketed, I agree such a criticism is prudent, valid, and necessary. 

Hudsons Answer:  Mr. Kobren has wrong information about how the machine is being marketed.   The most important fact is that it is not important who purchases the machine but who uses it. There are many different arrangements that doctors make in order to have access to a medical device. Some doctors purchase the device outright.  Some doctors have management companies that own and purchase the device but the doctor does the procedure. We have seen situations where doctors rent devices, and for most doctors finance companies finance the device. Technically the doctor does not own the device until it is paid for.  As for doctors flying into different locations to perform hair transplant surgery, this happens with regularity.  Many doctors have multiple offices, sometimes even outside of the U.S. and they fly out to these locations to do a procedure.  Many doctors in addition to their own practice fly out to the large hair transplant companies (with multiple locations) to do hair transplants for them.(Hair Club for Men is one example)  

I cannot understand the protest on Spencer Kobrens audio tape about a doctor flying in to a medspa to do a procedure. Just like some management companies, who own medical practices and have doctors do the procedures, med spas can make their own arrangements with doctors to come and do procedures for them.  Many doctors in aesthetic medicine have medspas and many medspas have doctors affiliated with them who come in to do procedures such as botox fillers and liposuction.  It does not matter how they get there -plane, bus etc. 

The NeoGraft company did not establish the rules for how doctors can partner with others who may own the machines to do procedures. These were set down by the medical community.  We stringently follow those rules that apply to us.   We are not responsible for whether the medical community allows or disallows a doctor to fly to an office to do a procedure.  Finally, Mr. Kobren is critical that NeoGraft is sold to doctors with no experience in hair restoration.  NeoGraft is a tool.  Any doctor can go and get training to become a hair restoration doctor. That is what our doctors are doing.  This is the same as the STRIP doctors are doing only instead of using the NeoGraft, they are trained to use a scalpel and tweezers.  No one is making warnings to not go to these doctors and that the scalpel and tweezers are going to the wrong hands. 

Mr. Kobren did not really do his homework to learn the responsibilities of a medical device company and he is not addressing the rights of doctors to train on devices. Mr. Kobren needs to know that a medical device company does not need to sell to doctors and most medical machines are not sold to doctors.  He has also missed the point that all doctors are newbies when they start out. I cannot figure out why Dr. Bauman came on the show to "Warn" about doctors, most of who are overqualified to train on the NeoGraft machine and who have the right to train on this device. I also cannot understand why he put Dr. Williams on the interview as he is a doctor with no prior hair restoration experience before he bought the NeoGraft device, and yet Mr. Kobren stresses NeoGraft should be sold to experienced doctors. This is doubletalk. He is out of line calling us irresponsible, dishonest and unreasonable. We believe that he is being irresponsible, and unreasonable and that his judgement does not seem to be as sound with the whole NeoGraft story as we have found him to be with other kinds of threads.

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## SpencerKobren

> Mr. Kobren, Hudson is an amalgam of ideas from different individuals that represent, are affiliated with or work with the NeoGraft Company. Our group includes those in management , investors, techs, doctors who have purchased the NeoGraft device, and patients.  We came together to address the many false, misleading assumptions, conjectures and incorrect statements, that were posted about the NeoGraft device.

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## Jkel

I read through the whole thing just now and found hudson's response very odd.  Spencer are you ever going to have hudson or anyone from Neograft on your show?

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## SpencerKobren

> I read through the whole thing just now and found hudson's response very odd.  Spencer are you ever going to have hudson or anyone from Neograft on your show?


 Hey Jkel,

While I appreciate your interest and your participation in this discussion,  I dont think its necessary to attempt to smoke Neograft out, so to speak. I know your intentions are good, but Hudson made it crystal clear that Neograft has no interest in presenting its case on _The Bald Truth_ so I think we need to respect their position.

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## Ritchie

> Gil,
> You make some good points, but I don't agree that the HT industry needs to be regulated. I find the cry for regulation to be a knee-jerk reaction that does far more harm than good. When has the gov't EVER done a better job than the free market in ANY arena? Any time the gov't sanctimoniously regulates an industry it NEVER gets better, just the opposite, and the cost of doing business skyrockets. Think gun control and car-seats for infants. 
> 
> In the end, gov't regulators are nothing more than people who couldn't get a premium job in the private sector and attempt to regain self-esteem by assuming an air of self-righteousness by bullying around their betters in the name of "the public good". My foot. 
> 
> -Dr. F


 Dr Feller

Under that logic the situation that the Miners in Chile went through should happen again in the near future, the safety regulations before the accident did not exist, or several Countries that have reached major developments with a strong State and Goverment regulations in the economical arena should leave their current model and so on. It all depends on the context. I believe in the Free Market for the American Society, but I also know that this Liberal or Neoliberal concept has not worked in poor countries were 95% of the GDP is in the hands of a couple of families while the rest is starving. In this situations I would definetly aim for a stronger, more regulated and social focused gov. Did you know that several State own Companies around the world produce higher revenues than the Private ones in the same country and sector and respect workers right and pay ethical salaries? That for me is a clear example on how the Gov has done better.
I graduated second of my class in Economics and decided to work for the Goverment because I believe in making my country a better place and by doing this I lost big time in the income spectrum to the extent that I need to safe for a long time before I can have an HT with you =)

Coming back to the main topic, I agree with you regarding the neograft and I woudn't have a procedure done with this "technique" after reading your statement so I thank you very much for taking the time on putting your valuable opinion on here. I have been promoting you big time in the Spanish forums and people are impressed with your results.

ps: I apologize for my english.

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## Ritchie

"in my view, work to convince your leaders that less gov't is best gov't. BREAK the unions, free private enterprise, and watch your country's GDP skyrocket and along with that enjoy a prosperity that only the U.S. has enjoyed up until fairly recently"

Ok, now this is a very powerful statement and imo a very wrong one. As I said in my previous post we have to put things into CONTEXT. 

Let me tell you a little story ( hope you are not bored already ! ). In  1977 an American Economist called Milton Friedman travelled to Chile to have a chat with Mr Pinochet, a right wing Dictator that had been in power for the last 5 years. The economy was sick, Friedman and his Chicago boys told Pinochet that there were 2 ways to get it healthy again, there was a slow and gradually one and a fast and schocking one. They went for the second one, basicly an all around Neoliberal political and economical Policy. They axed 200.000 goverment jobs, reduced the general budget saving millions and most improtant of all, they privatised 750 State own companies for 10&#37; their real value ( One of the people that took advantage of it and bought everything is the current president Piner).

Now what happened, the first 6 months were horrible, unenploytment rates and inflation was higher than ever and the country was still in recession, but then, BOM, the miracle of this model, the country started growing and growing up to 8% for the next 4 years until finally it stoped.

Chile became the most uneven Country in income distribution of Latin America, with the richest people of all and the poorest at the same, this social bridge between calsess caused criminal rates to go very high, differential education for children and 65% of the pople in debt with banks etc..

Now you mention the US, which with this same sustained model have had the major economical crisis since 1930 that has affected the entire world, this is the way it is, the financial world fluctuates but you canc ertainly prevent this with a bigger, not smalle, state. The us has has a shocking poor's rate of 17% living below that line, that is around 40 million people, 3 times the population of the Netherlands or Chile or 80% of the United Kingdom. 

Now countries with big goverments like Finland, Sweden, Denmark and Germany, were you pay up to 65% in tax have virtually no pooverty at all. Its a concept brought by Keynes after the war names the Wealthfare State, whicch was born under the necessity to provide care and basic needs to soldiers coming back home from the frontline, back in that day there was no National Insurance, no Public Hospitals or any kind of benefits.

I have mentioned the examples of Chile, a mixed economy, with low taxes to the private sector, neoliberal constitution but a lot of social care, the US, quite strong in the first one, not so much in the second and the Wealthfare State that we have in Europe ( I am half Dutch half Chilean ) which provides and guarantees basic needs such as education and health to all their Citizens. Now there is a 4th way, which is strng socialismt

Please don't say that Comunism and Socialism are the same, It's a very common mistake that people make, you are the smartest guy and I am very pleased to exchange this thoughts with you, Communism is a criticism to the means of production that keep man Alinated and without emancipation. Socialism is way of Goverment, Marx and Engel who wrote the Communist Manifest and "The Capital" said the state should be abolished, but never gave a clue on what to do after that. Socialism, which comes in the hand of Neo Marxist an usually wrong interpretators of the Theory fills that gap and invented a way that they thought it was right with the principles and values of the movement.

Now there is 2 big reasons why socialism didn't work, one is the violence desviations particulary in the Eastern European States which caused suffering, killing and violation of human rights. The second one is that ALL Socialist/Communist ( with the Political Party names Comunist) Goverments arised from a revolution and were not politicly elected, all but one case, Allende 1970 in Chile, who was actually voted. 

I don't agree with this paritcular model, where the big central state controlls and planifies all aspects of the economy, like the Neoliberal one, it has never achived sustainable growth either and I usually all big names in the goverment are their for political favours, instead of being professionals in their fields, another reason for it to Fail. But don't Forget the The Soviet Union, once the poorest country in Europe, became the largest steel producer and exporter, defeated germany in the second world war and became a superpower to rival the US in the 70ties with a Socialist Goverment. At the cost of 10 million peoples lives obviolsy, not a good example to follow.

Just fo finish, I am sorry for the long post and as I said, for me  mix Goverment is the Key, I support and will never try to convince the authorities above me to change what we have and take public health aid away or cutting funds for childs benefits or a better Education. Not everybody has money and some people have major needs, the world is unfair and we have a responsabilty , utleast to provide them with the tools and support to change their circunstances, in my viw, not having a public free health sector in the XXI century is a social crime.

Look forward hearing from you

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## gmonasco

For years, men worried about thinning hair, or going bald have turned to hair plugs, toupees and transplants.

Now, there's a procedure being done in the Phoenix metro area that uses vacuum technology.

No, it's not the "Flowbee!" It's called Neograft.

http://www.kpho.com/valleynews/26951628/detail.html

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## RichardDawkins

You know i see another potential in stuff like this way beyond FUE. If hair plucking and acell works this could be used to make hair plucking less time consuming :-)

But what do i know iam only a member in the baldness club

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## germandude

since the device is somewaht like $8k,i`m really surprised the clinics charge more than in a manual FUE..shud be the other way around-or did prices drop by now..
anyone know docs in europe/germany that practise this?

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## germandude

i meant $80k ofc-but still,it should be redeemed in notime..

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