Hair Restoration Through NeoGraft®: Portland, OR, Plastic Surgeon Dr. Kathleen Waldorf Explains

Gone are the days of strip harvesting and hair plugs – follicular unit extraction (FUE) is now considered the gold standard for hair restoration, and many hair transplant surgeons in the United States achieve this through NeoGraft®. Portland, OR, plastic surgeon Kathleen Waldorf, MD, founder of The Waldorf Center, explains how NeoGraft® can provide long-term results without the need for incisions or sutures.

According to the American Academy of Dermatology (AAD), about 50 million men and 30 million women in the United States experience either thinning hair or male and female pattern baldness respectively. Most of these individuals visit physicians to receive treatments to combat hair loss and help restore their confidence, and NeoGraft® provides the opportunity to improve the hair line and density without leaving a linear scar.

NeoGraft® is the first FDA-cleared automated, minimally invasive hair restoration device on the US market. FUE through NeoGraft® minimizes the likelihood of scarring, and allows both male and female patients to wear their hair freely in virtually any length or style in the future.

FUE involves the collection of thousands of individual “follicular units”. These are extracted from carefully chosen donor sites, and then transplanted on to the selected recipient areas. The donor sites chosen are usually at the back of the head, as the hair at this location is more resilient to the effects of fluctuations in testosterone.

While this extraction process may be performed by hand, the sheer number of follicles that need to be removed makes the process long-drawn and tiresome.

The automated NeoGraft®, on the other hand, is a much more efficient extraction process and greatly improves on the manual collection technique. It works based on a system of negative pressure – using a very small rotatory punch, it rapidly and precisely extracts each hair follicle along with the attached shafts and roots from the donor sites. All the grafts extracted by the NeoGraft® device are consistent in length and diameter, making the results of transplantation more even and uniform.

NeoGraft® allows better control of the speed and diameter of the micropunch; custom depth and orientation of each hair follicle; and pre-determined distance between each extracted follicle. As each follicular unit collected can hold between one and four hairs, the process as a whole can extract thousands of hairs in total (typically 1,000 to 2,500 grafts).

During the harvest procedure, the hair transplant technician uses a magnifier to keep a close watch on the scalp as the NeoGraft® micromotor works its magic, creating a small hole as it extracts each follicular unit. The area from which a follicle is plucked is left with a tiny round mark that heals over time to shrink to an inconspicuous spot. As hair grows into the recipient sites, these spots become even more obscured from view.

While the idea of “punching and picking” hair follicles may sound painful, patients under local anesthesia experience little to no discomfort, and often listen to music or read a book while they are being treated.

The precise and controlled approach to harvesting follicular units ensures that every follicle that is collected is completely intact, and results little to no trauma at the surrounding areas of the scalp.

FUE performed using NeoGraft® can also help with hair restoration in other areas, such as eyebrows, near the mouth, and on the cheeks to create beard and mustache transplants.

Dr. Waldorf and her fellow surgeons Dr. Rachel Streu and Dr. Christopher Zarella are board-certified in plastic surgery, and would be happy to answer questions about FUE or NeoGraft® and advise anyone who is looking to learn more about their options to combat hair loss or reduction. To request a consultation with one of them, contact The Waldorf Center for Plastic Surgery online or by phone at 503-646-0101 or 800-310-7901.


What is NeoGraft®? San Francisco Area Hair Restoration Specialists Drs. David Lieberman & Sachin Parikh Break It Down

Hair transplant surgery has come a long way from “hair plugging” and follicular unit transplants (FUT). Follicular unit extraction (FUE) is the gold standard in today’s hair restoration procedures, and the biggest advancement in this respect has been NeoGraft®. San Francisco area hair restoration specialists Drs. David Lieberman and Sachin Parikh explain how this sophisticated technology has made FUE hair transplanting much more precise, rapid, and natural-looking.

NeoGraft®, which is the first FDA-approved automated and minimally invasive device for hair restoration in the United States, minimizes the likelihood of scarring, as it eliminates the need for any large incisions, staples, sutures, or “plugs”, and allows patients to freely be able to wear their hair long or short in the future.

FUE entails collecting and transplanting thousands of individual “follicular units”, taken from healthy donor sites on the scalp. While the process of follicular unit extraction may be done by hand, the NeoGraft® device offers a much more efficient solution.

This technology improves on the manual collection technique, as it works based on a system of negative pressure (using a small rotatory punch) to rapidly, yet precisely, extract each hair follicle (including the attached shafts and roots) from the donor site. Patients under local anesthesia experience little to no discomfort as the NeoGraft® device works its magic.

During the actual harvest procedure, a magnifier is typically used to closely observe the scalp, while the NeoGraft® device’s micromotor that creates a tiny hole as it extracts each follicular unit. The area is left with a very small, round mark, which will heal over time and ultimately shrink to a tiny dot. And as the hair grows back in the donor area, these already small dots will be obscured from view.

By using NeoGraft®, a doctor is able to control:

  • The speed and diameter of the micropunch
  • The depth and orientation of each hair follicle
  • The distance between each extracted hair follicle

NeoGraft® balances being precise and meticulous with being extremely efficient – as each follicular unit extracted can hold between one to four hairs, the process as a whole can involve the extraction of thousands of hairs in total (typically between 2,500 to 3,000 grafts).

The hair follicles that are removed are completely intact, and the NeoGraft® results in little to no trauma to the surrounding areas of the scalp.

The donor area is typically at the back of the head, as this hair is more resilient to the effects of testosterone fluctuations. Each graft extracted by NeoGraft® has the same consistency in length and diameter, so the results of transplantation is more even and uniform-looking.

While FUE – generally via NeoGraft® – has become the norm in most cases of hair restoration, it may be more appropriate to utilize the strip-harvesting method or try non-surgical methods of for some patients. This can depend on a number of factors, and the most suitable form of harvesting will be best determined in a consultation with an experienced, board-certified physician.

In a few cases, NeoGraft® can even facilitate a type of scar revision without the actual hair transplant. If a white scar, for example, shows through dark hair, NeoGraft® can be used to make tiny holes in the scar, which will revascularize during the healing process and make the scar flesh-colored instead, thus making it much less stark or noticeable.

Drs. Lieberman and Parikh, who are both board-certified head and neck surgeons themselves, would be happy to consult anyone who is looking to learn more about their options for hair restoration and/or determine whether NeoGraft® is right for them. To request an appointment with them, contact the Lieberman & Parikh Center for Hair Restoration online or by phone at (650) 327-3232.