Thanks Atsushi, you make a good point. Could you also tell us how DR. FELLERS’s punch has REDUCED the cost of FUE at the Feller clinic?
Top Cat, that last post of your here is the real stuff.
Iron Man, I guess you’ve heard the rumor that damaged grafts often grow, with hairs of diminished diameter, or possibly fewer hair within the original follicular unit, so when you quote the transection numbers you are aware that transection is not a 1-0 binary. Why bring up Gho in the discussion of Cole’s tool?
I don’t expect any tool to reduce costs to the patient But it is a good thing that someone develops a tool. Remember Woods wouldn’t show his to anyone, and that left the few stateside doc’s in the limbo - either subscribe to the ‘Woods Franchise’ or go out alone. Results have been?? well, let’s say, strip has had a very long Indian summer. I say good on Cole for floging his tool, same for Feller and Neograft, but now , please, show us the results.
I’m a little late getting into this discussion but Dr. Cole has been performing his procedures almost exclusively with this instrument for the past several months. We’ve been diligently collecting data, and are primarily concerned with establishing a strong safety record and productive results. We’re planning to unveil the device at our Cole Instruments exhibit booth at the ISHRS convention in Boston later this month.
We definitely do anticipate making it available to other physicians eventually but one of the things that may delay the sale of the instrument is, to be frank, that Dr. Cole is skeptical of physicians’ willingness to invest in new instrumentation. For example, Dr. Cole invested a lot of time and money into developing and manufacturing his patent-pending Counting Incision Device (CID), which has been available since April of 2009. This is the only instrument on the market that accurately maintains the graft count (by digitally keeping track of the number of incision sites being made)- yet the only clinics who have consistently purchased these one-time-use devices are the Moser Clinic in Germany and HDC in Cyprus. This indicates that physicians are often unwilling to invest, even a small amount, for the sake of accuracy, or their patients’ best interest- even when they are making thousands of dollars off every procedure. That said, we anticipate making about five mechanical extractor units available to other physicians, but will then evaluate the demand before expending a good deal more on manufacturing.
This instrument is extremely fast. Dr. Cole is now able to safely extract up to 2000 grafts an hour (excluding donor site preparation time). This has allowed us to offer larger sessions to patients and complete them in less time than ever before. We certainly anticipate that we’ll eventually be able to take on even more patients and make hair restoration surgery more affordable across the board.
Even with the speed of the machine, Dr. Cole made sure that graft survival was not compromised. Dr. Cole has consistently achieved an average transection rate of under 4% with his power device, and he is still trying to bring that down. Our average transection rate using this device, as of this evening, is exactly 3.6%- within less than 1 out of 100 hairs of our manual extraction rate. This study includes 58 cases and just over 77,000 grafts to date.
» » » » Irrelevant? A more bulkier tool will stress out the surgeon very
» » easily
» » » » and can affect the yield.
» » »
» » » LOL! You have to be joking. Why are you being so negative about this?
» » If
» » » it transplates into lower costs (because the doctor uses less time
» per
» » » procedure) without negatively affecting yield and quality, it is a
» » great
» » » thing for us. If it doesn’t, THEN it’s time to be negative. But, at
» » this
» » » point there is absolutely no reason to be nagative.
» »
» » What’s the JOKE here? This is not the first time I have heard about a
» » motorized FUE punch. It has been in practice for a while now. Still,
» the
» » prices has not dropped down. Has Dr. Cole told you that he is bringing
» down
» » the pricing and improving upon the yield with this new (bulkier) tool?
» »
» » BTW, have you checked Dr. Feller’s motorized FUE punch? Do some
» research
» » on this forum and you will find it. It’s far better than this one…
»
» Feller’s motorized punch is far better HOW ?
Exactly, it never ceases to amaze me how people throw comments around as if they know it all. How can anyone know that Feller’s punch is better than Dr. Cole’s or vice versa just by looking at the tool? That is such an ignorant comment, Feller’s punch is more stylish so it must be better, really who cares what the tool looks like, this is not like buying a pair of jeans.
“This indicates that physicians are often unwilling to invest, even a small amount, for the sake of accuracy, or their patients’ best interest- even when they are making thousands of dollars off every procedure.”
That is a pretty broad assumption. Maybe they just don’t see any value in the product. Just because something new comes out doesn’t mean it’s a good idea.
My personal opinion is more focus should be put on obtaining a higher level of skill and treating patients with care and compassion.
» “This indicates that physicians are often unwilling to invest, even a
» small amount, for the sake of accuracy, or their patients’ best interest-
» even when they are making thousands of dollars off every procedure.”
»
» That is a pretty broad assumption. Maybe they just don’t see any value in
» the product. Just because something new comes out doesn’t mean it’s a good
» idea.
The CIDs are the only accurate means of ensuring that a patient is receiving the graft count that they are paying for so I don’t understand how a physician wouldn’t see value in that. As a patient, I would certainly want a physician to invest in an inexpensive tool like this when I am handing over thousands of dollars, based on the number of grafts I’m getting. Yes, there are physicians who have other counting means, such as using a foot pedal, assigning, a tech or even the patient himself to count- however, these methods are all limited by human error (something very common when you are counting into the thousands and distracted by the multitude of things going on in a surgery room).
However, if physicians don’t see the benefit to their patients, that’s their choice. Our greater concern is actually that a number of doctors have purchased a small quantity of CIDs yet never reordered them. It is possible that they are no longer using these devices, but we have reason to believe that a number of them are regularly using CIDs on patients, even though they are indicated for single-time use only. These instruments cannot be properly sterilized (due to the electronics and plastic casing)and any physician attempting to clean and then reuse a CID is putting their patients at great risk.
Thanks for the info, Emilie. Sounds like quite an exciting advancement. I assume the tool can only be used on patients who go the “shaven” route? Is that right?
Given the fact that Dr Cole has been using the tool for a while and can do more grafts (and patients) in less time, why has this not already translated into an ability to lower HT costs (which, you suggested, can reasonably be expected in the future because of the tool)? After all, affordability increases consumption and profits (see “Ford, Henry”) . 
» Thanks for the info, Emilie. Sounds like quite an exciting advancement. I
» assume the tool can only be used on patients who go the “shaven” route? Is
» that right?
»
» Given the fact that Dr Cole has been using the tool for a while and can do
» more grafts (and patients) in less time, why has this not already
» translated into an ability to lower HT costs (which, you suggested, can
» reasonably be expected in the future because of the tool)? After all,
» affordability increases consumption and profits (see “Ford, Henry”) .
Dr. Cole does use his mechanical extractor with his non-shaven technique (I would actually say that about fifty percent of our cases are non-shaven CIT). Non-shaven is a bit more laborious and requires more time to work around the existing hair but, as with manual extraction, it can certainly be done.
As far as dropping prices, I would love to say that will happen rapidly but I imagine the transition will take some time. Currently, the rate at which Dr. Cole can extract the grafts is so fast that we don’t have the staffing to keep up with his full capabilities. We’re working on bringing on additional staff but it takes time to find the best nurses and surgical techs, and to bring them up to the level Dr. Cole requires of his staff. Dr. Cole would also like to bring on another physician in the near future but, again, it will take time to find candidates with the skill, patience and education to master CIT to Dr. Cole’s standards.
Another project Dr. Cole is passionate about is setting up actual training centers for physicians who want to learn how to perform CIT. They would learn fundamentals such as hairline design, graft extraction, dealing with complications, dealing with complicated cases, scar grafting, how to revise flaps, remove plugs, etc… Dr. Cole is actually already in talks to set up training facilities in three cities in Asia.
One exciting possibility that we’d love to see happen would be if his mechanical extractor went mainstream. With the proper training, it is a very user-friendly device and, if we could get a number of physicians using it (whether they were previously strip surgeons, FUE specialists using manual extractors, or new to the industry altogether), the increase in competition would surely lower FUE prices universally.
» » “This indicates that physicians are often unwilling to invest, even a
» » small amount, for the sake of accuracy, or their patients’ best
» interest-
» » even when they are making thousands of dollars off every
» procedure.”
» »
» » That is a pretty broad assumption. Maybe they just don’t see any value
» in
» » the product. Just because something new comes out doesn’t mean it’s a
» good
» » idea.
»
» The CIDs are the only accurate means of ensuring that a patient is
» receiving the graft count that they are paying for so I don’t understand
» how a physician wouldn’t see value in that. As a patient, I would certainly
» want a physician to invest in an inexpensive tool like this when I am
» handing over thousands of dollars, based on the number of grafts I’m
» getting. Yes, there are physicians who have other counting means, such as
» using a foot pedal, assigning, a tech or even the patient himself to count-
» however, these methods are all limited by human error (something very
» common when you are counting into the thousands and distracted by the
» multitude of things going on in a surgery room).
»
» However, if physicians don’t see the benefit to their patients, that’s
» their choice. Our greater concern is actually that a number of doctors
» have purchased a small quantity of CIDs yet never reordered them. It is
» possible that they are no longer using these devices, but we have reason to
» believe that a number of them are regularly using CIDs on patients, even
» though they are indicated for single-time use only. These instruments
» cannot be properly sterilized (due to the electronics and plastic
» casing)and any physician attempting to clean and then reuse a CID is
» putting their patients at great risk.
There is really no incentive for the doctor to use it unless the patients demand that the device be used during the surgery. It’s the same with FUE, we are seeing more doctors offering fue because it is driven by the demand. Most doctors prefer strip rather than learning a new skill but now they have no choice, they have to offer fue in order to stay competitive. Anyway what I am saying is that there’s no point for Dr. Cole to convince other hair transplant doctors, it’s best to educate the patients about the benefits of CID and then other doctors will have no choice but to offer it to their patients.
»
» There is really no incentive for the doctor to use it unless the patients
» demand that the device be used during the surgery. It’s the same with FUE,
» we are seeing more doctors offering fue because it is driven by the demand.
» Most doctors prefer strip rather than learning a new skill but now they
» have no choice, they have to offer fue in order to stay competitive.
» Anyway what I am saying is that there’s no point for Dr. Cole to convince
» other hair transplant doctors, it’s best to educate the patients about the
» benefits of CID and then other doctors will have no choice but to offer it
» to their patients.
You make some great points here, NeverAgain. FUE is a more physically-demanding and time-consuming procedure for physicians, yet I think we are finally seeing more and more surgeons adopt the technique. I imagine that, in a lot of cases, this is attributable more to that demand than a desire to provide the best possible aesthetic outcomes to their patients. I guess, regardless of what drives it, wider adoption of FUE can only be a positive thing for patients. I found out just this morning that even some Bosley locations are offering FUE now.
Thanks for such a candid reply.
I hope more doctors make use of the tool, as well. Unfortunately, most HT docs don’t seem to be interested in improving on their 1990s-level skill set and technology (with those frequently mentioned on this site being the exception. I hope these higher quality doctors will give the tool a look!).
» I found out just this morning that
» even some Bosley locations are offering FUE now.
Holy cow! That’s like saying you heard that someone saw the devil in church!! (As a former Bosley patient, can you tell I wasn’t happy with their work? lol!)
» »
» » There is really no incentive for the doctor to use it unless the
» patients
» » demand that the device be used during the surgery. It’s the same with
» FUE,
» » we are seeing more doctors offering fue because it is driven by the
» demand.
» » Most doctors prefer strip rather than learning a new skill but now they
» » have no choice, they have to offer fue in order to stay competitive.
» » Anyway what I am saying is that there’s no point for Dr. Cole to
» convince
» » other hair transplant doctors, it’s best to educate the patients about
» the
» » benefits of CID and then other doctors will have no choice but to offer
» it
» » to their patients.
»
» You make some great points here, NeverAgain. FUE is a more
» physically-demanding and time-consuming procedure for physicians, yet I
» think we are finally seeing more and more surgeons adopt the technique. I
» imagine that, in a lot of cases, this is attributable more to that demand
» than a desire to provide the best possible aesthetic outcomes to their
» patients. I guess, regardless of what drives it, wider adoption of FUE can
» only be a positive thing for patients. I found out just this morning that
» even some Bosley locations are offering FUE now.
What is CID
» What is CID
Counting Incision Device (CID): an automated disposable tool which allows the physician to accurately maintain the incision count during recipient site preparation.
» » What is CID
»
» Counting Incision Device (CID): an automated disposable tool which allows
» the physician to accurately maintain the incision count during recipient
» site preparation.
Also watch this video:
click PLAY button in the media player below to watch the video
1_file60.flv
Dr. Cole is a sponsoring physician of HairSite
There are many people with a limited donor area who have a big bald area to cover (nw5-nw 6-nw7). Other had a bad bht and need repair.For them the only solution is a combination of fue scalp and bht.It is true that body hair has different characteristics and less survivor percentage from scalp hair so this is the reason many would not suggested bht.But for those with limited donor and a bad ht, bht is the only hope to camouflage a head with dispersed plugs and although the hair will be from body the result will be more natural.
In all over the world(Australia,Los Angeles,India,Turkey,Cyprus,
Belgium…)there are a lot of clinics who use bht because they intent to gain customers from the two categories i said above.
However it is very difficult for someone to pay 40000$ to have 6000 body grafts(with an uncertain survivor percentage) because the result may be dissapointing.It would be much easier if he had to pay half or less.This the reason most people (from the categories above) reconciled with their problem,shave their heads and dont proceed with a (b)ht
I think that Dr Cole now has a big opportunity.With his new Fue/cit extractor and the ability of extracting 2000 grafts in an hour can low the prices only in bht and become the first option for someone who needs a repair or is a big nw
it used to be a time when Cole used to post just as many before and after patient photos as Armani does now. what happened to that? a lot of the photos on the site are the same ones i’ve seen for the past several years. seems they’re only brought up every blue moon on the site now and other hairsites barely mentioned. reason??? anybody??
No Comparison, Dr Fellers tool is way better.
I am willing to bet sparky is a paid poster for one of the doctors.
» No Comparison, Dr Fellers tool is way better.
»
How much would you like to bet, i’ll put my house on the line and thats worth £350,000, willing to bet?