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FUE by SAFE Technique. an expose\' (0.75mm)... Hairtech


#1

Today we are performing FUE by SAFE method. I am going to start from the time we set up the OR and am already photograghing everything we do in terms of equipment/tools/procedures and will all day show everyone how FUE is performed in this clinic.

As soon as I get a break, the pictures will flow all day long. Everything will be here for any prospective patient/curious clinician/ or physician to see. No secrets of tools or procedures. I will also take a video to be seen publically on U-TUBE.

Packaged instruments before surgery


#2

Remember the inside diameter is 0.75mm. A standard punch now used in FUE.


#3

The blunt SAFE punch. SAFE = Surgically Advanced Follicular Extraction.


#4

These next instruments are the technician extractors. It is a common instrument that has a screw to limit the clamping abilities as not to smash or crush a graft.


#5

Here comes a mass of pictures. Sorry guys/gals. This is the anaestesia tray.

The all important FUE tray.

Let’s go over the instumentation. Ahem…

From left to right on bottom: a pair of scissors, a regular hemostat clamp, a petri dish, a standarm biopsy 1.0mm punch, 2 extraction forceps, a 0.75mm punch, and the SAFE blunt punch. Across the top is gauze, some epinephrine/lidocaine mix in a syringe to help control bleeding, some tape, and a bowl.

Well, that completes our FUE tray.


#6

Our holding solution. Plasmalyte A.

This is our cutting board. These and various graft cutting boards (translucent/solid/etc.) can be bought at Ellis instruments and Med-Equip as well as at trade shows)

This is our typical FUE station setup.

Notice the graft count sheet on the right. Every graft is microscoped for its viability as well as documentation of the types of grafts, i.e. 1,2,3,4’s.

Dr. Harris beginning to mark the areas for us to begin anaestesia.


#7

Dr. Harris is trimming the area that we are going to extract the grafts from. Notice that the patient is in a prone position and also notice the critical optics that in needed in this procedure.

I have to go back to place grafts but I will return back to the order. I had to release this one picture to prove to the world that 4 haired grafts can in fact be taken with a 0.75mm punch. More to come soon…


#8

I am so sorry… I just had to get this one out. Groups of 2’3, 3’s, and 4’s…and a freakon 5 haired graft from a 0.75mm punch. Look at these beautiful grafts. All taken quickly by Dr. Harris’s SAFE FUE technique and staff.

The SAFE technique uses a two step process. Some may argue that “two” steps waste time, however consider this. The field is always clean with minimal bleeding. Why? Because of the size of the punch. This alone already decreases the time in half of extracting the grafts. No mess to have to deal with. Just get into a rhythm of scoring, and punching. Here let me illustrate.

Here is Dr. Harris and Tina extracting grafts.

Here is how we segregate the grafts

This shows the length of a freshly extracted graft.

More scoring…

More blunt punching


#9

This is how we calculate our grafts. This count was very early in the case.

Here are two friendly techs Tina and Vanessa counting and verifying the viability of each and every graft. Not pictured is hairtech.

Here is the donor region just after the procedure. Friday he will come back in to get his first hair wash and full instructions for care of his grafts.

And that about does it for the expose’. I hope this shows what one office has to offer in this world of FUE. There are other great doctors out there that do great work. We just wanted to show everyone that we open our doors fully for anyone to ask questions and to see exactly what instruments we use, the manner in which we use them, and most importantly the quality that we can produce. No secrets. That is the best and safest route for the prospective patient.

I am not pictured here but if interested, I have a dumb myspace page at http://www.myspace.com/thomasortiz


#10

I will post more pictures tomorrow depicting placing and site production. I apologize for not putting that yet but I gotta get some sleep. :smiley: :smiley: :smiley:


#11

Two questions:

1)The hairs of this patient are completely straight. That means it is safe indeed to use small punch. But what about wave/curly hair that have significant angulation and spreading under the surface? The smaller punch leave no margin at all. Any comment?

2)Why is this patient not shaved to distribute the donor grafting all around for even harvesting? It seems that a “strip” like extraction is used that would leave a linear “absence of hair” gaps in one line. Isnt it better to spread the extractions evenly at the back?


#12

Why does it say 0.8 and 1.0 on the label? I thought it was 0.75


#13

First of all let me say Im impressed.

Question,

The doctor seemed to be holding existing hair back while extracting FUE’s with some kind of ‘paper’. Does this practice not make one shave the donor area to get FUE?

Im one of those people with one pre-existing scar, that I would have to have to walk around with for the whole world to see at my unfortunately very gossipy job. Ive always dreaded this if I ever decided to do an FUE, if I didn’t get that scar filled in first, wait until it grew out, and then did the traditional shave the donor-FUE later.


#14

The o.8mm is the outside diameter… The 0.75mm is the inside diameter of the punch. It is critical to know the the the inside diameter is able to encompass sizes of grafts that was once thought not too. Dr. Harris is looking for a micron measurement so I can post this type of measurement.

The questiona bout the shaving. It takes a wee bit longer to perform the no-shaven FUE. The longer the hair the better so we can shave in layers or patches if you will. Today, the patient is coming back in for his first wash and I will take photos of what I am talking about. It is 6:00AM Mountain time so there will be a few hours of lag. Thanks for the questions and ask away.:smiley:


#15

No hair prayer,

Question 1. In all FUE kinky or curly hair are especially good to be taken by the SAFE technique. This is because the curly hair will have almost no chance to be transected by the SAFE punch. It will slide up into the shaft. of the punch unharmed.

Question 2. The number of grafts that were taken were minimal, and strategically mapped out in a way so that:

  1. The patient did not have to fully shave the head.
  2. The patient could go back to work.
  3. there will be an un-noticeable drop in drop in density in any one area.

The layer shave method of doing FUE while slightly cumbersome for the staff, is standard practice in many clinics.

keep the questions coming.:slight_smile:


#16

Ok here comes the next series of pictures…

First before site production, we have to have a plan of action in terms of where we need to strategically place groups of hairs, singles, larger groups… This plan is discussed with the patient and then after Dr. Harris makes his completes site production he lays it out on this board.

Next I want to show you how we custom cut our blades. Custom cutting of blade for making sites for where the graft is going back into the scalp is very common among most all private HT clinics. I noticed that at Bosley and at MHR, they typically used SP 90 and SP 91. Which means “the sharp point”.

We cut our blades and then we have them organized as to which ones we might use.

We cut our blades and then we have them organized as to which ones we might use.

Then Dr. Harris measures large and small grafts to see what depth he will use. We measure several grafts from several technicians during our FUT procedures because not all technicians can cut exactly the same size of graft.

MY NEXT SERIES OF PICTURES FOR A FUTURE THREAD WILL IN FACT ENTAIL THE FUT PROCEDURE.


#17

It is time for the patient to get a shot. Ouch… Typically, clinics want some type of corticosteroid on board to help combat potential post operative swelling. Some clinics give PO (by mouth) medications. We give a corticosteroid that will last a little longer via intramuscularly. However, the Depo-medrol here is mixed with 2% lidocaine to ease the pain.


#18

Let’s make sites. Dr. Harris is producing sites… And he has a system of counting on his own to keep up with site counts. Lord knows I cannot count too well!


#19

» The o.8mm is the outside diameter… The 0.75mm is the inside diameter of
» the punch. It is critical to know the the the inside diameter is able to
» encompass sizes of grafts that was once thought not too. Dr. Harris is
» looking for a micron measurement so I can post this type of measurement.

What about the 1.0? It can’t also be .75, can it?


#20

Before I continue with this post, I need to throw this picture in. We are performing a case on a woman today that has all white hair. The reason for the interest is depicted in the picture below. Notice, the cutting board and surface. Also notice the friendly tech Danaery. She is counting and preparing grafts.

Anyway, cutting grafts of a person who has white hair can be somewhat dangerous if the correct equipment is not utilized. Translucent materials are needed to overcome this limitation. At our clinic we employ an old and new technology. The light board is an old technology. I have seen this technology used at various clinics… When people see it, some might say, “That’s old.” But not here. Further look at the board. We use a very thin bendable translucent disposable polymer. There are other board devices that are thicker and similar however there is a risk of chipping of other types of boards. These are time-tested and disposable.