Hey Parable Do you remember where Dr Feller gave his opinion on the machine
Thanks

Thank you all for asking some very thoughtful questions. I should make it clear that this tool is only useful as PART of a particular method. I guess we’ll call it the “Feller FUE Method” for descriptive purposes even though I’ve never officially named my particular style of FUE.

This tool is NOT a magic wand that will simply allow the novice to extract like a pro in one day… but this tool, combined with my methods of FUE, is the CLOSEST the FUE industry has come to it yet. It will NOT extract EVERY graft on EVERY person 100% of the time, but it WILL maximize the success/failure ratio as well as final growth yield compared to ANY other method-disclosed or non-disclosed. No question about it.

I will address all your concerns as best I can.

To begin, I’d like to set the record straight about my disclosures over the years.
I solved the problems of Torsion, Traction, and Compression years ago and disclosed it right on this site back in 2003, demonstrated it an Arkansas ISHRS meeting in a live surgery demonstration AND Video in 2003, described it in the leading Text on Hair transplantation published in 2004, and informed dozens of doctors over the years as to my methods.

I have never held that information to myself and never denied the information or the custom tools themselves to any doctor who wanted them. Furthermore, I NEVER sold any of my Feller punches for profit and NEVER billed any doctor to teach them my FUE method.
Because I was positive that my Manual method of performing FUE was solid, I disclosed it openly and transparently-consciously avoiding the “hype” and the “wishful thinking” of those who would frame it as something it wasn’t.

My motorized method was a different animal altogether. I designed, tested and used many different devices, but none of them were reliable enough to offer to other practitioners. I had reached the limit of my personal ability and realized I had to recruit professionals to bring this tool to fruition WITHOUT jumping the gun. Working with a team takes TIME, and I wanted to make sure this device had a real world track record before I offered it publicly. Now, it does.

I instantly understood the problem of using spinning punches on delicate tissue like FUE grafts back in 2003, but it took me time to be able to describe them and then come up with an appropriate solution. What AMAZED me is that no one else in the FUE field was seeking to do the same BEFORE offering their “technology” to the public. Rather than diving in like so many other clinics did, I held back and engaged in methodical experimentation and observation until I was as sure as I could be that I had the most practical and useful solution.

Why are “spinners” bad? Because they whip around at approx 7,000 rounds per minute. That creates A LOT of torsion and A LOT of friction. Friction creates heat- and heat causes injury and desiccation. Think of an “Indian rub burn” and you’ll get the idea.

This tool Oscillates through a very small arc. This means very little torsion force and 75% less friction. Combine this with a Feller punch which was designed to reduce friction in and of itself and you are left with an FUE instrument that produces the least of the two detrimental forces motorized tools inflict on FUE grafts: Merciless Torsion and Searing Heat. Then apply the Perforation technique during delivery of the grafts and you have a method that address all the Manual FUE problems AND the Motorized FUE problems.

Does it work?

Look at all my FUE presentations online from 2004 to the present. All of them have been performed using my particular FUE method with either some aspects or all aspects of the tool. The FUE surgery I did on Spex is only one example that most people online are familiar with. I will be supplying video that demonstrates me and other doctors performing FUE using my method and device.

More to come.

Dr. Feller

Likewise...where is the Neograft thread you're referencing Parable?

In short, the neograft machine is just a spinning punch. But rather than using a simple electric motor, it uses compressed air to spin the punch. Just another way to skin the cat, albeit more unnecessarily complex and expensive.

The neograft also features the use of suction to aid in the extraction process. This suction serves no useful purpose and is indeed a danger to the graft in that it will increase the chances of desiccation due to the continuous airflow over the graft.

But those aren't my biggest objections. The real problem is that this device requires the graft to travel through the punch and down a tube. Many FUE grafts splay out at the deep root, which means the chances of it getting clipped by the sharp edge of the punch is quite high.

The second problem is that as the graft is being desiccated while being sucked through the punch and the tubing, it is also being physically traumatized as it slams against the walls of the tubing as it travels on it's tortuous path toward the collection basin after which the graft has to be picked free of the other debris that travelled with it.

I love inventions generally and everything that has to do with good technology coming out that will make things better for us...

edit:i just understood it is only for extractions it just that it looked a bit like the choi implanter

If not, is it like a drill?you spin the top left and right and the bottom drills?(not very scientific i know but i dont know how else to express it)

Dr. Feller's references to the Neograft machine are on a different Forum.
Out of respect to the moderators on this site I won't name the forum but have a dig around and you'll find it.

Now Dr. Feller, you have a video demonstrating FUE on your website. From what I can gather this is your earlier work that you did on "B'man" correct? (If I am wrong I apologise).
However if this is indeed some of your earlier work then why do you keep that video on your site?
From what I can tell the punch used in the video on your site is an off the shelf 'cheapo' punch?
The one that left white pot mark scarring in B'mans donor area. (Correct me if I am wrong).
Why don't you show or why "haven't" you shown details/videos of your new punch and techniques over the years on your site? (Confusing if you ask me)..
Because now all of a sudden you explain that you have been doing an advance version of FUE (for over 3-5 years) but you choose to keep your old version of an FUE surgery (video) up on your website.
It doesn't make sense!!

Parable,

Why so accusatory? Rather than comment on the tool or ask questions, you attack me in a not so subtle way. Why is this?

If you had read any portion of the posts I've made about FUE over the years you would see that I've described and disclosed the details of my FUE surgery for years. It's even printed in the leading Text on HT published in 2004!

For the uninitiated potential HT patient, that FUE video from 2002 provides more than enough information to gain a visual understanding of the difference between FUE and strip surgery. Weather I show my tool or not makes no difference to the newbie HT researcher. Besides, a green punch looks better on camera than a surgical steel one.

The reason that video is still up on my site is because it is the FIRST video of FUE ever released on the internet. At the time it was very signfiicant because every other doctor claiming to offer FUE REFUSED to publicize HOW they did it. They shrouded their techniques in mystery and used "intellectual propriety" as the reason not to educate the public or their peers. An illegal lapse of disclosure and failure to provide informed consent by the way.

In it's day, that video I produced demystified FUE for thousands of doctors and potential HT patients and I was very proud to post it. I still am even though the green punch used in it was the standard Miltex disposable punch that no doctor should ever use for FUE today (although MANY do). It was the problems with this punch that lead me to design a specialized FUE punch that could do a better job.

The patient in that video is NOT Balloonman, but a man named Alex from White Plains, NY who volunteered to be one of my first FUE patients. I did not charge him a dime for his participation, nor the hundreds of people who volunteered to allow me to perform small FUE cases on them so that I could study the procedure and build my skill level BEFORE offering it to the public for a fee.

There are many things I would like to put on my website, unfortunately, it's a pain to get my website person to make the changes as I would like them,so instead I post regularly on the forums. Many of my tools and innovations have been posted online and discussed in detail. Just because they are not on my website doesn't mean I haven't disclosed them. Just search my name online around 2003-2004 and you will see quite a bit of disclosure of my methods and tools.

The only technology I held back from showing online were my powered tools. That took more time to perfect than my manual tools, and I wanted to make VERY sure that they worked better than manual tools before presenting it. This is in sharp contrast to other clinics that claimed superior new technologies to their potential patients, but had no results to back it up. I would not allow my instrumentation to fall into that catagory and waited until I saw grown out results. Unlike EVERY other FUE instrument presented to the world, THIS one has an acutal track record of SUCCESS. On this very forum is a recent patient-GROWN OUT- on whom I performed TWO FUE procedure with this very tool.

Here is a photo of the Feller Punch that I posted on this site back in 2004. The same technology that went into this unique punch went into the punches used in my new motorized FUE scoring tool.

quote:

Originally posted by Dr. Alan Feller:
Parable,

Why so accusatory? Rather than comment on the tool or ask questions, you attack me in a not so subtle way. Why is this?

Hey i asked on the tool lol.
What is it how it works different than the normal tools?
Why is it different and better?
Is it for making the procedure better and more trustworthy for the best FUE doctors?does it make a difference to them?

or its only for the ones that have no clue and wish to learn?

Sorry Hopeful, most of that last post was in direct response to Parable's post which seemed more interested in impugning my credibility than inquiring about this new instrument. A design I went to great lengths to create, test, and now present to the medical community and the HT community.

In short, this tool makes it FAR easier for the novice doctor to enter the FUE field, AND for the veteran FUE doctor to improve his yields and speed while reducing fatigue.

How does it do it?

The tool is a part of an overall FUE method that also includes something pioneered at Feller Medical known as "perforation" technique.
Combined, the tool and Perforation work by decreasing the three most detrimental forces associated with MANUAL FUE procedures (Torsion, Traction, Compression); as well as decreasing the two most detrimental forces associated with POWERED FUE (Torsion and Heat).

Yes, it will even improve the procedures of the more trustworthy and experienced FUE doctors. Untrustworthy ones too.

The tool is not a magic wand. It will not allow for a 100% success rate with respect to attempted extractions-that's just not a realistic expectation for any instrument, but I'm positive that it will ALWAYS perform better than manual FUE methods.

I, for one, will NEVER go back to manual FUE again.

Let's keep this tool in perspective and not allow it to be hyped into something it's not. But it is safe to say that no matter who performs FUE, if they incorporate this device into their practice they will perform BETTER and FASTER FUE with less fatigue than if they didn't have it.

hmmm it's still somewhat abstract and ambiguous for us laymen to understand the "perforation technique" but i trust you when you said "more to come". plus if a picture speaks thousand words, then a nice practical HD video would be great and i'd say it would speak volume, appx. ~1 million words.

cheers

To me the attributes and advantages of the method and tools are obvious, but perhaps it's harder for non-practitioners to envision.

I will post some video soon that may make it a bit clearer.

Dr. Feller,

With the use of this tool and mutliple techs doing placement is it possible to do the mega FUE sessions we hear about?

How many grafts can you currently do in a day via fue with this tool?

Thanks!
Abe

quote:

Originally posted by Abedogg:
Dr. Feller,

With the use of this tool and mutliple techs doing placement is it possible to do the mega FUE sessions we hear about?

How many grafts can you currently do in a day via fue with this tool?

Thanks!
Abe

Yeah good question abedogg i also thought of that.

Dr.Feller with this tool does your view chage regarding FUE transplants?Do you still feel the best approach is a combination of strip and FUE or now FUE can stand on its own on large balding areas?

Would you trust to completely convert your practice to all FUE?

All HT clinics use multiple techs to do placement of grafts.

I think you meant to ask can multiple techs do EXTRACTIONS during FUE to speed up the process and increase the overall graft count.

Only licensed doctors can use a cutting instrument like this one. So when it comes to the first step of FUE-scoring around the graft- NO, multiple technicians cannot do it. Not even one.

As for delivering the grafts after the scoring has been performed, the answer is really no. There really should not be more than one tech on the scalp for the delivery process because two techs would get in each others way and cause small disruptive motions to each other. Because my method utilizes Perforation, two hands are required to remove the graft from the skin and therefore takes up more space.

I invited Dr. Thomas Law to join me for an FUE procedure on one of my patients last week. We extracted 1,000 grafts in just under 3 hours, which also included refining them under the microscope. We could have kept going and probably done up to 1,500 graft leisurly, but the patient only needed a thousand grafts. I could have performed 1,500 grafts manually, but I would have been very fatigued toward the last 500 grafts and quality would have suffered. With the new instrument it was a piece of cake. No fatigue at all and the case wrapped up 4.5 hours after it began- from in the door to out the door.

So it sounds like in a long 9 to 12 hour day you could place 3000 grafts via FUE?

Abe

Dr. Feller,

In the past you have spoken about the scar tissue left behind in the donor area by FUE, and that this was not to be underestimated, that it would impact future extractions and yield.

Are you now advocating full-scale adoption of FUE, or are you providing guidelines for where FUE is indicated? My understanding is that this is an adjunct to strip and will never achieve the same yield or graft count.

If this tool streamines and simplifies FUE, I expect we will see a shift towards FUE out of convenience and profitability (have already seen one clinic attempt this and fail), which ultimately will be bad for the majority of patients. Please explain your position.

The Emperor

My position has not changed in 7 years. To me, FUE should be viewed as either an ADJUNCT to good strip surgery, OR a viable alternative to those patients who are absolutely dead-set AGAINST strip procedures.

I highly doubt anyone will shift toward FUE out of convenience as strip surgeries are just so easy to perform by comparison, but I should hope with all my heart and soul that many doctors become motivated to include FUE in their practice for the sake of profitability. How else could they sustain their business and earn a living? Not everyone can expect a multi-trillion dollar bailout-that seems to be reserved for the cheaters and losers.

There are definitely clinics that have tried FUE and failed-but still perform it anyway. Thankfully, it doesn't take long to find out who they are IF the public does some research on forums like this one.

Abedogg,

Tehcnically speaking, yes, 3000 grafts could be obtained in one day. There are even clinics doing that now, but as you may know, final results have been sketchy and inconsistent at best. Why?

The first reason is probably that the grafts are being damaged by the instruments being used.

The second is that as a 12 hour day wears on, fatigue sets in on the part of the doctor and team and quality naturally drops.

The third, but not least important, is that the grafts should go back into the head as soon as possible. In my clinic I rarely allow the grafts to sit out of the body more than 5 hours MAXIMUM. Keeping them out for twice as long could be detrimental to final yield.

So I would discourage 3,000 graft per day FUE procedures. If a patient is dead-set against Strip surgery AND is informed and accepts that FUE surgery has a higher chance of producing lower yields, then I would do that patient over two days instead of one.

The only thing that worries me is that these instruments get in the wrong hands.
We could very well see new places pop up all over the place offering fue with incompetent doctors.
That could potentially be a disaster with them offering scarless /painless surgeries.
I can already see it happening.
So although a blessing it could be a curse for the uninformed .
I really like your invention though.
Very impressed and thats hard to do to me unless she can tie a cherry stem with her tongue
and put both legs behind her back

quote:

unless she can tie a cherry stem with her tongue
and put both legs behind her back

Indeed!

I am sure the Doc wouldn't be selling it willy nilly as the purpose is to improve the industry via this tool, but good point. Many banditos i am sure will undoubtedly advertise that they use this new tool though