Combined 40+ Years Experience in Hair Restoration.
Our surgeons are among the pioneers of follicular unit transplantation and more importantly, they are experts at creating dense, natural hairlines in a single procedure. We are particularly interested in providing the most undetectable hairline results and have written and lectured extensively regarding this based on our 40+ years of experience
Follicular Unit Transplantation (FUT).
The technique that we employ is referred to as follicular unit transplantation which provides extraordinary naturalness. We isolate the naturally occurring hair groupings (hair grows in units of 1, 2, 3 or 4 hairs) from the donor area on the back and sides of the head using several different harvesting methods as explained below. Using an artistic sense, small slits are created in the correct angle, direction, and arrangement into which the hairs are inserted to grow permanently and naturally.
The procedure takes several hours depending on the number of grafts being transplanted. For a 2000 graft case the average time is about 7 hours. Patients are given local anesthesia (like a dentist uses) and an oral sedative and can watch movies/TV/ iPhone/iPad. Anesthetizing the areas is the only part of the session that causes mild discomfort and we minimize this with proprietary acupressure techniques and, if the patient chooses, nitrous oxide (laughing gas). The following day, the patient returns to have the areas checked and shampooed. After the procedure, patients have crusting and mild redness in the recipient area that can last 7-10 days and it is normal for the transplanted hairs to “fall out” in the first few weeks. The hairs then recycle and begin growing in about three to four months. The results are often not visible for six months with final results evident at 12 months. The results are permanent.
Individualized Care & Planning.
Generally, in a single procedure, sufficient follicles can be isolated to densley cover either the front half or the back half of the scalp. The number of grafts which should be transplanted at one session depends on the characteristics of each individual case and will be planned out in advance for each patient.. There are 4 different techniques to obtain the donor follicles:
- The Strip Procedure
- Hybrid FUE ™
- Manual FUE
- No-shave FUE
Strip Procedure.
The strip procedure is an extremely practical technique as patients do not need to shave their entire donor area and a large number of grafts can be obtained in a short period of time. Many hair restoration surgeons no longer offer this method due the fact that they cannot provide cosmetically acceptable donor scars. With elegant surgical technique and a special closure method termed the trichophytic closure our results consistently achieve a virtually undetectable donor scar with hair growing through it.
After locally anesthetizing the donor area, a a narrow “strip” of hair bearing skin is removed and immediately closed with the trichophytic closure which allows hairs to grow through the scar to minimize its appearance. . The “strip” is then divided under microscopes into small follicular units containing 1-4 hairs which are then re-implanted into the balding or thinning area. Immediately after the procedure, the donor area is covered by the hair above it and is therefore undetectable.
Hybrid FUE ™
The main advantage of the FUE method is that it allows the patient to wear their hair at a very short length without evidence that a procedure has been done.
Our surgeons have developed a novel technique, termed, Hybrid FUE™ which combines the advantages of ARTAS robotic hair restoration with the benefits of manual FUE performed with handheld instruments. For Hybrid FUE™ the patient needs to shave the entire donor area.
The ARTAS robot utilizes state-of–the-art digital optics and laser guided precision robotics to harvest individual donor follicles and Miami Hair Institute is #1 in the world in robotic procedures performed. Despite our expertise in robotic hair restoration, we are also known for our proficiency in using the most advanced manual FUE instruments, and we combine these skills to enhance the results of our FUE cases
Hybrid FUE™ provides superior blending of the donor area, resulting in less visibility of the procedure with extremely short haircuts. Hybrid FUE™ also increases the number of follicles that can be harvested with robotics alone, and facilitates the harvesting in patients with previous strip scars.
Manual FUE
Significant advances have been made in the ability of manual FUE devices to combine several movements such as rotation, oscillation, and vibration to facilitate the successful removal of donor follicles. Our clinic utilizes the Ugraft Zeus, Trivellini, and WAW systems to perform our purely manual FUE cases. With manual FUE, it is important to consider who will be extracting the follicles from the donor area as in the State of Florida, the Board of Medicine’s declaratory statement only permits licensed and insured medical personnel such as physicians, physician-assistants, or nurse practitioners to do so. Medical assistants or hair transplant technicians are not permitted to perform donor harvesting. As with Hybrid FUE™, manual FUE typically requires complete shaving of the donor area.
No-Shave FUE
With the other two methods of FUE, Hybrid FUE™ or manual FUE, the donor area is completely shaven which is perfectly designed for individuals who normally wear a short or “fade” haircut.
For those patients who generally wear a longer hair style or prefer to not shave their donor area, we perform a revolutionary procedure termed No-Shave FUE.
The No Shave FUE technique is performed by a unique manual FUE devices that has the ability to extract individual follicular units containing long unshaven hairs.
The donor area is undetectable from the moment you leave the office, and allows patients the best of both worlds; they can still reap the benefits of FUE yet remain discreet without shaving and return to normal activities immediately.
Dr. Nusbaum demonstrated the technique to other surgeons at an international conference.
Strip Harvesting vs. FUE
Patients often ask about the difference between strip harvesting and FUE Here is some information that may help clarify these approaches.
Strip:
- Able to harvest a larger number of grafts in a shorter time.
- No need to completely shave the donor area.
- Multiple sessions can often be performed using the same scar.
- Results in a fine linear scar. With the trichophytic closure the scar may be extremely difficult to see however you are limited as to how short you can wear your hair.
FUE:
- No Linear scar.
- The patient will be able to wear his hair much shorter than with a strip harvest.
- The donor area must be completely shaved for Hybrid FUE™ and manual FUE
- Scars that appear as “tiny dots” may be visible if the head is completely shaved
- No-shave FUE requires no shaving as the name implies