Trish
But so tell us, first of all, what is the Neograft Hair Restoration System? Can you give us like a little brief snapshot of what it is?

Dr. Zacharia
Sure. Well, I think you need to understand what type of hair transplants are available. And there’s two types: there’s FUT, which is follicular unit transplantation. And FUE which is follicular unit extraction, the if you see is one where they took the strip from behind the ear of the ear from one side of the ear to the other. And they take a strip of hair and then divide all the hair follicles so that they can be implanted. The FUE is a specialised technique where you take individual hair follicles so there’s no strip, you don’t have to make big cuts. And Neograft is a specialised machine and technique where it’s a much faster, less complicated system to actually take those hair follicles.

Trish
Okay, so basically, what happens is you take out the hair follicles from one place like you extract them, and then you transplant them in another place on the head, or wherever I guess..

Dr. Zacharia
That’s exactly right. So most of our patients are male, but also female. And the classic areas that that the males come in and see us are that that full lock of the the front of the hairline, the balding that area or the crown of the head, the ladies tend to come in with the loss of hair where the hair is pulled back, like the ponytail type of lift. And I don’t know whether you’ve seen it. But some girls do a brow lift by pulling their hair back so tightly that they can lose their hair in that area. So what we do is we take hair from the back of the head, which seems to be an area that is not affected by balding, and then reposition those hair follicles or the grafts into the front of the head into the boarding area.

Trish
So like even in the old days, the things that I’ve seen is where they actually cut out a whole strip of skin and put that skin somewhere. So it’s not like that is it, it’s actually just a hair of time.

Dr. Zacharia
Or when you look at some of the old day type images, it was crazy, they used to put balloons in the hair that under the bald patch and stretch up that skin, cut that skin out and then move the hair bearing skin closer together. And so there’d be scars on the head and all sorts of things like that. So that was that was the initial hair transplant type of procedure that was done. So now the beauty about the neograft is that there are no scars, you just take small little grafts from the back of the head and reposition those into the front of the head or wherever the bald patches you can do that into bald patches into scars, you know post surgical scars, that type of thing as well.

Trish
So that because I have seen a lot of women with In fact, this happened to me a while ago with a front of your hair, whether it’s from stress or whatever, I think it was my first husband that caused it but you know what the front of your head kind of just gets really thin and I was absolutely freaking out and as far as I was concerned there was nothing you could do about it, but I’m looking at some before and after pictures, and I’m blown away by this one particular woman who has had the Neograft done on the front of her head where she was like, you know, like just like a balding man. And now she’s got a full kind of mane of hair then. So that actually is possible.

Dr. Zacharia
Oh, yeah, it is possible. That we see a lot of these types of patients. And it’s interesting both, it’s usually the front of the head, you know, the front hairline. That is where the balding occurs, both in men and women and with that receding hairline. And interestingly, that their hair where we actually take the graft from at the back of the head doesn’t seem to be affected in the same way. So that when we take the hair from the back of the head, you can actually almost be assured that that’s going to survive and grow and flourish where you transplanted to.

Trish
Right… And certainly, so. And I guess it would depend on how many hairs you take, because it has to be a certain number of hairs, but it would depend on the balding. I guess that is the right average, like someone who wants to fill in those two bits of the front going a bit on top, like, Is it like coming in 10s of thousands of hairs? Or what kind of work? Do you do them? By the thousand? Or like, what the numbers like?

Dr. Zacharia
Yeah, that’s, that’s a good point. So for the say, the receding hairline, that of a man that hasn’t, we often see young young chaps coming in and having this done. So for the receding hairline, either side of the forehead, you probably put about a thousand grafts. And then if you’re going to do the receding hairline, the front of the hairline and also say the crown of the head, you probably need between 2000 and 3000 grafts. So what happens is we take an individual graft with the Neograft. And in that graft, there’s maybe anywhere between one and five hairs. So it’s not just the number of hairs that are taken. So we’ll take, say a thousand grafts, but there may be two and a half 3000 hairs in those thousand grafts. Because not every graft has just one follicle, some of them may have two or three follicles in it.

Trish
Got it! got it. And, like tell me if I’m right or wrong, certainly, this is actually a one treatment thing because like it could be one or like you can get away with one treatment depending on the habit, but sometimes it’s just a treatment to treatment thing. So like you come in, you have your treatment, like how a lot also you have your you have the hairs grafted. And then do you put them in at the same time? Or do you have to come back another day? like is that a one…

Dr. Zacharia
It is one night, it’s all done at the same time. And that’s one of the things about the near graft that makes it a faster process. It’s quite, you know, intensive, because you have to take the hair follicle, take the graft and then reposition it into the front of the head or wherever you’re putting it all in the same process. Because once you remove the graft from the scalp, there’s a period of time that it lasts and you can’t freeze it, you can’t save it, you’ve just got to re implant it. So it ends up being quite an intensive process. The new graft machine makes it a little bit faster because it has a very low level suction device that allows each graft to be sucked into a canister. And then whilst I’m taking the actual grafts, we empty the canister and one of the technicians will then sort the hairs out into one hair, grass, two hair, grass, three hair grass, that type of thing, sorts them out. And then once we’ve taken enough of the follicles, then we can start repositioning them. The good thing about the Neograft machine is it has a counter on it. So let’s say we predict that we are going to need a thousand grafts or 2000 grafts, then the machine actually counts up for you. So when you get to a thousand you can either stop there or go through a few more. And then by that stage once you’ve actually taken all the graphs, the assistant or the technician will have separated them all into one hair, two hair, three hairs, etc. And then you actually start the transplantation process. So usually we give the patient a bit of a break. So you spend a couple of hours taking all those grafts and give the patient a bit of a break, they can have a bite to eat and a drink and then we start the process of the transplantations. straight after.

Trish
Oh, wow. So basically, you can have all this done in a day. And..

Dr. Zacharia
Oh, yeah, absolutely. That you the usual time it takes is anywhere between between four and eight hours, just depending on how many grafts if you’re really going for it with 3000 grafts, you know, it may take a whole day.

Trish
Wow. Okay, so, so say, I have come and I have my grafts, however, however many I need, and then are first of all, what about pain? Like, does it hurt? Like, what do you give me for, you know? Like, like high pain? Is it local? Or is it general? Or is it like just..

Dr. Zacharia
No, it’s, it’s all done under local anaesthesia. So you come into the office, it’s just done in the normal office, you don’t have to go to a hospital where anything. So you come into the office, you, we give you a bit of valium, and if you wanted, some of the patients don’t even take valium, we shaved the back of the head where we are actually going to take the grafts from, and then we inject some local anaesthetic into that area. So you know, the local anaesthetic, you feel a bit of a sting here and there. But it’s, it’s really not that bad. It’s once you feel the first little sting, then it starts to numb up and you really don’t feel much at all. So once the local anaesthetic is in, you basically don’t kill anything, there’s probably more discomfort from lying in the same position, then having the actual grafts removed. Then, and of course, if you’re feeling uncomfortable, patients can say I’m feeling a bit uncomfortable, do you mind if I move and of course they can move. So that’s the beauty about doing it. And we try to entertain patients with an iPad or something like that with Netflix on there. Or if they’re sitting up, we can get them watching TV as well. like going to the dentist.

Trish
watch an episode of Real Housewives of whatever while I was getting down.

Dr. Zacharia
But yeah, but in that case, you probably have to have earphones in because it could distract us during the process. Yes, of course. Real Housewives. That is…

Trish
Yeah, of course. So all right, so I come and it takes, say four hours to have what I want. And then I go home. What happens after that? Like, is there any? Like, obviously, if my head’s a bit shaved? I’m gonna have to wait a couple of days for that hair to grow out? Yeah, look, if I wasn’t it, for me, I’ve got short hair doesn’t matter, I wouldn’t care. But..

Dr. Zacharia
I say get people, people really worried about what they’re going to look like afterwards. Immediately afterwards, I must say that the area that we take the hair from, you can hardly see the follicles where we’ve actually removed them from, because they’re just there between point eight, a millimetre and 1.25 of a millimetre there. So it’s very, very small the area we take it from, so you don’t see much happen there. And after a couple of days, it heals completely. And that’s that part where we actually place the grafts at the front of the head or wherever it is. And you’ll see a little bit of dried blood there for a period of time. But we don’t have to shave the head. You only shave the back of it. The hair where we actually remove the follicles from some people elect to go, you know, completely shaved. And so you go completely shaved, and then everything grows slowly back together. But you don’t need to shave the whole head. It’s just that area where we take the grafts on.

Trish
Yeah, right. And like this might sound like a really dumb question. But, can any of those grafts die like because obviously, you pull the hair out of the follicle. And you’re putting in, you’re creating a new follicle you’re putting in when all follicle was like..

Dr. Zacharia
Yeah, so each graft has anywhere between one and three or five hairs in it. So 1,2,3 or five follicles within it. So each graft, it’s important that when we take the grass, then you don’t transect them. So you don’t want to cut the follicles in half so that you’re not just inserting a hair, you need to insert the follicle. And that’s the growing and growing point of the hair. So some of those grafts can die, either because one they’ve been out of the body too long or two, they’ve been transected. The good thing about the Neograft is it’s such a nice technique that the transection rate is very, very low. It’s probably about 5%, which you know very low. So if you need a thousand grafts, you may take 1100 because you know you may transect a few of those graphs. So when you transect live grafts that go into the front of the head, we always reassure the patient that not to get too shocked, because what happens is they all drop out or most of them drop out. And you look like none of the grafts have survived. But what happens is that the actual hair drops out of the follicles survive, and, and then it starts growing back at about three months. So you know, if you do it correctly, and I’d like to say that you get 100% taken, but some of those hair follicles are just not going to survive, and you probably get a 95% survival rate of the actual grafts that had been transplanted.

Trish
Right. So if you, so basically, you could kind of take a week off of work, or you wouldn’t need to take a week off of work, like have it done on a Thursday and go back to work on the Monday. And..

Dr. Zacharia
Yeah, well, let me tell you a little secret, which I will, you know, share with the whole world. But my son had this done. And he was one of the first patients that we actually did the Neograft on. And he’s a personal trainer, we did him on a Saturday or Sunday, I think Sunday. On the Monday he was back at work, doing his training with his clients not doing anything too active. We said just you know, you can stand there, you can talk to the clients and you know, show them how to do things, but don’t lift heavy weights or anything. So he was back at work the next day, day three, he had a bit of swelling and puffiness around his eyes. But that didn’t actually stop him. And he was able to wear a cap on his head. And so that hid the area where the grafts were inserted into. And the beauty about the FUE, and the Neograft technique is that the back of his head, you just didn’t even know that he had had anything done because he wears his hair very short. And so you know, taking it, shaving it back a little bit more was just like a normal haircut for him. And you know, a couple little spots of redway and had the grafts taken but really he was back the next day and, and even yesterday morning, one of the reps that we performed the Neograft on he came to help out with a procedure I did yesterday. He said he was back at work after three days, and he had absolutely not one bit of pain and no swelling at all after the procedure. So yeah, so you know, day two, or three, or anywhere between day one to three can be a little bit stormy, just with some swelling. But once the actual procedure is done, it’s not painful, and very little risk of infection. So it’s a reasonably straightforward recovery.

Trish
As I was going to ask you, like, Is there anything that can go wrong?

Dr. Zacharia
Look, you know, if it’s not done in the correct manner, you can transplant a whole lot of hairs that are, you know, being lifted out of the body too long, and so they may not survive. You can get patients who are technicians who transect a lot of hairs. If it’s not done in a clean manner, clean instruments, you might get infection occurring. Fortunately, you know, in Australia, we’re all pretty high standards with all the procedures that we do. So the complications are pretty minimal, which is good. And I suppose the main complication is how well do the grafts survive? You know, if you’re balding already, and most of the people we see have male pattern baldness and they’re losing hair. So we can’t stop that process of further loss of hair. And we can fix the spots, we lost the hair but all those remaining hairs that are there can potentially be lost. So patients may need to come back and have a second transplant a couple of years later because they’ve lost some of that original hair that was not transplanted hair. And for those reasons, we often will put the patients onto some medications like patient which is finasteride or minoxidil orally as well to try and help survive those remaining hands. So yes, the complications fortunately, are pretty minimal. But one of the one of the things that is important, not so much a complication, but it’s creating the hairline, you’ve got to create a nice natural looking hairline because if you just go and implanted in a willy nilly manner and you’re not understanding of the flow of the hair, you may end up with a straight hairline that not many people actually have it and it just doesn’t look natural. And there’s little nuances like at the front of the hairline, you put grafts with one hair follicle in there only because at the front of the hairline, that’s a little bit wispy. So you don’t want to put grafts with five hair follicles, you just want to put one hair follicle at the very front, and then the large ones behind it. So there’s little little nuances there that you need to know about. And you know, the side of the head, you need to put the hairs in a manner so that the hairs agreement going to grow out to the side rather than growing upwards or to the front or so there’s some nuances like that, which are, I suppose complications, but they’re really technique issues.

Trish
And you know what, I guess it comes back to that thing of like, be careful who you get you like, you want to make sure you go to somewhere in there that’s properly qualified and got the right up to date equipment to do this sort of thing. Hey, and I guess that’s where the Neograft comes into its own?

Dr. Zacharia
Yeah, absolutely. Well, you know, that the Neograft guys have been around in the US for many years. And in fact, I saw the Neograft machine, probably five, six years ago. And then in 2016, I was in LA at a conference. And, and I thought, you know what, I’m going to sign up for this, and they’ve got good training, good preceptorships. And they also have a very important part of a hair transplant team, other technicians, and they’ve got world trained technicians that will help. You know, the whole procedure, so that it’s important to have good training, good equipment. And that’s why I like Neograft just makes the whole process a lot easier.

Trish
Right, and that support as well, because I guess every patient is different and something comes at least you’ve got, you know, people that you can call on that they’ve been through all that stuff before. So they can, you know, assist where it’s needed as well.

Dr. Zacharia
Yeah, exactly. That’s exactly right. And there’s always good support in Australia, and from what I understand the US has excellent support with the company. Yeah,

Trish
Yeah. And I want to ask for things. Like, I know that I’ve kept talking for too long. But I heard on the weekend that you can even do other parts of the body, like say, for example, like, I grew up in the 70s, where we plucked out eyebrows to you know, to nothing. And so of course, we’re now getting potatoes into that. But you can do your eyebrows as well. Is that right?

Dr. Zacharia
Yeah, look, it’s becoming very, very common. And it’s, you can do eyebrows, you can do beards. And in fact, you can actually take hair from other parts rather than the head. If someone’s quite balding and needs some hair follicles, you can actually take them from, from the back, from the chest, as donor sides. So you can take grafts from other areas, and then put them into any part of the body. So you can really transplant them anywhere. And it’s interesting, you take a hair and say from the back of the head, which is a different type of hair to the one in the eyebrow, but it somehow takes on the form of the eyebrow hair. So becomes an eyebrow hair, even though it wasn’t originally one like that. So it’s quite interesting and unusual.

Trish
Wow, a lot more than the hair. It should be.

Dr. Zacharia
Exactly, it somehow recognises the position that it’s in and what it should be like.

Trish
Yeah, right. Because it’s so funny, because I just saw a treatment recently. What the heck is that? And it’s called eyebrow laminating. It’s where they actually kind of straighten the eyebrows and it kind of sits them down. So I thought even if you could still do that anyway, you know, if you had to…

Dr. Zacharia
Make it right, yeah, if your body. Yeah, Correct. Correct. You’d really need someone who’s specialised in that technique of doing their eyebrows and I actually don’t do it myself. But the technician that I work with, she does and and she’s got great results and the beard as well.

Trish
Yep, I’ve heard that she’s the bomb. I’ve met her very quickly. And I heard that she’s the bomb. She’s supposed to be amazing.

Dr. Zacharia
Yeah, she is. And fortunately she does a lot of work for me. And we’ve been very close from the very beginning. So when Neograft came here, yeah, she’s very good at what she does, I must say.

Trish
Yep. That’s fantastic. That’s been so so interesting. I recommend probably covering everything that or follows having it done and I’ve got some pretty customers who do want to have it done. So it’s good to ask this, ask that. So it’s really good to get all those things answered. The big thing was about the downtime, you know, like a people going to know so it sounds like you know, it’s not going to be it’s not something like, you know, having a facelift or a nose or it’s right in front of your face people learn, it sounds like people aren’t really gonna know.

Dr. Zacharia
Do you know what they’re not gonna know? But it’s interesting because it’s a bit like noses nowadays. And once upon a time when I was doing a rhinoplasty, and even facelift surgery, which I do, once upon a time, people would say are, you know, I don’t want anyone to know and you know how long or there’s downtime. And now, my patients are putting their posts onto my Instagram page and saying, This is made- one day post surgery, post surgery, day five post surgery, and they’re given the whole story to the world. Same with hair as well, a lot of people saying, you know, I’ve had a hair transplant, and this is what I’m expecting. And so a lot of people are hiding from, from showing others what they’ve done. So it’s an interesting world nowadays. But for those who are a little bit hesitant to tell the world that they had something done with a hair transplant a couple of days, you can go back to normal activities.

Trish
Yeah, yeah, a couple of days. Beautiful.

Dr. Zacharia
A couple of days, not many people will remember that Trish.

Trish
That’s true, I’m showing my age now! That’s awesome. Look, I gotta say, thank you so much that it’s been so so interesting.

Dr. Zacharia
No problem at all. It’s been a pleasure talking to you. And if anyone needs any information, feel free to contact my office, and we can provide them with more information about Neograft.

Trish
Absolutely. So guys, if you’ve got any questions, or if you want to know anything else, you can check it out on their website, just Google it, it will come up. Dr. Zacharias’ page will come up as well. If you want to give them a call, you can give them a call in Sydney on 9192 1600 or email at office@drzacharia.com.au. And if you want to email us, because you can’t remember any of that, you can just send us an email to info@plasticsurgeryhub.com.au and I’ll pass you on. So thank you so much for joining us today Dr. Zacharia.

Dr. Zacharia
It’s been a pleasure, no problem Trish. See you later.

Trish
Thank you. Bye.

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