Dr. James Vogel Discusses his Follicular Unit Extraction (FUE) Hair Transplant Surgery Philosophy

Due to its less invasive nature and modern approach, Follicular Unit Extraction (FUE) hair transplant surgery continues increasing in popularity. As patients continue requesting FUE procedures in large numbers, hair restoration physicians have begun explaining their FUE philosophy and describing how they practice the procedure.

Recently, Coalition hair transplant surgeon Dr. James Vogel decided to take part in this ongoing trend and shared his Follicular Unit Extraction philosophy with our hair restoration community. According to Dr. Vogel:

I have been  performing FUE donor harvest technique for the past three and a half years.  My  philosophy has been never to be the first on the block to try new techniques on my patients; however when a new technique or procedure is proven safe and effective I embrace all new technology in a comprehensive manner.  The development and refinement of FUE is a perfect example. 

My  approach to FUE donor harvest is identical to the way I  manage all aspects of the transplant.  I am  extremely “hands on” and  intimately involved with every aspect of the procedure.  I have  tried numerous methods for FUE harvesting over the past several years. The current FUE device I  prefers to use is the Alpha Graft Unit. This is a simple FUE device that offers easy angulation and  adjustment to enable alignment with the  plane of the follicular unit as they exit the scalp.  Tumescent saline is used in the donor scalp to “straighten” the follicular units to maximize extraction and minimize transection of grafts.  Click here to see a video of my FUE extraction. 

I  exclusively use a 0.8mm extraction punch.  The benefits of this size punch are minimal to no detectable scarring and also the ability to more safely and densely harvest without visual depletion of donor density. When possible I like to use  a stealth technique of shaving.  This is an isolation of the area for FUE harvest below a layer of hair that will comb directly over the area to hide the open harvest region.  Even though the immediately extracted  grafts are “good enough” for immediate planting, each graft is evaluated microscopically and any excess scalp or hair shaft debris is meticulously dissected away so that only the perfect follicular unit is grafted.  

Here are some examples of my FUE work: 

1. 2700 FUE grafts in two sessions (from left to right: “before” front, “after” front, “before” side, “after” side):

2. Immediate appearance post 0.8mm FUE harvesting with stealth technique; and same area two weeks later:

3. 2000 FUE grafts in one session (from left to right: before front, after front, before side, after side):

4. Here is the Alpha Graft Unit FUE extraction tool:

We would like to thank Dr. Vogel for sharing his FUE philosophy, and encourage him to continue performing state-of-the-art Follicular Unit Extraction!

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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning

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