Dr Lisa Friederich Shares All Things Hair Transplants

To celebrate Venus Concept’s recent launch of Neograft for hair transplantation, SPA+CLINIC chats with renowned Plastic Surgeon Dr Lisa Friederich; Sydney-based physician and lover of Venus’ latest device to launch in Australia.

When did you first realise your dream of becoming a plastic surgeon?

I was first drawn to plastic surgery in my fourth year of medical school during a surgical specialties rotation. This was well before the rise of the internet and social media, and as medical students we really hadn’t had any exposure to what plastic surgeons actually did, nor the scope and complexity of the case load. It was incredibly interesting and creative, and unlike any of the other surgical specialties. As I had always been artistic I was hooked – cosmetic surgery is the extreme of this, where attention to detail and an aesthetic eye are essential.

Do you see your field as a predominantly male-dominated space? Are there any challenges associated with that?

 In regards to Plastic Surgery? Absolutely. There are a lot of challenges that come with this, as any professional woman will have experienced. I personally found it affected me more in training, with different standards for male vs female trainees, and females being judged more harshly for being assertive. Another challenge is the public perception. It is changing, but often people aren’t even aware they view us differently. A lot of women do deliberately seek out male surgeons, particularly the younger female group, perhaps thinking that men are better judges of what is attractive. I think women are actually better at this, and we also are very practical about the advice we can offer. 

 What made you decide to operate your own clinic?

I think we all want our own space, much like the Aussie dream of owning your own home. It gives you control, the ability to work on your own terms, and provides freedoms you wouldn’t have working in someone else’s practice or in a sessional arrangement.  However,  it is a big financial commitment and this can be a scary step to take, particularly as you have to balance being a doctor with managing a small business, and I never want to be in a position where I sell operations to pay the rent!

Of course, once I decided to enter the hair restoration market I really needed to get my own space. Hair transplantation is a full day procedure, and it is important to have a comfortable and ergonomic workspace for both patients and clinical staff.  

 What selection criteria do you follow when choosing treatments, devices and product ranges that you offer your patients?

Despite being a surgeon first, I have become more and more interested in non-surgical options for the face and body. Skin quality is so important in looking healthy and rejuvenated and it isn’t something surgery can fix. Surgery can tighten and lift, but it won’t improve collagen production, nor correct skin tone and pigmentation. 

I consider how I would treat myself – what would I want? I want to know that a product works as promised and that I can offer it to my patients at a reasonable price. High disposable costs are a definite negative and being able to use devices on my post-surgical patients is a plus. I can’t honestly offer a non-surgical machine that will be less effective and more expensive than surgery, despite the benefit of not having to actually undergo surgery. 

My choice of device or product is also affected by the company and their representatives. I don’t want to be sold something for profit and then be forgotten, I think it’s essential to develop trust and work together towards excellent patient outcomes. 

Why did you partner with Venus Concept?

I first met Mitch, the VP of Sales at the Non-Surgical Symposium a couple of years ago. I wasn’t looking to invest in any devices at the time, but their subscription model certainly made me think it wasn’t out of reach. A few months later I travelled to Spain to train in Hair Transplantation and mentioned this to one of the Venus Concept reps, who told me Venus Concept had acquired Neograft. Unfortunately, I had already committed to another before the Neograft device was available here. Despite this, the staff Whitney and Nadene were absolutely lovely and invited me to several educational evenings about their other products throughout the year. This is when I rethought my purchase of devices, because after attending several of these sessions with both international and local speakers, I could see excellent results and happy clinicians. And best of all low to no consumable costs! 

Tell us about Neograft and why you love it

Like the other machine I had, Neograft is used in hair transplantation – specifically Follicular Unit Extraction (FUE).  It utilises a suction assisted motorised micro-punch to harvest individual hair follicular units, which are taken from the safe donor zone at the back of the scalp and then implanted into the thinning or bald areas at the front hairline and crown. 

This technique is a much better option than the old fashioned method, where grafts are harvested by excising a long strip of hair-bearing scalp from the back of the head and then cut into individual grafts by a team of technicians. This is called FUT, Follicular Unit Transfer.

I’ve been interested in hair restoration for a long time as I have a lot of male friends who have always been acutely aware of their thinning hairlines. I attended a session by Dr Jack Fisher on Hair Transplantation at the American Plastic Surgery meeting way back in 2008, which discussed only the FUT method and this leaves a large scar at the back of the head. Whilst some heal well, [it is still] visible if the head is shaved or clipped short. None of my friends wanted that. FUE has changed the game, and although it leaves tiny scars, they simply aren’t noticeable, and men can shave or wear their hair as short as they please. The procedure is also less painful and the recovery is significantly faster.

The Neograft device is superior to manual harvesting because the suction allows for extraction of the graft in the same hand movement, and using a ‘pull and drag’ technique enables you to visualise the follicles – if not, the angle of the punch can be altered, which decreases the risk of graft transection and maximises yield. The grafts are collected in a small canister on the handpiece which is emptied as it fills. These grafts can then be sorted into single, double and multi-hair units (each hair follicle has between 1- 4 hairs) and kept chilled and moist until implantation. Our previous device collected grafts in a much larger canister which also chilled and moistened them, but we found that as we started sorting grafts before the completion of harvesting, we didn’t really utilise this function as we had to cool and moisten the grafts manually once removed. 

Unlike our old device, the Neograft has a couple of additional handpieces. The first is a recipient site creating tool, which like the harvesting handpiece has an integrated counter. This is very useful and as we make the recipient sites before harvesting, it gives an accurate count of grafts needed which doesn’t depend on me keeping track as I go.

There are a few different techniques in making a recipient’s site, some make each site as they implant a hair, but I prefer to make all the sites at once. This keeps the angles consistent and lets me check the overall pattern and density is before implantation begins. 

The second attachment is an implanting handpiece, which uses gentle negative and positive pressure to insert the grafts into the pre-made recipient sites. 

Despite all of these features, the device is really just a tool. It won’t deliver great results without an understanding of the principles of hair transplantation, and it won’t bring patients in the door for you. So the biggest benefit of Neograft and why we love it, is the support Venus Concept provides – clinical, technical, business and marketing support is all part of the package. This is the reason we changed over- and why we will continue to work with Venus Concept.

For more information on Neograft or to get in touch, visit www.venusconcept.com