Hair transplant by incisional strip harvesting

Follicular Unit Extraction Hair Transplantation with Micromotor: Eight Years Experience

OBJECTIVE

Follicular unit extraction (FUE) has been performed for over a decade. Our experience in the patients who underwent hair transplantation using only the FUE method was included in this study.

METHODS

A total of 1000 patients had hair transplantation using the FUE method between 2005 and 2014 in our clinic.

RESULTS

Manual punch was used in 32 and micromotor was used in 968 patients for graft harvesting. During the time that manual punch was used for graft harvesting, 1000-2000 grafts were transplanted in one session in 6-8 h. Following micromotor use, the average graft count was increased to 2500 and the operation time remained unchanged. Graft take was difficult in 11.1 %, easy in 52.2 %, and very easy in 36.7 % of our patients.

CONCLUSIONS

The main purpose of hair transplantation is to restore the hair loss. During the process, obtaining a natural appearance and adequate hair intensity is important. In the FUE method, grafts can be taken without changing their natural structure, there is no need for magnification, and the grafts can be transplanted directly without using any other processes. Because there is no suture in the FUE method, patients do not experience these incision site problems and scar formation. The FUE method enables us to achieve a natural appearance with less morbidity.

Donor hair follicle preservation by partial follicular unit extraction. A method to optimize hair transplantation

BACKGROUND

There are different stem cell pools located in the hair follicle.

OBJECTIVE

To try to determine whether follicular units can survive a partial extraction and whether this partial extracted follicular unit can regenerate new hairs.

METHODS

From five individuals, between 100 and 150 grafts were harvested from the occipital area of the scalp. Suitable grafts were implanted into the recipient area. Hair growth and characteristics in the donor area and the recipient area were observed at different intervals.

RESULTS

After 3 months, between 92.1% and 104.1% (mean 97.7%) of the partial follicular units in the donor sites survived and produced hairs with the same characteristics. After 1 year, 91.1–101.7% (mean 95.9%) of the implanted partial follicular units regenerated hair growth with the same characteristics as the hairs in the donor area.

CONCLUSIONS

We revealed that extracted partial longitudinal follicular units transplanted to the recipient area can be used as complete follicular units to regenerate completely differentiated hair growth with the same characteristics as in the donor area. We also revealed that the partial follicular units in the donor area can survive and produce the same number of hairs with the same characteristics. This technique enables us to generate two hair follicles from one follicle with consistent results and preserve the donor area.

Hair transplantation: New concepts in 2005

This article will provide a brief review of the current concepts in hair transplantation. Currently, hair transplantation creates natural appearing transplanted hair for men and women. Patient consultation is an essential component of a successful procedure. During the consultation realistic expectations are essential and are based on the patient's donor density, caliber of hair follicle, and rate of hair loss. Alternative and adjunctive therapies such as finasteride and minoxidil should be a basic component of any consultation. The only limit to the procedure is the amount of donor hair each patient has available. For the vast majority of patients, elliptical donor harvesting provides the most efficient technique for harvesting hair. Follicular unit extraction can be a useful technique for a minority of patients.

Calvitron Automated Hair Transplant System in Alopecia Treatment: A Case Report

The surgical treatment of alopecia is essentially based on minigraft and micrograft techniques in which grafts are inserted into a slit or punch recipient site. To facilitate the transplantation of large numbers of these small grafts, the Calvitron automated hair transplant system has been developed. We report a case of Norwood type V alopecia who received three sessions of hair transplantation (400-500 grafts per session) over 18 months with satisfactory results. During surgery, with one technician operating the machine, one surgeon and an assistant took 3.5 to 4 hours per session to accomplish the whole procedure from harvesting the grafts to implantation and closure of the donor scalp wound. This new automated minigraft and micrograft transplant technique is significantly timesaving for large numbers of grafts per session without altering the aesthetic results. It offers a good choice for hair replacement surgery to save manpower and cost. The use of the Calvitron automated hair transplant system proved to be a practical and effective approach to hair transplantation in this case.

Potential use of beards for single-follicle micrografts: convenient follicle-harvesting technique using an injection needle

The authors developed a convenient hair-harvesting procedure using a disposable 18-gauge injection needle, which is common in every clinical scene. The needle was used as a skin puncher to harvest single follicles. The harvested micrografts were transplanted without trimming any of the adjacent tissue around the follicle. Clinical applications for the reconstruction of eyebrows in cases of anhydrotic ectodermal dysplasia and facial scars are demonstrated. Each patient showed a favorable result, and there was no scar formation at the donor site. This procedure makes hair harvesting smooth, speedy, and less traumatic. Beards as well as occipital hairs can be used as donors for single-follicle micrografts with this method in male patients.

Hair transplantation in women

Female pattern alopecia is most often caused by androgenetic alopecia, and tends to take on one of several classic patterns. Progressive hair loss in women also tends to carry with it significant emotional and social pressures, and advances in hair transplantation techniques have begun to give women increased options for its therapy. Although female pattern androgenetic alopecia is often a diagnosis of exclusion, hair transplantation surgeons are now able to more effectively treat this difficult condition. Careful patient selection is critical to the success of the procedure, as is meticulous technique and surgical planning.

A novel application of the infrared coagulator in hair transplantation. Significant reduction of width of the donor site wound

BACKGROUND

The infrared coagulator, a by-product of laser technology, has been used in dermatology in a variety of settings. During hair transplantation sessions, we observed a significant reduction of the donor ellipse width while performing hemostasis with the infrared coagulator.

OBJECTIVE

Quantitative assessment of the donor wound width after infrared coagulator use, and correlation to the number of previous transplant sessions and patients' age.

METHODS

Twenty-four patients (22 men, two women) underwent hair transplantation. The infrared coagulator was utilized for hemostasis with a pulse duration of 2.5 seconds.

RESULTS

The infrared coagulator produced an average donor area decrease of 42%, while achieving rapid hemostasis. No correlation was demonstrated to number of previous transplant sessions or patients' age.

CONCLUSIONS

The infrared coagulator significantly decreases the donor wound width while providing hemostasis. Advantages include the potential of larger donor strip harvest, minimal tissue manipulation, and less traumatic closure.

Experience with laser hair transplantation in Orientals

BACKGROUND

The advent of high-energy carbon dioxide (CO2) laser-assisted hair transplantation in recent years provides a new recipient area technique for hair restoration surgery. It offers the advantages of less bleeding, time consumption, and graft compression. Specific laser parameters have been recommended in Caucasian but not Oriental patients.

OBJECTIVE

To determine the effectiveness as well as appropriate parameters of laser hair transplantation in Oriental patients.

METHODS

A Sharplan SilkTouch laser with the Flashscanner set to produce a 0.8-1-mm recipient site hole was employed for all subjects. Various CO2 laser parameters were used to compare the graft survival rate with traditional Nokor needle or microdilator methods for micrografting on each side of the scalp. A total of 20 patients joined the study in the past 18 months. A skin biopsy was performed to examine the tissue effect of the different laser parameters.

RESULTS

Hair survival was less than that seen with conventional micrografting techniques in the first five cases, in whom CO2 laser parameters of 36-40 W and 0.2-0.7 seconds were used. After adjusting the parameters to 55 W and 0.1-0.15 seconds, the survival rate increased to between 80% and 90%. In addition, most patients thought the laser-prepared sites resulted in a more natural appearance and better hair density, when they were compared with conventionally prepared sites.

CONCLUSIONS

From our study, we find that CO2 laser parameters of 55 W and 0.1-0.15 seconds seem to be the appropriate parameters for Oriental hair transplant patients. Further studies are required to establish laser parameters that will produce better hair survival.

Combining vertical strips and the ellipse in saving time and follicles

BACKGROUND

Various methods have been tried in collecting donor hair for transplantation. Punch grafts, horizontal strips using a multi-bladed knife, and elliptical excisions have been tried with varying success. Each has advantages, while each also has disadvantages.

OBJECTIVE

The purpose of this study was to develop a technique of harvesting donor hair that would decrease the time to prepare mini- and micrografts while minimizing damage to the follicles.

METHODS

The multi-bladed knife was used to create vertical slits, combined with an elliptical excision to remove the area en bloc.

RESULTS

Fewer follicles were damaged than when using the multi-bladed knife horizontally, and the preparation of mini- and micrografts took less time than with an elliptical excision.

CONCLUSION

This technique combines the advantages of the multi-bladed knife in saving time, and of the elliptical excision in reducing damage to the follicles. The disadvantages of using the multi-bladed knife in a horizontal manner and of taking only a large elliptical excision were eliminated.

Mini-slit graft hair transplantation using the Ultrapulse carbon dioxide laser handpiece

BACKGROUND

The new Ultrapulse carbon dioxide (CO2) laser technology has added a new dimension to many cosmetic surgery procedures including hair transplantation. Early reports by Unger and David (Laser Hair Transplantation. J Dermatol Surg Oncol 1994;20:515-21) have been encouraging with the potential of minimal bleeding, ease of placing transplanted grafts, and an overall shortened operative time. A 2-mm slit handpiece has been recently created to expedite this procedure.

OBJECTIVE

The purpose of this study is to further investigate the use and efficiency of the new Ultrapulse CO2 laser slit handpiece in hair transplants.

METHOD

Mini-slit graft hair transplants using the new Ultrapulse CO2 laser slit handpiece were done on 25 patients in 30 transplant sessions. Donor minigrafts were obtained by the strip harvesting technique using a triple-blade scalpel. Approximately 200-400 recipient slits were made with the 2-mm slit handpiece at the laser setting of 350 mJ, 12 W, 0.8 seconds per pulse.

RESULTS

All grafts were easily placed into recipient sites with minimal bleeding and charring. The procedure was done in half the time of the conventional non-laser technique. Postoperatively, patients were quite satisfied with little pain and swelling. Histologic exams of the laser-treated slits showed minimal adjacent tissue necrosis. Long-term follow-up visits showed good regrowth of hair in these grafts.

CONCLUSION

The new Ultrapulse CO2 laser slit handpiece proved to be an effective tool for mini-slit graft hair transplantation.