New Methods and Techniques for Hair Transplant
New Methods of Donor Harvesting
You have a restricted supply of hair at the donor area to distribute to areas of baldness, as hair loss is progressive. Professional hair transplant surgeons spend more time harvesting and cutting grafts in order to produce as little waste as possible. Many who opt for quick donor harvesting, experience blind techniques that cause significant follicular damage. This results in damaged hair follicles with lower growth rates and, if they do grow, they are often deformed miniaturized hairs.
At the Stough Clinic in Bangkok, Dr. Damkerng Pathomvanich was the first to pioneer the Open Technique in donor harvesting in 1997. A transection rate of less than 2% was achieved, a remarkably low result when compared to other techniques.
Information about this technique was published in April 2000’s Dermatology Surgery Journal and in the Hair Forum International Journal of October 1998. The open method has the lowest transection rates when compared to other techniques. A minimal transection rate means more grafts are available for transplantation and less skin is removed, minimizing donor scarring.
During the course of the last 10 years, the Open Technique has been refined and improved. Advances in the Open Technique came quickly overtime, and it was renamed the Refined Open Technique. This improved method was presented at the ISHRS Korea Asian Workshop of 2008.
Follicular Unit Transplantation
The design of natural looking hairlines is both a science and art. Professional doctors consult with patients to draw a new hairline that is most suitable for your facial shape. To ensure that you are comfortable, the surgeons administer an oral sedative followed by a local anesthetic once you are relaxed. The surgeons make a very tiny incision at the transplantation areas, after removing a piece of skin for graft harvesting. A natural look is achieved by orientating the slits in the same direction and angle of your existing hair. The transplant hair is then randomly placed along the hairline in order to look natural.
Most modern clinics employ follicular unit transplantation exclusively. Follicular units, or FUs, are the smallest groupings of hair naturally occurring on the human scalp. FUs generally contain 1-4 hairs. Surgical teams are very meticulous about handling and inserting the grafts into the prefabricated slits. The follicular grafts are first kept in special ring holders to prevent desiccation. The holders also help the doctors select the correct graft size for insertion. By choosing only thin one hair graft for the front, and two or three coarse hair grafts for the back, a very natural looking result is achieved.
The majority of hair transplant patients have minimal scaring because surgeons close the wound by a technique called ‘Trichophytic closure’. This method was first described by Dr. M. Marzola of Australia and Dr. Frechet of France in 2005. To enhance visibility, a high power magnifying scope is used. The lesser edge of the incision is trimmed to 1×1 mm in order to allow the hair stump to grow inside the incision scar, thus hiding it. Afterwards, the donor area is closed by utilizing absorbable and retention stitches. The use of retention sutures enables surgeons to close the area without undermining the graft and causing possible nerve damage, bleeding and or follicular transection. These steps combined result in less scars and a more natural authentic look for patients.
Donor strips are then slivered and placed upon a specially designed tray. This process helps stabilize each strip for simple slivering into narrow segments and also minimizing the transection rate. The donor strips are kept well hydrated in cool saline, and then further dissected under binocular stereoscopic microscopes into follicular unit grafts. One-hair grafts are put together for transplantation in the front of the scalp as a natural looking hairline. Afterwards, a surgical team will ensure that all grafts are re-inserted quickly, thus avoiding a wait in the refrigerator.
Expert hair loss doctors are always looking for innovative methods to improve their techniques. Over the years innovations such as the slivering board, graft storage rings, and insertion retractors have changed the hair transplant process. The latest device is a portable laser that can place grafts in a symmetrical hairline pattern in a fraction of time it takes a surgical team. This invention was presented in the ISHRS Korea Asian Workshop May 2008 and Regional Rome Meeting in June 2008. The device was well received and now faces a great demand from surgeons for production. More informational on this device, and the future of hair transplantation, can be found in the Hair Forum International publication. The future for patients suffering from hair loss is bright, as there are constantly new innovations and advancing technology being introduced to the field.