Donor Harvesting by Direct Visualization of the Hair Follicle
Abstract
Background: There are several methods for harvesting donor hair such as punch excision, single-bladed knife excision, and multibladed knife excision. All of these procedures are blind and thus resulted in transection of hair follicles and fewer follicles being available for transplantation that detrimentally affect the final cosmetic results.
Objective: To explore a new method of donor hair harvesting called "donor dissecting". This new procedure is an open technique as hair follicles are directly visualized during the harvesting process.
Materials and Methods: The technique of donor dissecting utilizes a #15 scalpel blade for single strip harvesting from the occiput while maintaining meticulous hemostasis. This enables individual hair follicle to be visualized and protected from transection during the harvesting process. Once the single strip is harvested, it is then further divided into individual follicular unit or mini- and micro-grafts using direct visualization of individual follicles to again prevent transection.
Result: The technique of donor dissecting was utilized in 50 consecutive hair transplant patients. Utilizing this new technique, only 1.9 % of hair follicles in the donor strip were transected during the harvesting process. At the dissection of donor strip 1.2% follicles were transected in the grafts cutting process. Combining the donor dissecting technique with dissection of the individual grafts, the transection of hair follicles was 1.59%.
Conclusion: The technique of donor dissection minimizes the transection of hair follicles in the donor hair harvesting phase of hair transplantation. This technique is superior to the blind methods of donor harvesting which have been plagued by the problem of excessive hair follicle transection.
References
2. Pinski JB. Hair transplantation. In: Roenigk R, Roenigk H, Jr, editors. Dermatologic surgery. New York: Marcel Dekker; 1988. p. 1047-78.
3. Arouete J. Minigrafts in hair replacement. In: Roenigk R, Roenigk H, editors. Surgical Dermatology. Philadelphia: CV Mosby; 1993. p. 517-26.
4. Shory C. Recent improvements in donor harvesting techniques. Hair Transplant Forum 1993; 3: 6-7.
5. Brandy D. A new instrument for the expedient production of minigrafts. J Dermatol Surg Oncol 1992; 18: 472-8.
6. Stough DB. Hair transplantation by the feathering zone technique: new tools of the nineties. Am J Cosmet Surg 1993;10:243-8.
7. Straub P. Graft harvesting: a third generation. Hair Transplant Forum 1990; 2: 2-4.
8. Alt T. The donor site. In: Unger W, Nordstrom, editors. Hair transplantation, 2nd ed. New York: Marcel Dekker; 1988. p. 145-121.
9. Carrierao S, Lessa S. New technique for closing punch donor sites. Plast Reconstr Surg 1978; 64: 455.
10. Hill TG. Closure of the donor site in hair transplantation by cluster technique. J Dermatol Surg Oncol 1980; 6: 190.
11. Morrison ID, An improved method of suturing the donor site in hair transplant surgery. Plast Reconstr Surg 1981; 67: 378.
12. Straub P. Evaluation the knife technique. Hair Transplant Forum 1992; 2:2-4.
13. Unger WP. Total excision techniques in donor area harvesting for hair transplanting. Am J Cosmet Surg 1994; 11: 15-22.
14. Stough DB. Strip harvesting. International Society of Hair Surgeons, 1st Meeting, Dallas, TX, April 1993.
15. Straub P. The donor site revisited. Hair Transplant Forum 1991;1: 4.
16. Limmer BL. Bob Limmer does it all one hair at a time! Hair Transplant Forum 1991; 2ะ 8-9.
17. Hugeneck J. The elliptical method. Hair Transplant Forum 1992;2:8.
18. Sandovol A. The elliptical method. Hair Transplant Forum 1992;2:8.
19. Vallis CP. Surgical treatment of the receding hairline. Plast Reconstr Surg 1968; 33: 247.
20. Vallis CP. Surgical treatment of the receding hair line. 1969;44:271-8.
21. Coiffman F. Injertos euadrados de cuero cabelludo, Presented at the First Iberoamerican Congress of Plastic Surgery, Quito, Ecuador, 1976.
22. Coiffman F. Use of square scalp grafts for male pattern baldness. Plast Reconstr Surg 1977:60: 228-32.
23. Bisaccia E, Scarborough D. A technique for square plug hair transplantation. Am J Cosmet Surg 1990; 7:219-22.
24. Scarborough D, Bisaccia E. Square-graft hair transplantation: an aesthetic surgical correction for bladness. Cosmet Dermatol 1991; 4: 10-3.
25. Bisaccia E, Scarborough D. Hair transplant by incisional strip harvesting. J Dermatol Surg Oncol 1994; 20: 443-8.
26. Bisaccia E, Scarborough D. Geometric-square hair transplant. In: Unger WP, editor. Hair transplantation. 3rd ed. New York: Marcel Dekker; 1995. p. 485-97,
27. Brandy D. The exclusive use of slit minimicrografting for the correction of a large fronto-parietal scalp defect. Am J Cosmet Surg 1993; 10: 111-5.
28. Waldman R, Craycroft K. From circular grafts to strip. Hair Transplant Forum 1992; 2: 5.
29. Scarborough D. The triple-bladed knife in perspective. Hair Transplant Forum 1991; 2: 5.
30. Rassman W. Blind graft production with cutting grates and multiblade knife, Hair Transplant Forum Int 1998; 8:22.9
31. Choi YC, Kim JC. Hair follicle regeneration after horizontal resectioning, Implication for hair transplantation. In: Stough DB, Haber RS, editors. Hair replacement: surgical and medical. 1996. p. 358-63.
32. Inaba M, Anthony J, Ezaki T, et al, Regeneration of axillary hair and related phonomena after removal of deep derma and subcutaneous tissue by a special shaving technique. J Dermatol Surg Oncol 1978; 4: 921-5.
33. Unger WP. Hair transplantation, 3rd ed. Revised and expanded. 1995. p. 195-212.
34. Limmer BL, Elliptical donor stereoscopically assisted technique. In: stough DB, Haber RS, editors. Hair replacement: surgical and medical. 1996. p. 133-7.
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