Optimal Hair Transplant Recipient Site Slit Design: Minimizing Vascular Damage

AbstractAn often overlooked aspect of hair transplantation is the art of recipient site design and slit creation. There is also a lack of consensus on which technique provides the optimum coverage while minimizing vascular damage. This paper aims to provide logical arguments to determine the optimal instrument and method of slit creation, in order to ensure maximum density, optimal survival, minimal pop-out, and minimal damage to scalp vascularity.The use of semiconical blades reduces the damage to the dermis and vascular plexus as compared with rectangular blades and needles, as the depth of penetration required is lower. The use of acute angle reduces the depth of penetration for the same length of slit and decreases damage to deep plexus. Coronal slits produce less vascular damage than that of sagittal slits with the same size blades.We believe that these recommendations provide the optimum volume slits while causing minimal vascular damage.

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Innovative modified hair follicle harvesting technique with reverse rake scalp elevator for lower occipital donor area in follicular unit extraction hair transplantation

Indian Journal of Plastic Surgery ◽

10.4103/0970-0358.197227 ◽

2016 ◽

Vol 49 (03) ◽

pp. 390-396

Author(s):

Chandrakant Rambhau Gharwade

Keyword(s):

Hair Follicle ◽

Acute Angle ◽

Hair Follicles ◽

Hair Transplantation ◽

Hair Transplant ◽

Harvesting Technique ◽

Donor Area ◽

Follicular Unit Extraction ◽

Follicular Unit ◽

Scalp Skin

ABSTRACTFollicular unit extraction (FUE) is one of the widely practiced minimally invasive follicular harvesting techniques employed during hair transplantation. FUE technique has an advantage of utilising lower occipital area and supra-auricular region as a safe donor area described by Unger, in addition to the standard occipital donor area used in strip method (follicular unit transplant). Despite its potential advantages such as rapid recovery, minimal scarring and reduced post-operative pain; its widespread acceptance is limited due to various factors in variable contribution like steeper learning curve and potentially higher follicular transection rates (FTRs). The main practical drawbacks in harvesting FUE from lower occipital donor region that lie inferior to the standard donor area, is its acute angle (10°–15°) of emergent hair from scalp skin, higher variance angle (15°–35°) between hairs below the skin and hair exit angle above the skin and comparatively loose scalp, preventing to provide stable platform for punching. Hair transplant surgeon faces difficulty in aligning and engaging the FUE punch leading to very high hair follicle transection rate, and therefore, it is not a preferred site for harvesting follicles in FUE. Authors description of modified technique using reverse rake scalp elevator helps in negating the acute angle of the hair follicles exit from scalp skin and reducing the variance angle between emergent hair and hair below the skin in lower occipital region thereby reducing FTR. Furthermore, an added advantage of reducing the overall operative time and surgeon fatigue, improve donor area healing, availability of a comparatively larger donor area which increases the confidence of the beginners. This method will be of help as it is easy to duplicate and follow by novice hair transplant surgeons and also for those who are routinely doing mega hair transplants sessions.

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Sigma Grafting: A New Recipient Site for Hair Transplantation

Dermatologic Surgery ◽

10.1111/j.1524-4725.1995.tb00140.x ◽

1995 ◽

Vol 21 (2) ◽

pp. 183

Author(s):

DARRYL S. WEISS

Keyword(s):

Hair Transplantation ◽

Recipient Site

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Does the Recipient Site Influence the Hair Growth Characteristics in Hair Transplantation?

Dermatologic Surgery ◽

10.1046/j.1524-4725.2002.02041.x ◽

2002 ◽

Vol 28 (9) ◽

pp. 795-799 ◽

Cited By ~ 11

Author(s):

Sungjoo Hwang ◽

Jung Chul Kim ◽

Hyo Sub Ryu ◽

Young Chang Cha ◽

Seok Jong Lee ◽

...

Keyword(s):

Hair Growth ◽

Growth Characteristics ◽

Hair Transplantation ◽

Recipient Site

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The Role of Hair Transplantation for Managing Facial Trauma

Facial Plastic Surgery ◽

10.1055/s-0037-1608782 ◽

2017 ◽

Vol 33 (06) ◽

pp. 613-620

Author(s):

Gorana Kuka ◽

Jeffrey Epstein

Keyword(s):

Platelet Rich Plasma ◽

Treatment Modalities ◽

Site Formation ◽

Facial Trauma ◽

Hair Transplantation ◽

Recipient Site ◽

Facial Hair ◽

Case Examples ◽

Multiple Treatment ◽

Follicular Unit

AbstractOftentimes, multiple treatment modalities are indicated for the management of trauma to the face. When this trauma involves a hair-bearing area, such as the eyebrow, eyelid, or beard region, hair transplantation can be an effective modality. While most of these facial hair transplants are performed for elective cosmetic indications, advanced techniques of hair transplantation can assure aesthetic outcomes in the optimizing of appearance after trauma. Because hair regrowth requires a good recipient bed, adjuvant therapies to promote vascularization, such as fat transfer and platelet-rich plasma, can be applied in conjunction with hair transplantation. The authors review the indications and the essential techniques of graft harvesting by follicular unit extraction and follicular unit grafting, and recipient site formation and graft planting and management, and present different case examples illustrating these technique.

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