Hair Transplantation Techniques

Follicular Units - The Gold Standard

Fortunately, more and more hair transplant clinics are beginning to convert to the follicular unit transplantation method exclusively. This may, in part, be due to better educated patients demanding the best techniques. There is no question that it is a long, tedious, and labor intensive procedure, but the results are so good that once the surgeon has made the difficult transition from mini and micrografts to follicular units, he will not go back. It is only common sense to move the hair in the same units as it started. And it only makes sense to microscopically enhance the dissection process to make sure that it is done with minimal damage to the roots.

Mini Grafts and Micro Grafts

Before follicular unit transplantation, grafts were dissected in random sizes and without magnification. The smaller grafts (not the 4 mm plugs) are called minigrafts and micrografts. Minigrafts consist of 3 to 10 hairs while micrografts consist of 1 to 2 hairs. These grafts were cut without regard to maintaining the integrity of the follicular units. Follicular units are routinely broken apart during the naked eye dissection. Graft sizes are determined strictly by the size of the recipient holes being placed in the scalp. Generally, a small plug is removed leaving a hole behind or a stab incision is made with a scalpel blade. The grafts are then sized to match the size of the hole in the scalp.

Traditional Plugs

Mini and micrografting is a much better method of transplantation than the large plugs that preceeded them, but it still has the same problem of giving a “pluggy” or “corn row” appearance. Additionally, an occasional patient will not have good growth after such a transplant. Most transplant surgeons still utilize this technique, although they may call it by a different name. It is a much quicker and simpler procedure from the transplant surgeon’s perspective.

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