Jean Devroye recently asked Alexandre Duvallet to create a software program to measure the scalp surface area.  The software is useful for measuring the both the donor area and the recipient area. One can also plot the follicular density in a given area using the software.

The software has it’s limitations however.  The scalp is a curved  three-dimensional surface.  Photographs are a two dimensional surface.  In order to convert a scalp surface area to a two dimensional surface area, one must take a clear surface area such as saran wrap, place it on the scalp, and then draw the surface area on the saran wrap with an indelible marker.

The next step is to place the saran wrap on a piece of paper and affix it with either tape or a stapler.  Now the 3D surface area has been converted to a 2D surface area.  Next, one must take a photograph with a metric ruler in place.  The photograph should b ...

Not all FUE punches for hair restoration are created equally.  Other than the punches Cole Instruments created, FUE punches have a thicker wall and are not as sharp.  Cole Instruments created the thinnest wall and sharpest punches on the market.  This is very important to the success of FUE hair transplant surgery.   

Removal of hair follicles in FUE depends on two forces.  One is the axial force or the inward pressure on the skin.  The second is the tangential force created by rotation or oscillation.  Both forces will be less with a thin wall and a sharp punch.  Lower forces create less fluid movement of the follicles.  This helps to reduce follicle transection or amputation of the follicles, which often results in such damage to the follicle that follicular survival is impaired.   

Cole Instruments recently created a new surgical punc ...

There are numerous instruments for creating recipient sites.  These include custom made blades, hollow core needles, solid core needles, sapphire blades, and SP 89 – 91 blades, as well as other less commonly used items.

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Custom Made Blades:

These consist of razor blades cut to a specific size.  We first began using these in 1991 as an alternative to the use of scalpel blades for micro and mini grafts.  Of the ensuing years, the number of recipient sites increased from under 100 in an average case to well over 1000.  Eventually, the number of recipient sites exceeded several thousand sites.  Custom made blades allow the physician to prepare specific size blades for grafts that contain a specific number of hair.  For instance, the physician might use a 0.7 mm to 0.9 mm blade for single hair grafts.  He might use a 1.0 to 1.1 mm blade for two hair grafts.  He might use a 1.2 to 1.4 mm blade for gr ...

In 2008 Follicular Unit Extraction (FUE) comprised 10.8% of all hair restoration surgery procedures performed by ISHRS members. ¹ Despite its  increasing popularity there is no dominant method utilized to perform FUE.  For the vast majority of physicians, however many questions remain.    How do we approach the donor area ?  How do we harvest the grafts?  With the many instruments on the market(Table 1) what do we choose to harvest the grafts?  What is an acceptable degree of transection?  What should a graft look like?  What are the minimum requirements to grow hair?  What is the yield with FUE?  What complications might occur?    Are the results as good as with strip surgery?  Many of these questions are discussed partially earlier in this text.  However, in  an effort to add clarity, it is of value to review and elaborate on  the literature to-date (Oct. 2010)..

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Introduction

FUE is becoming increasingly popular with both physicians and patients. As patient demand increases, the need for more physicians to provide the procedure is essential. Unfortunately, the procedure is difficult to learn for many physicians. There is a need to reduce the learning curve so that consistent results are possible. In addition, there is a need to provide logistics so that physicians are able to carry out large procedures in a shorter span of time. This presentation will detail how to provide the FUE rapidly while insuring quality grafts that insure consistent results.

Methods

I will discuss the overall planning and design I use to produce large procedures exceeding 2000 grafts with speed and efficiency. This discussion refers primarily to patients who are a Norwood class 3 or greater.

Results

Proper planning and instrumentation allows physicians to provide well over 2000 high quality grafts to a patient in a single day.

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Choosing to have a hair transplant procedure is a life-changing decision that should not be taken lightly.  If you are thinking about having hair restoration surgery, there are a number of steps you should first take.  We will discuss these steps in a multi-part series, starting today, with one of the most important:

Part I: RESEARCH, RESEARCH, RESEARCH

You will hear this generic-sounding advice over and over again but it is vital that you not overlook this important step.  It is so important to soak up all the information you can.  Make sure you spend time researching the following topics in particular:

Alternatives to Hair Transplantation – This is an important early step, and you should cert ...