December
10, 2002
Gho Clinic's Follicle Transplantation vs Traditional Strip
Excision Hair Transplantation: An Illustration
*Presentation
courtesy of Gho Clinic
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Traditional
Strip Excision vs Follicle Transplantation
- Phase 1: The removal of the hairs from the donor area.
- Phase 2: The preparation of the skin for transplantation.
- Phase 3: The preparation of the transplantation area.
- Phase 4: The implantation of the grafts.
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Phase
1: Removal of the hairs from the donor area |
Traditional
Strip Excision
In traditional
hair transplantation, strips of skin are removed using a
single blade or multi-bladed scalpel. |
Follicle
Transplantation
At Gho Clinic,
individual hair follicles are removed using a needle one at
a time. No scalpel or blade is ever used. |
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Traditional
Strip Excision
The donor area
is closed using stitches or staples which cause further
trauma to the donor site. Return visits are required for
suture removal. Patients will be left with a linear scar. |
Follicle
Transplantation
High
magnification of the donor area immediately after the donor
hairs extraction. The small wounds which remain do not
require stitching and leave no visible scars. Donor site heals faster. |
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Traditional
Strip Excision
Typical linear
scar from traditional strip excision procedure. The linear
scar has a tendency to stretch over time.
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Follicle
Transplantation
Donor site two
weeks after Follicle Transplantation. The site heals very
fast and scars are less visible.
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Phase
1 - Summary
In
traditional strip excision hair transplantation, the donor area
is first anaesthetized using a needle or syringe. As the skin is
stretched rather tightly across the scalp, administering
anesthetic using a needle can
be rather painful. A sharp blade is then used to remove
strips of skin from the donor area; this naturally causes
significant trauma and bleeding. The area must be stitched
to close the wounds and highly visible scar formation is inevitable.
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Phase
1 - Summary
No
blades or scalpels are used in Follicle Transplantation. The follicles
are removed using topical anesthesia, without needles.
The donor follicles to be transplanted (‘grafts’) usually
consisting of one or a few hairs and their follicles, are
removed using a needle. There is very little bleeding,
no need to stitch the wound, and no visible scar formation. After
treatment, the small wounds left by the needle can easily be
covered by the surrounding hair.
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Phase
2: Preparation of the donor hairs for transplantation |
Traditional
Strip Excision
Strips of skin
obtained by traditional strip excision hair transplantation
techniques. The skin is then dissected into individual hair
follicles on a workstation before transplanting
to balding
area. |
Follicle
Transplantation
In Follicle
Transplantation, the grafts usually consist of one or a few
hairs and their follicles and they are ready to be
transplanted soon after extraction without having to be
dissected like traditional strip excision surgery. |
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Phase
2 - Summary
In traditional strip excision hair transplantation, the
removed strips of skin are cut and dissected into individual
follicles before they are transplanted to the balding area.
Sometimes the dissection is performed by technicians instead
of the doctors. The doctors will then decide whether to
group the individual follicles into larger grafts for
transplantation purpose. In order words, a lot of human interventions
in the process. |
Phase
2 - Summary
The process of dissecting or separating the follicles is not
necessary under Follicle Transplantation. Soon
after the donor hairs are extracted by the needle, they are
ready to be transplanted to the balding areas. There is no
further or unnecessary intervention by the human hands. No
artificial groupings of individual follicles or risk of
additional transection of the follicles during the
dissecting process. |
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Phase
3: Preparation of the recipient area |
Traditional
Strip Excision
In traditional
techniques, punch-holes, slits grafts or round grafts are
made in the recipient area. The grafts do not always fit
nicely in the holes or slits. |
Follicle
Transplantation
In Follicle
Transplantation, micro incisions are made in the recipient area
using a needle the same size as the needle used to obtain
the grafts from the donor area. |
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Phase
3 - Summary
In
traditional strip excision hair transplantation, the
recipient area is anaesthetized by needles and incisions are
commonly made in one of the following ways:
-
the
punch method, where small holes of between 1.0 and 1.5
mm are made using punches;
-
the
slit method, where small slits are made using a sharp
blade;
-
the
laser method, where the holes are made using a laser
beam.
The
grafts do not always fit nicely into the holes under this
technique. Sometimes a bandage has to be wrapped around the
patient's head after the surgery for 24-48 hours in order to
keep the grafts in place. |
Phase
3 - Summary
In Follicle Transplantation, the recipient area is not
cut with a knife or punched as in traditional procedure.
Only a micro opening the size of a needle tip is required on
the recipient site. The surgery is less traumatic for the
patient so a small amount of anesthetic will be sufficient.
The anesthetic is administered without syringe or needles
and hence less pain is inflicted on the patient. A 23 gauge
needle (or sometimes 21 gauge), the same size as the one
that is used to extract the donor hairs, is used to make
micro incisions in the skin where the grafts are then
inserted individually. The grafts fit very well into the
micro incisions made by the needle. They heal very quickly
without leaving a visible scar. The patient is never asked
to have bandages wrapped around his head after the
surgery. |
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Phase
4: Implantation of the grafts |
Traditional
Strip Excision
Traditional
technique immediately after surgery. The grafts do not
always fit exactly into the slits or holes. The recipient
site is prepared with more traumatic cutting and hence a
potentially a higher chance of scar formation in and
unnatural results. |
Follicle
Transplantation
Follicle
Transplantation immediately after surgery. The grafts must
not be placed too close to each other in any one treatment.
For this reason, it is advisable to leave a period of at
least 3 or 4 months between treatments. |
Traditional
Strip Excision
Two weeks
after traditional surgery. Wound healing takes slightly
longer and the scabs have not yet fallen off. |
Follicle
Transplantation
Two weeks
after Follicle Transplantation. Scabs completely fell out
and redness almost all gone. |
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Phase
4 - Summary
With both
techniques, the implantation of the grafts has to be
performed very accurately. Using traditional techniques, the
grafts do not usually fit as well as in Follicle
Transplantation. Wound healing usually takes longer using
the traditional technique, and the risk of scar formation is
greater. Also, the newly transplanted hairs tend to shed
soon after surgery. The grafts will then go through a
resting cycle of 3-4 months before regenerating new hairs.
With Follicle Transplantation, most
of the newly transplanted hairs continue to grow after the
surgery. There is no resting period. |
Phase
4 - Summary
In the photos,
you can see that the density of the graft implantation is
not that high. This is because each graft needs a
‘so-called’ recovery zone. If the whole transplantation
process is carried out in the same area all at one time,
there is a good chance that not all the transplants will
‘take’ and also scar tissue may form. Gho Clinic
recommends that where necessary, the transplantation in one
particular area be carried out over several treatments, with
an interval of at least 3 or 4 months before consecutive
work is done on the same area. |
HAIR
TRANSPLANT FORUM
*Presentation courtesy of Gho
Clinic, for more info, email info@ghoclinic.com
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