Donor Harvesting of Hair Grafts

EFFECTIVE DONOR HARVESTING OF HAIR FOLLICLES

Drs. Miller & Heller utilize a number of different techniques for harvesting hair follicles, each with it’s own advantages and disadvantages. Regardless of which donor harvesting technique is employed, the proper extraction of the hair follicle is paramount to ensure the viability of the transplanted hair and avoid transection, the cutting of the hair shaft from the hair follicle. Hair follicles grow at a slight angle to the skin surface, which means that regardless of technique, punch removal or strip harvesting, the transplant tissue must be removed with a corresponding angle and not perpendicular to the surface.

STRIP EXCISION HARVESTING

Strip harvesting is the most common technique for removing hair and follicles from a donor site. A single-, double-, or triple-bladed scalpel is used to remove strips of hair-bearing tissue from the donor site. Each incision is carefully planned to insure intact removal of hair follicles. Once removed, the strip is dissected into follicular units, which are small, naturally formed groupings of hair follicles.

The incision is then closed using sutures or staples, with a resulting tightening the scalp skin area that slackens over time with skin elasticity. During any surgical procedure there involves a process of healing. Once sutured together, the area of extraction leaves behind a thin, pencil-like scar line, which is covered by existing hair. Like all scars, even this very thin line will improve over time.

A variation on strip harvesting is elliptical harvesting, where donor hair is removed with an elongated oval incision rather than a strip.

FOLLICULAR UNIT EXTRACTION (FUE)

One of the newest and most talked about method in hair transplantation is a procedure known as follicular unit extraction and transplantation, commonly known referred to as FUE transplantation.

The FUE transplantation procedure itself involves a different approach to extraction that pinpoints individual follicular grafts from the donor area as opposed to more traditional linear strip extraction. Each follicular unit graft, or compact bundle of 1 to 4 hair follicles, replete with oil glands, muscle and connecting tissue is removed individually and transplanted to the affected hair loss area.

An excellent procedure for selected patients. The transplantation procedure does not result in a linear scar which maybe a serious consideration for those who wear their hair short and wish to avoid a linear excision. Patients with very tight scalps or that have existing donor scarring that cannot be excised may also be good candidates.

The most significant drawback to follicular unit extraction (FUE) transplantation is the limit of donor supply and because each follicular unit is removed individually, the procedure takes a considerably larger amount of time. As such, each procedure is limited to approximately 500 grafts per session and the cost of each graft is almost double that of the standard linear extraction procedure.

PLUG OR ROUND GRAFT HARVESTING

An uncommon harvesting technique today. Plug and round graft harvesting was popularized in the late 1980’s, and was a more commonly used technique prior to the development of procedures utilizing smaller grafts and follicular units.