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Educational topics for laymen loosing hair (by Dr. A)


Recipient slits - pre prepared v/s stick and place

Dear forum readers,
This is a topic that is not discussed often. But I feel that it merits attention.


There are 2 basic ways of making the recipient slits.

  1. Make all of them at one go, before transplanting the grafts (pre prepared)
  2. Make one slit at a time and simultaneously place the graft into the slit. Then proceed to make the next slit and so on… (stick and place method)
    I personally prefer the first.
  3. All the slits are made at one go keeping in mind the angulations and densities, by the doctor (in pre prepared method).

In stick and place method, there is a wide time interval between making the complete slits during which the directions, angles etc. could vary

  1. In stick and place method, (unless the procedure is a very small one), the recipient slits would be made by more then one person. That could lead to a difference in aesthetics in the final result.

  2. In stick and place method, there is a very real possibility of graft popping out from the previous slit when a new slit is made adjacent to it.
    Leading to avoidable graft trauma.

  3. To avoid this popping out the graft placer may make the recipient slits further apart, leading to a low density transplant
    In view of the above, I prefer that all the recipient slits be made at one go and do not advise the stick and place method.

Dr. A

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Dear Dr, what could happen if someone is allergic to anesthetia? Does it mean the person cannot get a hair transplant ever?


Trimming of grafts v/s placing them direct

Dear forum readers,

This is another interesting topic.

Once the grafts are extracted, should they be implanted as such or should the excess tissue be trimmed. This is even more important for the grafts extracted by the fue method.

In my opinion, and experience, it would be very bad if the grafts were not trimmed of excess tissue.

The reason is very simple. In older times, recipient holes were made. Nowadays we make recipient slits . There is a crucial difference between the two. When making a hole, tissue is taken out (much like digging a pit in ground). When making a slit, no tissue is taken out (somewhat like an injection needle going in and coming out).

So, when a recipient slit is made and filled with an untrimmed graft, one is putting in excess tissue which may likely lead to cobblestone appearance (you are stuffing up a hole that does not exist).
One needs to put in the bare necessary minimum to acheive the most aesthetic result.

So, in my personal opinion, if someone says that their USP is that they are just extracting the grafts and placing them into recipient slits without touching or trimming them under magnification, they are not only doing less work, they are making a virtue of their lethargy.

Remember, we are not transplanting skin .
When transplanting follicular unit grafts into slits, its our duty to transplant the follicular unit alone, with bare minimum excess baggage.

Dr. A

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Hair transplant training for doctors

Dear forum readers,

Who are the doctors that get formal and comprehensive training in hair transplant?
When we need surgery for eye, we search for eye surgeons. Doctors that are formally trained in the field of eye surgery. It is taken for granted that only trained eye surgeons would perform eye surgery.

Similarly, it is assumed, mistakenly, that only doctors formally trained in hair transplant would offer hair transplant.

Any doctor, from any field of medicine, can offer hair transplants.
Where can doctors get formal and comprehensive training in Hair transplant?

In no medical college. In no medical speciality.

If modern hair transplant methods were routinely practiced and training offered in medical colleges and the hospitals affiliated to them, we would see patients going to those institutions for their hair transplants.

Combination of the above two factors is partly responsible for the majority of bad hair transplants we continue to see today.
It is a sad but true state of affair that we hope to rectify. But for now, it is important for the prospective patient to be aware of these facts and understand the true reason why it is so important to do their research prior to getting a hair transplant done.

Dr. A

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