I noticed in the post by bubbles linked bellow that he said it is necessary to use stick and place when making recipients with small needles. Jessica and Fit2btied pretty much rubished this idea.
In his review he clearly agrees with bubbles so I thought it fair to show this in his defence.
During the implantation stage, the follicular unit grafts are placed into the anesthetized recipient zone using small punch holes (0.75-1 mm), small slit incisions (1-2 mm in length), or needle tunnels made by 19- to 22-gauge needles. If using the punch or slit methods, the recipient sites may be made prior to beginning the implantation process.
The needle tunnel technique, also referred to as the stick-and-place method, requires that each graft be placed immediately after the needle has been removed, since the needle tunnel remains open only for a few seconds. An 18-gauge needle is preferred for implanting 3-4 hair grafts, while 19- to 20-gauge needles are used for implanting 1-2 hair grafts. The stick-and-place method provides greater density of follicular units within the recipient zone and causes the least trauma to the vascular system in that area. Thus, this is the method of choice for some physicians. Because of the smaller size of these grafts, it is important to handle them with extreme care and to keep them hydrated at all times. A goal of 20-40 follicular unit grafts per cm² is reasonable and readily achieved by skilled assistants.
» I noticed in the post by bubbles linked bellow that he said it is necessary
» to use stick and place when making recipients with small needles. Jessica
» and Fit2btied pretty much rubished this idea.
»
» http://www.hairsite.com/hair-loss/forum_entry.php?id=3037
»
» The link bellow is an article by Dr. Limmer
»
» Plastic Surgery Articles (Indications, Anatomy, Workup, Surgical Therapy, Treatment, Complications) - Medscape Reference
»
» In his review he clearly agrees with bubbles so I thought it fair to show
» this in his defence.
»
» During the implantation stage, the follicular unit grafts are placed into
» the anesthetized recipient zone using small punch holes (0.75-1 mm), small
» slit incisions (1-2 mm in length), or needle tunnels made by 19- to
» 22-gauge needles. If using the punch or slit methods, the recipient sites
» may be made prior to beginning the implantation process.
»
» The needle tunnel technique, also referred to as the stick-and-place
» method, requires that each graft be placed immediately after the needle
» has been removed, since the needle tunnel remains open only for a few
» seconds. An 18-gauge needle is preferred for implanting 3-4 hair grafts,
» while 19- to 20-gauge needles are used for implanting 1-2 hair grafts. The
» stick-and-place method provides greater density of follicular units within
» the recipient zone and causes the least trauma to the vascular system in
» that area. Thus, this is the method of choice for some physicians. Because
» of the smaller size of these grafts, it is important to handle them with
» extreme care and to keep them hydrated at all times. A goal of 20-40
» follicular unit grafts per cm² is reasonable and readily achieved by
» skilled assistants.
You can make the sites in an area all at once with either blades or needles and then place them.
Or,
You can make one site, then place a graft, then make another site, etc.
Stick and place means you make a site with a needle then place a graft into it. Then you make the next site.
It doesn’t matter which you do. Doctors prefer different methods and every one has their reasons for it. Every clinic is different.
The only wrong thing to say is that you must place a graft immediately after making a site with a needle before the needle hole closes up.
» I noticed in the post by bubbles linked bellow that he said it is necessary
» to use stick and place when making recipients with small needles. Jessica
» and Fit2btied pretty much rubished this idea.
»
» http://www.hairsite.com/hair-loss/forum_entry.php?id=3037
»
» The link bellow is an article by Dr. Limmer
»
» Plastic Surgery Articles (Indications, Anatomy, Workup, Surgical Therapy, Treatment, Complications) - Medscape Reference
»
» In his review he clearly agrees with bubbles so I thought it fair to show
» this in his defence.
»
» During the implantation stage, the follicular unit grafts are placed into
» the anesthetized recipient zone using small punch holes (0.75-1 mm), small
» slit incisions (1-2 mm in length), or needle tunnels made by 19- to
» 22-gauge needles. If using the punch or slit methods, the recipient sites
» may be made prior to beginning the implantation process.
»
» The needle tunnel technique, also referred to as the stick-and-place
» method, requires that each graft be placed immediately after the needle
» has been removed, since the needle tunnel remains open only for a few
» seconds. An 18-gauge needle is preferred for implanting 3-4 hair grafts,
» while 19- to 20-gauge needles are used for implanting 1-2 hair grafts. The
» stick-and-place method provides greater density of follicular units within
» the recipient zone and causes the least trauma to the vascular system in
» that area. Thus, this is the method of choice for some physicians. Because
» of the smaller size of these grafts, it is important to handle them with
» extreme care and to keep them hydrated at all times. A goal of 20-40
» follicular unit grafts per cm² is reasonable and readily achieved by
» skilled assistants.
I have a question on the same topic. It seems that strip doctors use slits (eg H&W) and fue doctors use needles (Arvind, Cole, Woods), is it just a conincidence, do or can strip doctors use needle to create the holes?
Jessica, we all know what stick and place means. I am not sure that you read the extract above at all.
You told bubbles that he was wrong and that it is not necessary to stick and place with small needles because he was wrong in saying that the site closes. This expert disagrees with you and agrees with bubbles. Can you read the extract and then respond, thanks.
» »
» » http://www.hairsite.com/hair-loss/forum_entry.php?id=3037
» »
»
» I have a question on the same topic. It seems that strip doctors use slits
» (eg H&W) and fue doctors use needles (Arvind, Cole, Woods), is it just a
» conincidence, do or can strip doctors use needle to create the holes?
Hi,
this was discussed at length in the linked thread above.
» Jessica, we all know what stick and place means. I am not sure that you
» read the extract above at all.
» You told bubbles that he was wrong and that it is not necessary to stick
» and place with small needles because he was wrong in saying that the site
» closes. This expert disagrees with you and agrees with bubbles. Can you
» read the extract and then respond, thanks.
In the excerpt, Limmer says, “the stick-and-place method, requires that each graft be placed immediately after the needle has been removed, since the needle tunnel remains open only for a few seconds”
I don’t agree. I have never seen a site close up immediately like he describes. I could speculate as to why he says this, but it makes more sense to ask him what he means than for me to guess.
Com’on Marco, you are beating a dead horse. I’ve seen good results from both schools, the doctors probably just choose whatever technique they feel comfortable with. The end result is not that much different, don’t you agree?
I saw with my own eyes Dr Woods and Dr Campbell both doing the stick and place methods where the needle goes in and the graft is slipped in through the bevel, then the needle removed. The needle is not even removed until the graft is in.
I was told by both doctors that with those small gauge needles that it must be done in such a way because the site closes up ver quickly. I would also imagine it is also the less traumatic to do it this way than to come back after and have to try to find and force the tunnel open again, if it can even be done at all. Like I said before, I dont know what her doctor is doing(maybe different type of needle?) but I would be very interested to see her come back even 5 minutes later and find a site made by a standard 25 or 23 g needle and get a graft into it, without using excessive force. Furthermore, think of the difficulty of this working between existing hair.
Thanks Marco for finding that excerpt. I knew there had to be some more proof around.
People can believe what they want but I know what I saw and I tend to believe the the experts.
» Com’on Marco, you are beating a dead horse. I’ve seen good results from
» both schools, the doctors probably just choose whatever technique they
» feel comfortable with. The end result is not that much different, don’t
» you agree?
You are wrong. Wrong, wrong, wrong! I noticed this all the time and even Jotronic said the same thing. For grafts that were inserted using needles, the exit path is not as clean or as natural as those that are done using lateral slits. It’s almost as if there is a tiny black dot at the exit point of each hair. The follicle is squeezed through the hole. Give me a link to the old forum and I will find you some examples.
» Com’on Marco, you are beating a dead horse. I’ve seen good results from
» both schools, the doctors probably just choose whatever technique they
» feel comfortable with. The end result is not that much different, don’t
» you agree?
John,
I just don’t know. Maybe you a right. There is a pattern building though. The needle surgeons that don’t use stick and place seem to be the ones that are more conservative with density. It maybe that they are limited in how small the needle is and it is this that limits the density. I don’t know but the more I see the more I think that all expert surgeons are not equal in the results that they get. I want to decide what surgeon I might go to and I remain confused by the mutually exclusive answers to questions from different clinics. This extract was directly at odds with the comments of Coles clinic and that is for sure! Also 40fue/cm2 looks very different from one clinic to another in my opinion.
Interesting topic. Can we name all the doctors who use needles? Marco you might be onto something here. There might be a connection, we can perhaps end the eternal debate between fue and strip
» Interesting topic. Can we name all the doctors who use needles? Marco you
» might be onto something here. There might be a connection, we can perhaps
» end the eternal debate between fue and strip
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