Tag: Dissection

Advancement in Hair Transplantation

A standard hair transplantation procedure involves the removal of donor strip of hair from the back of the head from where the follicular unit grafts are dissected under a microscope. These grafts are then preserved in saline and are then transplanted on a bald patch on the crown area of the scalp.

Given the time consuming and tedious nature of this procedure, a hair transplant surgeon is often able to transplant only about 500 to 600 follicular unit grafts per day. However, thanks to the recent hair transplant advances, this technique is often replaced by the follicular unit extraction (FUE). The cost per graft of FUE is typically twice the cost of the standard follicular unit hair transplant procedure discussed above but it is comparatively faster and minimally invasive.

Some hair transplant advances

In a typical FUE procedure a small round punch is made in the donor area to directly extract 1, 2, 3 and 4 hair follicular unit grafts. The follicular units extracted using this process is typically referred to as “blunt dissection” where a punch is made to envelope the entire follicular unit separating it from the surrounding soft tissues.

Once the underlying follicular unit is separated from the surrounding tissues, it is easily extracted using a small forceps. The small holes left behind after the follicular unit extraction gradually heal over the next few days and are not detectable to the naked eye once the patient’s hair grows out. The healing time is much less than the donor strip extraction procedure.

While the FUE procedure has been adopted by most hair transplant clinics, the standard strip excision method is still the most popular hair transplant procedure because it is more economical than the FUE.

Moreover, due to some recent hair transplant advances such as the use of trichophytic closure technique, the linear donor scar created by the strip excision procedure is now often rendered almost undetectable to the naked eye. This advancement in the hair transplantation technique has made FUE procedure relatively less appealing.

Hair transplantation research

Besides the hair transplant advances in the transplantation procedures, a lot of research is also underway to clone the hair. If the hair transplantation research is successful it will be possible to make several copies of donor hair in the laboratory. The application of this technique would be used in the form of hair transplantation. In the traditional procedures, the biggest limitation is often the donor which is not able to meet required density. However, hair cloning promises to overcome this problem by having the amount of hair required to be grown in a laboratory from a single donor hair and then implanting it into the scalp.

Hair transplantation research for cloning is very difficult and there are many hurdles that have to be overcome regarding the safety and cosmetic characteristics of the cloned hair. Some hair transplantation research has also provided breakthrough for some hair loss medication like Dutasteride.

Incisions and Scaring

Surgery leaves scars. While most breast augmentation incisions do heal well, a rate of 6-7% of unfavorable scaring has been reported for primary augmentation patients in FDA clinical trials.

The extent of the scaring can be determined by many factors. These include the patients ethnicity, smoking, tissue quality, suture material, wound tension, tissue trauma from surgery and the individuals tendency toward favorable wound healing.

The type of incision also affects the amount and visibility of scaring. The type of planned incision should be discussed with your surgeon prior to the procedure.

The most common incision for silicone gel implants is the inframammary incision. This affords maximum access for precise dissection and placement of an implant. The incision is placed below the breast in the infra-mammary fold. This incision can leave slightly more visible scars in smaller breasts which dont drape over the IMF.

Transaxillary incisions are placed in the armpit. This allows the implants to be placed without visible scars on the breasts. Its also more likely to consistently achieve symmetry of the inferior implant position.

Periareolar incisions are placed along the areolar border. The incision is usually placed around the inferior half of the areolas circumference. Because of the incision length required, silicone gel implants can be hard to place using this method. These scars are often less visible in women with lighter areolar pigment since they occur on the edge of the areola. There is a higher chance of capsular contracture with this incision.