Complementary techniques

1- Tricofitic Suture – An evolution of the classical suture.

The interest in the improvement of the quality of the scar of the donor area caught the attention of doctors and patients for new techniques. And, in fact, three modifications were created. Combined, they simply revolutionized the technique. They are:

1, Tricofitic suture – It’s an ingenious idea of uncertain authorship. The central concept is that after the withdrawal of the donor area, a bevel of 45 degrees, with 1.2mm of width and depth is made in one of the edges. This allows the hair to grow through the scar, becoming it pilose and even more imperceptible. The 1mm width scar is still there, but is now surrounded by hair.

2. Mayer-Pauls Scalp Elasticity Scale - Another shiningly ingenious idea. A table related with a scale of elasticity of the skin guides the surgeon on the maximum safe width of the donor area. Thus, we reduce the risks and surprises preventing an extreme tension of this area. The risk to widen the scar diminishes drastically, essential to bigger sessions (Super mega sessions).

3, Sandoval-Haber technique - By controlling the depth of the incision, we minimize the risk of trauma of the follicles during the withdrawal while preserve important vases and nerves in the cicatrisation process, making the post-transplant calm and almost painless.

15 days after the transplant.		Tricofitic suture.

2- Follicular Unit Extraction (FUE, FOX or FIT) – A new method for the donor area. Is it possible to reinvent the wheel?

The necessity of having the hair shaved – the donor area must be widely shaved, making easier to allow a bigger and better visualization of the hair angling.

The great loss of UFs - As its main diffuser, Dr. William Rassman, point out, even in the most experienced hands, the technique produces a minimum loss of 15 to 20% of the UFs removed. In clear language, it is hair thrown in the garbage. This occurs because this method is blindly made. One cannot actually see the roots inside the skin. That’s the Difference between it and the Follicular classic method, where the splitting of the UFs, made through the use of 3-D microscopes, has worthless loss. A new “punch” that’s been developed by Dr. Jim Harris promises to reduce the issue.

Not indicated for all types of hair - a previous test indicates if the hair is suitable. The UFs presents parallel roots next to each other, which facilitates the blindly withdrawal. On the other hand, the more opened and moved away the roots of the Follicular units are, the more UFs will be injured during the process of extraction and, consequently, lost.

It is a lengthy and tiring procedure - the withdrawal here takes a few hours, against 40-60 minutes in the classic withdrawal. The implantation time is the same. This end up limiting the method that allows lesser withdrawals, between 300 and 800 UFs for transplant, against the 2.000 - 4.000 UFs removed normally. In other words, much more sessions will be necessary.

It costs twice the price - the monetary cost is in general the double of a Follicular Transplant carried through with the classic technique for donor area.

Complications - the term “scarless hair transplant” is used improperly. Truth is that the technique leaves behind small hypochromic scars (clearer) in the withdrawal area that are practically imperceptible. However, these small scars can affect the donor area, making it difficult that a posterior session with the same technique be done. Besides, with multiple sessions, the donor area can start presenting a visible hair rarefaction, not desirable at all.

Conclusion: There’s a consensus around the FUE technique that affirms that it is indicated in the cases where the donor area is already compromised; for patients willing to have their hair totally shaved and for those who need a small Follicular Transplant, in just a few, restricted areas.