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AIRPT
Institute
for Research into Tissue Plasticity
Copyright
© 2005 AIRPT
Hair
Microtransplantation
Transplantation of hair grafts is the
most widespread among the surgical techniques for the treatment
of male pattern baldness. It combines the advantages of local
treatment with the absence of estensive surgical manipulation
and a natural aesthetic result, since micrografts have
been introduced fig 1.
1
Nevertheless,
it presents some difficulties caused by the laboriousness
of insertion of the hair grafts through the hundreds of stab
incisions, which are often hidden by the bleeding.
Mini and microdilators, which increase the width of the mini
and microincisions, carrying out, at the same time, hemostasis
by compression, lengthen the operative time and do not prevent
new bleeding when they are removed, because the blood clot
is removed with them.
Moreover, extreme caution is necessary during the maneuvers
of transplantation of the grafts with the microforceps, which
can cause extrusion of the limitrophe grafts and, more importantly,
crushing of the follicles with the forceps tips.
To
reduce the operative time and the surgeon's work, we adopte
needles of different gauges, which function as knives,
dilators, and carriers of the follicles. The external diameter
of the needles varies from 1.5 to 3.5 mm, their lenght is
40 mm.
Instant Calculation of the Number of Grafts
Transparent patterns, placed on the receptor area,
marked with ink, permit instant calculation of the number
of grafts. On the frontal area we transplant one or two hair
follicles into each needle incision. Three or four row of
these incisions are prepared with the needles inserted in
the chuck handle.
Trimming the Donor Area
The occipital donor area is trimmed , leaving inside the strip
hairs 2, or more, cm. long.
Local Anesthesia
Local anesthesia is achieved with 0.5% xylocaine with adrenaline
1/50.000. The supraorbital, temporal and occipital nerves
are also infiltrated.
Harvesting the Strip
The occipital donor strip is excised with a No. 23 scalpel.
The galea aponeurotica and the occipital vessels and nerves
are preserved. The dimension of the strip depends on the number
of grafts required. The hair of the graft is left 2 cm. long.
Grafting
Procedure
A) In hairless areas, we use the needles as blades, choosing
the right diameter and securing them into the chuck handle.
The needles produce an incision with a semilunar door, which
keep the graft better than a straight microincision.
B) When the patient has thin hairs and does not want them
shaved, we insert the minigrafts into the needle with the
follicle oriented toward the tip. The needles, filled with
the grafts, are inserted in the predetermined number, then
the grafts are pushed into the subcutaneous tissue with a
probe.
References
1
2
3
Copyright
© 2005 AIRPT
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