Reasons for low growth/yield count

[HK500]

In the past few months I have been reading a lot of topics concerning Dr's de Yarman, Armani, Epstein (recently reinstated), etc... The common denominator being patients disappointed by their HT results.

 

Now, when it comes to low yield in a FUE HT I understand the main reason being damage to the FU during extraction, are there any other explanations?

 

What would be the main causes of poor results in a strip HT? (of course excluding infections, illness or other unusual events)

 

Thanks gang

[HK500]

In the past few months I have been reading a lot of topics concerning Dr's de Yarman, Armani, Epstein (recently reinstated), etc... The common denominator being patients disappointed by their HT results.

 

Now, when it comes to low yield in a FUE HT I understand the main reason being damage to the FU during extraction, are there any other explanations?

 

What would be the main causes of poor results in a strip HT? (of course excluding infections, illness or other unusual events)

 

Thanks gang

[TheEmperor]

I think the two primary reasons for a strip procedure are 1) Damage during dissection, and 2) Damage during placement by techs

 

Keep in mind that every follicle is cut out from the surrounding tissue under magnification. It is very exacting work and some % of them are going to die.

 

Also, the placement of the grafts must be done without putting much force on them or they will be damaged and die. In my procedure there is a "line" up the middle. On the left the yield is good, on the right front, not so much. This follows the pattern that the technicians were working. (They usually have one on the left and one on the right and divide you head down the middle).

 

Furthermore, the longer grafts are out of the body, the more likel they are to die. I suspect this is why crown growth is slowed/delayed, because they are placed often after 10 hours of being out of body. Perhaps techs are getting tired and rushing to get things done.

 

I have also heard that dense packing jeopardizes the grafts. Its not clear to me if there is a lack of blood or if it is the tight handling which causes damage.

 

 

IOW, the yield is almost entirely a function of the skill of the technicians. How good they are in dissection and placement without traumatizing the grafts.

[HK500]

Thanks Emperor, this confirms what I suspected as the cause residing in the different stages of the handling of the FU's.

Anybody else with other ideas?

[PLEASE GROW PLEASE]

Emperor has posted the exact same thing I would have.

[Bill - Seemiller]

HK500,

 

"TheEmperor" has provided an excellent answer.

 

Other physiclogical factors do exist but are far less common.

 

Transplanting into scar tissue is one such factor that may contribute to poor growth. Much like a seed needs fertile soil to grow, so does a hair follicle need healthy tissue to survive.

 

There is also the "X-factor", in which poor growth occurs beyond the control of the physician. The "H-Factor" refers to human errors leading to poor growth, such as those TheEmperor mentioned.

 

Best wishes,

 

Bill

[HK500]

Thanks Bill, this really answers my questions.

[Dr. Jerry Cooley]

Please see my post about factors effecting growth:

 

http://hair-restoration-info.c...?r=52810352#52810352

 

As mentioned, trauma to the hair follicle during the transplant procedure (transection, crushing, dehydration) is the most important factor.

 

Next is the oxygenation and revascularization of the graft. The newly transplanted graft must get enough oxygen in the first few days to survive, and new network of capillaries must form around it ("angiogenesis" or "revascularization") within a few days.

 

Finally, there are factors that I refer to as 'biochemical' which refers to what happens while tissue is kept outside the body for a period of time ("storage injury") and when it is placed back in the body ("ischemia-reperfusion injury").

 

I believe all of these factors should be considered and addressed by the surgeon who wants to get conistently good growth.

 

Jerry Cooley MD