Needles or Blades?

[Jotronic]

A couple of years ago I was in a debate online in another forum where I was presenting my argument for blades instead of needles and how I thought blades were better. I presented photos and arguments for my position and at the end of the lengthy debate I had the idea to use a melon and actually make the incisions to compare.

 

Well, I finally did this and as it turns out my logic was correct. I made incisions with 18 gauge needles and compared them to 1.26mm blades which are the same width. I then used 25 gauge needles and a .5mm blade. Both are much smaller but the result was replicated.

 

I feel this video is a valuable tool when describing what the difference is between both. I have at least one more video to make to also show exactly what lateral slit and sagittal slit means. It should be up within several days.

 

The video is here:

 

Blades or Needles Video

[Jotronic]

A couple of years ago I was in a debate online in another forum where I was presenting my argument for blades instead of needles and how I thought blades were better. I presented photos and arguments for my position and at the end of the lengthy debate I had the idea to use a melon and actually make the incisions to compare.

 

Well, I finally did this and as it turns out my logic was correct. I made incisions with 18 gauge needles and compared them to 1.26mm blades which are the same width. I then used 25 gauge needles and a .5mm blade. Both are much smaller but the result was replicated.

 

I feel this video is a valuable tool when describing what the difference is between both. I have at least one more video to make to also show exactly what lateral slit and sagittal slit means. It should be up within several days.

 

The video is here:

 

Blades or Needles Video

[Jotronic]

Btw,

 

The video is about 15 minutes in length. Please report problems with the video if you experience any. As a suggestion clear your cache memory before you start this up and make sure of course that you have the latest version of Flash. If you do not there is a link on the page to download it.

[bayscholar]

Part of me likes how useful this example is...But part of me thinks you just want another reason to show off your hair....Both are very impressive.

 

thx

 

Bay

[Bill - Seemiller]

Joe,

 

Well for starters, I can certainly be glad that YOU were not the one making incisions in my scalp when I was there . Of course, magnification typically helps when attempting lateral slits .

 

Clearly custom cut flat blades are less invasive in the recipient tissue than needles.

 

I like how you used a few different sizes to demonstrate - the 1.26 mm needle verses the 1.26 mm blade and then the .51 mm needle verses .51 mm blade.

 

One comment: clearly the depth of the incision made by the blade is controlled by the tool that holds the blade, whereas the depth of the incision made by the needle was not controlled but more free.

 

That leads me to my question: Though this does not negate the results you've shown regarding recipient invasiveness...I do have to ask what other clinics use to control the depth of the incisions made by needles?

 

Thanks,

 

Bill

[spoon]

Do the blade incisions have to be dilated when grafts are inserted into them?

[Jotronic]

Bay,

 

LOL, I'm working on a separate video for that but thanks just the same

 

Bill,

 

I'm not sure what other clinics use. I know I've seen some do this freehand like I did but there may be some clinics that use some sort of handle. I'll look into this further and report back. I'm glad you liked the video.

 

Spoon,

 

No, dilation is not necessary if the grafts are cut correctly. Sometimes the incisions may be coaxed open a bit with a separate tool but this is not the rule but rather the exception.

[Bill - Seemiller]

Joe,

 

Btw...welcome to the Follicular Salvation Club . You are over 1000 posts now

 

Look forward to any additional information you can provide.

 

Bill

[Jotronic]

And it only took me five years Thank you, sir.

[the B spot]

Welcome to the dark side Joe!!!!

[Bill - Seemiller]

I thought I would bump this thread because it contains valuable information. I highly recommend watching the video if you get a chance. It is about 15 minutes long.

 

Best wishes,

 

Bill

[Jotronic]

I was doing a search in the archives and came across this old post. I made a newer version of this video in full HD several months back and forgot that I didn't update this thread. The newer video was shot in full HD so that the details could be better visualized.

 

http://youtu.be/a7Zdv6kdtms

[ej]

Joe

 

Great video ! interesting subject .

 

Graft site instruments , either needles or blades ,appears to be much like fue extraction devices , outer/ inner punch diameter which can be very misleading .

 

Looking at these instruments used , it looks like it comes down to almost ` shape `, round causes more trauma than slit so to speak , do you think its due to ` surface area ` and the blade has a lot lower surface area than a needle ? as it appears that way in the vid

 

many thanks

 

ej

[TommyLucchese]

Which doctors use needles and who uses blades?

[gillenator]

Custom sized blades are without question less invasive and IMHO was really the pioneering tool that provided entry into the concept and induction of proper "dense-packing". But this time with the corresponding yields to support the approach providing the surgeon(s) utilizing the bladed tool are skilled and competent in not only the spacing of the recipient incisions, but making them at the proper depths and corresponding angles.

 

From my understanding, most of the blades manufactured for this type of use have the depths set at the base of the various sized blades. Most of the variance in these blades are intended for the "width" of the blades, not necessarily the depth.

 

Either way, the blades have greatly reduced the level of overall trauma to the recipient areas and can also help to reduce or lower the overall effect of shockloss. Just another benefit of the blades

[gillenator]

Which doctors use needles and who uses blades?

 

Some doctors use blades almost exclusively and some still use a combination of both needles and blades to create their recipient sites depending on the type of incisions they feel will produce the best visual result for that particular case/patient.

[Jotronic]

Custom sized blades are without question less invasive and IMHO was really the pioneering tool that provided entry into the concept and induction of proper "dense-packing". But this time with the corresponding yields to support the approach providing the surgeon(s) utilizing the bladed tool are skilled and competent in not only the spacing of the recipient incisions, but making them at the proper depths and corresponding angles.

 

From my understanding, most of the blades manufactured for this type of use have the depths set at the base of the various sized blades. Most of the variance in these blades are intended for the "width" of the blades, not necessarily the depth.

 

Either way, the blades have greatly reduced the level of overall trauma to the recipient areas and can also help to reduce or lower the overall effect of shockloss. Just another benefit of the blades

 

Hi Gil,

 

Actually, the blades are not manufactured at all. They are cut on the fly from raw medical grade razor blades as needed during the procedure. The depth is also custom controlled by the handle that I was showing in the video. It is similar in concept to an exacto knife where the depth can be adjusted as needed and locked in.

[Dr. Ricardo Mejia]

I personally use the flat blades. They are precise and cut well. However , I tend to use a variety of blades depending on the type of tissue the patient presents with and which one will end up giving the best result with the size of grafts we are using.

[Dr. Michael Beehner]

I agree completely with Jotronic that the blades are less traumatic than needles. But the one fact that always has to be taken into consideration with every surgery is: How can I help my assistants place the grafts with the least trauma to the grafts? Trauma to the grafts from over-handling, repeated attempts at placement, and trying to squeeze an FU of a certain size into a hole that is just slightly smaller than the graft - these are the real killers of follicles.

I use the custom-cut blades in probably 80-90% of patients, but especially in those with a rigid, tight scalp I like to use solid-core needles, mostly the 20g, 19g, and 18g sizes. Besides making a lateral cut like the blades do, they also have a dilating effect on the opening, thus making placement a little easier.

Mike Beehner, MD

[Dr. Ricardo Mejia]

My point exactly Dr. Beehner. We also customize the blade type to the graft sizes and the type of scalp tissue.

[gillenator]

Hi Gil,

 

Actually, the blades are not manufactured at all. They are cut on the fly from raw medical grade razor blades as needed during the procedure. The depth is also custom controlled by the handle that I was showing in the video. It is similar in concept to an exacto knife where the depth can be adjusted as needed and locked in.

 

Joe,

 

Interesting. In my last procedure (strip) the blades were already there in the tray ready to use, and quite ceratain they were not made on the fly. I have seen these blades in medical supply catalogs as well in .25mm and .5mm increments.

 

Yet if some clinics/doctors make them on the fly, that's pretty cool because obviously the blades are customized right there in the OR and then the grafts can be cut to size of the blades being used.

 

Blades definitely have made a huge difference with the various benefits many of us have touched on.

 

Enjoyed the video!