Needle vs. Blade: Redness?

[TheEmperor]

I have noticed that of pictures posted of needle operations, there seems to be MUCH more redness than with blades. Also the redness seems to last longer post op.

 

Is this because the needle doc is planting at greater density? or does the needle cause more trauma?

 

It seems like a needle would cause _less_ trauma, but there is much more redness.

[TheEmperor]

I have noticed that of pictures posted of needle operations, there seems to be MUCH more redness than with blades. Also the redness seems to last longer post op.

 

Is this because the needle doc is planting at greater density? or does the needle cause more trauma?

 

It seems like a needle would cause _less_ trauma, but there is much more redness.

[Bill - Seemiller]

TheEmperor,

 

JoTronic has posted a demonstration video on needles verses flat blades which was very educational. Based on the outcome of the demonstration, it would appear that flat blades are less traumatic to the scalp.

 

You can view the video by viewing the following thread.

 

Best wishes,

 

Bill

[the B spot]

Given a choice, flat blades hands down----- there just seems to be a larger penchant for depth control problems with needles--- leading to pitting.

 

I don't know about the trauma issue, I think that has quite a bit to do with the doctor IMO-

Poor incision skills are going to equal more trauma regardless of the instrument used.

 

I am with Joe and Bill though--- I like blades.

[Janna]

"I don't know about the trauma issue, I think that has quite a bit to do with the doctor IMO-

Poor incision skills are going to equal more trauma regardless of the instrument used." -bspot

 

I agree with Jason on this point. We don't use needles at our clinic, but I believe Dr. Cooley uses needles on a regular basis. He seems to produced very clean and awesome results. He could clearly make a case for needles - IMO.

[Bill - Seemiller]

I would love to hear Dr. Cooley or another elite hair transplant surgeon who regularly use needles to present their reasons for it. I think this would be very educational.

 

Bill

[Guest]

I had a recent HT with Dr. Quatela who uses the needle method. My understanding is that he uses two different sizes...one for single hair grafts and one for larger grafts. My scalp came out feeling and looking pretty beat up...at least compared to some of the pictures I see on this site. I'm hoping there isn't a lasting impact. At two weeks there is a hint of pink, but the skin is still very rough/bumpy. I'm using aloe vera gel which seemed to knock down the redness. I'll post some recent pix tomorrow.

[M_D]

During my recent transplant, Dr. Rahal used needles. His reasoning was that because I had existing hair, he could control the angulation better and decrease the risk of transection.

[Ailene]

Hey Guys,

 

I am going to try to answer this question and also try to attach a photo (remember I am challenged in this effort so be patient.) The photo was taken at the follow up at about 24 hours post op.

 

Blades versus Needles

 

We have used both needles and blades for many years. In a large number of patients, we have used both and see no difference in post-op healing or redness. When patients come back in for followup when the hair is growing in, there is no difference in the appearance of the hair in blade areas compared to needle areas.

 

For grafting in hairless or shaved areas, we prefer the blades which we custom cut depending on the width and depth of the grafts. Since most of our patients do not want us to shave their heads and expect to be back at work in a week, we are often grafting into areas with significant hair. For this, we prefer the needles because the sharp point can be directed precisely and the larger caliber of the needle 'pushes' the hair apart, minimizing the risk of shock loss. We use different size needles ranging in size from 19 gauge being the largest and 22g or 23g be the smallest.

 

Whether using blades or needles, technique and sharp instruments are critical. When making the sites with either instrument, it should feel like cutting through butter (I am told) and the depth should be controlled. We use a very sharp brand of needles which is much sharper than the standard brand an more expensive but worth the price. This is what determines trauma and post-op healing, not whether it is made with a needle or a blade. If any resistance is felt, the blade or needle should be switched out for a fresh sharp one. Anyone who has assisted in this procedure and has slivered or cut knows that blades and needles will dull very quickly. This is caused by the tissue and the fluid they are subjected to.

 

We like having the option of using blades or needles (or both) to customize our technique for a given patient. Hope this helps.

 

Ailene

 

PS Let me know if I was successful in this attachment!

[Janna]

Thanks Ailene,

 

The picture came in beautifully as is the work itself. I agree with you that it's the skill of the physician rather than the instruments or the type of incisions (sagital, lateral, or needle) that really matters. The skilled physicians are able to customize every aspect depending on what works best. I think you're in depth reply should be very helpful.

[Eman]

I would love to have Adrian (who is a Patient Advisor for Dr. Rahal) or even Dr. Rahal respond to this question.

[Ailene]

Thank you Janna! I think the work speaks for itself. But, I forgot to mention that on this case we actually used a combination of both needles and blades. Dr. Cooley does a blue print and customizes it with the incision size according to what we are seeing in the dissection (number of 1's, 2's, 3's, 4's).

 

Regards,

Ailene

[Bill - Seemiller]

Ailene,

 

Thank you for participating on this thread.

 

Because there are a number of varying philosophies out there, it's important that all of them are described and properly understood so patients can make educated decisions on selecting a quality hair transplant surgeon. Cleary, Dr. Cooley does first-rate work!

 

Thanks,

 

Bill

[JagNet]

I'm sure there are guys around who had more than one session with different docs maybe one with needle and the other blade. Ask them to compare the two. I think both work well if the doc is good.

 

BTW. JoTronic's video was challenged by Dr. Wood's on another site. There is a video by Woods that shows the opposite of what JoTronic states.

[JagNet]

Originally posted by JagNet:

I'm sure there are guys around who had more than one session with different docs maybe one with needle and the other blade. Ask them to compare the two. I think both work well if the doc is good.

 

BTW. JoTronic's video was challenged by Dr. Wood's on another site. There is a video by Woods that shows the opposite of what JoTronic states.