Doubles/Triples in Hairline

[GoliGoliGoli]

Hey, I got wondering about this in another thread but didn't want to hijack too much.

How is it that double or triple follicles end up being put into the hairline? Is it not always easy to see once extracted that the follicle is a multiple, or is it more just due to the fact that the Dr is lazy or not very perceptive? Or could it be that they don't have enough singles for the hairline? 

[Antlor]

Some doctors don't use microscopes. Without at least 10x magnification, the follicle may seem to be only 1 hair but in fact there could be a miniaturized hair or hairs hiding in that follicle. Also, using loupes does not provide enough magnification. 

All the Coalition Doctors on the Forum's recommended list must use microscopes.

 

[NARMAK]

Sometimes it's the sheer fact microscope loops aren't used which can detect multiple hair follicles even with those hiding in telogen like mentioned above but in Turkey and most hair mills, 99.9% of the time, it's deliberately done to create a "thicker" look and people sometimes won't realise for a little bit how terrible that is and unnatural until they see regular hair. 

A few doubles or triples in the hairline can also naturally occur but it's so little that it doesn't usually look bad compared to the almost entire frontal hairline full of them

[slimjerky]

Magnification loupes are needed during extraction and microscopes to separate hairs into single grafts

2 hours ago, Antlor said:

Some doctors don't use microscopes. Without at least 10x magnification, the follicle may seem to be only 1 hair but in fact there could be a miniaturized hair or hairs hiding in that follicle. Also, using loupes does not provide enough magnification. 

All the Coalition Doctors on the Forum's recommended list must use microscopes.

 

I believe HLC uses 6-8x magnification during extraction but uses microscopes to separate the hairs.  Is this sufficient?

[Konfue]

8 hours ago, GoliGoliGoli said:

Hey, I got wondering about this in another thread but didn't want to hijack too much.

How is it that double or triple follicles end up being put into the hairline? Is it not always easy to see once extracted that the follicle is a multiple, or is it more just due to the fact that the Dr is lazy or not very perceptive? Or could it be that they don't have enough singles for the hairline? 

I think you might be referring to my thread. I don't really know the answer so didn't reply to you there, but the clinic said they used microscopes but missed "sleeping hairs". Doubles that appeared to be singles. Another well known clinic  I spoke with said that's complete BS, and wouldn't explain how many were missed in my hairline.  So I'm still wondering if this is true or if there's a better answer.

[mafpe]

There are times that the follicles are asleep, but unless youre on acute telogen phase, they are rare, and normally the number should be low. A few doubles are somewhat expected, but it shouldnt be a lot.

For lower cost surgeons though, as far as i can tell, most if not all doesn't bother using microscope since thats a lenghty process which needs a dedicated personel, and that means less graft usually.

I didn't go to a recc doc here, and the doc also doesn't use a microscope. My results isnt out yet but i think there would be a few if not several doubles.

[Adier]

Doubles and triples are found in the hairline because doctors aren't diligent. All HT surgeons know that hairline is only singles ,there might be some doubles but very few. But while doing a HT they tend to put density over naturalness which in turn result in doubles or triples in the hairline. Also magnification too.

Now few doubles will not necessarily look bad but if the hairline is filled with doubles and triples it will give a very artificial and pluggy appearance. 

[Gatsby]

14 hours ago, slimjerky said:

I believe HLC uses 6-8x magnification during extraction but uses microscopes to separate the hairs.  Is this sufficient?

I doubt it. Eugenix use Carl Zeiss microscopes of up to 20X

 

 

[THE TRUTH]

1 hour ago, Gatsby said:

I doubt it. Eugenix use Carl Zeiss microscopes of up to 20X

 

 

"It is natural to see double and triples in the hairline" 

Vicrum Jaypra CASH 😂

[gillenator]

1 hour ago, Gatsby said:

I doubt it. Eugenix use Carl Zeiss microscopes of up to 20X

And that is sufficient empowerment to dissect safely…the other critical factors are adequate lighting and skill with dissection 

 

 

[jjsrader]

Medispa has a good explanation. 

https://www.medispaindia.in/microscopic-dissection/

 

[Al - Moderator]

Clinics that remove all the grafts first, then look at them, sort them, and then implant them are going to have less multi-grafts in the hairline because they are actually sorting them out and can then say to themselves "We have 300 single hair grafts, so we will use these grafts in the hairline." and then specifically use singles in the hairline, doubles behind that, and the rest of the doubles and the triples behind that.

Clinics who remove the grafts and then immediately insert them into an implanter pen and then implant them can't spend the time looking at them and sorting them, so they are going to have a higher chance of ending up with multi-hair grafts in the hairline. There is one person removing the grafts, maybe 2 others putting them into implanter pens and handing the implanter pens to the person implanting them into the recipient zone. This is fast and they can get high numbers of grafts done in a day, but the quality as far as making sure singles are in the hairline will drop.

 

Edited July 19, 2022 by BeHappy

[GoliGoliGoli]

41 minutes ago, BeHappy said:

Clinics that remove all the grafts first, then look at them, sort them, and then implant them are going to have less multi-grafts in the hairline because they are actually sorting them out and can then say to themselves "We have 300 single hair grafts, so we will use these grafts in the hairline." and then specifically use singles in the hairline, doubles behind that, and the rest of the doubles and the triples behind that.

Clinics who remove the grafts and then immediately insert them into an implanter pen and then implant them can't spend the time looking at them and sorting them, so they are going to have a higher chance of ending up with multi-hair grafts in the hairline. There is one person removing the grafts, maybe 2 others putting them into implanter pens and handing the implanter pens to the person implanting them into the recipient zone. This is fast and they can get high numbers of grafts done in a day, but the quality as far as making sure singles are in the hairline will drop.

 

Is there any risk that by leaving them out longer to sort them that they don't implant as well? Or am I speaking out of pocket here

[Al - Moderator]

3 minutes ago, GoliGoliGoli said:

Is there any risk that by leaving them out longer to sort them that they don't implant as well? Or am I speaking out of pocket here

 

I think there was a study done on this. I can't remember but I think there was basically no difference for the first several hours and not any big difference until you get past 8 hours or something like that. I can't remember the times and how much it mattered, but basically 2 or 3 hours was no different than if it was only 15 minutes.

With organ transplant (which hair transplant basically is) such as hearts, lungs, kidneys, etc, those organs can stay outside the body for several hours and function fine after being transplanted, so I would think hair grafts should be OK for at least a few hours also.

[Al - Moderator]

I should add that what matters more is to get the grafts into a solution that helps preserve them. Making sure they don't dry out is key.

 

[ITA]

It is just a matter of using / not using microscopes and magnifying glasses.  In 99.9% - 100% of Turkish clinics, magnifying glasses or microscopes are NOT used, it would take too much time and staff to count / select the follicular units with one hair from those with more hair so they could not perform those hair transplants of 4000/5000/6000 grafts in one day only at those very low prices they are known for.

[Antlor]

On 7/18/2022 at 5:16 PM, slimjerky said:

Magnification loupes are needed during extraction and microscopes to separate hairs into single grafts

I believe HLC uses 6-8x magnification during extraction but uses microscopes to separate the hairs.  Is this sufficient?

Probably it's fine. I am basing this assumption on the generally positive reviews for HLC. However, to know with certainty is to ask HLC.

Also, not all microscopes are created equal. I did some googling. For instance, a $100 point and shoot camera will not take better images than a $3000 full frame camera. Similarly a 10x microscope will not provide better imaging than a high cost 10x stereo microscope. A good stereo microscope will provide a sharp image and good 3D clarity.