hair transection from donor harvest

[latinlotus]

When a strip donor is cut, does the doctor cut on a straight line or goes around the individual hairs in order the minimize cutting near a hair follicles?

 

If the doctor cuts on a straight line, i would assume that there will be some transection? How many grafts can be lost that way? Thanks.

[latinlotus]

When a strip donor is cut, does the doctor cut on a straight line or goes around the individual hairs in order the minimize cutting near a hair follicles?

 

If the doctor cuts on a straight line, i would assume that there will be some transection? How many grafts can be lost that way? Thanks.

[Bill - Seemiller]

latinlotus,

 

It's impossible to avoid transection entirely when harvesting a strip, but most of today's leading surgeons use a single blade or double blade held at an angle to minimize transection. Leading surgeons concerned about transection will do their best to cut around (rather than through) follicles to minimize damage.

 

The cut is never entirely straight, but not every follicle can be avoided during the cutting process.

 

Best wishes,

 

Bill

[javy]

Great question latinlotus... I had never though of that before and i have never though of so many other things before...Thanks Bill for clearing things up but your answer leads my mind to one question.. What other surgical equipments can a surgeon use to cut the strip to the same effect ?? And of what equipments should one be careful of and when should one write off the surgeon if he uses any of the one to cut the strip...sorry these are not one but many questions...

[Bill - Seemiller]

Javy,

 

If any surgeon uses a multi-bladed knife to harvest the donor strip, run away.

 

Single blades are optimal in my opinion, but proper use of a double blade can be a viable option.

 

The "donor spreader", designed by Coalition member Bob Haber has been found highly effective in signifincantly reducing transection, almost to nothing.

 

See "Leading Hair Restoration Clinic, Coalition Member Bob Haber" written and published by Patrick Hennessey for more information.

 

Below I've pasted a snippet from the article:

 

"The issue of how hair bearing tissue is removed from the donor area has been a particularly hot topic on the internet the past few years. Patients have been concerned about minimizing scarring in the donor area, while maximizing the amount of hair follicles that are successfully transplanted.Dr. Haber is very much at the cutting edge of addressing these issues so that patient's get the optimal amount grafts from a given amount of limited donor tissue, while minimizing the visibility of any donor scar. In fact, his new device, the 'donor spreader', which virtually eliminates any transection (severing) of hair follicles in the donor area during donor removal, was a big sensation when it was introduced at the annual ISHRS meeting in Australia in August of 2005.Dr. Haber's new 'Donor Spreader' ??“ making Donor Harvesting Transection Free.

 

The donor spreader enables a surgeon to remove a single donor strip from the patient's donor area without transecting the follicles along the edges of the donor strip. This single strip of hair bearing donor tissue is then carefully 'slivered' (trimmed) under microscopes into smaller sections, which are then trimmed into 1, 2, 3 and 4 hair follicular unit grafts.

 

While many leading hair transplant surgeons have the skill to cut along the edge of the donor strip and carefully remove a single donor strip with minimal transection of the follicles along the single blade incision, the donor spreader makes this process easier and more assured.This single bladed donor removal and dissection process, when skillfully performed, makes the harvesting and trimming of donor tissue into follicular unit grafts virtually transection free. Thus a patient can know with confidence that every follicle that is harvested from their limited supply of bald resistant hair follicles in the donor area is going to be carefully preserved and transplanted.Such careful attention to maximizing a patient's limited bald resistant donor tissue is the hallmark of physicians who really care about the patient's long term well being. Such care is often not taken by clinic's who use 'multibladed' knifes to quickly remove and trim the donor area in one step without carefully avoiding transecting and damaging the precious donor follicles. Such multibladed knifes and other patient unfriendly means of donor removal, while expedient for the clinic, are silent killers of hundreds of thousands of precious bald resistant hair follicles each year.

 

In my opinion, Dr. Haber's new donor spreader is an outstanding and innovative tool that will save hundreds of thousands of precious follicles in thousands of patients as leading physicians incorporate it into their practices. I really commend him for making the donor harvesting process virtually transection free!"

 

I hope this helps.

 

Bill

[javy]

That goes straight in to my article collection book...... Thanks Bill

[latinlotus]

Thanks Bill.

 

Many, including myself, are questioning FUE yield mainly because transection of the grafts. However, it seems that the issue of transections when the strip donor is removed is largely overlooked. Like you said, the risk is real and I wonder what is the % of transection. In addition, when trichophytic closure is used, some hairs are lost also. It is true that once a graft is implanted from a strip HT, it will almost always survive. However, one needs to see how many of those grafts were lost even before the donor is being put under the microscope to be trimmed.

 

With FUE being improved and the % of transection going down (dr. Shapiro and dr. True are claiming under 2%), hopefully, the main disadvantage of FUE will becoming less and less of an issue.

[HairHope]

Good question, however - I believe if you need a significant number of grafts initially (or for a first HT to define new hairline), strip is probably the way to go, next I would think cherry picking grafts using FUE in any follow-up transplant is optimal. My 2 cents