Which parts of the procedure should the surgeon always be doing?

[TakeAction]

Some doctors seem to be heavily reliant on technicians while others do the entire procedure themselves.

Which parts of the procedure are crucial to be done by the doctor and which ones are acceptable to be done by technicians? I feel like a lot of the variance we see in results is due to differences in technician skill since they perform such a large part of the procedure.

[A_4_Archan]

Preferably Extraction and incisions 

At least incisions 

[BackFromTheBrink]

11 minutes ago, A_4_Archan said:

Preferably Extraction and incisions 

At least incisions 

Extractions or punches, or both?

[Rahal Hair Transplant]

Because the recipient incisions ultimately determine the angulation, direction and growth of each transplanted hair (in other words, the actual appearance and naturalness of the result), it is crucial that the surgeon create all recipient sites.

It’s also equally important that the surgeon map out the entire procedure.  This includes which follicular units go into which recipient sites, exactly which follicular units are to be extracted from the donor area (this includes how many grafts are to be harvested, spacing between extractions, how many follicular units are available over the course of the patient’s lifetime, etc.), how long the grafts are to remain outside of the scalp, the type of holding solution, which technician is to perform a task, etc.

While some think It’s just a matter of randomly plucking and planting, naturalness and density is determined partly How are the recipient sites are created and which follicular units are placed into which incision.  For example, the crucial hairline areas are created mostly out of single follicular units, the first row of which should be exclusively singles.  Multi-haired  follicular units in conjunction with shingles are then strategically used further back in order to mimic nature and re-create as much density as possible.  But all of this should be determined by a skilled and experienced surgeon.  Execution of the work is then often performed by experienced technicians.

While it’s not always necessary for the surgeon to extract all of the follicular units, it’s important for the chairs to perform several of the initial extractions to ensure that the patient is truly a candidate, the skin isn’t overly soft and that transaction is practically nonexistent.  There have been times during the initial extractions that Dr. Rahal determined that particular patient(s) were not a good candidate due to some physiological issue, even after trying multiple devices/tools   Thus, it’s crucial that the surgeon be the one to perform the initial extractions to ensure an optimal environment for harvesting healthy grafts 

It is also highly important that each technician is highly experienced and has become part of a cohesive team orchestrated by the surgeon like a well oiled machine. Using temporary or inexperienced technicians can throw off the entire process and impact the ultimate result. So while her transplant surgery is a team effort, the team should be experienced working together in order to produce the best results.

The above is certainly how it is Rahal Hair Transplant.

I hope this helps.

Rahal Hair Transplant

 

Edited August 9, 2023 by Rahal Hair Transplant

[A_4_Archan]

1 hour ago, BackFromTheBrink said:

Extractions or punches, or both?

Would prefer my surgeon to do Extraction(punches on donor area to take out grafts) and incisions(creating slits)

And the least i would prefer him/her to do incisions(creating slits)

And yeh forgotten another important thing is that a surgeon should be fully involved in the planning stage ....

[Z--]

Four rules: 

1 Doctor should be in the room at all times. 

2. You should be the only patient at the time of your procedure. 

3. The more doctor involvement the better. Incisions are a must. Preferably doctor is involved with both that and extractions. Planning should be meticulous - rushing this or a sub-30 min plan is unacceptable. 

4. You should know who your doctor is beforehand (avoid clinics with multiple doctors on a rotational basis). 

If the above isn’t adhered to, please ask for a compelling reason. Tech-driven clinics or doctors seeing multiple patients at once (or doing the bare minimum, if not less) are a blight in this industry. 

Edited August 10, 2023 by Z--

[Emiry]

The whole thing