Regular Member wouldLikeMoreHair Posted March 2 Regular Member Share Posted March 2 hi all, is it a red flag if the surgeon does not trim grafts after extraction? leading to lot of tissue around the grafts when implanting as shown in the picture below (look like white 'caps') suregeon's reasoning is that they don't want to trim away any of the healthy tissues that help in growing... It concerns me since I've read that too much tissue around grafts can cause too much trauma and cause cobble stoning, ridging etc. AND it seems that most world renowned surgeons (Pekiner, Rahal, Konir etc) all trim the tissue around grafts to a point where these white 'caps' do not show when they implant. thoughts? thank you! Link to comment Share on other sites More sharing options...
Moderators Al - Moderator Posted March 2 Moderators Share Posted March 2 Some Drs like the untrimmed "beefier" grafts. They are less prone to damage when handling them and implanting them. Thinly trimmed grafts are very fragile and can damage more easily. However, trimmed grafts can be more easily dense packed. I personally think larger graft sizes generally have a better long term survival rate, but that's my personal opinion. I don't know of any actual statistics or studies on it. In any case, what matters most is the Drs end results. Al Forum Moderator (formerly BeHappy) I am a forum moderator for hairrestorationnetwork.com. I am not a Dr. and I do not work for any particular Dr. My opinions are my own and may not reflect the opinions of other moderators or the owner of this site. I am also a hair transplant patient and repair patient. You can view some of my repair journey here. Link to comment Share on other sites More sharing options...
Administrators Melvin- Admin Posted March 2 Administrators Share Posted March 2 Trimmed grafts while refined can lead to poor growth, especially with FUE. Usually graft trimming is exclusive to FUT. I’m a paid admin for Hair Transplant Network. I do not receive any compensation from any clinic. My comments are not medical advice. Check out my final hair transplant and topical dutasteride journey: View my thread Topical dutasteride journey Melvin- Managing Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog. Follow our Social Media: Facebook, Instagram, Linkedin, and YouTube. Link to comment Share on other sites More sharing options...
Regular Member Bhumik Shah MD Posted March 2 Regular Member Share Posted March 2 (edited) Trimming or not trimming the epidermal cap, which is what you see in the photo, will not effect the result. This is just "dead" skin tissue which is coming along for the ride with the follicle and has no bearing on the follicle's "health." It just looks cleaner cosmetically in the post operative period, but this is very temporary as everything sheds within 2-5 weeks. Edited March 2 by Bhumik Shah MD Medical Director/ Hair Transplant Surgeon at BKS Hair Restoration. NOTE: All posts are for educational purposes only. It is not intended as medical advice. Please direct all inquiries regarding specific health concerns to your physician. Link to comment Share on other sites More sharing options...
Regular Member Bhumik Shah MD Posted March 2 Regular Member Share Posted March 2 (edited) Trimming for a skinny graft vs a chubby graft, (what Al is referring too) happens more at the follicular level but will not be apparent to the patient. Edited March 2 by Bhumik Shah MD Medical Director/ Hair Transplant Surgeon at BKS Hair Restoration. NOTE: All posts are for educational purposes only. It is not intended as medical advice. Please direct all inquiries regarding specific health concerns to your physician. Link to comment Share on other sites More sharing options...
Regular Member wouldLikeMoreHair Posted March 2 Author Regular Member Share Posted March 2 Thank you everyone for your response. @Bhumik Shah MD I was wondering because some results from this particular surgeon shows a bit of cobblestoning, and I was wondering if that is any way related to the fact that he leaves the epidermis caps intact (and he has stated that he does not trim the grafts at all) Link to comment Share on other sites More sharing options...
Regular Member Woody1000 Posted March 28 Regular Member Share Posted March 28 On 3/2/2024 at 3:17 PM, Bhumik Shah MD said: Trimming or not trimming the epidermal cap, which is what you see in the photo, will not effect the result. This is just "dead" skin tissue which is coming along for the ride with the follicle and has no bearing on the follicle's "health." It just looks cleaner cosmetically in the post operative period, but this is very temporary as everything sheds within 2-5 weeks. Very interesting. I think what OP may be asking is does the “white cap” part heal into the scalp and cause the cobble stoning effect? Is this what ultimately becomes the scab? however how comes it is considered dead skin tissue and not heal into the scalp as both are tissue? Link to comment Share on other sites More sharing options...
Regular Member Otis james Posted March 28 Regular Member Share Posted March 28 (edited) Don’t most immediately post op pics show this? This is mine… there’s non on the immediate first few rows but lots behind…. I’m not sure this is a big deal… Edited March 28 by Otis james Link to comment Share on other sites More sharing options...
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