lateral slit

[so tired]

is the lateral slit superior for density

[Gorpy]

Yes it is. I believe it is mainly due to the fact that since the incisions are lateral (almost parallel to the head), the grafts will have less tendency to "pop". When grafts are inserted in lateral slits, the pressure they exert is up against the skin instead of up towards the hole itself.

[NikkiJ]

The reason you are able to achieve such better density is due to the fact that you can layer the sites or fan them out, like tiles on a roof. With needles you are forced to create rows, with space in between the sites, which creates a very unnatural growth pattern and also decreases density.

 

Using custom made blades also allows the sites to be much smaller, which can be a small as .6 millimeters in length.

 

With lateral slits you can transplant up to 70-units per square centimeter, and with needles, and/or sagital sites this is just not possible.

[Gorpy]

Thanks for that informative input NikkiJ. I think there are multiple reasons for the abililty of the lateral slit technique to allow for dense packing.

 

I got this from the learning center on this very site. This describes the "popping" I was referring to before.

 

Quote:

"Lateral slits can enable denser packing of grafts

 

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp's underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp." End Quote.

 

You can read more about it here

[Jotronic]

And now, a word from our sponsor...

 

You guys are kinda right, but kinda not. Let me give it a go.

 

What are lateral slits? Are they simply slits that point to either side of the scalp, like from ear to ear? While it may look like it this is not the case. The term "Lateral" in lateral slit is synonymous with perpendicular. If you remember high school geometry being perpendicular is being at a right angle, or 90 degrees, from the reference angle. Making lateral slits means to make incisions that are perpendicular to the direction that you are placing the graft or perpendicular to the direction of hair growth. Since the hair on top of the scalp tends to grow in a forward direction toward the forehead area the incisions are perpendicular in that they point to the left and right of the scalp, toward the sides of the head. If you had natural hair directions pointing toward the sides of the scalp then you would in turn have incisions that are pointing toward the back and the front of the scalp, again, perpendicular to the direction of hair growth. When I say "pointing" I mean the sides of the incision. If lateral slits meant only that the incisions are pointing to the sides then the crown work performed with this technique would look awfully odd.

 

NikkiJ said that higher density is achieved with lateral slits because the grafts can be fanned out. Actually, by being able to fan out the grafts the end result is better coverage with X number of grafts than one would recieve with the same number of grafts from using needles. With better coverage however comes the illusion of better density. Be careful with the term "illusion" as they are not interchangeable when dealing with density vs. coverage. You can have an illusion of density by having better coverage but you cannot have the oppposite. It just doesn't work like that.

 

The advantage of lateral slits for true density comes from not only the nature of the incision shape but also from the angle in which it is made. Either factor alone does not allow for the potential for high density but both combined do. Note that the incision itself looks like an envelope. Imagine holding an envelope in front of you with your hands outstretched. Imagine the broad side of envelope, the side where you right the address, as facing you. What happens when you stuff a letter into the envelope? It bulges, right? But where? Not on the left or right but in the middle or the side that faces and opposes your view. Now, turn the opening of the envelope toward you at about 35 to 45 degrees. Congratulations, you have just recreated a lateral slit (the right way). Observe where the pressure of the envelope is directed. It is vertical and does not radiate to the left or the right. Incisions made with needles exert their pressures to all areas around them no matter what angle they are made. When you have thousands of these incisions the pressures compound and when you have ever increasing pressures you have a restriction of blood flow. This is bad. It can also encourage popping of the grafts. When I say popping I mean the grafts literally "pop" right back out of the incisions. This, too, is bad.

 

When the pressure is exerted vertically from lateral slits it does not affect the surrounding area so when you have thousands of these slits next to each other in the same manner they are not affected by their neighbor. Furthermore, when the incision is made at the angle mentioned, roughly 35 to 45 degrees you do not have to go as deep into the tissue while still maintaining proper insertion depth for the graft. These more shallow incisions mean less disruption of blood flow thereby decreasing overall damage to the vascular scalp. When you have less disruption to the vasculature and less pressures you have less popping of the grafts, greater control over angle and direction of the grafts and the potential to hit much higher densities without sacrificing graft survival.

 

Also, blade sizes of .6mm are possible BECAUSE of lateral slits. They are able to be placed much closer together because of the reasons stated above.

 

So, lateral slits are beneficial because...

 

Better fanning of grafts equals better coverage with the same number of grafts as compared to other techniques.

 

Better coverage equals the "illusion" of better density.

 

Actual density is easier to achieve because of less damage to vasculature and less peripheral pressures being exerted on neighboring grafts. One will also experience faster healing as well.

 

There are other benefits as well but my fingers are getting tired

 

Hope this helps to explain it for you.