In the normal plug grafting technique healthy hair
roots from the back and the sides of the scalp are transferred
to the top of the scalp where needed by using an instrument
called a trephine.
This instrument has a circular cutting
edge and the circular grafts it takes will vary in size
from 2mm diameter to about 5mm diameter.
As many as
600 grafts could be removed from any one patient, although
a maximum of 50 grafts should be removed in any one
session of treatment.
Nowadays the donor tissue is removed with a multi-bladed
knife that produces long thin strips of donor tissue,
although single strip harvesting now appears to be a
superior method.
After anesthetizing the donar area, a strip of scalp
about ½" to 1" wide and 4-5" long
is removed. Since the scalp is very elastic, the resultant
gap is easily pulled together and sutured closed.
The
hair on the back of the head conceals the small thin
suture line
The surgery team then divides the donor hair strip,
which contains thousands of hairs, into individual "grafts".
Micro-grafts contain one or two shafts of hair. Mini-grafts
contain three to eight shafts of hair per graft.
With
these techniques the surgeon transplant as few as one
or two hairs at a time, which creates a more natural
look rather than the "toothbrush" or "plug"
effect.
These hair grafts are then implanted into recipient
sites in the balding area. Micro-grafts are inserted
into tiny punctures in the skin and mini-grafts into
extremely small (0.5 mm to 2 mm) openings.
This achieves
a more natural appearance. This is a big improvement
over previous techniques where transplants were inserted
into holes in the scalp. This often resulted in an abnormal,
compressed hair.
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