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Micro Grafting

Nowadays clinics all use different terms to describe transplants, such as micro grafting or mini grafting.

Micro grafting as we will call the treatment, is the most common type of hair transplantation procedure performed today and, the procedure that produces the most natural results.

Micro grafting depends upon the use of larger grafts to create density and smaller grafts to produce naturalness.

Whereas a normal graft will hold about twelve hair roots, a micro graft will hold about three or four hair roots, provided that the surgeon is skilled enough.

The mini-grafts (which are smaller than the old plugs) are generally used in the central part of the scalp where they give "bulk" to the transplant, but on their own don't normally look completely natural. Smaller micro-grafts are then placed in front of, and around, these larger grafts to produce a more natural, soft hairline and overall appearance.

A completely natural hairline is now possible by transplanting micro grafts to give a patient a natural look, something that is not possible with full sized grafts.

By using a combination of large grafts at the back and using progressively smaller micro grafts towards the front it is now possible to obtain excellent results that are virtually impossible to detect.

Hair roots could be transplanted one hair at a time if so required. Whilst this procedure would be completely undetectable, the finished effect would not achieve the thickness that can be obtained by using a combination of large and small grafts.

Transplanting hair roots one by one would be very time consuming and is extremely expensive.

As illustrated here plug grafts on the front hairline leave a very undesirable effect.

Often referred to as dolls head or cornfield effect.

 

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.

This picture show the crown area, having been prepared with the trephine just prior to the plugs from the back of the head being position to complete the transplant.

 

Recipient sites are made in several ways. Some physicians use punch holes, some linear slits, and others use a "slot" method that creates a narrow elongated oval incision.

As techniques develop, we may expect that in time a standardized method will emerge.

The goal of all the various procedures is to obtain a more dense, natural appearance for the patient which allows the hair to grow in its natural manner.

 

This picture shows how single incisions are made with a scalpel to take a single hair or two at a time.

 

The cosmetic effect of the placement of the grafts, the insertion angles, and the combinations of grafts are dependent of the skill and the "artistry" of the transplant surgeon.

The shape of the patient's face and predictions of areas of future hair loss must be planned carefully for optimal cosmetic results.

Most patients normally used to need three treatments to achieve an acceptable head of hair.

However nowadays the number of sessions could vary from one to six depending on how much work is involved, particularly since micro grafting techniques mean that one treatment can be suitable and involve very little discomfort and inconvenience.

 
 
 

 

Does It Hurt ?

Yes is the simple answer - The amount of pain varies between patients.

A lot of people say that it is like a visit to the dentist, however as with dentists there are good surgeons and bad surgeons.

Probably the most painful part of the procedure is during the injection of the anesthetic when a large number of injection are made to the donor area.

Often the patient is given a mild sedative to relax them before any treatment is carried out. It is normal in some cases to spray the area with a freeze spray to reduce the pain of the injections.

About fifty percent of customers will probably experience swelling on the forehead and face after a transplant.

This can be treated with an ice pack but in some cases is extremely noticeable and a return to work usually needs to be ruled out.

Patients have commented that their skull felt like a lump of wood for weeks afterwards.

They were aware of something having been done to their scalp but were not in any pain. The effects always seemed to wear off.

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