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Other Methods
THE STRIP EXCISION
Intravenous injection of narcotic drugs, (eg. Pethadine / Morphine) and sedatives, (eg. Valium / Hypnoval) are usually required.
A strip of flesh approx. 10-14 cm long, of various width (approx. 1-3 cm) and approx. 1.5 cm thick is cut out from the posterior scalp. In our opinion this is too traumatic. We believe excessive skin and tissue removal can 'stretch out' the remaining skin, leave unsightly broad scarring and 'thin out' the posterior hair.
Haemorrhage, vascular and nerve damage is a risk of this strip excision.
The surgeon gives this 'strip' to his assistant who places it onto a 'cutting block' . As the surgeon sews up the wound on the back of the head, the assistant commences cutting the strip of flesh into small rectangles. Sometimes, the assistant uses a stereoscope in order to see better.
We wish to make it clear that a Micro-Graft is a grouping of 1 to 4 hair. The term 'Follicular Unit' is a description of this anatomical natural occurence. Modern day Strip Excision surgeons use the term 'Follicular Unit' in prefernce to the older term of 'Micro-Graft'.
Cutting thick soft flesh into very small rectangles containing single follicles can be very tedious and we believe it can be very traumatic to the hair follicles. There are limitations on how finely and consistently a blade can be used to cut this soft thick tissue and for practical reasons, larger 'bites' are often required. Hence one can have rectangular grafts containing 5 and up to 8 hairs per graft. These are in fact not micrografts, but MINIGRAFTS. We consider such grafts cosmetically unacceptable.
Larger grafts are responsible for the 'Tuffty, toothbrush or dolls hair' appearance. The larger the graft, the worse the appearance.
These rectangular grafts are placed into the recipient bald area as follows:
The surgeon either punches holes into the skin, cuts slits, or drills out holes. The rectangular grafts are then inserted into these holes or slits.
THE GRAFT HAIR USUALLY FALLS OUT AND TAKES APPROXIMATELY TWO TO THREE MONTHS TO REAPPEAR.
The reasons for this we believe are as follows:
Traumatic surgery causes FOLLICLE AND SCALP SHOCK
The blood supply in the recipient bald area needs to nourish and fight through excess tissue surrounding the follicle (ie. Fat, dermis and skin) before it can get to the follicle itself. By the time it gets there, the hair can fall out and sometimes the follicle itself dies.
When a very large number of punctures are made into the scalp there can be Intrusion upon and demise of pre-existing hair. Hence the common complaint of, "after my transplant operation a lot of my natural hair has fallen out around the graft, making the graft stand out." Some of this loss would have occurred anyway but trauma to the scalp through excessive large hole punching or slits (scalp shock) is also responsible. Repeat sessions need to be usually 3 to 6 months apart.
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