CONCEPT BEHIND HAIR TRANSPLANTS
If you look at any balding man you will notice that he never goes bald on the sides or the back of his scalp, we call this his “hair bank”. We can take this hair and transplant it anywhere and it will usually grow forever. This is what we call “Donor Dominance”. If you transplant hair from a certain part of the body it will always grow like it did from the original donor site. In a hair transplant, we just take hair from the patient’s “hair bank” and transfer it to the balding area.
There are two innovations that have revolutionized the naturalness of hair transplants. The first is transplanting each individual natural grouping of hair as a unit and the second is the use of the stereoscopic microscope to dissect the hair to be transplanted into follicular units (natural hair groupings).
- Natural Hair Groupings (Follicular Units)- Hair does not just come out of the scalp individually, one by one, but actually grows naturally in groups of one to four hairs with a fibrous sheath surrounding the group. Since that is how God designed everyone’s scalp, that is how I perform a hair transplant. I transplant the single hair grafts on the hairline and the natural groups with three and four hairs farther behind for density. The benefit of transplanting individual, “natural hair groupings” is the completely natural look I achieve and the higher survival rate of the transplanted grafts.
- To try to obtain a natural look, many doctors perform transplants with what is called “single hair micro-grafts or ultrafine micro-grafts”- good for hair transplant doctors marketing hair transplants, but not logical in reality. They separate the “natural hair groupings” into single-unit hair grafts and transplant the hairs individually. By separating the natural groupings of hair, the hair transplant surgeon is going against nature. A study published in the Journal of Dermatologic Surgery showed that the survival and quality of these grafts markedly decreases.
- Stereoscopic Microscope– The stereoscopic microscope is the most important innovation in hair transplants. The “natural hair groups” must be preserved intact during dissection to insure increased survival and growth. Many doctors dissect with the naked eye or with minimal magnification. The vast majority of doctors marketing FUE hair transplants NEVER use this vitally important stereoscopic microscope. That leads to increase transection and destruction of the hair. When dissecting the donor hair without the stereoscopic microscope it is nearly impossible to ensure that the “natural hair groupings” will remain intact.
One of the major down sides to FUE hair transplants is it makes the stereoscopic microscope less useful. With any device (Neograft, Smartgraft, Artas, or other motorized/manual tool) used to surgically excise the donor tissue in the FUE hair transplant, the doctor does not know if he transected the follicular unit until after the graft is removed and the damage to the follicular unit is already done. Again, this increased transection rate of the follicular unit decreases the survival of the very limited donor hair.
For a balding man seeking a transplant, his most precious commodity is his donatable “hair bank.” The use of the “stereoscopic microscope” to dissect the grafts enables fully visualization of each and every individual “natural hair grouping.” By using the “stereoscopic microscope” the trauma to the surrounding hair is greatly reduced and our patients receive superior quality grafts with a much higher incidence of survival. I can now achieve survival rates of 95 to 100 percent, as compared to other techniques where the survival rate is much less. The “stereoscopic microscope” is still useful in FUE hair transplants because it enables us to trim excess skin away from the hair follicle, therefore, smaller incisions can be made, which enables us to pack the grafts closer together to give a denser, more natural look. Using the stereoscopic microscope after excising the donor tissue with FUE is also valuable to verify the size of the graft in order to avoid placing bigger grafts on the hairline (avoiding an unnatural look).