Art of Hair Micro Grafting:
Hair Micrografting Technic

Hair Micro grafting needs several steps, realized in the same journey :

First step : The removal of hair

Hair transplant surgery takes hair and follicles from a hair-bearing area of scalp and places them into a scalp area where hair has been lost. The donor site is the scalp area from which hair and follicles are removed.

Donor sites are most commonly the scalp areas at the back of the head, the nape of the neck and above the ears.
The removal of hair and follicles from the donor site is called harvesting. Harvesting is a multi-step procedure that begins with planning and ends with delivery of healthy hair and follicles that are ready for transplantation.

Strip Technic

The removal of hair consists in taking, under local anaesthesia, a fine scalp strip, in the low part of the crown, on the level of the most final hair.                                              
The size of the removal varies according to the work to be carried out, according to the surface to be filled; on average 1 to 1.2 cm broad on10 to 12 cm length following the cases.

Nevertheless in the cases of very great baldnesses, the removal can reach 25 cm length or more, and extend from one ear to another. It is not rare, in these cases to obtain a number of implants equal to or higher than a thousand five hundreds.

Strip-harvesting incisions are closed with resorbable sutures which avoids to the patient the nuisance of having to consult again for the ablation of wire.

At the place of this suture, a few weeks later, it appears a fine scar lost in the medium of the hair, most often perfectly undetectable.

FUE Technic

The FUE (Follicular Unit Extraction) Technic consists in taking, under local anaesthesia on the level of the neck, the follicular units ones with ones.
FUE is performed by using a punch-like “circular scalpel” to score the skin to a level of about 2 millimetres around a follicular unit.

The extracted Follicular Unit may be used intact, or may be divided into smaller units for transplantation.

This technique is to be held to the patients having already undergone several meetings of hair grafting, which thus present a scalp tended, but which preserves certain reserves of hair that it would be regrettable not to exploit in the case of great baldnesses for example.

Second step : The cutting up of the implants

Later, surgical assistants dissects the follicular unit out of the strip under a microscope.

The size of the grafts will be lower or equal to the  millimetre.

1 follicular unit with  2 hair

The FU is identified anatomically as a small bundle consisting of 1 to 4 hair follicles, full-thickness as well as fine hairs, and the oil glands, muscles and connecting tissue that accompany and support hair follicles.

This work of dissection, of an infinite delicacy, is a long and hard work for all the medical team, and can find its application only in one structure equipped with all average  techniques and human necessary.

It is thus necessary to insist on the capital part which the assistants play, who need to use of all their talent to preserve, initially, and to restore, in the second time, the organization decided by nature.

Third step : The transplantation

The Follicular units are transplanted into the scalp by inserting them into small slits incised into the skin with a small blade or needle.

The technique of the minis or micro slits makes it possible to implant in still hairy areas, without damaging the bulbs of the remaining hair, on the contrary minis or micro holes which, them, would be likely to destroy still healthy bulbs.

Whatever the type of baldness, it is certain that the realization of micro slits is the best technique by far, because it makes it possible, amongst other things, to bring closer the implants as much as possible the ones the others.
Thousand five hundreds incisions or more can be carried out at only one meeting.

The hair is then implanted in the direction of the original implantation, according to an axis of 45 degrees, and according to an orientation in range for the frontal area, or in rays of wheel for the tonsure, starting from a central point, called the swirl, which, if there does not exist any more, is him also reconstituted.

The ultimate stage consists in the implantation itself of the implants This last stage concerns at the same time competences of the doctor and the assistants who, especially were trained to transplant  the implants in the small niches carried out beforehand.
The realization of this last stage requires a great knowledge to make combining speed and dexterity, and does not support any improvisation, more especially as it acts of the treatment of great baldness, where a considerable number of implants must be implanted in a minimum of time.

Never lose sight of the fact that this act is held under local anaesthesia, and we must work by holding account of the limits of the time of action of the anaesthetic products.

Let us recall finally that three stages: taking away, preparation of the implants and transplantation, are realized in same operational time, and that the average duration of a large meeting is five to six hours.