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Hair transplant Surgery – FUE Punch technique.
3-Step Follicular Unit Extraction :
A
significant advance in Follicular Unit Extraction has been the addition of
“blunt” dissection to the original technique of “sharp” dissection followed by
extraction. This was described by Dr. Harris at the International Society of
Hair Restoration Surgery (ISHRS) in 2004. In this three-step technique, a sharp
punch is used to score the epidermis (cut just the upper part of the skin) and
then a dull punch is used to bluntly dissect (separate) the follicular unit
grafts from the surrounding deeper dermis. The third step is the same, namely
removing the follicular graft from the scalp using fine forceps.
The
advantage of this hair transplant technique over the original two-step process
is that using a dull punch minimizes follicle transection (damage). As the
blunt-tipped punch is advanced into the dermis, the follicles, which naturally
separate deeper in the skin, are “gathered together” within the opening of the
instrument, rather than risk the lower portions of the follicles being cut off.
Another significant advantage of the new technique is that it increases the
number of patients who are able to benefit from FUE.
A
problem of the three-step technique, however, is a higher incidence of buried
grafts. When a buried graft is identified, it can sometimes be extracted by
applying pressure to the surrounding skin. If this manoeuvre fails, a small
incision is made to enlarge the opening and facilitate the removal of the
graft. If not removed, a buried graft can occasionally result in a small cyst that
would need to be removed at a later date.
Another
problem is that during the extraction attempt the epidermis and upper dermis
may separate from the rest of the follicle. This phenomenon has been called
“capping.” When this occurs, the lower portion of the graft can sometimes be
grabbed and extracted. When this is not possible, the lower potion is simply
left behind. In this case the wound will heal and the lower portion of the
follicle should produce a new hair.
Dr. Vaibhav Shah
www.vaibhavshahblog.blogspot.com.
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