BACKGROUNDFollicular Unit Transplantation (FUT) is performed using large numbers of naturally occuring individual follicular units obtained by single-strip harvesting and stereo-microscopic dissection. Donor wound scarring from strip excision, although an infrequent complication, still concerns enou

/pdf/follicular-unit-extraction-minimally-invasive-surgery-for-4x8qzdnxhj.pdf

Follicular unit extraction: minimally invasive surgery for hair transplantation.

The logic of follicular unit transplantation

Follicular unit extraction (FUE) is a method of producing follicular unit hair grafts that involves removing the grafts individually from the scalp. The advantages of this technique over the conventional strip harvest are that it does not leave a linear scar, and the procedure produces little or no postoperative pain and discomfort. There are some disadvantages such as increased surgical times, graft fragility, and higher cost to the patient. This article describes the instrumentation and surgical methodology of FUE. It also presents some surgical difficulties and how to minimize their impact. Indications and patient candidacy are also discussed.

Follicular unit extraction.

The present invention provides fluid and material delivery methods and devices for practicing the methods. The invention provides a method of delivering cellular material comprising injecting the cellular material into a subject such that the injected cells retain their inherent morphologic characteristics upon injection. The method comprises the steps of aspirating the cellular material into a fluid delivery device which incorporates a syringe arrangement. The cellular material is aspirated into the main body of the syringe until the desired amount of a material has filled the syringe body. The needle of the fluid delivery device is then inserted into the skin of a subject at an angle about parallel to the skin until a desired depth has been reached. The cellular material is then injected in the subject until the desired volume of material has been injected. The needle of the device is then rotated approximately 45 to 90 degrees and the needle is removed from the injection site.

Apparatus and methods for delivering fluid and material to a subject

Background. The improved scalp coverage achieved by hair transplant for men with androgenetic alopecia can be diminished by continued miniaturization and loss of preexisting, nontransplanted hairs.



Objectives. To evaluate whether finasteride 1 mg, administered daily from 4 weeks before until 48 weeks after hair transplant, improves scalp hair and growth of nontransplanted hair in areas surrounding the transplant and to evaluate the safety and tolerability of finasteride for men undergoing hair transplant.



Methods. In this randomized, double-blind, placebo-controlled study, 79 men with androgenetic alopecia (20–45 years of age) were assigned to treatment with finasteride 1 mg (n = 40) or placebo (n = 39) once daily from 4 weeks before until 48 weeks after hair transplant. Efficacy was evaluated by review of global photographs by an expert dermatologist and by macrophotography for scalp hair counts.



Results. Treatment with finasteride resulted in significant improvements from baseline, compared with placebo, in scalp hair based on global photographic assessment (p < .01) and hair counts (p < .01) at week 48. Visible increases in superior/frontal scalp hair post-transplant were recorded for 94% and 67% of patients in the finasteride and placebo groups, respectively. Finasteride treatment was generally well tolerated.



Conclusion. For men with androgenetic alopecia, therapy with finasteride 1 mg daily from 4 weeks before until 48 weeks after hair transplant improves scalp hair surrounding the hair transplant and increases hair density.

Effects of Finasteride (1 mg) on Hair Transplant

The present invention is directed to a method for producing new hair growth in humans by implanting human dermal papilla cells into human scalp skin, wherein the human dermal papilla cells are cultured in a medium supplemented with a conditioned medium. The conditioned medium is formed from a culture of normal human keratinocytes.

Method for producing new hair growth

Unexplained poor growth after hair transplantation or 'X-factor'I has received a great deal of attention recently with the increasing popularity of dense-packing and megasessions. There has been a growing recognition that most of this 'X-factor' may in fact be due to follicular trauma caused by surgeon and staff, what Joseph Greco calls 'H-factor' .2 The recent work by David Seager on the poor growth of "skinny micrografts"3 and the followup work on follicular trauma by Greco4 further increases our awareness of this critical issue. We suggest that a significant portion of the follicular trauma contributing to poor growth may actually consist of loss of the dermal papilla during graft dissection and placement. This is based on observations we made during a recently completed ISHRS-sponsored research project studying the regenerative potential of cultured dermal papilla. As a source of cells for the study, hair follicles from miniand micrografts left over after hair transplantation pror.edures were used. To the naked eye, these were healthy grafts ready to be planted. However, when taken to the laboratory, a small but significant portion of the follicles within the grafts were damaged at the base with loss of the dermal papilla (figure 1). This was particularly notable in one and two hair micro grafts as well as around the periphery of round grafts. How can the dermal papilla be lost during the transplant procedure? Actually, quite easily. There seems to be a natural weak point just above the papilla where any trauma during harvesting, dissection, and placement leads to transection of the follicle. The dermal papilla can be lost if too much pressure is applied to the lower follicle with forceps as shown in Joe Greco's excellent studies. If pressure is placed on the follicle at this point, the dermal papilla seems to pop out when viewed under dissecting microscopy. If the epithelial cells of the matrix are extmded, this is of no significance because these die and are shed with each telogen phase. However, if the dermal papilla is lost, there may be delayed growth or none at all as we will discuss. It is probably best to avoid any manipulation of the the lower to mid portion of the

Loss of the Dermal Papilla During Graft Dissection and Placement: Another Cause of X-factor?

BACKGROUNDStudies highlighting the role of hair follicles (HFs) in wound healing have raised the challenge of bringing this knowledge to clinical applications. A successful translation is the transplantation of scalp HFs into chronic wounds to promote healing.OBJECTIVETo characterize scar formation

Distinct Patterns of Hair Graft Survival After Transplantation Into 2 Nonhealing Ulcers: Is Location Everything?

Oral minoxidil use in androgenetic alopecia and telogen effluvium

Follicle trauma and the role of the dissecting microscope in hair transplantation. A Multicenter Study

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