View Full Version : Mini Grafts - Run!!!

11-15-2012, 11:11 AM
Apparently a few doctors continue to place mini grafts via strip surgery in 2012! Dr. Cole received a call last Tuesday from a patient who just had mini grafts placed. If mini grafts aren't bad enough, the new hairline for this young man was placed way too low. This man could tell even before there was any growth something was seriously wrong. Mini grafts, just one step up from plugs can never produce a natural result where hair is needed under any circumstances. This young man was seeking advice because he's now considering having them all removed even before they begin to grow. Even if you're in the surgical chair, you hear you're getting mini grafts, grab your personal belongings and run!

-I work at Dr. Cole's office

11-15-2012, 01:26 PM
What exactly is a 'mini graft'? I've heard the term, and always assumed it was an ignorant reference to a normal follicular graft.

11-15-2012, 02:22 PM
What exactly is a 'mini graft'? I've heard the term, and always assumed it was an ignorant reference to a normal follicular graft.

Our hair grows in small groups of individual hair follicles. These groupings are called follicular units. They can consist of 1 to 4 and rarely even 5 hairs in one group.
Mini or micro grafting refers to an outdated and unacceptable hair transplant method where small grafts are punched and placed which do not necessarily correspond to the original follicular unit. Each mini graft would commonly contain approximately 3 to 6 hair follicles.
FUE stands for follicular unit extraction. The naturally occurring follicular “package” or unit is either placed as is or dissected into individual hairs when a finer appearance is necessary in the hairline zone.

11-15-2012, 02:34 PM
Mini-grafts are anything but a natural occuring follicular unit. Minigrafts are grafts cut from a strip specimen that are purposefully seperated by the number of hairs within each graft (manipulation). They are grafts made which bear 2 or less hairs. Micro-grafts are grafts that bear more than two hairs.

And Dr. Cole's employee is correct. This is technology that is "just a step up" from open donor plugs. They are larger grafts that do not look natural because they are not dissected under a scope like a true FUHT procedure is done. In the late nineties, a handful of renowned docs in the US developed the FUHT procedure whereby the strip is microscopically dissected into their respective FUs "as they naturally occur in the scalp". Micros and minis are the result of munipulating the dissection of the strip into the larger grafts.

Why do some docs/clinics still do this type of stone-age approach? Because they are lazy! They either never learned how to dissect under a scope nor do their techs. They cut the strip on plates under a lighted magnifying glass which sits on a pedestal stand. There is therefore no magnification that is critically needed to microscopically seperate those delicate FUs in their "natural state".

Yes, some patients have many natural occuring FUs in their scalps that bear more than two hairs however within the confines of a true FUHT procedure, the FUs are again dissected in a way that rarely disturbs their natural existense so that transection is not an issue. The larger hair bearing FUs are typically located behind the commencement of the new hairline to provide additional visual coverage. Only one hair grafts and some two's can be placed at the hairline to produce the most natural aesthetically pleasing result.

This mini-micro appoach as I stated promotes transection (damage to the grafts) and can affect and undermine the true yield. It should be outlawed along with open donor surgery (plugs) which somel docs still perform believe it or not. :eek:

I just saw a patient in my office last week who had several minis in his hairline and he had very dark hair on a light complexion so they stood out visually speaking. He had the procedure done last year with the largest hair mill chain in North America. :eek:

A must question in any strip consultation is, "How do you dissect my strip?" If they do not dissect under scopes, I agree, "Run for your life!"

11-15-2012, 03:32 PM
I had plug surgery back in the late 70's. My hair was almost black so the contrast made the pluggy hairline obvious. The work really wasn't as bad as some I've seen. Perhaps I was just in denial, since it was my head. I remember back then when people at work kept telling me my hairline looked too strong, I made another appointment to soften the hairline. Dr. Cole told me the doctor who softened my hairline still practices hair transplant surgery. He must be 90 by now. Well around 84' the doctor who did the work just basically slammed some more full-sized plugs on my hairline over the edges of original plugs to break up the round doll-hair appearance. My hairline still sucked. In 2006 Dr. Cole grafted around the plugs with leg, back, chest and stomach hair. My hairline now looks natural and no one stares at it anymore when I'm speaking with them. Even back in the 80's before I knew much about hair transplants, I remember wondering why doctors hadn't considered using individual hairs on people's hairlines rather than pluggy clumps of hair. I think they did it because they could get away with it and they could argue that hair transplantation is a subjective art. Everyone should find a doctor who views transplant surgery as an objective art. In other words, duplicate what occurs naturally as accurately as possible as opposed to creating some abstract interpretation of hair and hairlines.

11-15-2012, 03:41 PM
The industry as a whole has dramatically improved both in techniques and instrumentation compared to the eighties and nineties!

I did not pull the trigger until 1996 because I just could not accept the appearance of plugs. I wore hair systems for 11 years instead. :rolleyes:

Dr. Lindsey
11-27-2012, 06:49 AM
We fix a fair amount of plug surgeries, and maybe half of them were themselves "fixed" by minigrafts in the 90s. While minigrafts are a big improvement on plugs....they often still appear unnatural and clumpy. Its pretty easy to significantly improve this with dense placement of singles around the clumps.

I haven't seen a new case of minigrafts for about 2 years obtained from strip surgery. But I see a case every 3 or 4 months of an "FUE" done with what appears to be a 2 or even 2.5mm punch...which is effectively either a small plug, or a large minigraft. The main trouble with repairing these is getting the patient to understand what a refined FUE with 0.9 or 1.0mm punches are compared to what they thought they were getting elsewhere. Although pictures help...once fooled, twice shy is a common finding.

Dr. Lindsey McLean VA

11-30-2012, 01:14 PM
I still see these cases present day and one of the main reasons is that there is a clinic/doctor in our own backyard, specifically based in McLean, VA who are still doing these micros and minis. I mostly see these patients in person after they have the work done and unfortunately were sold by the clinic's low pricing. They do heavy advertising on the radio and in the Washington Post.

They charge very low prices for strip and IMHO the work is horrific. Lots of pitting, scarring, and they still do micros and minis in spite of claiming to do "follicular unit grafting". The work is anything but that. :eek:

01-26-2015, 09:27 AM
In reference to his post, 35YrsAfter was talking about my procedure. I did not know that this original post would have been made without my consent. Here are my results, no "mini grafts/plugs" were used, no big surprise there.

01-27-2015, 05:01 PM
In reference to his post, 35YrsAfter was talking about my procedure. I did not know that this original post would have been made without my consent. Here are my results, no "mini grafts/plugs" were used, no big surprise there.

I wasn't talking about you. The caller I referred to, had mini grafts and you stated that you did not. The caller I referred to was not happy with his procedure. You stated that you are in the thread you provided a link to. Why would you think I was referring to you? In the last few years Dr. Cole has performed many mini graft and plug repair surgeries that could be accurately described by my original post.


01-28-2015, 02:09 PM
ok glad you cleared that up