View Full Version : Maximizing Survival-Rate of Transplanted FUs AND Native Follicles

02-28-2012, 03:30 PM
Assuming for a moment that all other factors (e.g. extraction, FU treatment in between extraction and implantation, quality and artistry, doctors' skill levels, etc.) are equal, it seems to me that the process of [making the recipient-incision and inserting the FU into it] - the technique of actual graft-insertion - is very important. In this thread, I'm hoping to discuss the actual implantation techniques / tools and skillsets used by physicians. It seems to me that this is a step which can 'make or break' a good HT surgery, yet it is NOT standard ‘across the board’ by any means, and I suspect this step can have a big effect on viability (of both FUs and native follicles), and ultimately the overall result of the surgery. Of course each doctor has his/her own preferences for this step, and it is the overall efficacy of the insertion step that is most important for results: all other things being equal, I suspect that the best insertion technique is that which (A) produces the most natural, lasting results, (B) minimizes the percentage of FUs that survive the transplant, and (C) minimizes the percentage of native follicles that are killed. So perhaps one of the few objective ways left for we prospective patients to make intelligent decisions about how and with-whom we might want to proceed is to assume that there are enough talented HT doctors out there, and take a step back to concentrate on methods and tools which produce the best results, independent of the hands which wield them. Then we can choose whose hands we wish to have wielding the tools. So I'd like to hear your thoughts, and experiences specifically about the pros and cons of different implantation techniques. As a premise, I'd like to offer the following:

I know that some doctors use a flat-blade to make (straight) incisions, some use a hypodermic needle to make ('C'-shaped) incisions, and others use 'other tools'. I suspect that most HTs are done by inserting FUs into incisions that were made minutes / hours earlier (and are hence closed). I have begun to suspect that a technique that involves actually creating the incision and then ‘shoe-horning’-in the FU (either as the incision is made or as the incision tool is pulled from the incision) might hold inherent advantages over techniques which involve ‘stuffing’ the FU into a ‘slit’ incision with jeweler’s forceps. Especially since I suspect the FU should not be handled by the bulb, meaning, if forceps are used to insert the FU, it must be 'grabbed' with the forceps ABOVE the bulb, making it more difficult to insert (for basic mechanical reasons, largely because the FU is flexible, the bulb is of larger diameter than the shaft, and that bulb must be inserted into an incision which is naturally 'closed' when the scalp skin is relaxed).
There is a tool called the 'Choi' (SP?) tool into which the FU is evidently inserted just before it is used to (A) make the implant incision, inserting the FU as it does, and then (B) pulled from the scalp, leaving the FU implanted. Of course, doctors will have their preferences for tools, but these notwithstanding, it seems as if this 'Choi' tool may hold inherent advantages, should the tool actually work well, and the doctor actually WANT to use it. I have also been told that improvements have been made on this tool over the last 15 years or so, and that the tool now comes in various 'sizes', e.g for different sizes of FU implantation, which would seem to be advantageous also.

Has anyone had any knowledge of these various implantation / insertion techniques / tools? Any insight will be greatly appreciated.