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  1. #11
    Senior Member gillenator's Avatar
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    I cannot underscore the importance of adequate scalp laxity to accomodate the trico closure method. It's clearly not for everyone, especially considering those who had multiple prior strip procediures. I have seen some patients post-op who had this type of closure done who did not have adequate laxity. It's not a pretty result. It's very possible they should have had a double-closure method done or not even had the strip surgery at all. That's where FUE comes into play. I am still SHOCKED to hear patients tell me that their doc never even tested their laxity pre-op.

    Whether it's strip or FUE, there's no such thing as "scarless methods". Any cut, whether by scalpel or punch, a scar will be left. The real issue is, "How visible is it?"

    Part of the problem is that patients all too often come to the surgeon insisting that they have a trico closure done whether that is in their best interest or not.
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

  2. #12
    Member Laserhead's Avatar
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    Dr. Alexander, I had no idea that trychophtic closure was around for a long time. I read many different versions of who invented it. I read it was invented in France, then I read it was invented in Australia, then I read that a doctor in Florida invented it but called it the ledge closure. As I continue to research it seems like every doctor takes credit for other doctors inventions. I know there are like 10 doctors who claim to have invented FUE.
    It’s all very confusing if you ask me.

  3. #13
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    Default Question for Dr. Harris or Dr. Alexander or Spencer Kobren

    I still can not wrap my brain around how hair can grow through the skin. Can someone explain the process in laymen terms for me.

    Thanks!

  4. #14
    Junior Member Gregory Pistone, MD's Avatar
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    Default Trichophytic Closure

    Hello, all. First, let me say that I agree with all the docs above regarding trichophytic closure. It does work, usually quite well. Second, let me reassure all the patients who are concerned that it's a gimmick, that I understand and share your concerns. Unfortunately, in our field, as in many fields, there is a fair amount of quackery and greed and you must be on your toes as you evaluate your options. This website and Spencer can help you with your choice of surgeon and you should utilize it to the utmost. I should also add, although off the subject, that I completely sympathize with Laserhead and his laser "ripoff" I see it all the time and would warn patients away from laser clinics who promise amazing results. Yes, it can help but it's no miracle and can never be a substitute for hair transplantation.

    Trichophytic closures have been around a very very long time. I'm not quite sure who can take the original credit for it but it's not any hair transplant surgeon that I know. What we should ask it why it took someone so long to notice that this long time closure technique could be applied in donor incisions? Trichophytic closures are used quite commonly in brow lifts: this is where the sagging forehead is pulled tighter by making an incision in the frontal scalp, removing the excess skin, and then closing the incision. Oftentimes, in these closures both sides of the wound edge are "clipped", as opposed to the one side in donor closure. I've seen brow lifts with and without trichophytic closure and believe me it makes a huge difference.

    I want to state unequivocally that in my hands, switching to trichophytic closures about 2 years ago has had a tremendous effect on the aesthetics of the donor area healing. Patients often say that their barber can't find the incision....the ultimate compliment. Is is 100%? No, nothing is. Is there still a scar? Of course. Is the scar barely visible? Absolutely, if done properly in well selected patients.

    In conclusion, trichophytic closure is a valuable technique when used skillfully and in properly selected patients. It is not "scarless". I use it on 95% of my patients with excellent results and would never turn back.

  5. #15
    Senior Member gillenator's Avatar
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    I have heard many things myself. That the technique was in fact first performed in Europe, sepcifically in France by Dr. Fretchet. How accurate that might be is unknown. I even heard it was first performed in Japan in the 1940's so who knows for sure.

    You are thinking of Dr. Paul Rose of Tampa who has his variation in what he calls the, "ledge closure technique". In my opinion, it is basically the same approach in getting the hair to grow through the linear scar and I think the labeling has more to do with marketing than anything else.

    There are many rumors about who started FUE and I still say it was Dr. Ray Woods because he can prove when he started it since he never practiced strip and still does not to this day. That's not to imply that FUE is a superior technology although there are FUE practitioners that would disagree with me for the obvious reasons.

    IMO, some docs from North America bascially took his isolated extraction methods into their own hands and called it something else, again more for marketing purposes and to distinguish themselves from their competition to gain market share.
    "Gillenator"
    Independent Patient Advocate
    more.hair@verizon.net

    NOTE: I am not a physician and not employed by any doctor/clinic. My opinions are not medical advice nor are they the opinions of the following endorsing physicians: Dr. Bob True & Dr. Bob Dorin

  6. #16
    IAHRS Recommended Hair Transplant Surgeon Dr. Glenn Charles's Avatar
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    I have used Trichophytic closures for years, and have had some amasing results.
    However, I can honestly say that I have some legitimate concerns about this technique. I have seen a increase in cyst formation with this type of closure. There is also the question of whether or not to use this type of closure if the patient has already had hair transplantation, and you are dealing with a pre-existing scar. Sometimes the angle of the hairs that are growing threw the scar are so misangled that a crease is created along the entire suture line that is more noticable than a small pencil thin line scar would be under the hair. I now use more of a hybrid donor closure technique that combines a two layer closure and a Trichophytic closure techique and I think the results are better than ever.
    Remember, it has been proven many times in medicine and surgery that there may be more than one path a doctor can take and end up with a similar result.
    Dr. Glenn Charles
    Member, International Alliance of Hair Restoration Surgeons
    View my IAHRS Profile

  7. #17
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    It is nice to know that I can receive a professional’s opinion on these forums. Thanks to every for responding to my questions. It’s hard to know what to believe sometimes but I like the idea of having multiple opinions from different experts. Very reassuring for me.

  8. #18
    Doctor Representative the B spot's Avatar
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    Dr. Charles! Glad to see you posting over here.

    Hope all is well?

    Great info on the Trico closure.

    Take Care,
    Jason
    Patient Advocate/FUE Coordinator for Shapiro Medical Group. My advice and opinions are my own and is not medical advice. I am a Cubs fan.

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