5485 Grafts! (More than 10,620 Hairs!) Thank You Dr Wong! - Page 2 - BaldTruthTalk.com
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  1. #11
    Senior Member bigmac's Avatar
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    Hi Red
    Very interesting post about the single baldes.

    I checked with Janna from SMG if they used these on me which they did.

    She was kind enough to answer my questions and wrote this reply to me which i thought i would share.

    Quote

    Dr. Ron Shapiro wrote an article about the benefits of single blade harvesting in the HT text book. At SMG, for each session, there are two separate SCORING blades set up with different size of width of blades to coincide with patient's laxity and goal of the session. They are used to nick/score the surface of the skin only. We take the strips in multi sections to accommodate the laxity in different parts of the head. Some doctors will use a permanent marker and measuring tape to mark out the strip first then use the single blade scalpel. It's a matter of preference but the scoring method seems a bit more efficient, imo. Once the scoring is complete, a blunt hemostat or a Haber Spreader is used to spread the tissue apart to achieve virtually 0 percent transection.

    However, I've seen first hand at Live Surery Workshops that even the use of single blade scalpels without the spreaders get high transection rates if the docs are not experienced or skilled. There are more likihood of t-factors if just a multi blades is used because even if the top part of the strip looks perfect without transections, the bottom portion of the strip may be filled with transected hairs because due to the angle, it is a blind cut.

    ************************************************** ***

    One other point you mention is for patients to chect to see what blades a doc uses.This is something which never crossed my mind,maybe some pictures of blades etc would help people as most patients wont have a clue what the differences are.

    Cheers bm.

  2. #12
    Member Red20's Avatar
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    Hi Bigmac!


    Here is a write up by Dr Cole who explains the benefits of the single-blade scalpel much better than I do:

    As its name implies, single strip harvesting is the method by which a single strip of hair-bearing scalp is carefully, indeed, painstakingly, excised from the donor area; the strip is then broken down into its smallest functional units, or follicular units. Before single strip harvesting came to the fore in recent years, older, infinitely more wasteful methods were employed.

    The first of these was the circular, punch grafts of yore, which have little to recommend them save their simplicity (they are essentially biopsy punches), and the ease with which they were directly placed into correspondingly circular holes in the recipient area. Next, ingenious surgeons devised multi-bladed scalpels; three or more (sometimes many more) blades, attached to a handle, were oriented parallel to one another, and many thin, narrow, long strips could be excised with one pass of the scalpel.

    These strips could then be placed flat on their sides and sliced into small mini- and micro-grafts, with little or no concern for follicular unit integrity. This, however, was not the only drawback; transaction rates were generally rather high, and were even higher when more blades were used. So time was saved, but lots of valuable follicles were wasted.


    What we know as single strip harvesting overcomes many of these disadvantages. Using two passes with a single blade, or a single pass with a double-bladed knife, an elongated strip is excised. It is possible, with careful technique, to achieve transaction rates of less than 2% (this means that fewer than two FUís per 100 are sliced in two).

    It is estimated that transaction rates as high as 30% occur with the use of multi-bladed scalpels. Letís do the math. If the patient needs 1000 grafts, then an area containing 1300 grafts would need to be removed just to account for wastage and still produce 1000 intact FUís. If 2000 grafts were needed, 600 would need to be wasted! This is of serious import when we deal with a limited, finite amount of donor hair.

    This leads us to a discussion of graft dissection. One of the reasons many surgeons have used multiple strip harvesting with multi-bladed scalpels, is that an intact, single strip presents a number of difficulties in dissection. It is too thick to place on its side or to shine light through (transilluminate) in order to visualize the individual FUís.

    Therefore, thin, multiple strips lend themselves to rapid, albeit inefficient, slicing of grafts. We feel, however, that the degree of wastage is unacceptably high, both during the strip harvest, and during graft preparation.

    To avoid these problems, the techniques of stereo-microscopic "slivering" and dissection are utilized. As soon as the donor strip is harvested, the slivering process begins. This is extremely painstaking; the strip is divided into small "slivers", each one FU wide.

    These are then laid flat on their sides, and, also under the microscope, the individual FUís are carefully sliced out and trimmed of excess connective tissue and fat. During this process, the grafts are suspended in a physiologic saline solution and kept chilled; this insures their viability and health while they are "out of body". They are separated into one, two, three and four hair FUís, according to their natural occurrence, and then carefully placed into the recipient sites.

    We feel strongly that follicular unit transplantation is the state of the art in hair restoration surgery. Older techniques are easier and more lucrative for the surgeon, require a smaller operative team, and may be easier to "sell" with the false promise of higher density. Follicular unit transplantation, done with single strip harvesting and stereo-microscopic slivering and dissection, requires patience, a large team, and meticulous work by the surgeon and assistants.

    Despite these demanding criteria, we are committed to using and refining this technique; in one or two sessions, patients can achieve results that are natural, undetectable, and will stand the dual tests of time and of advancing baldness.
    http://www.forhair.com/Chapter_08.htm

  3. #13
    Member Red20's Avatar
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    Quote Originally Posted by PayDay View Post
    Looks like a great hair transplant so far. Congratulations!
    Thanks PayDay. I appreciate that.

  4. #14
    Member Red20's Avatar
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    Quote Originally Posted by uncjim View Post
    Red,
    Dr. Wong humble? This must be a new gig...kidding..KIDDING! I couldn't agree more. Congratulations. I can't wait to see your progress. Understand the "roller coaster" is real. Beyond month 4, it's gravy. All the Best.
    UNC

    Hi Jim!

    Did you use anything special after your hair transplant?

    I read about the benefits of MSM so I have started taking 3,000 milligrams a day.

    I am also using a colloidal silver product called "silver gel" on my donor incision to aid in healing. It's a mixture of aloe and colloidal silver in a gel.

  5. #15
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    Hi Red,
    My post op treatment was a simple anti-bacterial ointment, Bactroban. Beyond that, all I've ever used is one quarter tablet of Proscar every other day. In Dr. Wong's words, "It will keep your prostate healthy and let you keep the hair that you have".
    Jim

  6. #16
    Member Red20's Avatar
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    16 Days Post-Op Photos:

    I started using Advodart 4 weeks ago and I have noticed new hairs popping up in my hairline and crown.


    I decided to shave my head before my transplanted hair falls out.








  7. #17
    Member Red20's Avatar
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    Quote Originally Posted by uncjim View Post
    Hi Red,
    My post op treatment was a simple anti-bacterial ointment, Bactroban. Beyond that, all I've ever used is one quarter tablet of Proscar every other day. In Dr. Wong's words, "It will keep your prostate healthy and let you keep the hair that you have".
    Jim

    Hey Jim!

    How long did it take before you first noticed growth of your hair transplant?

  8. #18
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    Red your transplant looks insane!!! You must be extremely happy so far! Man that looks like it's going to give you crazy coverage. I'm happy for you.

  9. #19
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    Red,
    There was pretty much nothing until about 3 months.
    Month 5 is when the fun begins.
    Jim

  10. #20
    Junior Member Cyberdyne's Avatar
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    Red that looks bloody fantastic mate!
    All the best!
    Keep us posted!!

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