Modern techniques

Modern techniques

There are several different techniques available for the harvesting of hair follicles, each with their own advantages and disadvantages. Regardless of which donor harvesting technique is employed, proper extraction of the hair follicle is paramount to ensure the viability of the transplanted hair and avoid transection, the cutting of the hair shaft from the hair follicle. Hair follicles grow at a slight angle to the skin's surface, which means that regardless of technique transplant tissue must be removed with a corresponding angle and not perpendicular to the surface.

There are two main ways in which donor grafts are extracted today: strip excision harvesting and follicular unit extraction.

Strip harvesting is the most common technique for removing hair and follicles from a donor site, most commonly the area at the back and sides of the scalp. A single-, double-, or triple-bladed scalpel is used to remove strips of hair-bearing tissue from the donor site. Each incision is planned so that intact hair follicles are removed. Once removed, the strip is dissected into follicular units, which are small, naturally formed groupings of hair follicles.

Follicular Unit Extraction (FUE) takes place in a single long session or multiple small sessions. FUE is considered to be more time consuming, depending on the operator's skill, and there are restrictions on patient candidacy^[3]. 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 and higher cost to the patient ^[4]. Clients are selected for FUE based on a fox test ^[5]. There is however some debate about the usefulness of this in screening clients for FUE