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Logic Of Follicular Unit Transplantation By Robert M. Bernstein, M.D., F.A.A.D

  • Listed: 8 abril, 2019 12:05 pm
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Follicular Unit Transplantation is a method of hair restoration surgical procedure where hair is transplanted exclusively in its naturally occurring, individual follicular units. The evolution and rational for follicular unit transplantation might be mentioned, as properly because the logic for the various methods utilized in its implementation. Particularly, the logic for single strip harvesting, stereo-microscopic dissection, automated graft insertion, and enormous transplant sessions will probably be reviewed. The central position of the follicular unit fixed in the surgical planning will even be mentioned.
Progress in trendy drugs is often the results of sophisticated technology that allows us to quietly probe into the deepest regions of the human physique or to analyze its actions – https://www.b2bmarketing.net/search/gss/actions at the molecular stage. Rarely, is a discipline of drugs dramatically modified by easy statement. After more than three many years of relative inertia, surgical hair restoration is undergoing such a change. This writing discusses the logical functions of those observations to clinical follow, a logic that has actually revolutionized hair transplantation in only a few short years. It will even touch upon some of the illogical judgements that contributed to its delay.
Historic – http://Browse.Deviantart.com/?qh=&section=&global=1&q=Historic Aspects
A donor (graft) is best if it is as small as possible. The reason being that if a donor is massive, hairs grow in … a really unnatural look.
Hajime Tamura – 1943
If we had solely heeded the advice of the pioneering Japanese hair transplant surgeons in the first half of this century, we may have averted years of unsightly surgical outcomes that precipitated dismay to hundreds of unwary patients, and literally tarnished a complete area of medication. Unfortunately, the “Japanese insight” was lost to us throughout World War II and after we tried to “re-invent the wheel,” we did it unsuitable.
The Punch Graft Method
After the “rediscovery” of hair transplantation by Dr. Norman Orentreich in 1952, the pleasure that hair actually grew, and continued to grow after it was transplanted, clouded the very essence of hair restoration surgical procedure i.e., that it was a beauty procedure whose sole objective was to enhance the looks of the balding patient. The 4-mm plug that had been ordained as the optimal car for moving hair was truly of a measurement that had no counterpart in nature.
The initial drawback was that the decision to use 4-mm plugs was based primarily upon technical fairly than aesthetic issues. In the original, ingenious experiments carried out by Dr. Orentreich, revealed in the Annals of the new York Academy of Science in 1959, which established the concept of “Donor Dominance,” 6 to12-mm punches (trochars) had been used to create the grafts.18 At these sizes, there was an unacceptably high rate of hair loss in the middle of the grafts because of the difficulty of oxygen to diffuse over such massive distances. The initial effort to decrease graft size was thwarted by the concern that much smaller grafts wouldn’t move enough hair to make the procedure worthwhile. Finally a compromise was reached, and the 4mm graft was born.
As well as, a logic developed which postulated that by replacing bald pores and skin with hair bearing skin, most of the balding space might ultimately be replaced with hair. No changes for scar contraction were accounted for, and no changes in the size of the newly transplanted grafts were expected, despite observations to the opposite. Extra importantly, these assumptions have been based upon the mathematically impossible feat of covering a large area of balding with a much smaller donor provide, whereas maintaining the identical density.
The punch-graft, open-donor technique was developed with tools in routine use by dermatologists of the time. In the “open-donor method” devised by Dr. Orentreich, the identical trochar that was used to make the recipient websites was additionally used to harvest the hair. Since hair in the donor space emerges from the scalp at relatively acute angles, that varies in numerous areas, the physician was required to have the angle of the trochar exactly parallel to the angle of the hair. If there was even the slightest deviation from a wonderfully parallel orientation, important wastage of hair would occur from follicular transection. In truth, in many patients, a lot transection would occur that the doubtlessly “pluggy” appearance was diminished to a thinner look by the inadvertent reduction within the number of hairs per graft.
The hidden downside, after all, was that this harvesting method mirrored a grossly inefficient use of the donor supply, and patients typically grew to become depleted of donor hair long earlier than the transplant process was accomplished. These issues had been compounded by the truth that within the “open donor method” the wounds were left


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