Evaluation of Past and Present Hair Replacement Techniques

Abstract

To evaluate and compare past and present hair replacement techniques of standard grafts, minigrafts, micrografts, scalp reduction, scalp flaps, strip harvesting, and punch harvesting procedures with regard to aesthetic improvement, effectiveness, postoperative pain, and complications.Design: Three hundred surveys were mailed randomly to patients who had undergone hair replacement over the last 3 decades. The questionnaire asked patients to rate the level of postoperative results and complications in several comparison groups with regard to the following factors: itching, pain, swelling, scarring, bleeding, altered sensation, poor growth, color and texture, infection, hairline, and natural appearance. Each factor was rated by the patients on a scale of 0 to 3 (0, none [best]; 1, minimal; 2, moderate; and 3, worst [severe]).Setting: Private facial plastic surgery practice.Methods: A hypothesis about each set of survey questions was formed based on general trends in patient responses, also known as the null hypothesis; 2 tests were conducted for each of the survey questions to determine the statistical trend with a certain level of confi-dence. The weighted arithmetic mean of the expected response was used for the varying number of patients responding to each question. Using the 2 test, the formulated hypotheses can be accepted or rejected based on the observed and expected responses.Results: Between 1981Between -1990Between and 1991Between -1996, there was a reduction of 38 percentage points in the number of standard graft procedures performed, an increase of 31 percentage points in the number of minigraft procedures, and an increase of 48 percentage points in the number of micrograft procedures. The complication rate was 31% lower for minigraft procedures compared with standard graft procedures and 29% lower for micrograft procedures compared with minigraft procedures. The complication rate was 59% lower for strip harvesting procedures compared with punch harvesting procedures.Conclusions: Newer hair replacement techniques have improved aesthetic results, with lower morbidity and complication rates. These improvements are responsible for the increase in the level of satisfaction of patients undergoing hair replacement surgery today.

Follicular Unit Transplantation: The Option of Beard Construction in Eunuchoid Men

“…However, this procedure is time consuming and delicate procedure, and requires experience. In FUT, large numbers of very small follicular transplants are used to provide the best possible cosmetic results in the fewest number of sessions with the least disruption in the patient's lifestyle 8,16–18 …”

“…Such patients desire to get rid of this boyish appearance and want to grow a masculine beard. One of the easiest ways to achieve this goal is with follicular unit transplantation (FUT), and the major advantage of this procedure is minimal donor site morbidity 3,6–8 …”

Basic hair transplantation: 2007

“…It is easily seen that novel approaches to hair transplantation have improved aesthetic results and decreased complication rates. These improvements are responsible for the increase in the level of satisfaction of patients undergoing hair replacement surgery today (39).…”

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“…A total of 4 cc of glue was injected with intermittent angiograms performed via a catheter positioned in the right external carotid ar- ma development, and of greater concern, scalp necrosis, and osteomyelitis [18,19]. It is important to note that as the techniques of surgical hair restoration therapy have evolved, there has been a sharp decline in the incidence of complications [20]. In fact, scalp AVF following hair transplantation has only been described in cases where the classic punch-graft technique was utilized [3,4,[6][7][8][9][10][11][12][13][14].…”

“…Mini-micro-grafting and other newer methods of hair transplantation, including follicular unit transplantation, result in far less scalp trauma, and thereby a much-decreased risk of complications that likely include scalp AVF [20]. Table 1 outlines the characteristics of each case report of scalp AVF following hair transplantation since first reported in 1970 [12].…”