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Linear Grafting - My
$15 Laser
by Gary S. Hitzig, MD,
Rockville Centre, New York, USA
Linear Grafting is, in simple terms, the
creation of slot incisions with a length of 2.5 to 6mm and a width
of .5mm to .75mm. These slot incisions are created by the use of a
a cold steel punch rather than an ultra pulse laser. It's very
origin was derived from watching Walter Unger demonstrate superior results
with Laser slits (really slots) vs. the scalpel variety. It
essentially is an attempt to match the size and shape of the recipient
site to that of the graft we create from donor strip harvesting.
Over the past two years I have performed
over two thousand of these procedures. Like any new procedure or
technology, my approach has changed as we followed up patients and
monitored the results.
Before commenting on my total approach, I
wish to answer a comment made by Dr. Beehner in his "TOP TEN"
list in the Jan - Feb 97 Forum issue. Dr. Beehner is quite correct
that any graft, round, slit, square or "linear" of six to eight
hairs along the lateral or inferior portions of the crown can look
artificial. Although this was performed in 1995, I no longer
approach either the crown or part in this fashion. I treat the part
and crown (lateral & inferior) as I do the hairline. Single
hairs are first employed along the part and then two hair Linear grafts
are placed in a zone both laterally and inferiorly in the vertex .
Larger linear grafts are placed more
centrally angling them into a natural swirl to add density. The
results have been outstanding with this method. I also agree that
young men (or women) should not have transplants in the downward plane of
the vertex.
I now perform between 400 to 700 linear
grafts per transplant session. This corresponds to approximately
2500 to 4800 hairs per session. Due in part to the narrowness of the new
punches the grafts seem to heal more quickly with growth occurring in 2-3
months. Density, along with the naturalness, is achievable in
fewer sessions (usually 2) . The larger slot grafts are kept away
from any border zone. Since the graft is not compressed (in a slit) or
distorted (in a hole) hair distribution is excellent (density and
naturalness).
Most importantly 3000 to 4000 hairs can be
transplanted in a single 2 1/2 to 3 1/2 hour session. The shape of
the recipient site allows the technician to insert the graft quickly with
less trauma. This assures the patient of consistent quality of
growth and cost savings.
Key to using the Linear punch is the
creation of a stagger pattern in the front as well as following any
angling of natural remaining hair further back. This I hope to
demonstrate in further communications. Currently I am working with several
physicians as test "beta" sites to assist in refining the
instrument and technique.
Reprint: Hair Transplant Forum
International May-June 1997
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