Hair Restoration Surgery Philosophy

Combination Method Most Effective

At the 1998 International Society of Hair Restoration Surgery  meeting in Washington, DC many surgeons from around world acknowledged that the most effective treatment for most patients was a combination method of surgery. Utilizing single follicular units for hairline work and using various larger size grafts for supporting density created the best balance of patient satisfaction and cost savings. Many of these surgeons who initially treated patients with follicular units expressed patient dissatisfaction with both density and cost. Faced with the dilemma that most prospective patients do not have unlimited time, financial resources or donor hair; the hair transplant surgeon should be able to offer methods that can achieve a natural cosmetic appearance while remaining affordable to the average patient.

Procedures involving 1500 to 4000 grafts with teams of 4 to 8 assistants working on a single patient for over 8 hours can be unnecessarily dangerous both to the patient and the ultimate cosmetic result. Such complexity, repetition, varying skill levels of staff and handling and manipulation of tissue cannot be performed consistently in most environments with a high level of quality. These type of procedures in most cases cannot be performed "cost effectively" for the doctor or patient. Patient dissatisfaction with density versus cost are not always soothed with "how natural it looks". The issue of these lengthy procedures may become moot in the U.S. as some states are planning legislation to limit in-office cosmetic procedures to 4 hours and that procedures taking longer will only be allowed to be performed in a hospital or licensed ambulatory facility.

Creating a "Perfect Fit"

Linear slot grafting was developed so that a slightly larger 4 to10 hair graft could be transplanted without the cosmetic limitations of round grafts or the compression of slits. The multi-blade scalpel can excise donor strips with a width equal to the length of the slot incision. This makes it easy to dissect narrow (0.5mm) linear hair bearing grafts. These narrow linear grafts contain "Coupled Follicular Units" (CFU's). These CFU's are groups of follicular units in natural distribution. The spacing between follicular units is the same as it is in the donor area. With the use of the Redfield Slot Punch* (Redfield Corp., Montvale, NJ) a similar size sliver of bald recipient tissue is removed creating a  "perfect fit"  for the linear graft. The receptor scalp integrity is not altered or compromised because corresponding tissue replaces the bald tissue removed and the ultimate growth appearance is natural because the hairs are not compressed or distorted. It also exponentially increases the speed of the procedure and significantly lessens the X factor (manipulation, drying, crushing and striping of grafts) thereby insuring minimal hair loss in the transfer.

The Redfield Slot Punch (Hitzig Punch) removes corresponding bald tissue so the hair graft lies in the scalp naturally without compression.