Hair transplant bangkok

An Open Technique in Hair Transplantation REFINED OPEN TECHNIQUE IN DONOR HARVESTING openHair lossis progressive, meaning that you have a limited supply of hair at the donor   area to distribute to the area of baldness. Experienced and qualified hair surgeons are willing to spend more time in harvesting and cutting the grafts to achieve minimal wastage. Those who opt for quick donor harvesting will use blind techniques and that ends up with significant follicular damage, up to 37% transection rate has been reported in medical literature. The damaged hair follicles usually have lower growth rate and, even if they do grow, they are deformed and miniaturized hair. In 1997 Dr. Damkerng Pathomvanich at the Stough clinic in Bangkok was the first to develop and pioneer the OPEN TECHNIQUE in donor harvesting. Very low transection rate of less than 2% was achieved. graftThis technique was published in the Dermatology Surgery Journal (April 2000) and Hair Forum International Journal (October 1998).This open method has one of the lowest transection rate when compared to other techniques reported in medical literatures. Minimal transection which means more grafts are available for transplantation and less skin has to be removed thus minimal donor scarring. For the last 10 years this method has been continuously refined and improved. We now routinely employed 3-4 time magnified loupe plus multiple skin hook to speed up dissection and further decrease the follicular transection rate. We re-named it REFINED OPEN TECHNIQUE. This was presented in the ISHRS Korea Asian Workshop 2008.

Hair Transplant Technique

A. Harvesting: Currently, there are two techniques to obtain grafts from the donor site in hair transplantation. 1. Traditional Strip FUT (Follicular Unit Transplantation) technique This technique is still performed by majority (80%) of hair transplant surgeons worldwide. The recipient area is measured first. The density is then counted at the donor area using a densitometer. The strip is marked and excised after the donor area is anesthetized with local anesthetic. We prefer the Open Technique than using the spreader technique since we can obtain lower transaction rates with less tissue damage. The incision is closed with Trichophytic closure (cutting approximately 1×1 mm tissue at the inferior rim), which allows hairs to grow inside the scar tissue. Transection is minimized with meticulous wound closure resulting in a very small to almost invisible scar in majority of patients. Fo-1-1 Fo-1 Pictures of donor incision immediately after surgery and 1-year post-op 2. FUE (Follicular Unit Extraction) technique The entire area of the donor is shaved, after which, local anesthetic is injected. Our preference is to use an automated machine using 0.8-1.00mm size punches based on individual hair character but at times, we use a hand punch, all with depth control to avoid graft transaction. The grafts are then individually pulled out using special forceps. The grafts will be inspected under microscope and trimmed as needed. Since grafts extracted via FUE is usually devoid of surrounding tissues at the distal third of the hair follicle, we immediately immerse them in normal saline to prevent desication. The grafts are then ready for transplantation. The previously shaved donor site hairs will continue to grow and within a week will cover most of the punched holes. Fo-2Fo-2-2 Pictures of the donor with FUE scars immediately after surgery and at 4 months post-op 3. Combo (Combination FUT strip and FUE) A combination of these two techniques can be performed when more grafts are needed after the strip technique has been completed and the yield was not enough or vice versa. Picture of Combination FUT strip and FUE Fo-3 B. Slits creation: After harvesting the grafts, we make very tiny incision [lateral slit] at the areas to be transplanted. These slits are oriented in the same direction and angle of your existing hair. C. Insertion: Follicular units may contain 1-4 hairs. Our team is very meticulous in handling and inserting the grafts into the created slits. The follicular grafts are first contained in special ring holders designed by our clinic to prevent desication. The holders also assist the transplanters to select the appropriate graft size for insertion. By selecting only skinny 1-hair grafts for the front, and coarse 2 to 3 hair grafts on the back, we can create very natural looking result. We insert the hair in a purposefully random fashion along the hairline to look natural. Comparing Traditional Strip FUT and FUE At the DHT clinic, we can perform either Strip FUT or FUE techniques of donor harvesting and even a combination of the two. Both strip FUT and FUE techniques have advantages and disadvantages:

Technique

FUT (Strip technique)

FUE technique (extract follicular unit one by one)

Number of grafts

Can get a lot of grafts in 1 session (up to 5000 grafts depend on scalp laxity and donor density, recommend for mega-session) with good results

Majority of surgeons limit to 1000-1500 grafts per 1 session (recommend for small area), however, there are reports that more surgeons are able to harvest up to 4000 grafts per session.

Need to shave the hair for the procedure

Scar

A single thin ( 1-2 mm ) straight line with trichophytic technique (hairs come through the scar)

Minimally visible

Numerous dispersed small white circular scars

Minimally visible

Scar visibility

Can be covered if hair is worn at least 1cm long

Can be covered if hair is worn at least 1cm long

Time

Strip/ FUTcan finish a megasession in one time/one pass

FUE may need more than one session to complete (if more than 1500 grafts is required)

Quality of grafts

The grafts are prepared under microscopic dissection

Less transection due to the ‘Open Technique’

Good quality of grafts, can do double or multi-unit grafts to add more volume

The grafts are individually extracted after harvesting and are trimmed under the microscope

FUE is still a blind technique (may have greater risk for transaction, esp in curly hair)

Less fat around root à prone to trauma during insertion

Growth rate

80- 90% growth rate as reported by majority of hair surgeons

About 70-75% growth rate

Pain

More pain at donor wound on the first day

Less pain at donor wound

Indication

For small or large area of baldness

For small area of baldness

Patient who wants to cut the hair very short (scattered scars may be less noticeable)

Tight scalp

Fo-4Fo-4-1 Picture of a Strip FUT scar exposed when hairs combed up and concealed when combed done Fo-5 Fo-5-1 Picture of FUE scars exposed when hair is worn short and concealed when hair is worn long Fo-6 Picture of FUE scars exposed when hair is worn short and concealed when hair is worn long

Dht Clinic Chanel

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