Dr. Bisanga - How Many Grafts to Extract For a Hair Transplant Procedure?

[Raphael84]

How many grafts to extract for a Hair Transplant Procedure?

 

[Kevboy]

If the graft extractions are too close to one another that means you risk the punch chopping through the adjacent follicles blood vessel that feeds it and then that one will die. What angles do the blood vessels attach to the follicle?

 

[Raphael84]

The below image gives a representation of the hair follicle and blood vessels.
When a particular area is heavily extracted (over extracted) this can cause excessive trauma to the area in general including damaging blood vessels below the scalp surface which can negatively impact their efficiency and how they are able to provide for nearby follicles. This can influence hair groupings and/or the diameter and strength of the hair structure, adding to the visual effect of an over-harvested donor area.
The skin dermis contains blood vessels, nerves and other structures. Any cutting or damage to the dermis can affect blood supply and nerves and even more so when considering the subsequent healing process of scarring after any damage to the tissue. Scar tissue will have an impact on blood supply.
Another factor is considering the size and angle of the punch. The larger the punch, the more tissue is effected, and if less perpendicular (more angled), this will also increase the surface area of tissue.

 

[Kevboy]

Thanks for that explanation and the picture. I have another question if you'd be kind enough to answer. If a graft is extracted but some bits like the sweat gland or the muscle are cut off. Will that graft grow normal or die?

 

[Raphael84]

Thanks Kevboy

When punching grafts, you are essentially cutting the intact follicle from its surrounding tissue, including all other tissue structures. Within the follicular unit are sebaceous glands, nerves and tissue. The objective is to punch the full follicle without transaction which will include other structures, and this highlights why depth and angle are crucially important to understand when punching. Punching the full follicle in tact will encourage optimal growth.

 

[Kevboy]

That makes sense and I can see why bigger groupings could be chopped easily. When I watch the FUE extraction videos they make it seem so easy but there's a lot more to it than drilling and pulling them out.

 

[Raphael84]

When watching such video content as you say Kevboy, certain aspects of the procedure can look quite easy. I do believe that this is where some individuals believe that the procedure is straight forward and that all FUE is performed at the same standard without really appreciating the artistry, experience, bespoke approach etc. that the best and most ethical surgeons present.

 

[Kevboy]

When watching such video content as you say Kevboy, certain aspects of the procedure can look quite easy. I do believe that this is where some individuals believe that the procedure is straight forward and that all FUE is performed at the same standard without really appreciating the artistry, experience, bespoke approach etc. that the best and most ethical surgeons present.

Absolutely I agree with this.