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Is there a specific way to make recipient sites

bullitnut

bullitnut

4 awesome repairs with SMG
Just curious if a guy was addressing a large balding area say from hairline to vertex(crown) would there be a specific way in which the recipient sites were made?, as i would imagine every time you make an incision it will bleed and could get messy and reduce visability
If they are made right next to each other
 
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Bigmac

Bigmac

Administrator
Staff member
As far as i can remember you are sprayed continuously with the saline solution (i think) and wiped with gauze to keep the area clear.

bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
Yeah i remeber that too i think bud, but i was wandering if they scatter the incisions so there is less blood as they arent all made in the same place at the same time
 
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Bigmac

Bigmac

Administrator
Staff member
So you`re asking if they make an incision then maybe the next one is for arguments sake 5mm away and so on then the doc goes back and makes incisions between the 5mm gaps.

I`m not sure how they do this,i know some clinics use multi bladed incision tools where say 5 incisions are made at once so i guess this would be difficult to apply the above to.

bm.
 
bullitnut

bullitnut

4 awesome repairs with SMG
I was just curious as you cant see above your head lol, i was wandering mainly if they work from say the outer rim of the area to be transplanted inwards or do they do a small section at a time.
This multiblade tool sounds interesting though anyone got a picture of one?
 
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sl

sl

BHR Clinic Patient Advisor
Crown design is so different from the rest of the scalp, almost like concentric circles to mimic nature.

I've watched the doc do this and it involves him moving round the head much more to get the angles and direction correct.

The bleeding as such is not too much of an issue unless the person is bleeding a lot, and when it comes down to placing if he is significantly popping the grafts also .

We have never used the multi blade tools because we feel it limits the artistic design of performing a HT, can be too symmetrical and no "personal" design is possible. It's obviously quicker but not sure if it's better, especially with hair line work and crown, not sure how it can be used.
 
bullitnut

bullitnut

4 awesome repairs with SMG
Thanks dude makes sense re crown swirls, nice reply cheers
 
Bigmac

Bigmac

Administrator
Staff member
Hi Stephen.

Do you have any close up pictures of Dr Bisangas crown designs.
 
J

JJ09

Member
In general, are multiple incisions made prior to placing grafts and furthermore would survival rates be any different if you were to apply a €œcut and place procedure € so to speak?
 
D

Dr Rogers

Valued member
Making recipient incisions is a whole controversial topic in itself and there isn't universal agreement on the best method.

There are many factors to consider:

Firstly, the exit angle of each hair plus where that hair is in relation to the "whorl" pattern of hair (which varies from patient to patient i.e. single versus double crowns).
That is a "patient" factor.

Then there are surgeon preferences - most use blades that make a slit (very thin blade but makes a slit of length 1mm, for instance) but some still use needles (makes round incisions, not slits).
In addition, the orientation of the blade is a choice - sagittal or coronal or indeed, a cross between the two, which I call a slanticle (or slateral), which more closely follows the exit angles of the existing hair.

Also, the size of the incision and closeness of the incisions does make a difference to the regrowth rates - the only problem is what difference does it make? Some studies show close packing decreases regrowth, some studies show improved regrowth when close packed.

The bottom line is, hair transplant surgeons try to mimic nature as much as possible whilst "artistically" trying to make one hair count for many, as we have a limited donor resource. There are differences between surgeons but probably no absolute consensus.

In an ideal world, you would take take a hair out, place the incision then immediately place the graft. This can be done with FUE if the recipient area is practical. Then again, studies show regrowth rates are over 90% with strip removal, if replaced within 6 hours. But the regrowth rate does go down after 6 hours, so those mega sessions lasting longer than that, could be a cause for concern.

 
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V

VCM761

Member
Dr Rogers wrote:
In an ideal world, you would take take a hair out, place the incision then immediately place the graft. This can be done with FUE if the recipient area is practical. Then again, studies show regrowth rates are over 90% with strip removal, if replaced within 6 hours. But the regrowth rate does go down after 6 hours, so those mega sessions lasting longer than that, could be a cause for concern.

Dr. Rogers,

Do you know what the growth rate is after 6 hours? When a megasession is performed is the strip removed all at once or in sections?
 
D

Dr Rogers

Valued member
Without checking past journals, I can't give you the exact rates quoted in the studies, but:
Up to 6 hours, regrowth is above 90%
between 6 and 12, it's dropping into 80%
by 24 hours, it's about 50%.

It's obviously not a sudden cut off and there is research into the best holding solutions - saline/Hartmanns/specialist solutions etc. Also, cooling can help after 6 hours but could be detrimental before, depending on which solution you are using. Quite a lot of variables!

How the strip is taken also varies. Some take half first, stitch that half, then come back later. Some will take all of it but have a big team to process quickly. Finally, some take two strips for megasessions, doing one first.
 
Prohairclinic

Prohairclinic

Prohairclinic FUE and SMP
I would like to add that using high magnicifaction is also a huge factor when making recipient sites.
It makes sense to use high magnification in order to aim between existing hairs.
At our institute for example a factor 5 times magnification is used in order to securly fit the transplants between original hairs.

Today and tommorow we are doing a 2700 FUE crown session with a strong single whorl, I will see if I can post some post OP pics.

bart
 
H

hairtech

member
The yield percentages are as what Dr. Rogers has stated in terms of time out of body vs. growth. This research was based on cold storage 0.9% Sodium Chloride.

Having said this... there are a plethora of new technology storage solutions that have increased the survival beyond the typical 6 hours before a drop in yield percentage. Hepes, DMEM, BSS salt solution... and other solutions that provide a nutrition as well an antioxidants such as glutathione that ward off free-radicals are now coming into play to increase survival rates.
 
H

hairtech

member
The yield percentages are as what Dr. Rogers has stated in terms of time out of body vs. growth. This research was based on cold storage 0.9% Sodium Chloride.

Having said this... there are a plethora of new technology storage solutions that have increased the survival beyond the typical 6 hours before a drop in yield percentage. Hepes, DMEM, BSS salt solution... and other solutions that provide a nutrition as well an antioxidants such as glutathione that ward off free-radicals are now coming into play to increase survival rates.
 
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