Minis, micros, and more
Minigrafts and micrografts consist of multiple (partial or complete) follicular units along with the intervening skin. This technique solves the problem of the hairs in the center of the graft dying off, but the contraction of the graft in the healing process still produces a denser graft than normally found throughout the scalp.
These grafts also can cause loss of pigment cells, which can be a particular problem for people with darker colored skin.
Although minigrafts and micrografts are a significant improvement over larger hair grafts, they’re not ideal. The idea behind them is reasonable: to keep the number of hairs in each graft low and spread more hair in these smaller grafts around. But the following problems are common with minigrafts and micrografts:
Many surgeons promote a variant of minigrafts called a double follicular units (DFU), in which two follicular units are used, each containing one to three hairs. The main disadvantage of the DFU is that there’s intact skin between the follicular units, and particularly in the dark-haired, light-skinned, or coarse-haired person, the skin produces a small, white scar as well as cobblestoning (irregularities) on the scalp surface.
This is a subtle change, but one that’s visible on close inspection, particularly in bright sunlight. The loudest complaints about such defects come from patients who can see on themselves the points where the transplanted hair exits the skin.
Hybrid grafting techniques
The use of larger hair grafts for the top and non-central portion of the crown and smaller grafts for the frontal hairline and perimeter of the transplant has a variety of names including blend grafting and variagrafting. Although this hybrid approach is detectable on close inspection, it may not be noticeable in a social setting unless the hair is wet or the patient is in bright sunlight.
The results from larger grafts are best in patients with curly, white, or blonde hair. If you have curly or wavy hair, the hybrid approach or the use of DFUs (refer to the previous section for an explanation of DFUs) may be a reasonable way to reduce the costs of the hair transplant.
If you have straight hair, such an approach can be disastrous, particularly if your hair color stands out against distinctly contrasting skin tones (for example, you have dark hair and fair skin). All larger graft procedures generally cost less if the surgeon charges by the graft, and the procedures can be performed without the intense labor required for larger sessions of small grafts.
Another disadvantage of larger grafts may become more evident when further hair loss occurs, particularly when recession allows the grafts to be viewed from a different angle. Using larger grafts or DFUs is more a short-term economic fix than a long-term solution, and we don’t recommend it.
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Note: This article was sent to us by: Lionel Venera at 06192010
1. A hair transplant that relied entirely on the use of micrografts
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