Chapter 1 - Defining a Hair Transplant Chapter 7 - Who gets Transplants? Chapter 2 - Follicular Unit Transplants Chapter 8 - Expecting the Best Chapter 3 - Suggestions for your Surgery Chapter 9 - Corrective Procedures Chapter 4 - Post Surgery Experience Chapter 10 - Learn to be Cautious Chapter 5 - Doing the Research Chapter 11 - Myths and Legends Chapter 6 - Setting Expectations Chapter 12 - Credits

Keeping Recipient Sites Small

Using only follicular units enables the recipient sites to be kept very small. In fact, in Follicular Unit Transplantation, the sites are so small that they are made with specialized instruments that are the size of 18-20 gauge needles. This is about the size that is used in routine blood tests.

The importance of minimizing the wound size in any surgical procedure cannot be over emphasized. This, of course, includes hair transplantation as well. The effects of recipient wounding impact many aspects of the surgery. Larger wounds tend to injure larger blood vessels and although the blood supply of the scalp is extensive, the damage to these vessels can have a deleterious impact on blood flow to the tissues.

Especially when transplanting large numbers of grafts per session, it is important to keep the recipient wounds as small as possible so that growth will be maximized. The compact follicular unit is the ideal way to permit the use of the smallest possible recipient site, and has made the transplantation of large numbers of grafts technically feasible. Another important advantage of the small wound is a factor that can be referred to as the "snug fit." A follicular unit graft is so small that it can always fit into a tiny wound without having to remove tissue. Unlike the punch, which destroys recipient collagen and elastic tissue, a small incision, made with a needle, retains the basic elasticity (recoil) of the recipient site. When a properly fitted graft is inserted, the recipient site will then hold it snugly in place. This "snug fit" has several advantages. During surgery, it minimizes popping and the need for the sometimes traumatic re-insertion or re-positioning of grafts. After the procedure, it ensures maximum contact of the graft with the surrounding tissue, so that oxygenation can be quickly re-established. In addition, by eliminating empty space around the graft, microscopic clots are minimized and wound healing is facilitated.

It is important to note that when trying to place larger grafts (either round or linear), into a small site (kept small to minimize tissue injury) compression of the grafts is an undesirable consequence, and may result in a tufted appearance. In contrast, when transplanting follicular units, there are no adverse cosmetic effects of compression, since follicular units are already tightly compacted structures.

Finally, large wounds cause a host of other cosmetic problems including dimpling, pigmentary alteration, depression or elevation of the grafts, or a thinned, atrophic look. The key to a natural appearing hair transplant is to have the hair emerge from perfectly normal skin. The only way to ensure this is to keep the recipient wounds small.

Recommended Resources

	Ask questions and get information on Hair Transplants in our Men's Forums and Women's Forums! Information provided courtesy of the New Hair Institute, taken from "The Patient's Guide to Hair Transplantation" William R. Rassman, MD and Robert M. Bernstein, MD