Clusters of hair follicles: Hairs on the scalp grow naturally from as one, two, three or more tight clusters hair follicles, called follicular units. Microdissection follicular unit micrografts preserve these clusters in graft form. Only the excess tissue around the follicular unit is trimmed away, and the follicular units are left largely intact. Follicular unit micrografts typically measure 1/2mm to 1 mm across, which is much smaller than a grain of rice. Follicular unit micrografting is now the current state-of-the-art surgical hair restoration technique, and is the method Dr. Karalexis uses.
Old Style Micrografting: Up until the mid 1990’s some other hair restoration surgeons performed micrograft procedures with single hair grafts in an attempt to achieve the widest possible distribution of the donor hair follicles. Others simply mapped out a plan for the number of single-hair, two-hair, and three-hair grafts they needed, and instructed their assistants to make the grafts to fit the plan. But the cutting of single hair grafts from follicular units containing two or more hair follicles increased the risk of graft failure, and the end result of using only single-hair grafts was a sort of thin fuzzy coverage that did not look natural.
New style Follicular Unit Micrografting: By the mid 1990’s follicular unit micrografting became the favored technique. With follicular unit micrografting, the surgeon places the grafts based on how they naturally occur, rather than making them fit a pre-designed plan. It is a subtle distinction, but follicular unit micrografting produces a more natural result with the hands of a skilled and artistic surgeon.
Advances in Training: Dr karalexis has a highly trained and skilled surgical preparation team, who are able to determine which hair follicles should be used for single hair grafts, and which ones are better suited to follicular unit micrografts of two or more hairs.
Nationally Recognized: Dr Karalexis has presented lectures on the techniques at the Hellenic Dermatology Society meetings.
One Procedure May Do It: Most hair transplant patients express a desire for hair density that would require two or sometimes three follicular unit micrografting procedures. However, many patients are satisfied with the density achieved from just a single session. There are increased risks when trying to place too many grafts in a single session. Dr. karalexis takes each patient’s needs and desires into consideration when designing a treatment program.
Combination of sizes: In most hair transplant procedures a combination of single hair micrografts and multi-hair follicular unit micrografts are used. The smallest grafts are used for the hairline because they are less detectable, while the larger follicular unit micrografts are used to thicken areas on the top and back of the head.
Number of grafts: The number of grafts placed in a hair transplant micrografting session can range from a few hundred to a few thousand. Some surgeons boast of performing “massive megasessions” of 3,000 and even 4,000 single-hair grafts in a single session.
While more grafts placed in a single session may seem to provide greater density in a shorter period of time, the opposite result can occur if many of the additional grafts fail to survive. And once these failed grafts are gone, they are gone forever. Also, it is important to consider the actual number of hairs placed, rather than just the number of grafts. 2,500 single hair grafts will not provide as much density as 1,500 grafts with many containing two or more hairs.
A variety of factors affect the number of grafts placed, including the size of the individual grafts, the size of the area needing coverage, the density of hair follicles in the patient’s donor site, the patient’s budget, and perhaps most importantly the surgeon’s judgment. Many experienced surgeons, including Dr. Karalexis, choose to not take excessive risks with their patient’s donor hair follicles, as there are only a very limited number of these hairs, and if they fail to survive a transplant procedure, they are gone forever. If 4,000 grafts are required for a particular patient, Dr. Karalexis will design a hair restoration program consisting of two or more procedures, in order to achieve the maximum survival of the transplanted hair follicles, and ultimately do the best job for the patient.